GP Services

Debate between Roger Williams and Sarah Newton

Thursday 5th February 2015 Commons Chamber

[Sarah Newton]

That is a good point. We have to look at how general practices are set up these days. Not all general practitioners want to be part of the old partnership model, which is a sort of small business. Many now would like to be salaried and work particular hours in particular settings. I would not want to prescribe a particular model: we need to look flexibly at different models of provision that meet patients’ needs, taking into consideration what the work force need to enable them to play their full part.

GP practices in my area are expanding the range of services that they are able to provide to the community. As hon. Members will know, I represent a large, remote, sparsely populated part of the country, and such expansion is especially important for rural areas. One example is the Probus surgery of GPs, which serves many villages in its rural community. It is expanding into many areas, including minor surgery. I have yet to come across anyone who has anything other than praise for the Probus surgery, which provides the normal services one would expect from a surgery, but also works closely with its primary care partners and district nurses. It also links up with care managers for people with chronic conditions and elderly people living at home.

By comparison, a very different group of GPs work at Penryn surgery. They serve a large campus that is home to Exeter university, Falmouth university and parts of Plymouth university. There is a growing student population and the surgery has been able to expand its services to provide mental health services, prescribing services and on-campus surgeries. In attracting additional funding for services to meet the needs of the young people—we welcome them into the constituency to study there—they have additional resources from which the whole community can benefit.

Those are two very different examples of how GPs are working positively and constructively with local commissioners to expand services, bring in additional resources and improve patient outcomes for the local community.

[Roger Williams (Brecon and Radnorshire) (LD)]

My hon. Friend represents a very rural constituency, as I do. We do not have any single GP practices, but many of our practices have fewer than five GPs. Our experience is that when one leaves and the practice has difficulty recruiting, it really puts the practice under pressure. Can anything be done to make rural GP practice more attractive to young doctors?

[Sarah Newton]

That is a very good point, and I was just about to make the point that although I have given two good examples of larger GP practices that are doing very well, I also have similar issues to my hon. Friend in more sparsely populated areas of my constituency, such as the Roseland peninsula. It has an older population and it is difficult for GP practices to innovate and bring in additional services to make their future sustainable. I am in regular correspondence with NHS England, which has taken away some of the specific funding that used to be available to support remote rural GPs, in the expectation that they will be able to attract additional funding for providing additional services. That is really not possible or viable. In order to maintain access for people living in sparsely populated areas, where the population is unlikely to grow rapidly, NHS England needs to look again at funding for GP practices in such areas. I hope that my hon. Friend will make common cause with me in writing to NHS England to ask it to reconsider that point as part of its five-year plan.

The third point I wish to make is the positive work I see at the accident and emergency department at Treliske. The Royal Cornwall hospital is the only acute hospital in Cornwall and I am proud to have it in my constituency. The head of the A and E department at Treliske has worked innovatively with his primary care partners to introduce GPs into that setting. As people arrive at the hospital, a triage system is in place so that if people would be better served by seeing a GP, they can do so, which takes pressure off the A and E department.

Finally, I wish to share some of the learning from the integration pioneer work that is happening in Cornwall. The Government designated 14 areas of the country as pioneer areas to look at how we can better integrate care services with the NHS. GPs in Cornwall have provided an essential foundation for that work. Our pioneer bid is led by Volunteer Cornwall and Age UK Cornwall—I think it is the only voluntary sector pioneer bid in the country, and it is very much supported by the NHS right across Cornwall, and by Cornwall council.

By working carefully with GPs to identify frail, elderly and vulnerable groups of people with chronic conditions who tend to use the NHS a great deal—GP services, care services or the acute sector—the pioneer discovered that having a trained volunteer attached to a GP surgery to work alongside families, linking up all available support and enabling them to reintegrate into the community around them, leads to a huge reduction in the use of acute and GP services, and, most importantly, significant increases in self-reported well-being.

There are a lot of lessons that can be learnt from the reforms we have put in place. I am confident that if NHS England’s five-year programme learns the lessons from the pilots and the past five years and puts proper resources into primary care, we can see the improved health outcomes I know we all want.

National Pollinator Strategy

Debate between Roger Williams and Sarah Newton

Thursday 16th October 2014 Commons Chamber

[Sarah Newton]

My hon. Friend makes a very good point. Without the services of these pollinators, who depend on the sorts of measures my hon. Friend has mentioned, we would see a decline in the variety and availability of nutritious food in the UK, or we would have to introduce expensive mechanical or hand-pollination methods, which would drive up food prices in our country.

[Roger Williams (Brecon and Radnorshire) (LD)]

The hon. Lady makes the important point about the role of pollinators in agriculture, and yet we have some difficulty in getting a figure on that. The Royal Society for the Protection of Birds says in an article that it is worth between £186 million and £567 million, and yet a few inches down the page it says that the services are potentially worth only £500 million.

