GP Services

Debate between Paul Burstow and Annette Brooke

Thursday 5th February 2015 Commons Chamber

[Paul Burstow]

Absolutely, and certainly in its local planning my local authority does exactly that—it looks at what the community facility needs are. In the southern part of my constituency, in south Sutton, there has been some controversy over plans for a new GP centre. It is planned on a piece of land that was NHS land but which does not sit within easy reach of public transport and is perceived to be in the wrong place. It is also less than a mile from a soon-to-be-unused hospital site that many of my constituents feel would be a more sensible location. It will be the basis of a new housing development in the coming years and so will be the perfect place for a consolidation of existing substandard GP surgeries currently based in houses.

In its briefing, the Royal College of General Practitioners has set out some of the pressures on GPs, including increased levels of stress and depression. In a ComRes poll it conducted, eight out of 10 GPs expressed concern that those pressures were leading to an increased risk of misdiagnosis. Yesterday was world cancer day but there are still serious issues with the number of people who do not get a cancer diagnosis until they are in an accident and emergency department, by which point it is far too late, and consequently their lives are cut short.

GPs are at the heart of delivering health care: nine out of 10 NHS consultations take place in a GP surgery, while the number of consultations has increased by 40 million since 2008 to 340 million. Interestingly, according to the 2012 GP patient survey, 1.2% of patients went to a walk-in centre or A and E department because they could not get a GP appointment at a time that worked for them, but that figure has now risen to 1.7%. I am sure the Minister will tell us that those are very low percentages and therefore not a cause for concern, but given the number of consultations—340 million—it does not take a very high percentage to have a significant impact on our A and E departments. Given that there are nearly 14.6 million A and E attendances, we can see that the gearing is such that ensuring sustainable and easily accessible GP and primary care services is critical to getting the balance in the system right.

I hope the Minister will say something about the piloting of 24/7 access to GPs and ensuring we have the right data to better understand which areas are under-doctored so that we do not have to rely on anecdotal evidence. There is clearly a concern about deprived and rural areas not having sufficient doctor cover, but at the moment we cannot map that accurately. I hope he can tell us what is being done to target resources to support areas crying out for better GP coverage. In addition, I hope he can say what will be done to address the fact that, despite the Government’s having identified the need to train more GPs and despite the number of places having increased significantly under this Administration, not enough places are being filled. What is being done to get up to the right number?

[Annette Brooke (Mid Dorset and North Poole) (LD)]

I have visited a number of GP practices and I agree that while they are desperately trying to meet the increased demands, the frustration at not being able to recruit is adding seriously to their stresses and strains.

[Paul Burstow]

It is said that we need about half of all trainees to go into general practice and, at the moment, only 2,700 of the more than 3,250 places that are available are being filled. That is an issue, but it sits in the context of a global workforce pressure when it comes to medical staff. The opportunity to fill this gap by recruitment overseas will be difficult as well.

I am conscious that others wish to speak so I shall end by asking the Minister to address the issues of access, of how we make sure that more deprived areas do not suffer a double disadvantage by not having access to good quality primary care and of what will be done to ensure that we cease to have this distortion of funding priorities caused by a payment-for-activity system in our acute sector and a contracting model for primary care that has disadvantaged primary care for too long and led to this reduction in funding that other hon. Members have talked about. I look forward to the rest of the debate and the Minister’s response.

Tobacco Products (Plain Packaging)

Debate between Paul Burstow and Annette Brooke

Tuesday 3rd September 2013 Westminster Hall

[Paul Burstow (Sutton and Cheam) (LD)]

I congratulate the hon. Member for Harrow East (Bob Blackman) on securing the debate at this early stage, so that we can put the case for Parliament making the decision and getting the solution, getting on with it in a way that the Government have been reluctant to do.

I want to pick up on the phraseology: standardised packaging versus plain packaging. Standardised packaging is what we are talking about. It is clear, and enables public health messages to be delivered powerfully. The way in which the packages are designed has a clear psychological impact in reducing the likelihood of people taking up smoking and increasing the likelihood of their quitting. It is important that we talk about standardised packaging, because it really makes a difference.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

The case has been well made that clever packaging seduces children into smoking, but how will standardised packaging impact on the rational adult person’s choice to smoke?

