Access to Primary Healthcare

Caroline Nokes Excerpts

Wednesday 16th October 2024 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. Before I call the Minister, I must respectfully point out that a huge number of Members wish to speak, and that interventions from Members will only eat up the time available to colleagues and, in some instances, themselves. I call the Minister, Karin Smyth, to move the amendment.

--- Later in debate ---

[Ben Coleman (Chelsea and Fulham) (Lab)]

As a new Member, I am learning how this place works, so I am interested to see how much you expect the Labour Government to have achieved in 100 days. Why is it, after 14 years, that you left the country with the longest waiting lists ever and small children having to get their rotten teeth seen at A&E? What can you say that is helpful to us in understanding why the failure of 14 years of Conservatism took place, and do you feel any remorse about that?

[Madam Deputy Speaker (Caroline Nokes)]

Order. Before I call on the shadow Minister to return to the Dispatch Box—

[Ben Coleman]

I apologise, Madam Deputy Speaker. I used the word “you” instead of “the hon. Member”.

[Madam Deputy Speaker]

Yes, several times. It is not me; I have never been a Health Minister. I reiterate that interventions will have to be short. I will be imposing a time limit, as we have to hear from an enormous number of Members this afternoon.

[Dr Johnson]

I thank the hon. Gentleman for his intervention. I have talked about the challenges the NHS faces. I will come shortly to the achievements of the Labour Government so far in the Department of Health and Social Care.

Turning back to technology, I was saying that I agree with the Secretary of State on how technology can improve NHS services. Over the last few years, in my professional capacity, I have seen improvements in making communication between primary and secondary care and within secondary care much more efficient. As a patient, I have used the askmyGP service, which is an excellent way to communicate with a GP, particularly for working people. I have also used the NHS app, which millions of people have downloaded and which has huge potential. I hope he intends to build on that potential and harness the benefit of AI for diagnostics in particular.

The Secretary of State and I also agree on the importance of prevention. It is vital to make the NHS accessible to those who need it, but it is even better if people stay healthy in the first place. Before the election, he was supportive of measures to protect children from the dangers of vaping—measures I campaigned for actively. In fact, he was quite critical that it had not been done sooner, as in some respects was I. Given that the legislation has already been written and that it passed both Second Reading and Committee stage with the support of his friends on the Labour Benches, why is it taking him so long to produce a tobacco and vapes Bill? Can he guarantee that he will deliver it, like a present, in time for Christmas—for clarity, I am hoping for this Christmas?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Before I call the chair of the Health and Social Care Committee, I inform the House that there will be time limits of three minutes on Back-Bench speeches and six minutes on maiden speeches.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. Before I call the next speaker, I am going to give some helpful guidance to Members still wishing to speak: interventions are only going to eat up your own time and that of others, and may well see you put to the bottom of the list.

--- Later in debate ---

[Deirdre Costigan (Ealing Southall) (Lab)]

There is an old Irish saying, “Your health is your wealth”, and all the money in the world and all the nice things mean nothing if we do not have our health. Too many people in my constituency do not have good health—10% have diabetes, which is higher than the London and UK average, and the rate of preventable deaths is almost 14% higher than the England average. Time and again when I knock on doors across Ealing Southall, people tell me three things: they cannot get a GP appointment when they need it; they cannot see a doctor face to face; and if they are lucky enough to see a doctor, they never see the same one twice. With long-term conditions such as diabetes, not seeing the same doctor is damaging the health of my constituents. They are getting sicker, and they end up relying more on expensive hospital services. In Southall, emergency hospital admissions are 47% higher than the England average. Why can’t my constituents get to see a doctor? For starters, there simply aren’t enough. North-west London has a ratio of one GP for every 2,268 patients—a lot worse than the UK average.

We have had 14 years of the Conservative party running our NHS, and it is clear that it has run it into the ground. It started with a big-bang approach and the disastrous top-down reorganisation of the NHS. That caused so much damage that even they recognised it in the end, and they had to dismantle many of the changes a few years later, but not before the rot had set in. Since then, their approach has been like moving the deckchairs on the Titanic. All they can come up with is piecemeal tweaks and small pilots that never seem to amount to anything. In the meantime the NHS ship is slowly sinking.

Lord Darzi’s independent and honest report found that patients have never been more dissatisfied with the services they receive. I can only take the empty Conservative Benches as proof that they are finally embarrassed about it. We must also ask why Conservative Members have been happy to preside over 14 years of decline in our NHS. Is it because they want it to fail, or to replace our NHS with a privatised American-style insurance system? The mask slipped during covid when they fast-tracked their private healthcare mates and handed them multimillion pound contracts for often dodgy personal protective equipment. Was that the future they have in mind for the NHS? That is not what the public wanted, and it is why the public voted them out. My constituents in Ealing Southall are already impressed by the new Government’s approach. They know that the damage to the NHS is so deep that it cannot be fixed overnight.

