Access to Primary Healthcare
Debate between Karin Smyth and Andrew George(2 weeks, 4 days ago)
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Karin Smyth
I wish the hon. Gentleman well with his own access to a GP at the moment. We are committed to working with the profession on the best way to organise primary care. The critical point is that primary care, however it is organised in neighbourhoods, is there for our constituents when they need it. It is not there now. The model is not working and has not worked over a period of time. It has merits, as we have said, and we are continuing to talk to people. I have worked in the sector for a number of years, so I understand the point the hon. Gentleman makes.
Karin Smyth
No, I want to move on. I will take one more intervention from the Government Benches at some point and then it is all fair, but I want to allow time for hon. Members to speak.
In our first week, we pledged to increase the proportion of NHS resources going into primary care, and in our first month, the Government made a down payment on that pledge, providing GP practices with their biggest funding increase in years. But we are not just increasing funding; we are also cutting the red tape that stops many staff doing their jobs.
Some GP practices currently have to fill in more than 150 different forms to refer patients into secondary care services. They are spending as much as 20% of their time on work created by poor communications with their secondary care colleagues. That is totally nonsensical in 2024 and it has to change.
Time spent doing needless paperwork and bureaucracy means appointments lost for patients, which is why we have launched a red tape challenge to bulldoze bureaucracy and free up GPs to deliver more appointments. It will be led by Claire Fuller and Stella Vig, established leaders in primary and secondary care. They will check with staff what is working well and what needs to change, so we can take the best of the NHS to the rest of the NHS.
Initiatives like Consultant Connect in south London allow GPs to talk to mental health consultants in real time, reducing the number of referrals they have to make by 40%. Delivered across the country, such schemes could save thousands of hours of time and create thousands of new appointments—that is what our red tape challenge is all about.
We want to help patients see specialists faster. Starting in November, 111 online will pilot directly referring women with a worrying lump to a breast clinic. That means faster diagnosis for cancer patients and more GP appointments freed up, which is better for patients and better for GPs.
On dentistry, as the hon. Member for North Shropshire outlined, we inherited an NHS dentistry system in disrepair thanks to 14 years of chaos, failure and neglect. As we have to keep reminding Conservative Members, it is a national scandal that tooth decay is the leading cause of hospital admission for five to nine-year-olds. We all see that in our constituencies. The last Government broke their relationship with the British Dental Association, as they broke so many relationships. During the election campaign, we pledged to meet the BDA immediately upon taking office to start rebuilding the relationship, and that is exactly what we did.
The BDA is right that the last Government’s dentistry recovery plan did not go far enough. We are keeping parts of it that are the right solutions, including the golden hello and some other measures, but we want to go further to deliver an NHS rescue plan that gets dentistry back on its feet. We are working around the clock to end the truly Dickensian tooth decay that is blighting our children. As well as our additional urgent appointments for all ages, we will work with local authorities to introduce supervised tooth brushing for three to five-year-olds in our most deprived communities. We will see the difference getting them into healthy habits can make, protecting their teeth from decay and ending the national scandal the last Government presided over.
On pharmacy, previous Governments dithered and delayed, failing to find a sustainable and long-term funding solution. NHS England is working with the sector to assess the cost of providing pharmaceutical services, and we look forward to seeing its outcome. Consultation around this year’s funding and contractual arrangements with Community Pharmacy England did not make it over the line before the election was called, so we are looking at that as a matter of urgency.
We want to continue to make it easier for pharmacists to take referrals and support people with common conditions, using prescribing skills to treat a wider range of conditions and patients. Pharmacists are highly skilled people in our communities. Allowing patients to get the care they need in the community, saving time and freeing up GP appointments by using the skills of pharmacists, will be really helpful for the wider system.
Those are our first steps. Primary care is central to the three big shifts that underpin our ten-year plan to make the NHS fit for the future, taking it from analogue to digital, from sickness to prevention, and from hospital to community.
We will soon begin a public consultation that will be the biggest listening exercise in NHS history. I look forward to taking part in that and I urge all right hon. and hon. Members, their constituents, and staff across primary care to tell us what is working and what needs to change. We will use their responses to take the best of the NHS to the rest of the NHS and build a neighbourhood health service.
