GP Services: Christchurch

Debate between Christopher Chope and Peter Dowd

Tuesday 20th May 2025 Westminster Hall

[Peter Dowd (in the Chair)]

I will call Sir Christopher Chope to move the motion and I will then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and from the Minister. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move,

That this House has considered access to GP services in Christchurch.

It is a pleasure to serve under your chairmanship, Mr Dowd. This short debate was triggered by the perverse decision, announced last week, of the Dorset integrated care board to refuse permission for Burton surgery to reopen. The surgery is a premises in Burton village in Christchurch constituency, which has had a GP surgery for more than 30 years. The surgery was converted from a guest house. It has good car parking nearby and a pharmacy adjoining it, and is a well-loved community facility.

In 2007, the GP practice in Burton was amalgamated with Christchurch medical practice and became a branch of that practice. Then, in December 2023, patients were told that the Burton premises would be closed and all patients transferred to Christchurch medical practice in Purewell. I wrote to the integrated care board to express my concern at the impact that would have on the people of Burton. Although the ICB said that it was powerless to intervene because the surgery was only a branch, local residents were confident that another GP practice would acquire the premises and continue to provide GP services, because the building is in really good order: it has 11 consulting rooms and is a very attractive proposition for another GP practice. It was expected that it would be put on the open market for sale.

Much to everybody’s frustration, that did not happen. The owners of the practice decided instead to do a closed deal with a veterinary hospital based in Christchurch, which agreed to acquire the site, thereby excluding the possibility of another GP practice taking it over. However, one thing they had not thought about was that they needed to get planning permission for a change of use. The planning application was strongly opposed by local residents, backed by me, and it became a major issue in the general election campaign. Eventually, Bournemouth, Christchurch and Poole council refused the application on a series of grounds, the principal one being that

“insufficient evidence has been submitted to demonstrate that the loss of a community facility at this site would not result in a substantial decline in the range and quality of facilities and services available for local people.”

In essence, the local planners said that it was necessary to keep the surgery in Burton because removing it would take away an important community facility. If nobody else was willing to open such a community facility, I would not have been able to put forward this argument, but another practice has now purchased the premises and is willing and ready to open a branch in them. However, in order so to do, it had to apply to the integrated care board for permission. It did just that last November. Extraordinarily, it took months before a decision was reached—so long that I raised the issue in an oral question. The Secretary of State himself took it on board and, as a result, the ICB was pushed into having to make a decision on 23 April. As I understand it, the decision was made on 23 April, but was not communicated until some time afterwards.

In the meantime, and in anticipation that the application to reopen the branch was essentially a formality, South Coast Medical completed the purchase of the building and started the refurbishment. The plan was that it would reopen this summer. The ICB’s decision to refuse permission for the branch surgery to reopen is, in my view and that of my constituents and local residents, beyond belief. I appeal to the Minister to intervene on behalf of the 4,500 patients whom the ICB accepts would choose to re-register at Burton were the surgery to reopen.

Ironically, it is said that the cost of re-registering those 4,500 patients would be a significant burden on the health service. That is because people who are in their first year with a GP are thought to be more burdensome, so the GP gets paid a slightly larger amount for each of them. To describe the exercise of patient choice in that way—as a burden on the NHS—seems to me to be pretty wide of the mark.

After I heard the outcome of the application, I tabled a series of questions, one of which sought to establish how many people have been transferring from one practice to another in Christchurch each year, because I wanted to get a feel for that. The answer, from the Minister for Care, stated that the information is not available.

Some of the arguments made in favour of not allowing the surgery to be reopened, in answer to another of my questions, were based on the number of appointments already taking place in Christchurch. That prompted me to table a named day question on that subject. At about 9.30 am this morning I received a holding response, saying that the information relating to the number of appointments at surgeries in Christchurch over the past couple of years is not available, yet the ICB says that it used that very information to help it reach its conclusion. I hope the Minister will explain why the ICB, which I think is basically the custodian of all this information, so far has not decided to share that information with Ministers. Either it has the information or it has not been wholly open in suggesting that the information helped in its decision.

Arm’s-Length Bodies (Accountability to Parliament) Bill

Debate between Christopher Chope and Peter Dowd

Friday 14th March 2025 Commons Chamber

[Sir Christopher Chope]

Absolutely; that is why, although the term “independent” sounds seductive to people outside, it quite often means a lack of control by elected representatives over the body in question.

I am not going to spend all my time talking about NHS Dorset, but I must offer one other illustration of my concerns. I have a letter here from the chief executive of NHS Dorset, who I think receives a lot more remuneration than even the Prime Minister. I wrote to her in November, and she wrote back at the end of January about an issue relating to dermatology services in Dorset. I wrote back to her saying, “What is being done to address this issue? You haven’t answered that in your letter.” It took until 5 March, with further queries following up on it, for me to receive an answer. The letter cites my question, which I first raised back in November, as:

“Concern over the ‘unacceptably long waiting list for dermatology services. What is being done to address this issue by the Integrated Care Board?’”

