Oral Answers to Questions
David Johnston Excerpts(1 year, 5 months ago)
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David Johnston (Wantage) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
We are conscious that more is going on in general practice than ever before. There are 10% more appointments than before the pandemic, as well as 29,000 extra clinicians and nearly 2,000 more doctors, but we are conscious of the pressures that puts on the estate locally. I would be very happy to meet and have further conversations with my hon. Friend.
Health Services: Wantage and Didcot
David Johnston Excerpts(1 year, 7 months ago)
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David Johnston (Wantage) (Con)
I campaign a lot in this House on behalf of young people, having had a career working with them before I got here. I campaign a lot on the environment, which is important to me and to many of my constituents. But the biggest thing I campaign on in this place is infrastructure, because we do not have the infrastructure for the number of houses and the population in the constituency.
I campaign for the reopening of Grove station, which my constituents have wanted for over 50 years. I campaign for better broadband in certain parts of the constituency. I campaign about our roads, because most visitors and most residents, like me, feel that the roads in Oxfordshire are more pothole filled than almost anywhere else we go in the country. We have two important roads in my constituency, the A420 and the A34, both of which have significant safety concerns. Indeed, the last time I had a debate of this kind, it was on the A420 and A34. But the No. 1 infrastructure issue in my constituency is access to health services—in particular, GPs and dentists.
For six weeks or so, I conducted a survey of my constituents, asking them to tell me about their experience of accessing health services. I am grateful to the nearly 3,000 people who completed the survey. More than three quarters of them said that they had found it difficult to get a GP appointment in the past 12 months, which is significantly more than the number who said they had found it difficult to get a dentist appointment, although that figure was also far too high at 44%—the issues for dentistry are slightly different. Only one in 10 people who completed the survey said that they had had no trouble accessing health services, and 5% had not tried to access health services in the past 12 months and so were not able to say whether it had been difficult. Overwhelmingly, I heard over and again that we need more GP surgeries and more dental surgeries. People would like to see other services, such as more mental health provision and more physiotherapy provision, but GPs and dentists had by far the biggest responses.
The situation is most acute in Didcot, where I live. Huge numbers of people have come to live in Didcot in recent years. The Great Western Park estate, with 3,500 homes, was promised a GP surgery, and it is still waiting eight years later, with absolutely no progress having been made. Meanwhile, the new Valley Park development on the border of Didcot will have 4,200 homes, so it will add a lot of pressure. Those two estates alone will add about 18,000 people to the area’s population, which is more than enough to fill a GP surgery, yet we continue to see no progress. After encouraging people not to use NHS services if they could avoid it during covid, we now have a backlog to address, but there was an issue long before covid, too. Infrastructure has not kept pace with population growth.
The politics is that the Liberal Democrats are running every part of local government, including both district councils in the seat I represent, and they run the county council in coalition with the Greens and Labour. Of course, the Liberal Democrats say that this is all the Government’s fault, but they have been in charge of one district council since 2019, and they have been in charge of the other in coalition with the Greens since 2019, so it is not good enough to say it is all the Government’s fault. We have to get to a better system of accountability for both local council leaders and local health leaders.
It is partly about the Government training more doctors, and I very much welcome all the things the Government are continuing to do in this area. We are training 2,200 more doctors than in 2019, and last year a further 4,000-plus took up training places to become doctors. The increase in appointments is welcome, with 2 million more appointments in March 2023 than in March 2022, and there is investment to get 15 million more appointments by 2024.
The recent announcement on tackling the 8 am rush chimes with my inbox. My constituents are constantly writing to explain to me how frustrating it is to ring at 8 am, as they are advised, and not get through. The record goes to the person who told me they had called 117 times, and others have called 89 times. The numbers are huge, with people ringing over and again, getting very frustrated and eventually contacting me to say they do not know what to do. It does not matter how often they ring, because they are not able to get through.
