General Practice: Large Housing Developments

Debate between Gavin Williamson and Andrew Selous

Tuesday 29th March 2022 Westminster Hall

[Andrew Selous (South West Bedfordshire) (Con)]

I beg to move,

That this House has considered general practice capacity for large-scale housing developments.

It is a pleasure to serve under your chairmanship again, Mr Dowd. I am grateful to the Backbench Business Committee for granting me this important debate and to colleagues who have come along this morning and who clearly have the same issues in their constituencies.

Every one of our constituents hugely values the ability to get a timely appointment, without too much hassle, at their local surgery. General practice is the front door of the NHS and all GPs, practice nurses, clinical pharmacists and the whole primary care team do an amazing job under enormous pressure. I express my profound gratitude to them.

In parts of England a third more GP appointments were delivered between September and November 2021 compared to the same period in 2019, yet many of our constituents regularly tell us of the difficulties they have getting a timely appointment at their surgery. GPs and primary care staff are exercised about the strain on the system. In addition, there is considerable variability in the numbers of GPs, practice nurses and people in direct patient care roles per 10,000 registered patients. I think there should be a recommendation as to how many patients a GP should have. I accept that different populations in different parts of the country will have different demands, so a number of indicative levels would be required. We have requirements in relation to the number of children who can be in a class, so why is it different for patients in GP practices?

I have analysed the numbers of GPs, practice nurses and direct patient care staff per 10,000 registered patients in each of the three primary care networks that cover my constituency and, with one exception for GPs in one primary care network, the whole of my constituency has fewer GPs, practice nurses and direct patient care staff per 10,000 patients than the averages for England and for the east of England. From the plans I have seen from my clinical commissioning group, the projected increases in primary care staff will not be enough to bring my constituency up to the average, and I am told that no figures for future GP recruitment are available from the CCG because GP recruitment is left to individual practices.

As a country, we know that we need to build more homes. and I want everyone to be decently housed. Too many people still do not have a decent home. As elected representatives, we also know that new housing development is often vigorously opposed by existing residents. That opposition has some merit to it if the existing services in that area are already under strain and are going to be put under even greater strain.

A constituent wrote to me on Saturday to say:

“Leighton Buzzard has expanded massively in the last 20 years, however the investment in infrastructure and facilities has in no way kept pace with this and access to healthcare is inadequate leaving the GP surgeries under great pressure despite the best efforts. I dread to think what the situation will be like when the massive building programme is completed.”

That is spot on. Everyone pays taxes, and those new residents will make their contribution, so it is essential and only fair that the services in an area expand as the population rises to meet that growth.

I am told that in Norwich North, the seat of my hon. Friend the Minister for Disabled People, Health and Work, who is not here to speak for herself, wave 4b CCG funding will provide an extension for one local surgery, but that will accommodate only a small fraction of the population increase and no provision is being offered for another GP practice or through section 106 money.

I understand that in the constituency of my right hon. Friend the Member for Sherwood (Mark Spencer), who, as Leader of the House, is a member of the Cabinet, 6,000 new homes are planned for Hucknall, a town where the GPs are already oversubscribed and there is no commitment to a new Cavell health centre to meet the needs of existing and new residents.

I have rarely found children without a school place to go to. However we plan for additional school capacity when massive new housing schemes come along, the system seems to work reasonably well. The classrooms get built and the teachers employed to welcome those new children and to give them a good-quality education. That is not my experience with general practice capacity, however. I represent an area that is due to have about 14,000 new homes built and that already has, before those new residents arrive, below-average numbers of GPs and primary care staff.

[Sir Gavin Williamson (South Staffordshire) (Con)]

My hon. Friend made an important point about the planning on education places. What we need to see from Government and local authorities alike is a much more robust approach to developers, to ensure that they are paying for what is required and that they are not leaving it to the NHS and local communities pick up the bill. We need to see that strong lead from Ministers, for them to be standing up for communities and not for developers.

[Andrew Selous]

I completely agree with my right hon. Friend and I defer to his expertise on education. I would add that an element of retrospection is needed, because many of those new housing estates have already been rolled out in our constituencies. The new infrastructure levy cannot be just going forward; there is an immediate deficit that we need to remedy.

The system is broken, and that is the reason I have been campaigning on the issue and have called this debate. Contributions from section 106 funding or from the community infrastructure levy often go to provide other facilities rather than for health. The guidance states:

“It is helpful if the Director of Public Health is consulted on any planning applications (including at the pre-application stage) that are likely to have a significant impact on the health and wellbeing of the local population”.

I do not think it is “helpful”—it is absolutely essential. It should be a requirement that leads to a clear outcome of additional ring-fenced health funding to employ and accommodate the necessary GPs and practice nurses that the area’s population requires.

I have good support in my request. When I put that point to the Prime Minister on 5 January this year, he replied:

“Yes...my hon. Friend…is completely right: we cannot build new homes without putting in the infrastructure to go with it.”—[Official Report, 5 January 2022; Vol. 706, c. 20.]

I can quote no higher authority, Minister.

My argument is that no new infrastructure is more important than looking after the health of the existing and new population in an area. At the moment, the system is fragmented and uncertain, in that we might be lucky and be funded through section 106 money or we might be lucky and get it from the community infrastructure levy. Again, we might be lucky and get what is needed from the housing infrastructure fund. If we are fortunate, the local authority might come to the rescue, or it could be that Treasury funding to the Department of Health and Social Care will do the job. My CCG tells me, however, that capital funding from the Treasury for new general practice capacity appears too late to be of any use in making a sensible forward plan, and disappears equally quickly.

Education Settings: Wider Opening

Debate between Gavin Williamson and Andrew Selous

Tuesday 9th June 2020 Commons Chamber

[Andrew Selous (South West Bedfordshire) (Con)]

Children at Wombourne High School in the Secretary of State’s own constituency are very fortunate because they continue to enjoy virtual lessons. What will the Secretary of State do to make sure that all children can have that?

[Gavin Williamson]

My hon. Friend is right to highlight the brilliant work of Wombourne High School in supporting pupils in my constituency of South Staffordshire. We want to see that replicated across all schools. That is why we will set minimum expectations for curriculum delivery for the remaining weeks of this term. We are also working with schools to make sure that the bar is set as high as possible for those children who are not able to go back to school, perhaps because they are shielding, in our minimum expectations for what they should be learning at all times.