The answer given is:

“As part of a Commissioning for Sustainability programme, Dermatology is one of the services that is being focussed on. The aim of the programme is to recover services to the 18-week standard target, whilst maintaining sustainability. As part of this we are currently reviewing how the commissioning and delivery of services can best achieve this.”

That is after more than four months. There is no suggestion of when the review started, when it is likely to end or what will happen. I take that as an example of the Member of Parliament being fobbed off by officialdom for having the temerity to raise an important issue on behalf of his constituents.

I could go on with many other examples from NHS, but I will not do that. Instead, I will see whether, through this debate, I can encourage the Government to go further than just abolishing NHS England. I have had many dealings with the NHS Business Services Authority, another arm’s length body, apparently controlled by the Department of Health and Social Care, but essentially a law unto itself.

I have been in dealings with the NHSBSA on a number of different subjects, but particularly on the subject of the access and treatment of people who suffered vaccine damage and have applied for vaccine damage payments. The NHSBSA is responsible for organising and running that scheme, yet progress in dealing with applications is desperately slow. As at last November, it had more than 17,000 claims relating to covid-19 vaccines, but of those, more than 7,000 were awaiting resolution, and some had been waiting more than 18 months to be resolved.

Once a claim has been rejected, as it often is, the claimant has an opportunity to go for a mandatory reversal application before they can get access to a tribunal. Dissatisfied claimants can go for the mandatory reversal, but the NHSBSA can hold up that process. As at 27 February this year, 1,657 rejected claims had been subject to mandatory reversal. Some 600 of those are outstanding, and 81 have been outstanding for more than a year. That is intolerable, because it can take more than a year for someone to have their claim dismissed. They then get a mandatory reversal and need to go to tribunal. After three years, someone’s right to litigate on this subject is taken away by the limitation period. That is an example of what happens when Departments and arm’s length bodies start taking over and being thoroughly incompetent.

[Peter Dowd (Bootle) (Lab)]

If the hon. Gentleman was so concerned about that, why did he vote for the Health and Social Care Bill, which included the setting up of NHS England, on 13 March 2012?

[Sir Christopher Chope]

I was probably in one of my less rebellious periods at that stage, but the hon. Gentleman is right to chide me, because I think it was a big mistake.

[Peter Dowd]

This is such a fundamental issue for the hon. Member, so why should we pay any attention whatever to what he is saying to us today?

[Sir Christopher Chope]

I am not insisting that anybody should pay attention to what I am saying. All I am putting forward is a proposition that these arm’s length bodies, of which there are far too many, should be brought to account more than they are at the moment.

I have just given an example of the NHS Business Services Authority. Another example is Natural England. One of the means by which arm’s length bodies are meant to be accountable to Parliament is through the publication of annual reports, with accounts. If one looks at the situation with Natural England, it has not produced an annual report and accounts for the year ending 31 March 2024. The last accounts it produced were in December 2023 for the financial year ending 31 March 2023. That is unacceptable. The Government guidance is that these arm’s length bodies should produce their report and accounts within three months of the end of the financial year.

--- Later in debate ---

[Sir Christopher Chope]

The Environment Agency as an arm’s length body is found wanting in many respects, not least that it argues that it has a lack of resource to introduce the necessary prosecutions and enforcement of the regulations that it is meant to be in charge of. Just to illustrate that point—this also relates to Natural England, actually—towards the end of the last Parliament, I arranged with the then Minister at the Department for Environment, Food and Rural Affairs to have a meeting in his office with officials from Natural England and the Environment Agency to discuss the state of the Avon valley: the river, the nitrates and phosphates problems, and the break in the Avon valley footpath, which crosses the River Avon in my constituency but, as a result of neglect, is no longer viable.

The Minister set up the meeting in his Department. The first time I went along to the Department with him, he was sitting there with his private secretary and we were meant to have officials from Natural England and the Environment Agency with us online on Zoom—I do not know whether they were working from home—but nothing happened. At the last minute, there was a message saying that they could not attend. I said to the Minister that he should get heavy with them, because this was intolerable. It was another month or six weeks before we had an in-person meeting with them. I wish that I could say to the hon. Member for Hyndburn (Sarah Smith) that, as a result of all that, the issues have been resolved, but they have not. I have got a meeting with Natural England on site on 1 April in the Avon valley in my constituency.

All is not well with these arm’s length bodies. There are probably different solutions for resolving that, depending on their specific nature.

[Peter Dowd]

The former Paymaster General, the right hon. Member for Salisbury (John Glen), said in guidance that

“ALBs are closely aligned, but distinct from their sponsor departments”

and so on. It continued that ALBs

“are each responsible to Parliament for their use of public funds.”

Is that not contrary to what the hon. Gentleman seems to be telling us? Who is right—him or the former Paymaster General?