[Sarah Newton]

The hon. Gentleman raises a good point about the evidence base, and that is a key part of the draft national pollinator strategy. I will come on to the importance of ensuring that we are very much an evidence-based policy-making body.

There is a mounting evidence base to show that a huge range of threats is leading to overall declines in the number of pollinators, but with no single factor accounting for those losses. There are numerous factors involved, with habitat loss and intensification of land use probably at the top of the list. Pests, disease, the use of agri-chemicals, invasive species and changes to the weather are all factors as well. Those factors affect different species, wild and managed, to different degrees and in different ways. According to the excellent Library briefing prepared for this debate, there is evidence that the losses in wild pollinator and wild insect-pollinated plant diversity might be slowing. But the Parliamentary Office of Science and Technology has produced a useful note that provides more detail for Members and for members of the public who are following this debate.

Off-gas Grid Households

Debate between Roger Williams and Sarah Newton

Tuesday 16th April 2013 Westminster Hall

[Roger Williams (Brecon and Radnorshire) (LD)]

I pay tribute to my hon. Friend the Member for Truro and Falmouth (Sarah Newton) for securing this debate. As the hon. Member for Angus (Mr Weir) said, it has been oft-repeated. It is none the worse for that, but progress is pitifully slow. I am sure that constituents throughout the UK who are represented by hon. Members across this Chamber must feel that their cause has not been addressed by this Government or, indeed, by previous ones.

I want to raise several issues, on the first of which some progress has been made. My predecessor, Richard Livsey, pressed the Office of Fair Trading to conduct an inquiry into the supply of LPG for many years, but I was the Member for Brecon and Radnorshire when that inquiry was completed and a report made. It gave customers greater flexibility in being able to compare prices from various suppliers. Until then, they had to change the bulk tank when they changed suppliers, and the complexity and expense of doing so meant that changing suppliers was very difficult.

There have been incredibly good examples of communities coming together to form purchaser groups that can negotiate more strongly with suppliers. Certainly, the little community of Llanspyddid in my constituency has achieved that, although again—we have heard this message from hon. Members—the tariffs proposed by suppliers were so complicated that it was difficult for consumers to come to a conclusion and they needed help to evaluate suppliers’ proposals. That is nevertheless a good example of how the consumer can be more powerful in the market, given the right conditions.

I say to the Minister that those people need support to get groups together. A document has been produced on good practice for consumer groups in the energy market, but the Department of Energy and Climate Change could certainly do more to ensure that LPG consumers know that they can have competitive tenders from different suppliers. I often talk to LPG consumers who still do not understand what can be done, and there should certainly be a public information campaign to enable people to benefit more from that.

[Sarah Newton]

This topic is very important. In Cornwall, a huge amount of work has certainly been done, with some financial help from the Government, to set up such buyer co-operatives. They have been successful, but there are limits to their success, because of fundamental issues in the market. If there are only one or two suppliers, people can get a discount, but it will be about 10%, and we have heard about the huge disparity between on-grid and off-grid. Such help is welcome and a step in the right direction—of course, 10% is still a decent saving—but it will not really tackle the underlying market issues.

[Roger Williams]

My hon. Friend makes a good point. However we cut the cake, heating a property with LPG is almost twice as expensive as doing so with mains gas. I am sure that consumer groups can achieve a 10% reduction, which is valuable.

My hon. Friend leads me on to say—this point was also made by the hon. Member for Angus—that although off-grid energy consumers often live in very isolated properties, sometimes their communities have never been connected to the gas mains for some reason or another. Certainly in my constituency, old coal-mining communities where there used to be deliveries of free coal to miners or their widows seem to have been left off the mains grid. As I understand it—the hon. Member for Strangford (Jim Shannon) will correct me if I am wrong—the number of people off-grid in Northern Ireland is much higher than in the rest of the country. Yet, work is going on there to get more people on to the gas mains, which will give them huge savings on their energy consumption.

Whenever I have tried to inquire about getting communities such as Llangynidr and Abercraf on to the mains supply, the cost—as the hon. Member for Angus said—was so enormous that taking that forward was impossible. There is not just the cost of the infrastructure, but people have to be made to commit to taking mains gas, which is a question not only of putting in a connection, but often of having appliances changed for mains gas. In the old mining communities in my constituency, some people are particularly vulnerable and certainly do not have the spare cash to make that type of investment in their properties. I believe that the Government should have some system for making mains connection more affordable for communities, because at one stroke that would make a great impact on fuel poverty. I am not sure what the arrangements are in Northern Ireland, but I would be pleased, perhaps after this debate, to talk about that with the hon. Member for Strangford.