GP Services: Christchurch

Jim Shannon Excerpts

Tuesday 20th May 2025 Westminster Hall

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move,

That this House has considered access to GP services in Christchurch.

It is a pleasure to serve under your chairmanship, Mr Dowd. This short debate was triggered by the perverse decision, announced last week, of the Dorset integrated care board to refuse permission for Burton surgery to reopen. The surgery is a premises in Burton village in Christchurch constituency, which has had a GP surgery for more than 30 years. The surgery was converted from a guest house. It has good car parking nearby and a pharmacy adjoining it, and is a well-loved community facility.

In 2007, the GP practice in Burton was amalgamated with Christchurch medical practice and became a branch of that practice. Then, in December 2023, patients were told that the Burton premises would be closed and all patients transferred to Christchurch medical practice in Purewell. I wrote to the integrated care board to express my concern at the impact that would have on the people of Burton. Although the ICB said that it was powerless to intervene because the surgery was only a branch, local residents were confident that another GP practice would acquire the premises and continue to provide GP services, because the building is in really good order: it has 11 consulting rooms and is a very attractive proposition for another GP practice. It was expected that it would be put on the open market for sale.

Much to everybody’s frustration, that did not happen. The owners of the practice decided instead to do a closed deal with a veterinary hospital based in Christchurch, which agreed to acquire the site, thereby excluding the possibility of another GP practice taking it over. However, one thing they had not thought about was that they needed to get planning permission for a change of use. The planning application was strongly opposed by local residents, backed by me, and it became a major issue in the general election campaign. Eventually, Bournemouth, Christchurch and Poole council refused the application on a series of grounds, the principal one being that

“insufficient evidence has been submitted to demonstrate that the loss of a community facility at this site would not result in a substantial decline in the range and quality of facilities and services available for local people.”

In essence, the local planners said that it was necessary to keep the surgery in Burton because removing it would take away an important community facility. If nobody else was willing to open such a community facility, I would not have been able to put forward this argument, but another practice has now purchased the premises and is willing and ready to open a branch in them. However, in order so to do, it had to apply to the integrated care board for permission. It did just that last November. Extraordinarily, it took months before a decision was reached—so long that I raised the issue in an oral question. The Secretary of State himself took it on board and, as a result, the ICB was pushed into having to make a decision on 23 April. As I understand it, the decision was made on 23 April, but was not communicated until some time afterwards.

In the meantime, and in anticipation that the application to reopen the branch was essentially a formality, South Coast Medical completed the purchase of the building and started the refurbishment. The plan was that it would reopen this summer. The ICB’s decision to refuse permission for the branch surgery to reopen is, in my view and that of my constituents and local residents, beyond belief. I appeal to the Minister to intervene on behalf of the 4,500 patients whom the ICB accepts would choose to re-register at Burton were the surgery to reopen.

Ironically, it is said that the cost of re-registering those 4,500 patients would be a significant burden on the health service. That is because people who are in their first year with a GP are thought to be more burdensome, so the GP gets paid a slightly larger amount for each of them. To describe the exercise of patient choice in that way—as a burden on the NHS—seems to me to be pretty wide of the mark.

After I heard the outcome of the application, I tabled a series of questions, one of which sought to establish how many people have been transferring from one practice to another in Christchurch each year, because I wanted to get a feel for that. The answer, from the Minister for Care, stated that the information is not available.

Some of the arguments made in favour of not allowing the surgery to be reopened, in answer to another of my questions, were based on the number of appointments already taking place in Christchurch. That prompted me to table a named day question on that subject. At about 9.30 am this morning I received a holding response, saying that the information relating to the number of appointments at surgeries in Christchurch over the past couple of years is not available, yet the ICB says that it used that very information to help it reach its conclusion. I hope the Minister will explain why the ICB, which I think is basically the custodian of all this information, so far has not decided to share that information with Ministers. Either it has the information or it has not been wholly open in suggesting that the information helped in its decision.

[Jim Shannon (Strangford) (DUP)]

Will the hon. Gentleman give way?

[Sir Christopher Chope]

I will not just at the moment, but I may do later.

This whole issue is a test case for the credibility of the new Labour Government’s promises about increasing access to GP services. In August 2024, after the general election, no one in government or in the NHS, including Dorset ICB, was suggesting that a GP surgery in Burton was not needed. Now that a serious plan to reopen the surgery is in place, without any capital cost to the NHS because South Coast Medical has acquired the premises using its own resources and does not need a grant, it is surely perverse that the ICB is arguing that such a branch surgery can no longer be afforded and that reopening it would adversely affect the financial viability of other practices in Christchurch.

I tabled questions on that issue as well. There is no evidence that other practices in Christchurch would be adversely affected, and I challenge the Minister to share with me, the House and my constituents the evidence that has been used to reach this decision. Will she also explain what can be done to appeal against the decision? It has been handed down by an unelected and unaccountable quango, or arm’s length body, which, among other things, has said to me in a letter that there have been no complaints about the quality of service being provided by the other main practice in Christchurch, which was operating the Burton branch and chose to give it up. However, there have been many complaints; I have fistful of them here, some of which I may refer to. Either the ICB does not open its post, or it is closing its eyes and ears to representations about issues relating to the availability of doctors, the importance of patient choice and the inconvenience of having to travel so far in a community that is not well served by public transport and where taxis are very expensive. If somebody is dissatisfied with the quality of service being provided by their general practitioner, they may wish to exercise their choice, and it is good to have some healthy competition, but all that seems to be being squeezed out by the integrated care board.