Technology will help doctors, dentists and pharmacists meet demand for same-day appointments, giving patients a digital front door to end the 8 am scramble. Big data will end the cruel postcode lottery of health inequality, so that we can take screening, checks and care directly to the communities that need it most, intervening early to prevent ill health and deterioration. We want colleagues from across primary care to come together with their partners in social care and mental health to work in lockstep, as one team, to treat patients in the comfort of their own homes, which is where those patients want to be. That is the neighbourhood health service that we want to build. That is the future that our constituents want to see.
In the interests of time, Madam Deputy Speaker, I will conclude. Our constituents were let down by the previous Government. They were let down by broken promises, underfunding and a failure to listen to patients and staff. We will repair the damage. We have already begun investing in GPs and pharmacies to fix what is broken. We will cut the red tape, speed up treatment, and build a neighbourhood health service that works for everyone. The NHS may be broken, but it is not beaten. We are determined to rebuild it for our people, our communities and our country.
Oral Answers to Questions
Debate between Karin Smyth and Andrew George(2 weeks, 5 days ago)
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Karin Smyth
I commend my hon. Friend for championing this issue on behalf of his constituents. I understand that he has raised it with the chief executive officer of his local trust. He will appreciate that commissioning decisions are a matter for the local integrated care board, in this case Kent and Medway ICB, but I am, of course, very happy to meet him to discuss it further.
Andrew George (St Ives) (LD)
I wish the Minister well in her efforts to address this issue, because it is extremely serious. There are very often more than 20 ambulances queueing outside Treliske hospital, which has a serious impact on expectations for patients. Will the Minister please look at the potential for urgent treatment centres to take pressure away from emergency departments, such as the urgent treatment centre at West Cornwall hospital in Penzance, which really needs to be re-established on a 24/7 basis? That would make a real impact.
Karin Smyth
I thank the hon. Gentleman for his good wishes. It is, indeed, a huge task we have before us. We will maintain ambulance capacity throughout this winter. He makes a valuable point about alternative models to hospital admissions and treatment in the community. That is a matter for the local ICB, as I know he knows. It needs to look at which model is the best fit, particularly in rural areas, to reduce the pressure on frontline A&E services.
Oral Answers to Questions
Debate between Karin Smyth and Andrew George(3 months, 1 week ago)
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Karin Smyth
I welcome my hon. Friend to his place. He knows what we all know, and what we know the entire country knows because we spent the past six weeks campaigning: it is the same story across the country. That is why we are committed to restoring standards and why we will fix this broken NHS, and of course I am happy to meet with him.
Andrew George (St Ives) (LD)
A decision by the Conservatives two years ago means that the urgent treatment centre at the West Cornwall hospital in Penzance is now closed at night, and that has put pressure on the only emergency department in Cornwall—a long peninsula—at Treliske, where routinely 20 ambulances are parked outside creating a new metallic ward at the front of the hospital. That situation has had a detrimental impact, of course including avoidable deaths. Will the Minister meet me and colleagues and the local NHS to discuss this issue, to see how we can restore our emergency services?
Karin Smyth
Again, across the country we see the damage done over the last 14 years, and the hon. Gentleman is absolutely right to highlight that the situation in one part of the system knocks on to other parts. That is why we want a 10-year plan to look at this, an immediate look with Lord Darzi, and, critically, to understand which community and primary care services can be supported to support the rest of the system. I am very happy to meet with colleagues across Cornwall, where we now have many Labour MPs.
Health Services: Rural Areas
Debate between Karin Smyth and Andrew George(3 months, 2 weeks ago)
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The Minister of State, Department of Health and Social Care (Karin Smyth)
It is a privilege to be the first Minister of this new Labour Government to respond to an Adjournment debate. I am grateful to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for raising this important matter and, indeed, for his kind words.
I hope we can begin this Parliament as we mean to go on, by being candid about the formidable challenges that the NHS faces. As my right hon. Friend the Secretary of State said on his first day in the job, the NHS is broken, and it will be the task of this Government to build a new NHS for the future. That means the NHS in our rural and coastal areas no less than the NHS in our towns and cities. I agree with the hon. Member for Strangford (Jim Shannon) on that point.
Facing these hard truths does not take away from the heroic efforts of the people working in health and care, who have done their utmost in incredibly difficult circumstances. We all owe them, on behalf of our constituents, a debt of unending gratitude.
