GP-Patient Ratio: Swale

Debate between Helen Whately and Gordon Henderson

Tuesday 19th March 2019 Westminster Hall

[Gordon Henderson (Sittingbourne and Sheppey) (Con)]

I beg to move,

That this House has considered the ratio of GPs to patients in Swale.

My constituents have a number of major concerns, including local roads, the level of housing in our area, and the ratio of GPs to patients. The three issues are intertwined, as I will explain, but to set the issue in context, I will explain a little about my area. The local authority district of Swale is on the north-east Kent coast. It covers the whole of my constituency of Sittingbourne and Sheppey and also includes part of the constituency of my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), whom I am delighted to see here today. However, the Swale clinical commissioning group area is not coterminous with Swale Borough Council. Instead, it has responsibility only for Sittingbourne and Sheppey. Faversham falls within the remit of the Canterbury and Coastal CCG.

Swale CCG is one of the smallest CCGs in the country, if not the smallest, because when CCGs were first set up, Medway CCG did not want to include Sittingbourne and Sheppey, nor did any of the east Kent CCGs, because my constituency has, historically, a number of areas with a high incidence of health deprivation. Life expectancy in Swale is the lowest in Kent. Within Swale itself, there is a huge, 10-year gap between the highest and lowest life expectancy. In some of the more affluent areas, life expectancy is 84 years, while in the more deprived areas, life expectancy is just 74 years.

A number of areas in my constituency have been identified as being in the bottom quintile on the national deprivation scale—a clear demonstration that not every area in the south-east is affluent—and there is an above-average incidence of obesity-related illnesses in my area. The number of people admitted to hospital in Kent because of health problems related to obesity has rocketed in recent years—around half of Kent’s 1.5 million population is now overweight or obese—and the highest rate in Kent was recorded by Swale CCG, where 1,726 people per 100,000 were admitted to hospital due to obesity-related conditions. My constituency also has a higher incidence of lung-related disease than many other areas in the country. That is particularly true on the Isle of Sheppey.

Such health problems put huge pressure not only on our local hospitals, but on primary care, yet my constituency has the worst ratio of GPs to patients in the whole country. To give an idea how bad the situation is, in Rushcliffe, the ratio is 1:1,192; in Camden—hardly the most prosperous area in the country—the ratio is 1:1,227; and in Liverpool, it is 1:1,283. By contrast, in Sittingbourne and Sheppey, there is just one permanent GP for every 3,342 patients.

My local CCG recognises that the lack of doctors is a problem and managers are doing everything they can to improve the situation, but to succeed, they need to attract more GPs to our area, and to do that they need more help, and more money.

[Helen Whately (Faversham and Mid Kent) (Con)]

I congratulate my hon. Friend on securing this debate on a really important topic. My constituents also face some difficulties getting access to a GP in my area of Swale borough, and also on the Maidstone side of my constituency, where in one practice the ratio of GPs to patients is 1:4,000. It is a real problem. I am concerned that there is not enough of a sense of urgency among some CCGs about fixing the problem. When the Minister sums up, I would be grateful if she could confirm the CCGs’ responsibility, and what metrics they are held to account for, for access to GPs.

[Gordon Henderson]

I accept and understand my hon. Friend’s concerns, but I would put on the record that Swale CCG is doing everything it can to resolve the problem, and does not fall into the category that she mentions.

I accept that Swale is not alone and that the shortage of GPs is a national problem, and that the reason for that shortage is complex. There is little doubt in my mind that successive Governments, including the Labour Government that was in power from 1997 until 2010, and the coalition Government that followed, which of course had to clear up the financial mess left by its predecessor, failed to invest enough in training the doctors we need today. Let us not forget that it takes 10 years to train a GP. To have them practising today, they would have had to start their training back in 2009.

Although there is a nationwide shortage, the problem is more acute in my constituency, and across Kent generally. Indeed, out of the top five areas in England with the worst GP to patient ratios, three of them—Swale, Thanet and Bexley—are in our county. That cannot be a coincidence.

Why is there such an acute shortage in Kent? I believe that the reason is twofold. First, doctors can earn more working in London than they can in Kent, because of the London weighting allowance. I would like to see the London weighting allowance extended to cover Kent, which would make it easier to recruit not only doctors, but also other public sector professionals, such as nurses, police officers, teachers, fire-fighters and prison officers, all of whom it is difficult for us to recruit.

