GP Funding: South-west England

Debate between Rachel Gilmour and Stephen Kinnock

Wednesday 25th June 2025 Westminster Hall

[Stephen Kinnock]

Integrated care boards in the south-west have received almost £1.3 billion in their primary medical care allocation for ’25-26, which is an increase of nearly 13% compared with ’24-25, so I am not quite sure where the hon. Lady is getting her figures. For me, a 13% increase is not a cut.

That growth in local resources includes the south-west’s share of the additional £889 million agreed for the GP contract, as well as the transfer of some additional roles reimbursement scheme funding that had previously been held centrally by NHS England. Those funding allocations will be further uplifted to fund in full the pay recommendations of the DDRB and the NHS Pay Review Body.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I appreciate that recruitment, including of GPs, is extraordinarily difficult in the south-west. In Minehead, there is one GP practice and just one doctor. He is outstanding, and everybody knows him—to that extent, he fits the named GP pledge—but he serves 11,000 people. Rural premium or not, would the Minister agree that that is simply unacceptable and unsustainable, irrespective of where in the country one might be?

[Stephen Kinnock]

That is an extraordinary statistic. There are clearly major imbalances in the way the system works and general practice is funded in our country. A little later I will come to the Carr-Hill formula; I am sure hon. Members will have seen announcements trailed in the media today about what my right hon. Friend the Health Secretary will say shortly in a speech in Blackpool. The issue raised by the hon. Member for Tiverton and Minehead (Rachel Gilmour) is directly pertinent to the work we are doing around the formula for funding GPs, to ensure that it is needs based, unlike the current, deeply anachronistic and dysfunctional funding system.

On funding, general practices are funded through a range of streams, the majority from core payments known as global sum payments. The rest is made up of incentive schemes, premises payments and enhanced and additional services. The Carr-Hill formula is applied as a weighting of 50% to 60% of GP funding allocated through the core contract, and is a workload-based formula designed to reimburse practices for their expected workloads.

The formula takes into consideration patient demographics, such as age and gender, and factors such as morbidity, mortality, patient turnover and geographical location. I am truly proud that today my right hon. Friend the Health Secretary is in Blackpool to announce that we are reviewing the Carr-Hill formula, which is outdated and not fit for purpose. Currently, GP surgeries that serve working-class areas receive on average 10% less funding per patient than practices in more affluent areas, and that needs to change.

Politics is about choices. For 14 years, the Conservatives —propped up for five years by the Liberal Democrats, I am afraid to say—chose to favour the richest. Who can forget the right hon. Member for Richmond and Northallerton (Rishi Sunak) boasting about how he had deliberately redirected funding from deprived urban areas to leafy suburbs? This Labour Government are reversing that ethos. Our decision to reform the Carr-Hill formula is a clear example of how we are putting our Labour values into practice.

We recognise the importance of ensuring funding for core services is distributed equitably between practices across the country. In our upcoming 10-year health plan, that is what we will do, through our review and reform of the Carr-Hill formula. Alongside that work, the Advisory Committee on Resource Allocation—ACRA—will be asked to advise on how the setting of ICB allocations can better support the reduction of health inequalities, to ensure that resources are targeted where they are most needed.

On workforce and recruitment, we recognise the difficult situation whereby patients have been unable to get GP appointments and recently qualified doctors have been unable to find jobs. That is why, in August last year, we announced £82 million in ringfenced funding, allowing primary care networks to recruit newly qualified GPs through the additional roles reimbursement scheme. More than 1,700 GPs have now been recruited through that scheme.

As part of the 2025-26 GP contract package, we made the additional roles reimbursement scheme more flexible, to allow PCNs to accommodate local workforce needs better. That includes removing restrictions on the number or type of staff covered, including GPs and practice nurses. When I took up my ministerial responsibilities in July, I was astonished to find that it was not possible to recruit GPs through the ARRS. We have bulldozed that red tape, which has resulted in a dramatic increase in the number of GPs on the frontline.

