Oral Answers to Questions

Sam Carling Excerpts

Tuesday 19th November 2024 Commons Chamber

[Chris Vince (Harlow) (Lab/Co-op)]

8. What assessment his Department has made of the adequacy of patient access to primary care services.

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

21. What assessment his Department has made of the adequacy of patient access to primary care services.

[The Secretary of State for Health and Social Care (Wes Streeting)]

Mr Speaker, I associate myself with your remarks about the war in Ukraine. I know the whole House stands with Ukraine as it defends its freedom and democracy. This is precisely why the Prime Minister’s leadership at the G20, and in other international fora, is vital in standing up not just for our national interests but for our values across the world.

Over the past decade, the Conservatives’ mismanagement has left the NHS with 1,400 fewer full-time equivalent GPs than in 2015, hundreds of practice closures, the loss of over 1,000 community pharmacies, and NHS dentistry a distant memory, which is why this Government took immediate action to employ 1,000 more GPs. Through the additional roles reimbursement scheme, through the Chancellor’s Budget measures and through our 10-year plan, we will shift the focus of healthcare out of hospitals and into the community.

--- Later in debate ---

[Wes Streeting]

My hon. Friend is right that many of the pressures on our hospitals, such as the Princess Alexandra in Harlow, are a result of pressures in other parts of the health and social care system. It is outrageous that the biggest reason for five to nine-year-olds presenting to hospital is tooth decay, which is why we need to get NHS dentistry back on its feet, along with the rest of the NHS.

My hon. Friend the Minister for Care and I have regularly met the British Dental Association since the general election to consider how the dental contract can be reformed to retain dentists and rebuild NHS dental services.

[Sam Carling]

In my local area of Cambridgeshire and Peterborough, GPs are reporting feeling increasingly burnt out, with working conditions becoming more extreme. The number of patients per fully qualified GP in my area has increased by nearly 400 since December 2016, a higher increase than the national average. Can the Secretary of State tell me what his Department is doing to make the situation more sustainable while improving access to primary care?

[Wes Streeting]

General practice is a valued part of the NHS, and GPs are a vital part of our NHS family. In fact, they are delivering more appointments than ever before, and we recognise the significant pressures they face. At the same time, we know that patients are struggling to see their GP, which is why we have invested an additional £82 million into the ARRS to recruit 1,000 more newly qualified GPs this year. This will take pressure off general practice, and we will be announcing further budget allocations in the not-too-distant future to set out what further support we will provide for general practice.

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.