I welcome the fact that the Government are now saying that people who ring will be referred to an appropriate service, such as 111 or a pharmacy, without needing to call back. I also welcome the increased role for pharmacists, because it right that they ought to be able to give out the oral contraceptive pill and medicines for sore throats, earaches and such things. They are well equipped to do that and it will ease some of the pressure on the GP surgeries.
The situation we find ourselves in is not the fault of the existing GP surgeries. Indeed, I asked them to promote my survey and many of them did so, because they are feeling the pressure. Several surgeries have closed their books temporarily because they were simply unable to take on many more patients. Of course, that affects everybody’s quality of life, because people who have lived in the area for a while and used to find it easy to get an appointment no longer can, and people who have moved to a new area and hope to be able to register with a doctor find that they are unable to do so. This is one of the most important services we could be providing for people.
The Minister knows that because I am the Parliamentary Private Secretary to the Secretary of State for Levelling Up, Housing and Communities, I am going to swerve housing and planning policy, as I should not be talking about it in that role—I know the rules. However, we do need a couple of things, one of which is a much better accountability mechanism for local councils and local health leaders to plan for population increases and then deliver services as the population increases. The Government can and will train more doctors, but we are making promises to local people about what is going to come with increased numbers of people, and those promises never arrive. People then stop believing in the promises, and those who were not opposed to new houses, because they realise that people need somewhere to live and perhaps their children and grandchildren are struggling to get on the ladder, become resistant to more housing as they have seen so much housing arrive without the services that should go with it.
Let me move on to the other thing that is important to me. It may feel like a side issue, but it is fundamental. In my pre-politics career, I ran charities for disadvantaged young people and promoted social mobility. The medical profession is the most socially exclusive profession in the country—only 6% of doctors come from a working-class background, and someone is 24 times more likely to become a doctor if they have a parent who is a doctor—and it has been that way for some time. To an outsider, the situation seems to get worse. Recently, the British Medical Association’s junior doctors passed a motion to cease apprenticeships into medicine, which are supposed to widen access to it. Almost every other profession has some form of apprenticeship to try to widen access, but the BMA’s junior doctors have passed a motion saying, “We don’t want them.” Given the state of the profession, which in no way reflects the country’s talent, for all sorts of reasons—I used to work on this, so I know that it is about access to work experience, recruitment methods and so on—that is a very retrograde step. That is certainly the case when this is the most socially exclusive profession in the country. We have a shortage of doctors in particular areas, and this is profession where the ratio is at least 10 applicants to one medical school place. I worked with so many disadvantaged young people for whom this was their dream career—it was the most popular career at one charity I ran—so it seems mad that we are not making better use of that talent. I feel sure that it could help ease some of the pressure we are seeing, not just in my constituency, but in others.
In closing, I say to the Minister that I very much want to meet him to discuss how I can bang heads together and make progress to get things delivered. It is a shame that it is not within an MP’s control to be able to deliver new GP surgeries and so on, but I want to work with him to work out how we can do that and possibly have a health hub in my constituency. This is not the first time I have talked about this matter—I have done so more than 20 times—and it will not be the last; I will do so until my constituents get the health services they deserve.
Oral Answers to Questions
David Johnston Excerpts(2 years, 1 month ago)
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Steve Barclay
The wellbeing of staff—especially in the NHS, and especially after the pressure of the pandemic—is a crucial issue, and one on which I have focused in particular since returning to the Department. I look forward to having discussions about it with the hon. Lady.
David Johnston (Wantage) (Con)
The Minister of State, Department of Health and Social Care (Helen Whately)
I have shared my hon. Friend’s concern about this issue in the past, and I know he has taken a long-term interest in it. We must ensure that people living with dementia are prescribed anti-psychotic medication only when it is clinically appropriate., and NHS England is actively monitoring the position. I have already asked for the latest data, and I will be keeping a close eye on it.