Your health is indeed your wealth, Madam Deputy Speaker. The last Government frittered away that wealth, gave it to their private healthcare mates, and squandered it on damaging and costly reorganisations. This new Labour Government will turn the page on over a decade of Tory decay and help us all to live longer, healthier lives.

[Madam Deputy Speaker]

I call Ian Roome to make his maiden speech.

--- Later in debate ---

[Andrew Lewin (Welwyn Hatfield) (Lab)]

It is a privilege to follow that powerful maiden speech. I am certain that the hon. Gentleman will do his constituents proud, as he did in his time serving in our armed forces.

I welcome this debate. After 14 years of Conservative government, our health service is in a critical condition. In my constituency, the drive from the centre of Hatfield to Welwyn East takes about 10 minutes, but the difference in life expectancy between the two areas is now 10 years. The responsibility for the crisis sits not with our wonderful healthcare professionals, but squarely with the previous Conservative Government. I have spent as much time as I can with our NHS heroes, and I recently saw the professionalism of our paramedics at first hand after joining a shift with Daisy and Jake in the East of England ambulance service. They were a credit to their badge, and I am pleased to say that I got through blue lights okay. But GPs are battling a backlog—in my constituency more than 2,000 people have been waiting more than a month for a local appointment—dentists are withdrawing from the NHS, including in Peartree ward in Welwyn Garden City, and, invariably, the most vulnerable are the most seriously impacted. As the Darzi report made clear, people experiencing homelessness attend A&E four times as often as the general population and are eight times more likely to need in-patient care, all at immense cost to them and the overall NHS budget. We will only rescue our health service if we reform primary care, and that is why this debate is so important.

Despite rising demand, 5% fewer nurses were working in the community in September 2023 than in September 2009. The NHS Confederation is clear that spending in primary and community settings has a superior return on investment compared with spending on acute hospital services, and Darzi was clear that it “therefore makes sense that” there should be a “fundamental strategic shift” to the community.

Innovative work is out there. In my constituency, the Hospital at Home service run by East and North Herts NHS trust is particularly powerful for those over 80 who need rehabilitation and care, but for whom the best place for that is their home and not the hospital. The shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), said that she was not expecting to hear new ideas, but they are out there, and it is the job of our Government to embrace them and take them forward. I have every confidence that this Labour Government will do that. The party that founded the national health service has a clear vision for the future —from analogue to digital, from hospital to communities, and from sickness to prevention.

[Madam Deputy Speaker (Caroline Nokes)]

I call Llinos Medi.

--- Later in debate ---

[Madam Deputy Speaker (Caroline Nokes)]

I call Martin Wrigley to make his maiden speech.

--- Later in debate ---

[Dave Robertson (Lichfield) (Lab)]

I congratulate the hon. Member for Newton Abbot (Martin Wrigley) on his excellent maiden speech. I am sure he will be a fierce advocate for the people of Newton Abbot and the surrounding area over the coming years. I look forward to working with him.

I am very glad to be able to speak in this debate, because primary care is an important issue that affects all our constituents. During the election campaign, it was absolutely the No. 1 issue that came up on the doorstep across Lichfield, Burntwood and the villages in my constituency.

We are effectively here to discuss the centralism and poor decision making that typified the last decade and a half of incompetence by the Conservative party on primary care. There can be fewer more obvious examples of that than the fate of Burntwood health and wellbeing centre in my constituency. The building was home to a GP surgery serving almost 5,000 residents in the town. The contract for the surgery expired in March last year, but no replacement facility was ready for that date. The surgery could not move, which meant it had to close. The building itself is still in use by the integrated care board and the practice was happy to seek an extension, but that was not allowed by NHS England.

As a result, more than one in eight people in the town have had to be redistributed to other surgeries because a process in London did not allow organisations in Staffordshire to deliver the best solution for my constituents. It is centralist and wrong. It was wrong then and it is wrong now, and it needs to change. Even worse still is that the proposed replacement facility, originally scheduled for completion in October 2023—last year—is nowhere near ready. We are expecting planning permission sometime in early 2025 and who knows when it will actually be completed.

This is such an important issue for my constituents in Burntwood, as we all know the potential knock-on effects that delays in accessing primary care can cause. The staff at the remaining surgeries are doing all they can to support the community, but at some point increased patient rolls like this cannot be mitigated. It is one example of the challenges people face in seeing a GP. It is not the only one in my constituency and very far from being the only one across the whole country. It cannot be fixed overnight; 14 years of it going wrong will take longer than 14 weeks to fix. However, I applaud the Health Secretary for going as far as he has so quickly: cutting red tape to allow 1,000 new GPs to be taken on and commissioning the Darzi review of the NHS so that this party, the one that created the NHS, can ensure that we build a health service that is fit for the 21st century.

[Madam Deputy Speaker (Caroline Nokes)]

I thank the hon. Gentleman for not using all his time. I call Tom Gordon to make his maiden speech.