NHS Staff: Oxfordshire

John Howell Excerpts

Tuesday 20th February 2018 Westminster Hall

[John Howell (Henley) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on securing this debate, and I echo her praise for NHS staff who do a fantastic job—indeed, only the other day I was approached in the street by a constituent who told me just how fantastic his NHS treatment had been.

The issue under discussion is not a new problem or something that started only in the past year. I have chaired a group of Oxfordshire MPs and the clinical commissioning group for a number of years, and this issue has been there from the beginning. If I can segment the NHS market a bit, perhaps we can consider how different elements of the NHS can play their part. First, however, let me say that the release of information to The Times by Churchill Hospital must be opposed. It created much stress among patients, and it bore no resemblance to the policies of that hospital. We should send a firm message to Churchill Hospital that the way it behaved was unacceptable.

Perhaps my constituency is very fortunate, but on several occasions I have been told by constituents that a surgery is full and can take no more people, and that that is all down to new housing. Each time I rang the GP surgery, however, I was assured that that is not the case and it still had a tremendous amount of room to take more people. Nevertheless, that does not reflect the current problem with the GP practice system which, however we look at it, we must admit is in need of considerable reform. There are at least two reasons for that. First, we have the problem of young doctors who are unable or unwilling to take on the stress burden created by taking out the loans necessary to buy into the surgery. Secondly, there is a limitation on the ability of GP practices to do some of the minor operations that they have done in the past, and which allowed them to carry on the excellent work that they do for their communities. I urge the Minister to look at that, and perhaps to remove some of the restrictions that apply to the ability to operate in GP surgeries.

Of course GPs need to adapt to new ways of working, and they need to use the internet in a much better way. My own results from what is, I hasten to say, a minor health issue are dealt with by the internet. I email the information in on a regular basis, and the results come back on the internet—fortunately they come back clear each time. [Interruption.]

[Mr Edward Vaizey (Wantage) (Con)]

We are all speculating now.

[John Howell]

I know, and I will leave that issue there.

Social care has been mentioned in terms of its competition with the retail sector in Oxford, which I think is a very real threat. Another issue goes back to one of the more substantial points in the Care Quality Commission report, which is that the joining up and interlinking of different aspects of social care in Oxfordshire leaves a lot to be desired. For example, the amount that was paid by the NHS health trust was different to the sum paid by the county council for the same number of people doing the same amount of work. Evening up that difference must be something to concentrate on, and I wish people success in doing that.

The income of the clinical commissioning group amounts to about £880 million. Staff costs are about 70% of that, at just over £600 million. A 1% pay increase means at least £6 million to £7 million as an unfunded pressure on the health care system, and that is not a very productive way forward. There is no getting away from the fact that the biggest problem with recruitment and retention is living costs in Oxfordshire. There are a number of ways that we can tackle that problem, such as by building more houses—the Oxford-Milton Keynes-Cambridge express way is a good joined-up process for dealing with that, and I hope it comes to fruition.

The second thing we can do, I am afraid to say, is change the housing policies in Oxford city. That goes back to conversations that I had ad nauseam with the predecessor of the hon. Member for Oxford East (Anneliese Dodds). We were known for our fighting over the green belt, and I am glad to infer from what the hon. Lady has said that Oxford is changing the way it deals with issues of planning and housing.

We are talking about a marginal increase across the board, and the uplift that that will bring will not have a big impact on retention and recruitment. It would be much better for us to focus any increase in funds on the issue itself. I ask the Minister, formally, to agree to a weighting for Oxfordshire that gives it some of the strength that London has. As we have already heard, housing costs in Oxfordshire are at least as great as those in London, and that must be tackled. We need a specific weighting, not a marginal increase in pay, and since there will be only a limited pot of resources for increasing pay, it makes a lot of sense to concentrate the impact of that in those places with more intractable problems, such as the housing market and living costs in the city.