Access to GP Services and NHS Dentistry
David Johnston Excerpts(2 years, 6 months ago)
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David Johnston (Wantage) (Con)
All the GP surgeries in my constituency have worked incredibly hard throughout this period. I saw some of that up close when I was volunteering with the vaccination effort in the weeks that I could. The entire period has been a complete whirlwind for them, and they went straight back into there being a huge demand for appointments. I commend them for what they did during covid and what they are doing now.
The job of an MP is to not just champion but challenge. As every other Member of the House has, I have heard complaints about the difficulty of getting GP appointments, which I need to raise with surgeries. Those complaints are about getting an appointment at all, getting a face-to-face appointment, getting through on the phone, or—more for dentists than GPs—being able to register.
We know that the covid pandemic is a huge part of that problem, because we asked the public to stay at home and protect the NHS, which they did almost to a fault. I remember Ministers at the Dispatch Box, as the pandemic went on, pleading with people to come forward if they thought they had something. Understandably, however, people did not want to burden their GP or hospital. They are now rightly coming forward, and they may have had hospital treatments delayed again because of the backlog, so they are going to their doctor instead.
Sometimes, my constituents are unhappy about not getting face-to-face appointments; they dislike eConsult and telephone appointments. I have used eConsult successfully, and I think it and telephone consultations have a place, but as a GP at one of my surgeries said, the risk with both of those is that GPs do not see the thing that the patient has not come in about. A patient may come in about their leg, and while they are there, the GP says, “Can I just have a look at the thing on your neck?”.
Emma Hardy
I completely agree with the hon. Gentleman’s point about GPs not being able to identify the issues that people have not come in for. Another thing that doctors can notice at face-to-face appointments is that someone is a victim of domestic abuse or violence.
David Johnston
I completely agree; the hon. Lady has made an important point. Sometimes, what people present with is not the biggest issue in their lives, and a skilled practitioner can uncover that.
As has been touched on, the issue is partly about telephone systems, bizarrely, as I will come on to, but it is also undoubtedly about a shortage of GPs. The Government have a grip on that: we have 1,500 more GPs now than in March 2019; 4,000 more trainees have taken up training places this year compared with 2014; and we have a health and social care levy which, as has been touched on, the Labour party opposes but which provides £12 billion a year to the health and care system, so there is more money to improve telephone systems and face-to-face appointments. Looking at the data this morning, we had 2 million more face-to-face appointments in April this year than in April last year, but we are still below pre-pandemic levels.
The complaints I get about dentistry are more about not being able to register anywhere. There is a particular issue with the promise that we make to pregnant women about being able to see a dentist, because even they cannot get registered. I met the Minister about that recently. The issue there is less about a shortage, as it is with GPs, and partly about the contract; there seems to be cross-party agreement that the 2006 Labour contract needs to be changed. I am also pleased that the Government will allow more internationally qualified dentists to support the dental system here.
There are two things that we need to get better at. One of them was touched on by my hon. Friend the Member for North East Bedfordshire (Richard Fuller). My constituency has also seen a huge growth in housing—we have two housing developments in Didcot alone, which will house 18,000 people—and the promised GP surgeries for these increased populations never arrive. As my hon. Friend said, we must get better at putting in the infrastructure first and at planning for the increased populations.
I shall finish on the second thing. Some Members may know that I worked in social mobility before I became an MP, running charities for disadvantaged young people. Unfortunately, the medical profession is the most socially exclusive profession in the country. Only 6% of doctors are from a working class background. A person is 24 times more likely to become a doctor if they have a parent who is a doctor. That is worse than politics, worse than the media, worse than the law, and worse than any other profession that we can think of. There are many reasons for that. It is about the allocation of work experience, how the recruitment process works, and the fact that 80% of applications to medical school come from 20% of schools. There is a whole range of things.
The young people with whom I worked were eligible for free school meals. A very high proportion were from ethnic minorities. Medicine was the profession that they most wanted to get into. It was the most popular profession. On the one hand, we have a shortage of GPs, and, on the other, we have this incredible talent pool that finds that it cannot get into the profession.
