GP Appointment Availability

Rosena Allin-Khan Excerpts

Tuesday 26th October 2021 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank all hon. Members for their contributions this afternoon and the hon. Member for Beaconsfield (Joy Morrissey) for securing this debate on an extremely important issue as we recover from the pandemic. This issue is close to all our hearts and to the hearts of the people whom we service.

GPs play an essential role in our communities. They are often the first port of call for people accessing a wide variety of health services, and their hard work and dedication to serving their communities ensure that we can always obtain advice, medicine and referral to other services.

When we discuss GPs, it is important to remember that they are more than just nameless public servants doing a job. They do not just serve communities; they are an integral part of them. I myself have had the same GP for my whole life, if people can believe that. I am slightly giving my age away to say that she has been my GP for over 40 years.

GPs are the foundations of our national health service, and without access to them our whole health system would collapse. Chronic illnesses would not be caught in time, mental illnesses would go unchecked and life-saving medication would simply not be prescribed. From our birth to our death, a GP is there for us all, and everyone in this country should have access to their GP.

However, like much of the NHS, GPs are overstretched and under-resourced. Even prior to the pandemic, GP surgeries had to contend with a double hit of fewer doctors in the workforce and a rising ageing population. Demand simply outweighs supply. We need more GPs, pharmacists, physiotherapists and community health workers. But instead of supporting GPs during this challenging time, the Government prefer to blame them, making their jobs even more difficult at the time of greatest pressure for our NHS.

We have looked for virtual solutions so often during this pandemic, and for the most part their effectiveness cannot be disputed. They have allowed our economy to keep going and our public services to continue functioning, and also allowed a small degree of normality in what has been an extremely challenging and turbulent 20 months. I know from my own experience on the A&E frontline, especially early on in the pandemic, that infection protocols and social distancing made many elements of delivering compassionate care very challenging.

Digital solutions have worked well, but we know that they are not appropriate in every setting and they do not work for everyone; we have heard ample example of that today in this debate. However, we need to be careful not to conflate two separate issues. Digital solutions in practices were not just necessary for infection control. The sheer demand for appointments is through the roof. GPs have been offering telephone consultations and online appointments for some time now, even prior to covid. There were 2.2 million more appointments in August this year compared with August 2019. The percentage of appointments being delivered face to face is also rising. That shows that GPs are striving to see as many patients as they can, but to increase that number even further they need more support from the Government.

The Conservatives have promised more GPs in every one of their manifestos since 2015. However, we have approximately 2,000 fewer GPs now than we had in 2015. It seems like a simple fix for Government—deliver on manifesto commitments and expand the GP workforce. That will allow for even more appointments and it will help to reduce the burden on existing staff, leading to less burnout and less fatigue.

The British Medical Association conducted a survey of GPs in July. Half the respondents said that they are currently suffering from depression, anxiety, stress, burnout, emotional distress or other mental health conditions. I repeat—half the respondents said that. That is a huge percentage. Around the same proportion of respondents said they now plan to work fewer hours after the pandemic. When a workforce are supported, their absence rates come down and their productivity goes up; it is pretty basic. Ensuring that staff are supported not only benefits the workforce but the patients, through more effective and timely care. It is a virtuous cycle, which surely even the cynics would support, as it ultimately leads to more patients being seen and better care being provided.

We have heard about the trickle-down effect of not being able to see GPs and the knock-on impact that has on the rest of the NHS. Yet instead of delivering on their manifesto pledges, this Government would rather stoke the flames of division, by attempting to shift the blame to GPs and encouraging local residents to vent their frustrations at them rather than at the Government. The Health and Social Care Secretary has resorted to attempts to name and shame GP practices that were unable to guarantee face-to-face appointments. The Government will then deny additional essential funding to the practices they deem to be performing poorly. That provocation does nothing to improve patient care; it serves only to deflect anger away from the Government and towards the health service. I know from colleagues in GP surgeries across England that it has already resulted in abuse both online and in person. That leaves so many practitioners considering their career choices, and will lead only to further shortages in future.

Fundamentally, the Government need to make good on their manifesto pledge of an additional 6,000 GPs. Without that, there will be a detrimental impact on the workforce and, crucially, on patient care. That has a knock-on impact on how much time GPs are able to spend with patients. Patients are understandably frustrated, as the backlog of care due to covid continues to pile up, with a knock-on impact on waiting times throughout the NHS. At a time when case numbers are soaring again and the booster programme is faltering due to Government inaction, people are anxious about their health and the health of their local community.

[Chris Green]

Will the hon. Lady give way?

[Dr Allin-Khan]

No; I want to make some progress. The imminent arrival of winter is also a great cause for concern. Winter is always an extremely challenging time for the health service. GPs will be the first point of contact for the majority suffering from winter respiratory illnesses. However, GP surgeries cannot be blamed for being unable to fill vacancies as a result of wider workforce and funding issues. It is simply not acceptable. The Government are purposefully turning communities against one another, risking the health and wellbeing of patients and staff simply because they are unwilling to put forward a sustainable plan to support GPs to manage their workloads. GPs’ needs and patients’ needs are one and the same. It is a failure of Government that has led us here.

[Chris Green]

The Labour party voted against compulsory vaccination in the care setting, presumably because they sensed that it would have an impact on carers and their ability to carry on in the sector. Does the hon. Lady think that it would also have an impact on the NHS, with perhaps up to 100,000 people leaving, and GP surgeries?

[Dr Allin-Khan]

That is beyond the scope of this debate, but I am very happy to have a discussion with the hon. Gentleman afterwards. I do not believe it is appropriate to mandate vaccinations for NHS staff, forcing them to leave their jobs if they do not accept vaccination, as I put forward in the Labour party’s position on the care sector.

Let us be clear: GPs are being scapegoated for a failure of this Government to act and put people’s health first. The war against GPs that is being propagated by the Government does nothing to serve patient needs or to serve GPs, who are exhausted and unable to fulfil the commitments that they trained hard to carry out, because of a failure of this Government. I see that the hon. Gentleman feels rather pleased with himself for his intervention on me. Forcing people to have vaccinations in the communities that have been hardest hit, for whom trust has been completed eroded by this Government, does nothing to serve our collective aim, which is to ensure that the communities that we all serve have the treatment that they need and timely and respectful surgeries and appointments. That is the very thing that will keep our communities alive and well this winter.

Will the Minister, whom I welcome to her place, please outline what steps the Government will take to tackle the workforce shortages in GP surgeries? Will she outline what resources will be provided to ease the intense workload that GPs are already contending with? Will she outline why additional funding is all directed to secondary care, while our primary services are left to crumble?

I thank all the GPs out there serving our communities. I hope that the Government have listened to our points on the support that GPs, patients and communities need.