Healthcare: Hampshire

Debate between Gregory Stafford and Andrew Gwynne

Wednesday 20th November 2024 Commons Chamber

[Andrew Gwynne]

As I said before the hon. Gentleman’s intervention, ultimately these are local decisions, and they must be clinically led. If the trust has decided that certain outcomes that he would like to see are out of scope of the consultation, we must take it as read that there are sound clinical reasons for that. If he thinks otherwise, I am sure that he can bring that up with my hon. Friend the Minister for Secondary Care, but ultimately we must be guided by the clinicians. They know, more than we Ministers in Whitehall will ever know, what the better outcomes for their areas are.

The hon. Gentleman mentioned primary and community care. We know that patients nationally and in Hampshire find it increasingly difficult to see a GP. We are committed as a Government to fixing the front door to the NHS, to ensure that patients receive the care that they deserve. If patients cannot get a GP appointment, they end up at accident and emergency, which is worse for them and more expensive for the taxpayer. That is why we will shift the focus of the NHS out of hospitals and into community. One of our three big shifts is from hospital to community; the others are from analogue to digital, and from sickness to prevention. Those three things, taken as a whole, could be quite transformative in how we deliver primary care.

[Gregory Stafford]

I agree entirely with the Minister on the shift from hospital to community. I do not want to labour the point that I made when I intervened on the hon. Member for Winchester (Dr Chambers), but in the Hampshire part of my seat, we have a debate about whether we will still have Chase community hospital or a new health hub there. They are both essentially local services. The ICB is dragging its feet and will not make a decision on which it will be. Local people do not know what will happen, and decisions are being kicked down the road by the ICB. As my hon. Friend the Member for Hamble Valley (Paul Holmes) said, the leadership of the Hampshire and Isle of Wight ICB is not fit for purpose. Will the Minister meet us and them to ensure that we can get this moving?

[Andrew Gwynne]

I hear loud and clear what Conservative Members say about the leadership of their ICB. I hope that the ICB management will obtain a copy of today’s Hansard and read not only those comments, but the Minister’s reply. I expect them to make decisions in a timely fashion, so that there is some certainty for the local population about the new make-up of health and care services in that area—not just for the sake of patients and the local population, but staff. As we redesign services and change towards more preventive, community-focused care, some parts may become obsolete, and it is absolutely crucial that we take the workforce, as well as the population, on that journey of change in services. I very much hope that the hon. Gentleman’s ICB leadership will have heard the message from the Minister at the Dispatch Box, which is that they really need to crack on, make a decision, communicate it and work with Members of Parliament, the public and staff on whichever changes they propose.

I return to primary and community care. As I said, our manifesto commits to moving towards a neighbourhood health service, with more care delivered in local communities, so that problems are spotted earlier. We will bring back the family doctor by incentivising GPs to see the same patient, so that ongoing or complex conditions are dealt with effectively. In doing so, we will improve continuity of care, which is associated with better health outcomes for patients, and our plan will guarantee a face-to-face appointment for all those who want one; we will deliver a modern booking system that will end the 8 am scramble. That is crucial in improving access to general practice.

The hon. Member for Winchester rightly raised the huge problems with dentistry in his area, which are not that uncommon across the whole country. I do not believe that the previous Government’s dentistry recovery plan went far enough; too many people were still struggling to find an NHS appointment. We are working to ensure that patients can start to access additional urgent dental appointments as soon as possible, and we will target the areas that need the most—the so-called dental deserts. Integrated care boards have started to advertise posts through the golden hello scheme. This recruitment incentive will see up to 240 dentists receive payments of £20,000 to work in the areas that need them most for three years. The common reason why children aged five to nine are admitted to hospital—this is absolutely shocking in the year 2024—is tooth decay. We will work with local authorities to introduce supervised toothbrushing for three to five-year-olds in the most deprived communities. These programmes are proven to reduce tooth decay and boost good practice at home.

To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focusing on prevention and the retention of NHS dentists. To be fair, this has been an issue for all Governments, going back to the Labour Government who introduced the dental contract. They did so for the right reasons, but in 2010, we recognised that the dental contract was not working in the way we envisaged, and that it had to change. It is shocking that 14 years have passed since then with no real action having been taken—we are determined to fix that. At the same time, we will not wait to make improvements to the system to increase access and incentivise the workforce to deliver more NHS care. We are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition of improving access for NHS dental patients.

I have to say that the statistics for Hampshire and Isle of Wight integrated care board make sorry reading. Only 36% of adults were seen by an NHS dentist in the 24 months to June 2024, compared with 40.3% across England, and 54% of children were seen by an NHS dentist in the 12 months to June 2024, compared with 56% across England. In 2023-24, there were 46 dentists for every 100,000 people in the hon. Gentleman’s trust, whereas the national average across all ICBs in the same year was just under 50 dentists, and in 2024, the general practice patient survey success rate for getting an NHS dental appointment in the past two years in the Hampshire and Isle of Wight ICB area was 72%, compared with 76% nationally. They are not great statistics nationwide, but they are certainly not brilliant in the ICB of hon. Members present, and we look for real improvements there.

Turning to the pharmacy sector, we want to take pressure off GPs by increasing the services offered in community pharmacies. There is so much more that our pharmacists could and should be doing to deliver basic healthcare services on the high street and in the community, as part of the shift from hospital to community. That would free up thousands of GP appointments in cases where people do not really need to see a general practitioner for their condition. We are committed to looking at how we can further expand the role of pharmacies and better use the clinical skills of pharmacists as more become independent prescribers—that is where the potential gets really exciting. Now that the budget for Government has been set, we will resume our consultation with Community Pharmacy England shortly. I hope Members will understand that I am unable to say more until that consultation has concluded. Suffice it to say that Pharmacy First and community pharmacies have a huge role to play in improving health outcomes in the community.

Oral Answers to Questions

Debate between Gregory Stafford and Andrew Gwynne

Tuesday 15th October 2024 Commons Chamber

[Andrew Gwynne]

My hon. Friend is a doughty fighter for her constituents. I am aware that the decision she mentions is an interim measure made by the critical care network, the Lancashire and South Cumbria integrated care board and the NHS trust. The decision will be kept under review and patients impacted will receive the appropriate support. The Government recognise that more must be done to improve the sustainability of the NHS both nationally and in rural and coastal areas.

[Gregory Stafford (Farnham and Bordon) (Con)]

Services at Chase community hospital in my constituency, in Whitehill and Bordon, are being run down by the ICB. This is based on a promise that a brand-new health hub will be built in place, which is much welcomed. It has the support of the Defence Infrastructure Organisation, which owns the land, East Hampshire district council and the community, but the ICB is suffering from inertia. Can the Minister speak to the ICB and suggest that it either builds this new health hub or refurbishes and renovates the Chase community hospital?

[Andrew Gwynne]

I have every sympathy with the case that the hon. Gentleman has put forward. This Government want to see a shift of health services from hospital to community, from analogue to digital, and from sickness to prevention, but these decisions are not taken through inertia; they are taken because of the Government’s inheritance from the Conservative party. We have had 14 years of running down our health services, with needless reorganisations that have destroyed and set back the progress that the last Labour Government made on the NHS. This Government will fix the NHS, including in the hon. Gentleman’s local area, but he has to recognise that the root cause of many of the problems faced by Members across the Chamber lies at the feet of the former Secretary of State and the last Government.