Access to Dentistry: Somerset

Debate between Rachel Gilmour and Stephen Kinnock

Tuesday 1st April 2025 Westminster Hall

[Stephen Kinnock]

I take the hon. Gentleman’s point about the ringfence, but in a way, ringfencing addresses the symptoms, rather than the cause, of the problem. The fundamental cause of the problem is the amateurish way in which the previous Government set up the NHS dentistry contract so that it does not incentivise dentists to do NHS work. That is what leads them to drift off. In a sense, we can do all the ringfencing we like, but if the workforce that we need is not incentivised to do the work that we need them to do, we are going to have that problem, because they vote with their feet. That is why the radical overhaul of the dentistry contract is the key point. However, I agree with the hon. Gentleman that once we have got a contract that works, we must ensure that every penny that is committed to NHS dentistry is spent on NHS dentistry, rather than the absurd situation that we have now, in which we constantly have underspends in the NHS dentistry contract while demand for NHS dentistry goes through the roof. It is a truly bizarre situation.

I return to the subject of the dentistry recovery plan. The new patient premium, introduced by the previous Government, aimed to increase the number of new patients seen, but that has not happened. In reality, since the introduction of the previous Government’s plan, there has been a 3% reduction in the number of treatments delivered to new patients. It is clear to this Government that stronger action is needed, and we are prepared to act to stop the decay.

[Rachel Gilmour]

In Minehead, in my constituency, a dental surgery responded to the ICB in October and said that it would provide 12 NHS appointments a week for people who currently do not have a dentist. I have chased that ICB on five occasions, but we still do not have a result. That is 48 appointments a month that my constituents are missing out on. Would the Minister please agree to write a letter, on my constituents’ behalf, to the Somerset ICB?

[Stephen Kinnock]

We are very keen to ensure that targets are being met, and the ICB clearly needs to ensure that that is happening, so I would be happy to do that. Perhaps the hon. Lady could write to me so that we can get all the facts on the table, then we can take action accordingly.

We will make the difficult decisions necessary to restore NHS dentistry to ensure that patients can access the care that they need, at the best value for taxpayers. Since coming into office, we have focused on implementing new initiatives and stopping the things that are not working. From today, 1 April 2025, the public will see 700,000 additional urgent dental appointments being delivered every year, as we promised in our manifesto. The urgent appointments will be available to NHS patients who are experiencing painful oral health issues, such as infections, abscesses, or cracked or broken teeth. Somerset integrated care board has been asked to deliver 13,498 of those appointments. That is 13,498 more chances for the hon. Lady’s constituents to get the urgent dental support that they need, every single year.

Across the south-west region, there will be 106,776 extra appointments—that is more chances for patients in urgent need of care. However, to have a truly effective dental system, we cannot focus just on those who are already in pain; we must have a system that prioritises prevention. A cornerstone of the Government’s mission to prevent ill health is supporting children to live healthier lives. We want to ease the strain on the NHS and create the healthiest generation of children ever. As colleagues will be aware, too many children are growing up with tooth decay, which is largely preventable. That is why we have invested £11.4 million to roll out a national supervised toothbrushing programme for three to five-year-olds that will reach up to 600,000 children a year in the most deprived areas of England.

The latest data shows that the rate of tooth decay for five-year-olds in Somerset is 20.2%, which is lower than the 22.4% for England but still far too high. We are taking a targeted approach to support those in the most deprived areas, which is why we have been able to allocate £50,000 of funding to Somerset to support around 2,000 three to five-year-olds. Our additional funding will help to secure and expand supervised toothbrushing based on local needs. This is extra resourcing to support targeted work by the local authority and its partners.

I am determined that we will reduce inequalities faced by children living in the most deprived areas, helping them to brush their teeth daily in the nurseries and schools that they attend. Alongside this, we have launched an innovative partnership with Colgate-Palmolive, which is donating more than 23 million toothbrushes and toothpastes over the next five years. This is of incredible value for the taxpayer, and a fantastic example of how business and Government can work in partnership for the public good.

A strong dentistry system needs a strong workforce. We recognise the incredible work that dentists and dental professionals do, and we know that the current NHS dentistry contract is not fit for purpose. We need to build an NHS system that works for patients and their dentists. A central part of our 10-year plan will be workforce, and we will ensure that we train and provide the staff, technology and infrastructure that the NHS needs to care for patients across our communities. We will publish a refreshed long-term workforce plan to deliver the transformed health service that we will build over the next decade, and to treat patients on time again.

We know that some areas face challenges in recruiting and retaining the dental workforce they need. The golden hello scheme offers 240 dentists a £20,000 joining bonus to work in underserved areas of the country for three years. The recruitment process is well under way, with posts being filled by dentists in these areas as we speak.