General Practice: Large Housing Developments

Jim Shannon Excerpts

Tuesday 29th March 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak in a debate in Westminster Hall, and today I basically support what the hon. Member for South West Bedfordshire (Andrew Selous) has put forward. I always give the perspective from Northern Ireland. What is happening there mirrors what the hon. Gentleman has introduced, and I thank him for setting the scene so well.

Access to GPs would probably make a debate on its own. I think we could all give myriad examples of where the system is failing. I know that Northern Ireland is not the responsibility of the Minister, but I want to add weight to what the hon. Member for South West Bedfordshire said. I am convinced that others, including the shadow Minister, will also mirror that. We could all speak for ages about access to GPs, but I will fight the urge to spend my time discussing the disgraceful routine that too many practices have adopted of withholding face-to-face appointments, and the problems caused, including with house calls to vulnerable patients.

One of my constituents, who uses a wheelchair, was the only family member to have covid. Her carers and the district nurse expressed concern about sores on her legs, because she is a type 1 diabetic. Her GP refused the call-out and asked an 80-year-old woman to WhatsApp a photograph. My goodness, how ridiculous! Not to be disrespectful, but the lady has no idea what a WhatsApp photograph is or how to take one. That says more about the GP, who has not understood the issues. It seems I did not resist the urge well, but I remain infuriated at the abject dereliction of duty that GP practices continue to hold fast to. That was one example, but many other GPs, as referred to by the hon. Member for South West Bedfordshire, do it right and do their best to help people, as they should.

I will not say any more about that at this stage, because it is not the purpose of this debate. I want to talk about the other part of the debate, which we need to take steps to address. We need to ensure that enough thought is put into not simply whether the roads can handle the additional pressure from large-scale housing developments but whether community GPs and pharmacies can handle it as well.

My GP cannot take another patient without expanding. I have been with that practice for all my life. It has expanded once and will expand again—a planning application is pending—within its property because there is room to do that. It is not the same in every case, but we need flexibility for that in the planning process. To back up what the hon. Gentleman said, I will give an example of where the process fails badly—I know that my area is not the Minister’s responsibility—and there does not seem to be any vision or idea of how to do it the right way.

I live in a village between Greyabbey and Kircubbin and patient numbers in the GP surgeries in Kircubbin are growing, so an extension has been accepted by the trust and will go ahead. There is money to invest in that surgery as well. I know that is not the Minister’s responsibility, but this ties in with what the hon. Gentleman said: we need funding from the Minister’s sister Department in Northern Ireland, the Department of Health, to ensure that moneys are there to help with those extensions.

A local doctor’s surgery in Newtownards has a wonderful idea, similar to that described by the hon. Gentleman and what he wants to see for his constituency. It is currently based above a pharmacy, and its vision is to expand. It put in an application to build a further three rooms for a physiotherapist, a nutritionist and a mental health nurse so that, when someone goes to their clinic to see their GP, they can do almost everything. That would take the pressure off the NHS—or the HSC as it is in Northern Ireland. It is important to have a strategy in place. I was incredibly impressed by that vision and drive for my constituency, which is like the vision to which the hon. Gentleman referred. That could address the needs of the adolescent having difficulty with their relationship with food, the needs of the grieving widower by giving them something other than anti-depressants and making sure that they always have a face-to-face consultation, and the needs of the overweight working mother who needs an adaptive plan to help her achieve her goals in her busy life. That is not a criticism but a fact of life—it happens sometimes. However, the planners turned the application down.

The planners did not have the vision or the strategy to see how important it was to have a better surgery and a better clinic, so a project that could provide a benefit was turned down. Where is the planners’ vision? Where is the co-operation between the health departments and the housing and planning departments? I do not see that in this application and I feel greatly aggrieved. I will fight the issue—I intend to take it as far as I can, along with others—because it infuriates me. The planners look at it as a tick-box exercise and think, “It doesn’t do this and it doesn’t do that,” and yet this is the place for the project. There is room to do it on site, so why not let it take place?

The choice for the GP service is to move out of town or simply to carry on as it is, which will not meet the needs of the practice, with the growing numbers coming. We need fully serviced practices and must be able to host them. We must also ensure that large-scale developments recognise that integral need of the community and address this issue. It is no longer enough to tick the box and build a play park when people need access to GPs in their areas. To continue to ignore that will only move concerns down the line.

I see the Minister in his place and know that he is consistently interested and committed to the change that the hon. Gentleman is asking for and that others will ask for. I am confident that he will respond positively—he always does, as that is in his very nature—so I will be pleased to hear his response.

On 2 November 2021, the Secretary of State for Health and Social Care acknowledged that the Government were not on track to meet their plans to recruit an additional 6,000 GPs by 2024—that is not a criticism but an observation of his comments—and the Government had a manifesto commitment to expand the number of other primary care professionals by 26,000. How can we entice young people to be doctors when they go for work experience in poky offices and are inundated with unsafe patient numbers, and when GPs tell them to run? The right hon. Member for Chipping Barnet (Theresa Villiers) referred to that and to some of the issues.

That situation will only continue, and the Minister can respond in a positive fashion only if he has co-operation from the Health Department to make things happen; we need a two-pronged attack on this one. Do we, as I would like to see and as the hon. Member for South West Bedfordshire said, invest in practices now and entice medical students into seeing that the dream of holistic general practice is a reality? That vision of a future in which we can do better and look after more people in a focused way is what I would like to see and what I think everybody else wants to see as well.

Having specifically designed facilities is key to that aim. That is why the application in Newtownards addresses a number of things, which are all part of what comes to a GP every day. That GP surgery and clinic is in the centre of Newtownards. It is accessible; there is car parking. It is right in the middle of the town. It makes more sense to let it do what it wants to do within the room that it has on site, but the planners do not want that to happen. There is no vision, no strategy, no co-operation with the Health Department and no helping to address the issue.

Therefore I find myself fully supporting the hon. Member for South West Bedfordshire, and I implore the Minister to make this initiative—although it is not his responsibility—UK-wide. What starts here can ripple out, like when a stone hits water, and when it gets to Scotland, Wales and Northern Ireland, we can have some vision as well. I will send a copy of the Hansard record of this debate to the planning department in Newtownards and make it aware of my plea on behalf of the GP surgery there. Planners and healthcare commissioning groups alike should be legally obligated to abide by this initiative. They should have a strategy, a vision, and do it right. The future of our NHS depends on change, and this change is fit for every area. We must move on this need now, before the implosion of general practice that is on the horizon and becoming ever clearer.

I again thank the hon. Member for South West Bedfordshire. I look forward very much to other contributions and I look forward especially to hearing what the Minister has to say.

[Several hon. Members rose—]