Healthcare Provision: East of England

Sam Carling Excerpts

Tuesday 3rd September 2024 Westminster Hall

[Sam Carling (North West Cambridgeshire) (Lab)]

I thank my hon. Friend the Member for Norwich South (Clive Lewis) for securing this important debate.

Following the election, some of the earliest emails I received were from NHS staff from a variety of disciplines who feel deeply undervalued, under-appreciated and overworked. In May of this year, GPs in Cambridgeshire carried out 547,804 appointments, 62.5% of which were face to face. That is the equivalent of 64% of the county in just one month.

There are more patients per fully qualified GP in the east of England than the ratio for England as a whole. It is the same for my region of Cambridgeshire and Peterborough, and in my constituency of North West Cambridgeshire there are fewer fully qualified GPs than in 2017. Local practices simply do not have the funding to hire more GPs, so we find ourselves looking at a ridiculous situation where we invest as a nation in world-class training for new GPs, through six years of medical school followed by foundation years and more, but once they qualify they often cannot find work.

It is not just about putting more funding into the system as a whole; allocation is not working fairly either. As the hon. Member for South Cambridgeshire (Pippa Heylings) just mentioned, the funding formula used for the general medical services contracts, under which most GP surgeries operate, is based in part on data originating before 2000. Leading GPs I have spoken to expressed a firm view that it discriminates against not just some of the areas the hon. Member for South Cambridgeshire mentioned, but urban settings with younger patients, despite significant health needs in those areas. I represent a significant part of urban Peterborough, which last year was ranked as the least healthy place in the entirety of Britain. This must be seriously examined, with changes made.

GMS contracts are held by practices in perpetuity, but a number have had to hand back their contracts to local NHS commissioners, which leads to their practices being put under time-limited commercial contracts called APMS contracts—alternative provider medical services contracts. That occurs when practices just cannot cope financially any more, and the rate in our region is truly shocking. Nationally, around 1% of GP practices are on APMS contracts. In Cambridgeshire and Peterborough, it is 12.5%, or one in eight, with many more on the edge.

These contracts are held by private companies whose loyalties lie with their shareholders. The stealth privatisation of our regional services is an appalling legacy of the last Government’s 14 years of failure. Not only are these private contracts bad for patients, with continuity of care poorer due to a higher proportion of locum staff employed, but they are far more expensive for the taxpayer. I know of one practice in the region that is being given £40 of additional funding per patient under an APMS contract, when ironically even half of that extra funding added to the GMS contract they handed back would probably have solved the problem. That makes me even more pleased and proud that this new Government are taking immediate steps to address the situation, with a 7.4% increase to the global funding sum for GP practices announced for 2024-25. We will fix this mess, but it is going to take time.

Healthcare needs have become greater over time. This is particularly acute in the east, the fastest-growing region in the UK in the 2010s, where the population grew by 8.1% between 2011 and 2021. Like much of the UK, the east is ageing. As people live longer, their healthcare needs become more complex and challenging, and a thriving workforce is needed to address those appropriately. If those needs are left unaddressed, NHS England warns of a shortfall of between 260,000 and 360,000 staff by 2036-37, with patient demand increasing across the board.

In my maiden speech, I highlighted the dental desert that we face in Peterborough; others have mentioned their areas. Some people have to travel as far as Stevenage and Kettering to receive treatment because, in our city, there are no adult dental clinics accepting new NHS patients. The British Dental Association has warned that unmet need for NHS dentistry in the UK is at an all-time high, and the Government will need our support to bring that down.

Of course healthcare is a joined-up issue affected by several other policy areas. The crisis in social care, for example, has exacerbated many of the issues faced by the health sector. Some in our eastern region have championed innovative methods to tackle that, such as models using virtual beds—of which there are 190 in Cambridgeshire and Peterborough; feedback has been really positive there. We need to support that kind of innovation to make our NHS fit for the future, as I know the Government will.

However, the issues in healthcare seem never ending: RAAC-ridden hospitals are having to be replaced; GPs and NHS workers are burnt out; recruitment and retention are difficult yet, simultaneously, some cannot find work; access to dental care is non-existent for some; healthcare inequalities persist; and patient demand is growing and growing.

Dealing with all of that is a huge undertaking, and the Government have been left with a terrible inheritance. Addressing it will require a deftness, competency and compassion that we have not seen for 14 years. But the Government have started well, and I have every confidence that the east, and those in my constituency of North West Cambridgeshire, will benefit from this Labour Government’s approach and see a better experience for staff and patients alike.