Secondly, doctors undertake their training in London, so they tend to settle in the capital when they qualify. I am pleased that the Government have recognised that problem and a new medical school will be opening in Kent next year. We hope that doctors training in Kent will be more inclined to stay in the county once they have qualified. However, the reality is that any such newly qualified doctors who do decide to stay in Kent and go into general practice will not be available until at least the year 2030, by which time the need will be even greater because of other factors. That is where the two other concerns I mentioned at the beginning of my speech—roads and housing—come into the equation.

The roads infrastructure in my constituency is close to breaking point. We have continual problems of congestion, particularly on the M2, the A2 and the A249, and that congestion is creating ever higher levels of air pollution. As I mentioned, my constituency suffers from a high incidence of lung-related diseases. Ever more traffic congestion will produce ever more air pollution and increase the number of people who, in the future, will seek medical help. Their first port of call will naturally be a GP, putting even more strain on an already stretched primary care system. Something must be done to improve the strategic roads infrastructure in Sittingbourne and Sheppey in order to reduce congestion and air pollution, and that something must be done soon. Time is running out.

The second concern, and a major contributor to our poor GP to patient ratio, is the huge number of housing developments in my constituency over the past 20 years. The area has been transformed and is changing beyond all recognition. Housing numbers have already grown dramatically, and the housing targets being imposed on Swale Borough Council by the Government will see that growth accelerate. The reality is that we are facing the prospect of an ever-growing population at the same time as the number of GPs is diminishing, because the shortage that I spoke about earlier is being made worse by the number of doctors in our community who will retire in the next few years.

If the Ministry of Housing, Communities and Local Government were represented here today, I am sure that it would insist that any future housing developments should have planning conditions placed on them to require the developers to provide health facilities such as a local health centre, as the Ministry has done in the past. What is the use of section 106 money and the community infrastructure levy if we fail to recognise an inconvenient truth: forcing a developer to build a health centre is all well and good, but without the necessary doctors to staff it, at the end of the day it is just another building? Somehow, we have to ensure that something is done to reduce housing targets in areas in which GPs are in short supply, such as my own, until such times as more doctors come on stream.

I appreciate that the Minister has no responsibility for either roads or housing, but I hope she will at least join me in lobbying her colleagues in the Department for Transport and the Ministry of Housing, Communities and Local Government to provide Sittingbourne and Sheppey with the help that is needed to solve the road congestion problem and reduce the planned level of house building. If we can do that together, we will go some way towards improving the health of my constituents and reducing the pressure on primary care in Sittingbourne and Sheppey.

HGV Driver Regulation

Debate between Helen Whately and Gordon Henderson

Wednesday 11th October 2017 Westminster Hall

[Gordon Henderson]

I agree wholeheartedly with the hon. Gentleman. Part of what I am saying is for the benefit not only of hauliers but of drivers, who deserve and should be given decent working conditions, including decent accommodation when they have their 45-hour rest.

On off-street parking, in November 2015, the then Chancellor announced a £250 million fund to provide a large lorry park alongside the M20 in Kent. Two years on, we have yet to see a single piece of tarmac laid. I would be grateful if the Minister told me what discussions he has had with Kent County Council and what progress is being made to deliver that project.

One lorry park, however, no matter how large, is not the answer. That is why I very much hope that consideration is given to providing more localised solutions, such as the proposed lorry park near the Sheppey crossing in my constituency—a scheme I fully support. Such a lorry park, just off the A249—which, incidentally, is one of the busiest trunk roads in the south-east of England—would provide proper parking for the increasing number of HGVs that service the businesses in the area, which include two major regional retail distribution centres, a number of recycling plants, the largest paper mill in the UK, the thriving deep-water port at Sheerness and Eurolink, which is one of the largest industrial sites in southern England.

In summary, we should take a lead from our European neighbours and clamp down on the inappropriate parking of HGVs by properly enforcing the law on sleeping in cabs.

[Helen Whately (Faversham and Mid Kent) (Con)]

I congratulate my hon. Friend and constituency neighbour on securing this debate and on making the case so strongly that the problem of lorry parking needs urgently to be addressed, across the country but especially in our area of Kent, for the sake of residents and lorry drivers. We must ensure that the parking of lorries in the right place is effectively enforced, and that has to go hand in hand with ensuring that there are places for lorries to park, such as the Operation Stack lorry park and further lorry parks on the route, which he mentioned.

[Gordon Henderson]

I fully agree. My hon. Friend mentioned enforcement; there should be an increase in fines for those who break the law and the police should be given more resources to assist the Driver and Vehicle Standards Agency in issuing those fines. We should move quickly to provide the lorry parks needed in Kent and look seriously at local solutions, similar to the one on the A249 to which I referred. One way of achieving that would be to encourage local authorities to work with the private sector, which might feel more inclined to invest in a better lorry park network following a change in the enforcement regime.