Instead, we want to focus our attention on what needs to be done, including early action to improve access to primary care, dentistry and dental health services in particular. We await the conclusions of a thorough investigation undertaken by the distinguished surgeon Lord Darzi to properly understand the scale of the problem. The Government will then begin work on an ambitious programme of action—a 10-year plan to put the NHS back on its feet. It is a privilege to be part of a Labour Government who are committed to fixing the NHS and making it fit for the future.
As the hon. Member for Caithness, Sutherland and Easter Ross said, the Department’s responsibility stretches only to the NHS in England. Healthcare is devolved in Scotland, Wales and Northern Ireland, and it will continue to be so.
I congratulate the hon. Gentleman on being first out of the traps to secure this debate on behalf of his constituents. As a committed advocate for his constituents in one of the most rural parts of Scotland, he has a deep understanding of matters affecting rural communities, as we have heard this evening. He also has a deep understanding of care, about which I have often heard him speak in this Chamber. It is good to see him back again doing just that.
I cannot speak in detail about the NHS in Scotland, of course, but I can speak about many of the common issues affecting access to care that are relevant to rural constituencies in England, Scotland, Northern Ireland and Wales. I know how rural the hon. Gentleman’s constituency is, and I know the particular challenges that creates in accessing GPs, dentists and emergency care, and in accessing women’s health and maternity services—an issue he has been passionately raising for so long. Maternity services are a problem across the United Kingdom, but I accept the examples he outlined.
Few places in England are as remote as the hon. Gentleman’s constituency, but I am very aware of similar issues affecting more rural areas near my Bristol South constituency. We have heard from the hon. Members for Glastonbury and Somerton (Sarah Dyke) and for St Ives (Andrew George) about morale and the difficulties we face in the south-west.
I hope that, in the years ahead, we can share and learn from one another across all of our borders. In many rural areas, the challenge of improving access to services is compounded by travel times and by the recruitment and retention of staff. We must recognise the importance of designing services that reflect an area’s particular circumstances, which is a growing challenge. As the chief medical officer has pointed out in his reports, people are moving out of towns and cities to coastal, semi-rural and rural areas as they age. At the time that people are most likely to need care, they are increasingly living in the places where it is most difficult to provide that care.
In England, integrated care systems will have a key role to play in designing services that meet the needs of local people. To do this, they will need to work with clinicians and local communities at place or neighbourhood level. We know that excellent primary care is an essential foundation for improving access, tackling the root causes of poor health and tackling problems early so that people remain in better health for longer, and hopefully do not need to access secondary and tertiary care at the same level. That is why Labour has pledged, as part of our health mission, to train thousands more GPs and bring back the family doctor, and that applies to all the nations.
We are also doing more to use the transformative power of technology. There is enormous potential in ideas such as virtual wards, which allow care to be delivered in people’s own homes. Such models of care can have disproportionate benefit in areas where rurality is a barrier to care.
Equally, we are committed to seeing the NHS app reach its full potential under the new Government. We understand that some people will need support to use that technology and we are aware of the challenges of rural broadband, but we are committed to making the benefits accessible to all.
Andrew George
The Minister has committed the new Labour Government to address those issues, but will she specifically address the matter of the two coroners’ reports into avoidable excess deaths as a result of very long waits for emergency services in Cornwall? They were never addressed by the previous Conservative Government. The reports were about not just the hours spent waiting—sometimes elderly, frail people were on the floors for 10 or more hours—but the fact that sometimes 20 or more ambulances greeted patients when they arrived at the emergency department. Two coroners’ reports were sent to the then Secretary of State, but there was never an adequate response. I very much hope the new Labour Government will review the failings of the previous Government and address those very serious concerns, which affect many other rural areas.
Karin Smyth
I am aware of the issues facing the south-west and, when in Opposition, I spoke in the local media about some of the ambulance challenges. I am not aware of those reports, but if the hon. Gentleman writes to me with the details, I will happily look into the issue and get back to him.
We also recognise the additional cost of providing services in rural areas, for example in travel and staff time. That is why the funding formula used by NHS England to allocate funds to integrated care boards includes an element to better reflect needs in some rural, coastal and remote areas.
The NHS faces significant challenges. It needs fundamental reform. The Prime Minister is personally committed to resetting the UK Government’s relationship with devolved Governments in Scotland, Wales and Northern Ireland. I echo the Prime Minister’s words today about our commitment to rural constituencies across the entire country and I hope we can work with hon. Members from across the House, including the hon. Member for Caithness, Sutherland and Easter Ross.