[Paul Burstow]

I would use the phrase “insidious packaging”. That is what we are talking about. We have seen today examples of the sort of packaging that has been used, and in the evidence submitted as part of the preparations for the debate we have seen how those who lead tobacco companies talk about the value they place on packaging as a tool to solicit more custom and get more people to take up smoking in the first place. Big tobacco needs to recruit more smokers because it has to replace those who quit and, more chillingly, those who die as a consequence of taking up smoking. That is why we must have a bias towards action to protect the health of children and young people from the harm that smoking does.

In its systematic review of evidence, published as part of its consultation, the Department of Health gathered absolutely clear and strong evidence of the impact of standardised packaging on reducing smoking. The evidence is there; what is lacking is the political will. The Minister has that will, but the Government as yet do not. Parliament should take a leaf out of the book of the previous Parliament, when it came to smoking in enclosed public places. It was not the then Government who led on that; they hid behind many of the same arguments that are being used now. Yet again, it took the leadership of the Health Committee—having an inquiry, producing a report and publishing the evidence—to make the case for the ban, and the Government being prepared to allow a free vote.

We should have a debate and a free vote in this House to give effect to the policy change, because it will save lives. It is no longer satisfactory or acceptable to be kicking this can down the road. We should not have been doing that with the ban on smoking in enclosed public spaces and we should not be doing it now with standardised packaging.

I hope that people will be moved by this debate and that the Minister can move her colleagues. I know that both she and the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), are committed to this change, which is an essential public health goal. As one speaker said, controlling tobacco and saving lives requires us over time systematically to improve and strengthen regulation. This is another step on the journey of changing public attitudes and saving lives.

Oral Answers to Questions

Debate between Paul Burstow and Annette Brooke

Tuesday 26th April 2011 Commons Chamber

[Annette Brooke (Mid Dorset and North Poole) (LD)]

I have received representations from constituents regarding the reclassification by the primary care trust of elderly relatives for continuing health care funding, with severe needs apparently becoming moderate over time. Does the Secretary of State share my concern about this, and how widespread is this practice in the current climate?

[Paul Burstow]

My hon. Friend’s point is important and I regularly receive correspondence about this from hon. Members from all parts of this House. If she wishes to write to me, I will be happy to discuss the matter with her further, once I have had a chance to look at the details.

Oral Answers to Questions

Debate between Paul Burstow and Annette Brooke

Tuesday 25th January 2011 Commons Chamber

[Paul Burstow]

The last comment was pretty cheap, and no Government Member has suggested that the future of the cancer networks is in doubt. Indeed, in the coming financial year, the funding is secure. As we move to the new arrangements, it will be for the NHS commissioning board to decide the appropriate arrangements for commissioning in the future. We are clear that the expertise of those groups could, should and will continue to be used to support commissioning in the future.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

4. What steps he is taking to improve co-ordination of social care and health care for the benefit of patients.

[The Minister of State, Department of Health (Paul Burstow)]

We have set out in the White Paper “Equity and Excellence: Liberating the NHS” and the Health and Social Care Bill how we will deliver the coalition programme for Government commitment to promote greater integrated working. This includes local authorities taking the lead role in the future in joining up local NHS services, social care and health improvement via council-led health and well-being boards.

[Annette Brooke]

Can my hon. Friend assure me that there will be a joined-up approach when addressing patients’ interests and complaints when they straddle social care? Perhaps a single point of contact for a complaint would be a good step forward from what we have now.

[Paul Burstow]

My hon. Friend is right to draw attention to the need to integrate not only the way in which we deliver and plan services, but the way in which we manage complaints. That is why the Government have included in the Bill our proposals for the establishment of local healthwatch and healthwatch England. Local healthwatch will have the ability to deal with complaints and also have the capacity to refer concerns about services to the Care Quality Commission so that it can take the necessary steps to investigate. In that way, we will deliver a more integrated system for dealing with such complaints.