Rural GPs: Funding

Peter Prinsley Excerpts

Wednesday 11th February 2026 Westminster Hall

[Esther McVey]

It is always good to have my hon. Friend—and I do call him my hon. Friend—intervene on me. He makes very good points. It is also important that a local GP chooses, and can see what their local constituents require and what is best for their health outcomes.

The move to a new model based on deprivation rather than workload is, at best, an act of ignorance that fails to acknowledge the significant challenges of running GP practices in rural areas; at worst, it represents yet another example of Labour’s assault on rural life. Measuring pressures on GPs solely through the lens of deprivation would ignore the complex, distinct demands faced by rural practices. Rural communities have older populations. In 2019, the House of Lords Rural Economy Select Committee found that the average age in rural areas was almost six years higher than in urban areas, and a quarter of the rural population were over the age of 65.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I am grateful to the right hon. Member for securing this important debate. Dr Richard West MBE and Dr Daniel James, general practitioners in Woolpit in my Suffolk constituency, have been awarded the Royal College of General Practitioners East Anglia Faculty GP prize this year in recognition of sustained contribution to rural mental health and community-focused general practice. Does she agree with me that we must do all we can to look after the mental health of the rural population, particularly isolated farm workers?

[Esther McVey]

The hon. Member raises a very good point indeed. I congratulate his constituents. The pressure that I know the farming community is under and the impact that the family farm tax has had on the mental health of the rural community and farmers has been significant.

Life expectancy is longer in rural areas, placing greater demands on GP practices. Statistics published by the Department for Environment, Food and Rural Affairs suggest that people born in mainly rural areas in 2018 to 2020 were expected to live two and a half years longer than people born in urban areas. Older populations place greater demands on GP surgeries, presenting with complex healthcare needs and higher levels of chronic illness and frailty. The Rural Services Network analysis shows that GP-registered patients over the age of 75 account for 11% of rural GP patients, compared with just 7.5% in urban settings.

--- Later in debate ---

[Esther McVey]

I agree with the hon. Member. I will come on to my surgeries that are indeed in Victorian buildings—spread across four—and need to be brought together and modernised. That is in Knutsford in my constituency. I know that there will be many other places like that across the country. The hon. Member raises a valid and pertinent point.

We know that GP services in rural communities are spread across a large geographical area, and many elderly residents in Tatton live alone. Although such independence is cherished, travelling long distances to access healthcare is more difficult. Public transport is often limited or non-existent. Community transport schemes exist in Tatton, but they cannot always accommodate short-notice or urgent medical needs. Often, elderly residents do not drive, so they are left reliant on costly taxis or GP staff taking the time to travel to a patient’s home. That places additional pressures on already stretched services. In Lostock Gralam, despite a population of about 2,800 people, there is no GP practice. That forces patients to make a lengthy journey to Northwich, and without a direct bus service many are left to rely on taxis to make their appointment.

For those communities, recruiting and retaining staff becomes more difficult and more expensive. The Rural Services Network reports that 59% of hard-to-recruit GP speciality training posts are located in rural areas. There is less access to specialists and consultants, which makes their services more expensive. Community services and provision are sparser in rural areas, too. Pharmacies, which help to relieve pressure on GPs in urban areas, are not as common in rural areas. When I secured this debate, I was contacted by the Dispensing Doctors’ Association, which provides an essential role in dispensing medicines to patients who live more than 1.6 kilometres from a pharmacy. It delivers to about 10 million patients across England, but is facing increasing challenges due to its reliance on manual delivery.

In addition, while urban pharmacies move ahead with digital efficiency, rural pharmacies often struggle to keep pace because broadband coverage is often unreliable, rendering remote consultations near impossible and service delivery more difficult. The benefits of digitisation in healthcare are well understood across this House, but they rely entirely on having the right infrastructure in place. Without connectivity, rural practices are simply unable to access or benefit from Government investment in that area. There are lots of people from rural areas here, and we know how unreliable our broadband infrastructure is.

In 2022, the all-party parliamentary group on rural health and care published an inquiry into healthcare in rural areas. It concluded:

“Rurality and its infrastructure must be redefined to allow a better understanding of how it impinges on health outcomes”.

No progress has been made on achieving that. Removing the rurality measure of GPs’ funding entirely would be a step backwards in understanding how settings impact GPs’ ability to provide healthcare.

There is little transparency about who exactly will be consulted in the funding model review. In a written answer to a parliamentary question, the Government confirmed that the review

“will draw on a range of evidence and advice from experts,”

such as the Advisory Committee on Resource Allocation and the British Medical Association general practitioners committee, but there is little information beyond that. There are GPs in Tatton who are keen to contribute but, as of yet, have not been able to.

[Peter Prinsley]

Will the hon. Member give way?

[Esther McVey]

I will indeed, although I am keeping an eye on the time.

[Peter Prinsley]

There is obviously a problem with funding the recruitment of additional GP partners in rural surgeries. Does the hon. Member agree that we should think carefully about how the partnership model itself might be improved?

[Esther McVey]

The hon. Member raises another good question, and we can ask the Minister to look into that.

The logical conclusion of not having GPs from rural areas take part in this review is that the Government do not want to listen to them. They are intent on rewriting the formula without acknowledging the realities of delivering rural healthcare. A broadbrush measure such as deprivation cannot take into consideration the very close link between the ability to deliver healthcare and the rural or urban settings in which GPs exist. It comes as little surprise. Whether selling off our family farms or introducing a devolution agenda that pits rural against urban areas, time and again the Labour Government have shown that they are not willing to listen to rural areas, but are quick to sell out rural Britain at the first chance.

As is typical, Labour’s response to pressure is to level down some areas, which serves only to create additional pressures elsewhere, rather than acting to fix them. The pressure faced by rural healthcare will not disappear soon. The NHS long-term workforce plan, published under the previous Government in 2023, recognised that the increased demand from an ageing population is not uniform in the UK. It estimated that

“In 2037, a third of people aged over 85 will be living in rural communities”

compared with just a quarter now. The Government must act to address that trend.

I have been campaigning for a new medical centre in Knutsford, as was acknowledged before, where doctors desperately need more space and modernised facilities to meet patients’ needs. The current surgeries in Knutsford do not do that; they are all Victorian buildings and are not suitable. I have been pressing for that for a long time. I have met with the Minister—I thank her for that—and I would be grateful for an update on the progress of the practice in Knutsford.

GP practices deliver community care and their ability to deliver is reliant on the environment in which they serve the patients. We must have a funding formula that acknowledges the challenges of delivering healthcare in rural areas. I would be grateful if the Minister could answer the following questions. Who is being consulted in the review, and will it include those with first-hand experience of delivering healthcare in rural settings, like my GPs in Tatton? What assurances can be provided that rurality will remain a factor in a new funding formula? Given the specific challenges they face, will the Department commit to publishing an assessment of the impact on rural communities ahead of any change to the funding formula?