One thing the Government might consider, as well as how we get the infrastructure in first, is how we make what is a hugely popular profession more accessible for certain groups of young people with whom I used to work, because, at the moment, they simply do not get into it in the numbers that they should, and, if they did, they might help with this GP shortage.
Covid-19 Update
David Johnston Excerpts(2 years, 11 months ago)
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Sajid Javid
The deal that the hon. Lady refers to was negotiated by the NHS, and I think it has done an excellent job in its negotiations. It is also absolutely right for the chief executive of the NHS to write to the Government—to write to me—to request such a direction, because the NHS’s job is obviously running the NHS, but the Government’s job is to think beyond the NHS and the impact of covid beyond just health. The hon. Lady should know by now that the more capacity we have in the NHS, the less need there is for restrictions. What I can say for sure is that had we not taken out this insurance policy with the independent sector and got this extra capacity, she would be one of the first to stand up in this House asking us why we did not work with the independent sector.
David Johnston (Wantage) (Con)
I welcome my right hon. Friend’s statement about reducing the self-isolation period. I have a number of constituents who have not seen their relatives in care homes for a considerable time. A member of my own family can have one visitor but has been confined to her small room for coming up to five weeks now because every time there is a case anywhere, everybody is kept in their rooms and cannot go in the garden or the communal areas. Will my right hon. Friend look at these guidelines again, because of course we want to protect care home residents, but the way they are being implemented is having a considerable impact on those people’s physical and mental health?
Sajid Javid
My hon. Friend is absolutely right to raise this most important of issues. In the way he phrased his question, he reflects just how difficult it is to strike the right balance in care homes between protecting the residents but also making sure that they can get the visits that are so important for them. The approach that we have taken in England is different from that in other parts of the country. We do allow more visitors. We are supplying a record number of tests to care homes, not only for the residents but for the staff. For the reasons that he has so clearly laid out, we keep this under review and will remove restrictions as soon as it is safe to do so.
Covid-19 Update
David Johnston Excerpts(3 years ago)
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Sajid Javid
I do not want to pre-judge the review, but I know that my hon. Friend would agree that our best form of defence is our vaccine programme, and the fact that we are doing better than any other country in Europe in our booster programme gives us a really strong level of defence.
David Johnston (Wantage) (Con)
Over 90% of the people getting the most serious care for covid are unvaccinated. Does my right hon. Friend agree that if people are not getting a vaccine without good reason, they do not just endanger themselves, but put a strain on the NHS that it does not need when trying to treat people for other conditions?
Sajid Javid
I agree with my hon. Friend. Taking a vaccine should be a positive decision. With the exception of NHS settings or social care settings, no one should be forced to take a vaccine, but people who have not yet taken a vaccine should know, as my hon. Friend said, that they are not only endangering themselves, but wider society. That hospital place that they might take perhaps would have been taken by someone else with a different illness. I urge them to please think of others.
Covid-19 Update
David Johnston Excerpts(3 years, 2 months ago)
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Maggie Throup
The booster has been offered to all those in cohorts 1 to 9, so cohort 6 is included in that.
David Johnston (Wantage) (Con)
People in Wantage and Didcot, and across Oxfordshire, have been doing a great job of administering the vaccine to 12 to 15-year-olds, as they did for the older age groups, but unfortunately a small minority of people have been giving them abuse for that. Will my hon. Friend join me in saying that that is completely unacceptable and in thanking them for doing what is a vital task to keep us all safer?
Maggie Throup
I completely agree; there is no room for intimidation. I thank everybody who has taken part in delivering the amazing vaccine programme.
Social Care Reform
David Johnston Excerpts(3 years, 5 months ago)
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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Helen Whately
I hope my hon. Friend will forgive me if I am not drawn on the assumption point that he made in the second part of his question, but what I can say to him is that the Prime Minister has been clear that he wants a social care system where no one needing care should be forced to sell their home to pay for it.
