Tuesday 25th February 2020

(4 years, 1 month ago)

Commons Chamber
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Ruth Edwards Portrait Ruth Edwards (Rushcliffe) (Con)
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I am most grateful for the opportunity provided by tonight’s debate to highlight the situation in East Leake health centre in my constituency, where patients are in great need of an upgraded new facility. I will highlight the problems and constraints that they face with the current building. I will also set out the huge opportunity we have to co-locate primary, social and community care services, offering patients a wider range of services in one place within their community and taking away the need for them to travel to Nottingham for out-patient services, and in doing so relieving pressures on nearby hospitals such as the Queen’s Medical Centre, providing care for a much larger population, which will increase further in the next few years, and enabling the delivery of joined-up services in line with the Government’s objectives for primary care networks.

I thank the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) in advance for responding to the debate today. I would be grateful to hear what plans the Government have for investment in the primary care estate and the mechanisms and timetable by which such funds might be made available. I also invite her to see the strength of our bid in person by visiting East Leake health centre with me.

East Leake is a large village in the south-west of my constituency. It has seen significant growth due to the building of 1,300 new houses in recent years and is earmarked to take a minimum of 400 more in the current local plan period. Local people are worried about the fast rate of new housebuilding. They are concerned about whether the number of school places and GP appointments can keep up with demand. East Leake health centre is rated as outstanding by the Care Quality Commission and by its patients. Residents tell me that their care at the centre is excellent, but they are concerned about how busy it is becoming. I would like to take this opportunity to put on record my gratitude to the doctors, nurses and all the support staff for the excellent job that they do for their patients in challenging conditions.

The current health centre is owned by Rushcliffe clinical commissioning group. It is the oldest in Nottinghamshire. It is a prefabricated building constructed 60 years ago, and it is no longer fit for purpose. There are problems with the fixtures and the services on the site. There are constant leaks when it rains, leading to regular flooding. As a result, parts of the already over- crowded practice are often unsuitable for patient use and have to be closed off.

Jim Shannon Portrait Jim Shannon (Strangford) (DUP)
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I congratulate the hon. Lady on getting her first Adjournment debate. It will be the first of many, I have no doubt. I congratulate her as well on fighting hard for her constituents. I spoke to her beforehand.

Jim Shannon Portrait Jim Shannon
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To support the hon. Lady; that is why I am here.

Does the hon. Lady agree that a vibrant and smoothly functioning health centre is a key facet of any local community, that if more funding were given to this frontline service there would be less unnecessary pressure on A&Es and that we really must get back to having GPs and nurses in place and functioning to provide an acceptable standard of the national health service?

Ruth Edwards Portrait Ruth Edwards
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I thank the hon. Gentleman for his sensible intervention and his points, which I completely agree with. I shall be going on to make those points myself in a couple of moments.

The Minister may have received a photograph from me showing half of the waiting room in East Leake screened off, the floor filled with buckets and water; we had leaks coming in through the ceiling. If a new building is not constructed, substantial sums will still be needed for essential maintenance just to keep the current one functioning. Simply maintaining what is already there will not offer the best value for money, given the huge increase in the number of patients the practice is now serving and will need to serve in years to come.

Alicia Kearns Portrait Alicia Kearns (Rutland and Melton) (Con)
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I commend my hon. Friend and neighbour for securing this important debate for her constituents. The issue she raises applies to many rural constituencies such as mine; the numbers are important. In Melton, 30,000 people in my constituency are served by just one GP practice. [Interruption.] I respect very much that gasp of awe, which I did not pay for or prearrange. In Oakham, 16,000 people are served by one GP service. Does she agree that if we are truly to be the party of the NHS, we need to invest in primary care, because that is what people feel and experience on the ground that makes them feel that the NHS is truly on their side and we are on their side. It will also get those numbers down, so that people get the fair, honest and decent primary healthcare they deserve.

Lindsay Hoyle Portrait Mr Speaker
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Order. I just need to help a little. Unfortunately, I have been very soft with Mr Shannon in previous times. This debate is about the East Leake health centre and therefore we should not be widening it; the danger is that people’s Adjournment debates are going to be captured. I understand why people want to raise these things, but I think we are going to have to tighten down in the future if people are going to start spreading the debate around everybody.

