GP Services: Christchurch Debate
Full Debate: Read Full DebateClive Jones
Main Page: Clive Jones (Liberal Democrat - Wokingham)Department Debates - View all Clive Jones's debates with the Department of Health and Social Care
(1 day, 18 hours ago)
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The hon. Gentleman mentions the issue of finances. I tabled a written question about how much the health service has been spending on general practice in the Christchurch constituency. Again, rather surprisingly, the information is available only for the year ending 2023, so we do not have any information for 2023–24. Although I would not expect the figures for 2024–25 to be available, I certainly would have expected the total costs for 2023–24 to be available by now. The answer says that in 2022–23, some £17.5 million was spent on providing GP services in Christchurch.
The idea that the cost of transferring patients from one practice to another should be a decisive factor against the reopening of a branch seems extraordinary. It makes a nonsense of the argument that we must rein in our expenditure. While we are talking about the ICB’s expenditure, for the last several years I have been complaining that, at any given time in Dorset, under the ICB’s supervision, there are some 250 patients in Dorset hospitals who have no need to “reside”, as it is called. In other words, those people are in hospital but do not need to be there. Every day, that is 250 patients at a cost of between £500 and £1,000 each.
The same body is presiding over that scandal. It said last year that it was going to halve the number, but it has failed to do so—indeed, the number is just the same as a year ago. Instead of taking it out on the people of Christchurch and saying, “You can’t have access to a reopened branch surgery,” it should be looking at its own poor performance. As I have said to the Minister informally, the idea that Dorset ICB will somehow be amalgamated with other ICBs—creating even more bureaucracy, and making it even more remote from the people—is, again, farcical.
My final point—I want to give the Minister time to respond—is that, in answer to a written question, the Minister for Care said that as a result of what has happened in the last year, the number of patients in Highcliffe has increased by about 150. In Christchurch medical practice, the total number of patients has actually fallen; in the Stour surgery, it has increased; and in the Grove, it is about the same. To suggest, on those figures, that the financial viability of other practices in Christchurch will be threatened if this branch surgery is reopened seems to be without any justification. I hope that the Minister will be able to give a positive response, although I note that the Minister for Care is not responding to the debate.
I will not, because I want to ensure that the Minister has time to respond to those points.
It is a pleasure to serve under your chairmanship this morning, Mr Dowd. I thank the hon. Member for Christchurch (Sir Christopher Chope) for raising GP surgeries, which is a vital matter to so many of our constituents. That is because GP surgeries are the front door to our NHS, and visiting a GP represents far better value for taxpayers’ money than accident and emergency departments. That is why, since coming into office, fixing general practice has rightly taken up a lot of our bandwidth, energy and focus.
It is worth remembering that we inherited a system in total disarray, and a bizarre situation in which we simultaneously had a GP shortage and newly qualified GPs looking for work. I am proud of everything we have done to turn GP services around in the nine or 10 short months we have had. However, before I come on to that, let me address some of the hon. Gentleman’s points.
Ahead of this debate, I asked my office to get in touch with the integrated care board locally so that we had a fuller picture of what is happening on the ground. My understanding is that Burton surgery was previously a branch of Christchurch medical practice, which is just under two miles away. The surgery closed in August last year because the owners wanted to sell. Although the ICB did not approve of the closure, it recognised that it had little influence over the sale as GPs are independent practitioners.
I am informed that the local community were—as they often are—understandably unhappy with the news about changes to the services, and that the hon. Gentleman got in touch with Dorset ICB. When a veterinary business tried to buy the site, the application received over 100 objection letters and the sale did not go ahead. The ICB then received two further applications to renew the site, about which it considered a number of factors, as is normal practice: whether there is good access to surgeries in the area; what the impact would be on patients and on community needs; how it would affect the quality, equity and safety of provision; and how it might affect the stability and ability of other local GP services to run viable surgeries in their area.
I have been assured that the decision that Dorset ICB took was not taken lightly but based on the needs of and the benefits to all prospective patients in the area. The surgery catchment area for Burton is covered by Christchurch medical practice and Farmhouse surgery. As the hon. Gentleman outlined, reopening would have required additional costs, which were not justifiable given the financial challenges facing the NHS—something that we all understand. Consequently, Dorset ICB felt that those costs would reduce provision in the area and lead to significant financial pressures on other local surgeries, which could lead to further closures.
Dorset ICB has seen no degradation of services for patients since the surgery closed and the number of appointments has not decreased overall. I take the hon. Gentleman’s point about the numbers, and I do not know why that information is not available; I am happy to take that question back to the Department. Local MPs should have as much information as possible about services in their areas. These are taxpayer-funded services, so I will check as to why that information is not available. Dorset ICB has not received what it calls formal complaints from patients, but it has received communications from a local campaigning group, which is important. On balance, however, it decided that it could not reopen the practice.
On the point about housing needs, which I talked about for many years when I was an Opposition Member of Parliament, the Government absolutely understand the issue of additional demand and the challenge it poses to primary care infrastructure.
I will not, because the hon. Member for Christchurch wants me to answer his questions.
We are working closely with the Secretary of State for Housing, Communities and Local Government to address the issue of additional demand in national planning guidance and ensure that all new and existing developments have an adequate level of healthcare infrastructure for the community. The NHS has a statutory duty to ensure that there are sufficient medical services, including general practice, in each local area, with funding and commission reflecting population growth and demographic changes. The hon. Gentleman highlights an important point that we will continue to pursue.
Those are the facts about the decision made by the ICB, which was its decision to make. I am not going to stand here and tell the hon. Gentleman that he is not right to do what he is doing; he is absolutely right to fight for the best possible service provision for the people of Christchurch, and I would do the same for my constituents—all hon. Members do that. These decisions are best made locally, however, and it is for Dorset ICB to use its autonomy to make them, not Ministers in Whitehall.