NHS Backlog

Ben Spencer Excerpts

Monday 6th January 2025 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I thank the hon. Member for North Shropshire (Helen Morgan) for securing this important and timely debate. I must begin by declaring my interests: I am a non-practising NHS consultant psychiatrist and my wife is an NHS doctor.

Christmas and the festive period is always a taxing time for the NHS, especially for those working on call, as indeed it is for all those in the various emergency services and those outside the public sector who are on call. It is important to pay tribute to them for all their hard work over the past couple of weeks.

Much of the correspondence that I have received from constituents over the past few years has concerned the difficulty of obtaining GP appointments. Interestingly, the demand for GP appointments has risen since before the pandemic, following the advent of virtual appointments and different means of contact. Patients are now finding it more difficult to see someone in a general practice, although overall performance in general practices has improved since before the pandemic. It is important that we support our GP practices as much as we can, to ensure that they deliver the high-quality care that our patients expect. Our local practices are fantastic: they are working very hard, in tricky circumstances, to deliver for patients.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

My hon. Friend is, of course, absolutely right. Does he agree that part of our duty is to support our general practices? Our constituents often say, “I cannot see my GP”, but if we probe, we find that it is a question of whether they are prepared to accept a telephone consultation, which is probably just as good for most of them. Radiology was mentioned earlier. The issue for the future, surely, is embracing technology rather than outsourcing. In many cases, AI reading of films and scans is probably as good as, if not better than, a reading by a radiologist in India, Shropshire or anywhere else.

[Dr Spencer]

I entirely agree with my right hon. Friend about the use of AI to improve productivity in the NHS, and with what he has said about general practices.

I generally take a neutral, honest-broker approach when people raise concerns about general practices. Of course it is important for us to ensure that our practices are performing well, to support them, and to respond to our constituents’ concerns more broadly. However, given that the bulk of care is coming through general practice—and I was interested to hear, in recent days, about the renewed focus on patient choice, particularly in respect of secondary and tertiary care—I think that one of the challenges posed by our current general practice system relates to the absence of patient choice. Effectively, general practices, which, as the Minister will know, are private organisations, have a monopoly in terms of the patients who are in their catchment area. It is very difficult for patients to move to different practices when the ones that they are currently using are not meeting their needs: when seeking an appointment with a GP, they are stuck with their own practice, or else they must go through various mechanisms to obtain care elsewhere.

[Mr Richard Holden (Basildon and Billericay) (Con)]

My hon. Friend is making an excellent point about something that is currently affecting my own constituency. South Green surgery in Billericay has recently been told that it is to be closed down, and the integrated care board is not ensuring that we retain what is essentially competition, so a single surgery will be serving one of the towns in my constituency. Does he agree that the Department of Health and Social Care should be leaning in to ensure that we maintain that competition between GPs’ surgeries, so that standards can be driven up wherever possible?

[Dr Spencer]

My right hon. Friend is absolutely right; it is important that patients have information and choice, and that they have the flexibility to move between different practices to suit their needs. My view is that the GP list system does not work. It does not make sense as it currently stands, and it limits the ability of patients to seek the care that they need in a timely manner. As he just mentioned, people get stuck in practices that are not performing or are not working for them, and they have no ability to move out of them.

My right hon. Friend also mentions the role of the ICB/ICS system, which brings me to my final point. As a constituency MP, I find it incredibly frustrating that I have no direct control, power or hard influence, as opposed to soft influence, over the local ICS/ICB system. I can write letters and campaign, and I have spoken in debates in Parliament. I have led a debate on the Weybridge health centre, which is finally going to planning after the drama of multiple consultations. My only ability to direct what is happening on the ICB is through directly asking Ministers questions in Parliament, or by trying to get them to intervene. When the Health and Care Act 2022 was going through in the last Parliament, I raised with the then Minister my concerns about the accountability of our ICSs and ICBs. We have a real problem with what we MPs can do to ensure that our ICBs and ICSs are performing for people locally, because there is a disconnect in the link of accountability.

I believe that the Secretary of State for Health and Social Care and the Ministers on the Front Bench absolutely want to see all our local NHS services performing at their very best. I totally believe that they are in it for the right reasons and want to see better performance, and I want to help them deliver that. But with all the enthusiasm and will in the world, are they going to take the same interest in my local area as I do? We MPs need the ability to cajole and to direct what our local NHS services are doing in order to deliver the best possible care for patients. After all, we are the locally elected representatives and, as we saw in this year’s election and will see in elections going forward, there are always 24 hours to save the NHS.