David Johnston (Wantage) (Con)
On Friday I met my constituent Phil, whose mother, given the state of her dementia, has gone to into a care home. The day before I met my constituent Denise, who is trying to keep her mum, who has Alzheimer’s, in her own home. I think they are pretty typical of most of our constituents, because in addition to the cost issue, they are dealing with the complexity of a system they do not have experience of, as well as trying to get the right quality of care. Can my hon. Friend confirm that the issues of cost, complexity and quality of care will all be dealt with in the reform proposals?
Helen Whately
Yes, I absolutely can. We know that cost is a real problem, but there is also a real variation in quality of care. In fact, we are already taking steps on that. That is one reason why the health and social care Bill introduces an assurance or oversight system of the provision of care commissioned by local authorities. Yes, the breadth of the issues that my hon. Friend refers to is being considered in our reform proposals.
Oral Answers to Questions
David Johnston Excerpts(3 years, 6 months ago)
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Robert Largan (High Peak) (Con)
David Johnston (Wantage) (Con)
Paul Howell (Sedgefield) (Con)
Jo Churchill
I could not agree more. Data saves lives —it is as simple as that. We have seen that in the pandemic, and it is one of the lessons of the vaccine roll-out. The GP data programme will strengthen the system and save lives. Patient data is, of course, owned by the patient. We are absolutely determined to take people with us on this journey. We have therefore decided that we will proceed with the important programme, but we will take some extra time, as we have conversed with stakeholders over the past couple of days. The implementation date will now be 1 September. We will use this time to talk to patients, doctors, health charities and others to strengthen the plan, build a trusted research environment and ensure that data is accessed securely. This agenda is so important, because we all know that data saves lives.
David Johnston
I have been contacted in recent weeks by quite a number of constituents who are struggling to get a GP appointment, but we have a pre-covid problem as well, which is that thousands and thousands of new houses have gone into the constituency without an increase in GP services. Will my hon. Friend meet me to discuss how to get my constituents the GP services that they need and deserve?
Jo Churchill
It is right that local health commissioners pay careful regard to the impact of new housing and growing areas, which is to be welcomed. I understand that both practices in my hon. Friend’s area are still accepting patients and that the Oxfordshire clinical commissioning group has been working closely with the practices in Wantage to make sure that the impact of housing growth is being accommodated, which I expect all CCGs and councils to be doing. I would be happy to meet my hon. Friend to discuss the matter further.
Covid-19 Update
David Johnston Excerpts(3 years, 7 months ago)
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Matt Hancock
I am afraid I do not agree with the hon. Lady’s characterisation of the situation, not least because the approach we are taking in Bolton did work effectively in south London. We are piloting new approaches to ensuring that we can support people to isolate, and some of those pilots are taking place in areas where we can see cases of B1617.2. We keep this under close scrutiny and review to see what works effectively.
David Johnston (Wantage) (Con)
Part of our fight against covid, and indeed against future viruses, is to improve our domestic vaccine manufacturing capability. To that end, the Government are fast-tracking the Vaccines Manufacturing and Innovation Centre at Harwell in my constituency. I will be visiting it in a few weeks, but could my right hon. Friend provide an update on the progress so far?
Matt Hancock
Yes, we are making significant progress with the onshoring of vaccine capability. It is about developing the vaccine, as the team in Oxford did brilliantly, but also about manufacturing it onshore, and boy, if there is one lesson we have learned from this whole thing, it is that we cannot just not care about where manufacturing happens. Having it onshore really, really matters, for resilience but also to ensure that it is close to the NHS so that the whole supply chain can learn and constantly improve. I am delighted that we are pushing forward with the VMIC project in the same way that we have brought onshore manufacturing supply in Teesside, in Livingston in Scotland and in the fill-and-finish plants at Wockhardt in Wrexham, at Barnard Castle and elsewhere. It is a big project and, frankly, a big opportunity for life sciences in the UK to ensure that we can do all this onshore, because in my view, the pandemic has shown that we need to.