I will quote from a letter from Helen Yonwin, who writes: “Since the surgery closed last year in Burton and patients were transferred elsewhere, trying to get an appointment has been a nightmare. They seem to be unable to cope with the extra patients. The telephones are not always answered and it can take over 30 minutes to eventually get a response, only to discover that you are number 20-something in the queue. After a long wait to be told there are no available appointments, so ring again the next day, there are still no appointments, ‘But you can receive a telephone consultation from a GP’—but the next available slot is in four weeks’ time.”

That is not improving access to GP services, which is what the Government pledged. It is a levelling down and reduction in service. I hope the Minister will say that it is intolerable and unacceptable, and that for it to be condoned, if not supported, by the ICB is appalling.

[Jim Shannon]

Will the hon. Gentleman give way?

[Sir Christopher Chope]

I will just finish quoting from this letter: “If you are lucky enough to get an appointment, the next problem is getting there. Many people don’t drive or have a car, public transport is not easy for those with mobility issues, and taxis are expensive. If you do drive, another problem arises because parking is very limited.” It continues: “I cannot understand how it was stated that no complaints have been made. I and many others, in emails sent to the ICB, mentioned several issues, but I doubt any were noted.” That is a letter from one constituent; there are lots of others.

A new housing development has been approved in the locality of Burton; with some 700 new houses, there will inevitably be increased demand for GP services. Indeed, the developer, or the owner of the land, has already approached a surgery to see whether it would open a branch on the new estate. That will not be necessary if the branch to which I have referred is reopened.

I will quote from another letter. I will not give the person’s name because it refers to their condition, but she has multiple sclerosis. She says: “It’s so hard for me to get to the Purewell surgery even if you can get an appointment…I fell nearly two years ago, and I still haven’t had a proper appointment to see a doctor to see what’s causing my pain.” She says that she wants to have a choice.

Another person wrote: “I previously lived in Stour surgery’s catchment”—that is another surgery within the Christchurch constituency—“and they were amazing. I couldn’t fault them one bit. I then moved to Burton and was forced into this alternative provision.” She says that it is a nightmare to get hold of and that we should have a right to choose who we want as our GP. She also says, “Every time I’ve had an appointment, it’s been running 30 to 45 minutes late.” Reopening the local branch surgery would resolve those problems.

I hope that I have given a flavour of the strength of local feeling on this fraught issue. Somebody else wrote to me that not everybody wishes to complain publicly about the lack of service available from providers in the Christchurch medical practice, because they are worried about the consequences for them. I think that such concerns are irrational, but they are understandable.

[Jim Shannon]

I commend the hon. Gentleman for his campaign on this issue. It is what we expect from him, because he is very assiduous and very committed to his constituents. He has clearly laid out the issue. Does he feel that the main reason for the ICB’s not pursuing the case is finance? If it is, even with the proposed new housing, perhaps the Minister needs to look at the case personally to ensure that it is not being held back by anything that the Government are doing at this moment in time.

[Sir Christopher Chope]

The hon. Gentleman mentions the issue of finances. I tabled a written question about how much the health service has been spending on general practice in the Christchurch constituency. Again, rather surprisingly, the information is available only for the year ending 2023, so we do not have any information for 2023–24. Although I would not expect the figures for 2024–25 to be available, I certainly would have expected the total costs for 2023–24 to be available by now. The answer says that in 2022–23, some £17.5 million was spent on providing GP services in Christchurch.

The idea that the cost of transferring patients from one practice to another should be a decisive factor against the reopening of a branch seems extraordinary. It makes a nonsense of the argument that we must rein in our expenditure. While we are talking about the ICB’s expenditure, for the last several years I have been complaining that, at any given time in Dorset, under the ICB’s supervision, there are some 250 patients in Dorset hospitals who have no need to “reside”, as it is called. In other words, those people are in hospital but do not need to be there. Every day, that is 250 patients at a cost of between £500 and £1,000 each.

The same body is presiding over that scandal. It said last year that it was going to halve the number, but it has failed to do so—indeed, the number is just the same as a year ago. Instead of taking it out on the people of Christchurch and saying, “You can’t have access to a reopened branch surgery,” it should be looking at its own poor performance. As I have said to the Minister informally, the idea that Dorset ICB will somehow be amalgamated with other ICBs—creating even more bureaucracy, and making it even more remote from the people—is, again, farcical.

My final point—I want to give the Minister time to respond—is that, in answer to a written question, the Minister for Care said that as a result of what has happened in the last year, the number of patients in Highcliffe has increased by about 150. In Christchurch medical practice, the total number of patients has actually fallen; in the Stour surgery, it has increased; and in the Grove, it is about the same. To suggest, on those figures, that the financial viability of other practices in Christchurch will be threatened if this branch surgery is reopened seems to be without any justification. I hope that the Minister will be able to give a positive response, although I note that the Minister for Care is not responding to the debate.