Access to GP Services and NHS Dentistry

Debate between David Johnston and Emma Hardy

Tuesday 21st June 2022 Commons Chamber

[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.

Supporting Small Business

Debate between David Johnston and Emma Hardy

Tuesday 19th October 2021 Commons Chamber

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

It is a pleasure, as always, to follow the thoughtful contribution by the hon. Member for Thirsk and Malton (Kevin Hollinrake).

I start by congratulating HullBID on winning its recent ballot. It had an 87% turnout from businesses in the city centre, and it won the vote by 81%. I am sure that every Member of this House would be delighted to have those percentages. I congratulate Kathryn Shillito, the executive director of HullBID, on her amazing work throughout the pandemic, offering advice, grants and financial support for businesses right in the city centre.

That support and advice has been needed more than ever, because we see from the data that more than 197 businesses in Hull West and Hessle are at risk, despite the excellent work that is going on in the city. Our independent retail scene is thriving. As some of the bigger names are moving out, we are home-growing our own talent and our own businesses in our own city. Trinity market is full of exciting independent shops, as is Hepworth arcade, and we were shortlisted for the Great British High Street awards just last year—I am sure they will look on us favourably again next year.

Although there has been some disagreement during the debate, there has been so much consensus, and there seems to be a consensus that the business rates system that we have at the moment is simply not fit for purpose. In my city of Hull, the high street has moved from one location to another, but the rating system for business rates has not moved with it. One part of the city centre used to be the thriving area where everyone shopped. It is now completely different, yet businesses there still pay higher business rates, because those rates are set on an old-fashioned and outdated model. That must change.

I want to mention Ye Olde White Harte pub in Hull, which I highly recommend to everyone. It has been there since 1550, and it is famous for its “plotting room”, where the people of Hull apparently got together to decide that they would turn away Charles I when he came to try to enter the city, thus starting the English civil war. I have no reason to start a civil war right here, right now, but I do want to point out the unfairness of the business rates and taxation system that that pub is under. When I visited, its landlord told me that its rates are based on “fair maintainable trade”, which has been criticised for lacking transparency, being open to manipulation and being biased in favour of pub companies and against landlords. I wrote to the Minister about this issue, raising the case of the White Harte, and I hope that he will review my letter again.

However, if we waited for the Government to fix the problems in Hull, we would be waiting an awfully long time. As I proved with my story about Ye Olde White Harte, we have nothing in my city if not an independent and fighting spirit, so we are coming to our own solutions and solving our own problems. I have been working closely with businesses in Hull to champion the city as the capital of home working and remote working, so it was very disappointing to read on the front page of one newspaper that the Prime Minister and the Chancellor want everyone to go back to the offices where they worked before. That seems to me to be re-establishing the inequality that existed previously. Why?

Why do people have to go back to the cities and offices in which they worked before? Why not look elsewhere, at other parts of our beautiful country? Look at the city of Hull, where we have the fastest broadband and affordable standards of living. We are right by the ferry—if someone wants to pop off to Holland, they can do so for £40 return on P&O—and we can get a direct train down to London in only two and a half hours on Hull Trains’ bespoke open railway service. We have everything we need to offer remote workers. We have a much higher standard of living than they would have if they were living in a tiny little flat and commuting. No offence to my colleagues from London, but the prices in London are extraordinary. Living in a small flat in London and getting stuck on the underground, or living in the city of Hull, in a beautiful, much bigger house, with the Yorkshire countryside and the beautiful east coast on the doorstep—which would we rather?

Why are the Government insisting on sending everyone back to the office as they were before? No—send everyone instead to cities such as Hull, where they would be welcomed with open arms. They can give our high streets a boost by coming and living in our city centre, they can spend their money in our city, and they can truly achieve a bit more equality than the Government are offering. So I hope we are not going to return to business as normal. The first step in not returning to business as normal is to look at reforming the business rate system. It is outdated, it does not work and it is unfair to businesses in my constituency.

I hope that while we look at changing things for the better, we also change our attitude towards remote working, because it really can offer the skills revolution and the opportunities we need for cities like mine. For too long in cities such as Hull, if people wanted a good job, they had to leave. Remote working changes all that. People can have the job of their dreams in the city where they grew up, sitting behind a laptop.

[David Johnston]

I completely agree with the hon. Lady that we need jobs in other parts of the country, but does she agree with me that the big risk of remote working is that younger workers will not develop the skills, knowledge and connections that they do when they are in the workplace? They, at least, need to be able to go into the office to develop them.

[Emma Hardy]

I am so pleased the hon. Gentleman raises that point, because it brings me on to my second point. He is absolutely right and we are solving that problem here in the fine city of Hull by working with businesses to set up remote working hubs. We are looking at hotdesking situations and bringing together people who wish to have remote jobs, but who do not wish to be isolated forever in their bedrooms away from everybody else and not have those opportunities to network. We are looking at changing part of Princes Quay shopping centre into an area where we can have remote working desks based around particular industries, so that people can network, get to know each other and mix while still working remotely for different companies around the country or even around the world. This is happening right now. We have turned the old HSBC bank on Whitefriargate, owned by businessman Gerard Toplass, into the most stunning place to work. We will be setting up hotdesking opportunities right there in that old bank, utilising the assets we have in our high streets into new resources—resources for hotdesking and remote working, and bringing more residential living into the city, too.

To do all that, however—I could enthuse about this idea for hours, but I will stop now, Madam Deputy Speaker—we need to start with a fundamental reform of business rates. To give Hull a chance to help itself, we need fair taxation for everybody.