GP Services

Debate between George Howarth and Jim Fitzpatrick

Thursday 5th February 2015 Commons Chamber

[Jim Fitzpatrick (Poplar and Limehouse) (Lab)]

It is pleasure to follow my right hon. Friend the Member for Knowsley (Mr Howarth). I congratulate my hon. Friend the Member for Halton (Derek Twigg) and his supporters on securing this important debate.

I first raised this question on behalf of GP practices in Poplar and Limehouse on 13 May last year and the issue has not gone away, as the Minister is aware. The motion states that the House

“notes the vital role played by local GP services in communities”.

I am sure that we all feel that we do more than note those services—we are very appreciative of them, we value them and have high regard for them. Doctors at the Ettrick Street practice on the Aberfeldy estate in east London, especially Dr Phillip Bennett-Richards, do a first-class job for us and are highly regarded by the local community.

I was grateful last year when the Minister’s colleague, Earl Howe, agreed to meet me and a small delegation from two practices in my constituency.

[Mr George Howarth]

Earl Howe refused to meet me to discuss the problem I described earlier, which is an unusual thing for a Minister to do.

[Jim Fitzpatrick]

I am surprised that the Minister declined to meet my right hon. Friend. The Minister certainly showed me every courtesy and I was grateful for the opportunity to meet him, his officials and officials from NHS England. As a result of that meeting, we identified solutions for both the Jubilee Street practice and the St Katharine’s Docks practice, which were under severe pressure at that time. Indeed, last Friday I had the pleasure of attending the opening of the refurbished St Katharine’s Docks practice, which is run by Dr Sarit Patel. I pay tribute to Ms Sue Hughes and the Friends of St Katharine’s Docks for the central role they played in supporting their local GP and his practice. The Jubilee Street campaign, also supported by its local community, was also effective.

Now we have a borough-wide save our surgeries campaign, with banners across Tower Hamlets outside every GP practice. The Jubilee Street and St Katharine’s Docks practices have solutions, but they are not permanent. On Tuesday, I received an e-mail from Sue Hughes. She reports, among many other matters, that

“Dr Patel has found it impossible to have a meaningful dialogue with our local representative of NHS England to discuss in detail the future funding of the Practice. NHS England insist on using one size fits all formulas to calculate additional financial support for GP Practices which clearly have differing requirements. NHS England are not paying the Practice for work they already do over technicalities which NHS England refuse to discuss with them. NHS England disregard ‘quality of outcomes’ when deciding on funding formulas—why is this?”

Having received that e-mail, I wrote to the Minister and I look forward to a response in due course.

The Limehouse practice in Gill street is also struggling to secure its future and is under great threat. I have written separately to the Minister on the Limehouse practice. Other GP practices are under huge pressure. In addition, there is the worry over the future of the walk-in centres at the St Andrews and the Barkantine health centres.

I wrote to the Department of Health about Barkantine because it combines a walk-in centre with a 10-handed GP practice and as a result is able to offer 8 am to 8pm, seven-day-a-week services to patients, which are under threat. The Prime Minister announced some time ago that the Government were going to spend significant sums trialling 8 am to 8pm, seven-day-a-week services, but there was not any need. The Department could have easily sent officials to east London and we could have shown them how such services can operate efficiently and effectively. However, that is all under threat.

During recent years, when the PCT was in charge, we had the fastest improving GP services in the country. The CCG has done excellent work and is staffed by first-class people. It is doing all it can to assist but we need NHS England and NHS England London to provide reassurances that all will be well.

Yesterday I received this e-mail in response to my correspondence on the walk-in centres—I thank my hon. Friend the Member for Halton for securing this debate because it is a great coincidence that the e-mail arrived the day before it. The response from the Department of Health is efficient and I am grateful for it. It has some good news. It says:

“NHS England have agreed to extend the existing break clause”—

this is in relation to the walk-in centres—

“in each of these two contracts by 9 months moving this date from 30th September 2015 to 30th June 2016.

Tower Hamlets CCG has applied to become the commissioner of primary care services under delegated approval arrangements from NHS England. If approved, this will become effective from 1 April 2015 and this will become a matter solely for the CCG.”

That is good news as it lifts the immediate threat to the walk-in centres, but it is not a permanent solution; it is a temporary reprieve. However, this is clearly new, certainly to me, and shifts the focus from the Department of Health and NHS England to the local CCG, which I hope will be able to fund the right decisions for local residents on a permanent basis.

On the temporary solution for the Jubilee Street practice, the practice manager, Virginia Patania, reports that meetings have been held with Department of Health officials, including Simon Stevens. She says that there should be protections for

“practices whose MPIG”—

the minimum practice income guarantee—

“has been removed”,

and that

“NHSE is completely ignoring the issue of cumulative losses. In any reply to our challenges to NHSE, there is no mention of the cumulative effect of losses—this has not been addressed by NHSE in any correspondence or response. It is unfathomable to us that NHSE is not or cannot be held to account for having only looked at 25%...of overall losses and estimating these as final.”

She concludes that

“we can demonstrate that populations of the most deprived adults attend GP surgeries up to twice as often as populations of the country’s wealthiest adults. This makes the Carr Hill formula entirely inadequate for areas such as Tower Hamlets”.

Tower Hamlets GPs have offered solutions and we have asked for another meeting with Earl Howe. I hope that we will be successful in that.

Like other colleagues, I have received briefings from the BMA, the RCGP and Londonwide LMCs. What is significant are the stats they all have in common, which my hon. Friend the Member for Halton and others have mentioned. Only 8.3% of the overall NHS budget goes to GPs but they are dealing with 90% of patient contacts. The royal college has estimated that at least 500 practices are at risk of closure and that nationally we need to recruit 10,000 more GPs, which has also been mentioned. I got a sticker from Londonwide LMCs this morning saying, “I love my GP.” I refer to it cautiously because I do not want to suggest that I am trying to have a relationship with my GP, no matter how much respect I have for him. Everybody does love their local GP, however, on the basis of the service we receive in east London.

The most threatened practice in Poplar and Limehouse is Limehouse. I have mentioned that I have written in detail about its problems, and I would appreciate a response. There has been extensive contact with NHS England and between NHS England and the practice manager Mr Warwick Young on the minimum practice income guarantee, the quality and outcomes framework and other issues. It is looking like it will lose more than £600,000 over the next seven years. That makes a great deal of difference and the practice could close.

Last year I began my remarks by saying the debate I had asked for was about three things. The first was to find out the nature of the problems facing GP services. The second was to determine whether the Government accepted there was a problem. The third was, hopefully, to identify a solution. We are still looking at the problem. The Government seem to accept that there is a problem and are trying to find solutions, but they have only been partly addressed and not resolved. There is still great concern not only among clinicians and staff, but among patients and residents in Tower Hamlets, that their GP services are not safe.

I know the Government have their five-year forward review and their focus on giving GPs a more central role. I look forward to hearing more about that from the Minister in due course, but the issues are not resolved, and I would be grateful if he would take back my request to Earl Howe for a meeting with him, or at least with his officials, on the three main practices I have mentioned and collectively on GP services in Tower Hamlets.