Ruth Edwards Portrait Ruth Edwards
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Thank you, Mr Speaker. I completely agree with my hon. Friend’s point; we need to invest in health centres in our rural communities, because that will also take the pressure off accident and emergency units, and hospitals

There has been a 25% increase in patient numbers at the East Leake practice in the past five years. With the new housing I referred to earlier being built in the next four or five years, an additional 3,000 patients—a further increase of 27%—are forecast. The medical team and services needed to effectively serve the growing population can no longer fit inside the building. At present, there are more doctors than consulting rooms, and the district nursing team has had to move out of the health centre due to a lack of space.

A few weeks ago, I visited the practice. I am hugely grateful to the practice manager, Nicky Grant, to doctors Neil Fraser and Nicolas Milhavy, and to Conrad Oatey, the chairman of the patient participation group, for showing me the great work done at the practice and the ingenious use they have made of their already limited space to try to accommodate growing demand. It is a rabbit warren of rooms, squeezed in to accommodate 45 members of staff, including nurses and 12 doctors. They are dispensing advice, immunisations, vaccinations, blood tests, treatment for minor injuries and illnesses, antenatal care and palliative care, and they are helping people to quit smoking——the list goes on. The building has already been expanded four times on the current site, and there is no further land for it to be expanded again. Having been there myself, I cannot see how a further 3,000 patients could possibly be served from the current practice building. As I mentioned in my opening remarks, I would like to invite the Minister to visit the practice with me, both to see the current conditions in which the team are working and to hear more about the exciting proposals for a new health centre.

The proposals are indeed very exciting. We will have a bigger, modern practice that is designed for the number of patients being served today, rather than 10 years ago, but it will be much, much more than that. The proposal is for the practice to relocate to a new site, still based in East Leake, which will accommodate a range of primary, social and community services. Those include community pharmacists, dentists, social services, the public library and the parish council, and the return of the district nursing team. It will also enable new diagnostic services and out-patient services, such as ultrasound and physio- therapy, to be located on site. Treatment will be delivered in the heart of the community, meaning that fewer people will have to make trips to already stretched hospitals. It will also provide a proper space from which local mental health services could be delivered—that is a priority that many of my constituents have raised with me.

This will mean that the elderly gentleman can collect his repeat prescription, take out a book from the library and talk to the parish council about an issue in his street all in one trip. It also means that the young pregnant mum who needs an ultrasound scan, but also a dentist’s appointment for her eldest child, can access both on the same day in the same place. Someone who has been injured at work can see their physiotherapist and GP, and pick up their painkillers.

The cost of the new building will be £12.4 million. Rushcliffe clinical commissioning group is asking for £7.3 million in capital funding from the Government, which it will supplement with contributions from developers, plus investment from the other organisations that would co-locate into the building. The cost is therefore significantly less than if the co-location model was not pursued, and the primary care aspect of the health centre was moved to a refurbished site on its own. It will allow delivery of enhanced primary care services and community facilities in the most cost-effective way, serve as a model for modern delivery of multiple services in the community and relieve the huge pressure on the A&E department at Queen’s medical centre.

Furthermore, this will help to deliver on many of the priorities for primary care networks, as set out in the NHS long term plan, providing better management of financial and estate pressures, a wider range of services to patients and better integration of GP services with the wider health and care system. It will also enable better integrated care for people with complex needs, including many elderly residents, and better enable the provision of proactive, preventive measures and holistic solutions, such as social prescribing.

I strongly welcome the Government’s focus on levelling up investment and opportunity across our country. For the benefits to be fully realised, this will also need to involve levelling up between urban and rural areas, as the latter have historically often seen lower investment. Investment in healthcare is one of the many levers for doing that. This Government’s hospital building programme of 40 new hospitals and 20 upgrades—the first in a generation—is fantastic news for everyone. However, it needs to be matched with investment in primary healthcare, particularly in rural areas like many parts of my constituency, to offer better access to integrated healthcare services within rural communities. This will make it easier, more convenient and cheaper for patients to access healthcare services, drastically decrease the number of times people even have to go to a hospital for treatment due to better joined-up care and a focus on prevention, and help to care for elderly patients with complex needs in their homes for longer.

With its growing population, East Leake and the surrounding areas have growing need, but its health centre can no longer grow to match it on its current site. Its practice team have an exciting, forward-thinking vision for the future delivery of health and social care services. Its future provides us with a golden opportunity to invest in local, community-centred care. I thank the Minister again for taking the time to listen and to respond to this debate. I would be most grateful for any guidance on Government plans for future investment in primary care, and any reassurances she can give me about the bigger, brighter future for East Leake health centre. Once again, I reiterate my invitation to visit.