[Sir Christopher Chope]

That is the difference between the words and the reality. Strictly speaking—I was coming on to this—they have to produce annual reports and accounts, which go to what are described as their sponsoring Departments. In most cases, the sponsoring Department lays those accounts before the House. With Natural England, for example, we do not know what has been going on since 31 March 2023, so it is accountable, but not in what I would describe as a meaningful sense such that we can ask specific questions.

[Sir Christopher Chope]

My hon. Friend takes me back to the content of my Bill, which seeks to achieve exactly what she requests. Clause 1 states:

“House of Commons approval of relevant documents

(1) Within a period of forty days starting on the day on which a relevant document is laid before the House of Commons by, or on behalf of, a qualifying body, a Minister of the Crown must move a motion that the House of Commons approves the relevant document.”

That means that we, in the House, would be able to decide whether we approved that document.

The Bill goes on to say:

“If the House of Commons does not approve a motion under subsection (1), the relevant document shall stand referred to the Committee of Public Accounts.”

It seems to me that the best body that we have in the House to deal with this sort of situation would be the Public Accounts Committee, so there would be an automatic referral to that Committee if the Members of this House decided that they were dissatisfied with the performance of the relevant arm’s length body.

[Peter Dowd]

Has the hon. Gentleman had any discussions with the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), to assess how much of the Committee’s time would be taken up with going through the accounts of, potentially, 150 quangos, which would be directly responsible to Parliament?

[Sir Christopher Chope]

Quangos are not directly responsible to Parliament, which is why I have brought forward the Bill.

[Peter Dowd]

rose—

[Sir Christopher Chope]

I am not going to give way any more, but I will just make this comment: the hon. Gentleman seems to be intent on finding a reason for not taking action in this area and to block progress. May I suggest that he pursue an alternative career in the civil service, because that is exactly the sort of role that he would be well suited to?

The Planning and Infrastructure Bill was published this week. It gives extensive and revised powers to Natural England, which has not even produced its annual report for last year. Instead of abolishing Natural England, which might have been the right approach following the Prime Minister’s abolition of NHS England, so that the relevant responsibilities could be taken on by the Department for Environment, Food and Rural Affairs directly, clauses 48 to 78 of the Planning and Infrastructure Bill give Natural England, an unelected, arm’s length body, responsibility for environmental delivery plans, the administration and control of the nature restoration levy, and a whole lot of other responsibilities, which would be better suited to the Government so that there is more direct accountability.

I can see why the Government are frustrated at the delays by Natural England. I have experienced that in my own constituency, where there was a ridiculous attempt by somebody to try to build a new open-air surfing lake. Although the site was only three miles from the coast, they wanted to build that new infrastructure, but Natural England sat on the responsibility of advising on the project and refused to take action. I kept asking the planning inspector what we could do about that, and the answer was nothing. We had to wait until Natural England got round to deciding what it was going to do, if anything, which added months.

There is a development site in the middle of Christchurch, a former police station. As a result of Natural England’s faffing about over phosphates, the cost of developing the site has increased by over £3 million, and there is a significant delay of probably two years or more. The Government need to take these powers back into the Department, rather than, as set out in the Planning and Infrastructure Bill, give even more power to Natural England, which is an unelected and scarcely accountable quango.

European Union (Withdrawal Arrangements) Bill

Debate between Christopher Chope and Peter Dowd

2nd reading
Friday 6th December 2024 Commons Chamber

[Peter Dowd]

My hon. Friend makes a good point. At the end of the day, whether the hon. and learned Member for North Antrim and I like it or not, and I do, they are allies in virtually the biggest trading area—in fact, it is the largest—in the world, but I accept that Members have concerns. I am not trying to deny that, and I am not trying to demean them or push them under the carpet.

I also do not want to revisit the pre-referendum process. It is unavailing at this stage to rehash or regurgitate the arguments, warnings, finger pointing, claims, vilifications, passions and tensions that at times dominated the debate in the lead-up to and during the last weeks of the referendum campaign, but the situation we face is a direct result and consequence of that decision—of that, in my view, there is no doubt. I believe it is fair to say that personalities, rather than policies, often dominated the discussions and debates at the time. I also believe that, at times, high-politics issues around sovereignty, self-determination and other factors came into play. However, such matters are really symmetrical. That is the nature of the democratic debate and of the democratic debate that we have in this country, for better or worse.

[Sir Christopher Chope (Christchurch) (Con)]

Does the hon. Gentleman accept that one consequence is that we have a United Kingdom in part of which people have a second-class citizenship compared with the rest of the United Kingdom? Does he have any solutions, other than the solution put forward by the hon. and learned Member for North Antrim (Jim Allister) in his brilliant Bill, as he brings intellectual rigour to try to address this intractable problem?

[Peter Dowd]

I think the fact that the hon. Gentleman used the word “intractable” gives us a clue about how challenging it actually is. When a country decides, for better or for worse, to withdraw from a treaty to which it has been a signatory for more than 50 years, issues are bound to arise.