Access to Primary Healthcare

Shockat Adam Excerpts

Wednesday 16th October 2024 Commons Chamber

[Helen Morgan]

My hon. Friend is entirely right. I believe that the Government are taking steps to address that, but he has made an important point about the need for flexible GP funding. A general practice may have money to spend on professionals and need more fully qualified doctors to deal with its patient list, but can only spend that money on another pharmacist or another nurse. That is a ridiculous situation, and I am pleased that the Government are dealing with it.

[Shockat Adam (Leicester South) (Ind)]

Will the hon. Lady give way?

[Helen Morgan]

No, I will make some progress.

People do much better if they have access to continuity of care, but 8,000 more GPs are needed to deliver the rights that we laid out in our manifesto. We do not shy away from the fact that that is an ambitious objective, and we accept that it cannot be achieved through training and recruitment alone: we need to retain and incentivise our existing workforce. As I said earlier, seeing people in their communities avoids hospital admissions and saves money. Unfortunately, although the Conservatives promised us 6,000 more GPs in 2019, we ended up with 500 fewer. That is why people are so frustrated. According to the findings of research carried out by the House of Commons Library, GP funding has fallen by £350 million in real terms since 2019. As a result, not only are people struggling to gain access to basic care in their communities, but there is a postcode lottery when it comes to availability of that care.

In the area where I live, which is covered by NHS Shropshire, Telford and Wrekin, the number of fully qualified GPs fell from 280 in 2016 to 242 in 2023, despite an increased and increasingly ageing population with a much higher level of demand, while 43% of patients are waiting more than 28 days for non-urgent appointments. The Darzi report showed that the number of people waiting for long periods for appointments is rising throughout the country: it is a national issue. We know that from our own doorstep conversations.

Members might ask me, “Where are you going to get 8,000 more GPs from? That is a big number.” Apart from training new ones, we should value greatly our experienced ones. A recruitment and training programme is one idea, and, as my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out, using the dentists we have trained properly is extremely important, but we also need to focus on retention and incentivising our existing GPs, to ensure that we hold on to valuable experience and valuable patient continuity.

Let me move on from GPs to local pharmacies. Pharmacy First was a great idea of the previous Government —I am willing to give them credit—but pharmacists are under huge strain. According to the Darzi report, some 1,200 have closed since 2017, and spending under the community contract has fallen. Tomorrow I am going to visit Green End pharmacy in Whitchurch, in my constituency, which wrote to me:

“As an independent pharmacy, we’re unable to keep on absorbing costs with losses on dispensing.”

The pharmacy is struggling because it is making losses on the drugs that it gives out on prescription. Given that it is a small, independent pharmacy, it does not have a massive shop from which to make profits to subside that work.

In 2023, Community Pharmacy England warned of

“systemic pharmacy funding cuts of at least 25% in real terms since 2015.”

That has led to a postcode lottery of access, and to many pharmacies being unable to have a full-time pharmacist and relying on locums, which has led to a really poor and insecure level of service. That is impacting on people who just need to go and pick up their prescription and get on with their day.

--- Later in debate ---

[Helen Morgan]

I will make some progress now, if that is okay, because I am conscious that lots of people want to get in and make full speeches.

We have called for a guarantee for urgent and emergency dental care. Check-ups for those people who are already eligible and those needing check-ups before things such as chemotherapy and surgery were also in our manifesto. It is only going to be possible to offer those guarantees if we deal with the issues in the dental contract and the flexibility of commissioning.

Primary care is the front door to the NHS, as I mentioned at the beginning, and Lord Darzi pointed out in his report that that is where we should be investing. At the moment, money is flowing to secondary care—to hospitals—yet most people’s experience of the NHS is with their doctor or dentist. We must ensure that that first point of call is a good point of call, and reduce the numbers of people going to A&E. That is so much more cost-effective, but it is also so much better for those people who could manage their health condition without a crisis and without ever having to go near a hospital.

We should also think of the knock-on impacts on those hospitals. We all have horror stories of ambulances queued up outside hospitals because so many people are in A&E and so few people can flow through the hospital. The issues around that are complex, and they link in to social care as well, but the reality is that if we can treat people in the community, we will save the lives of people who need emergency care. This is absolutely fundamental: we need investment in our GPs and in dental and pharmacy contracts because we cannot afford not to do it.

[Shockat Adam]

In addition to pharmacists and dentists, I would like to mention my profession. Optometrists can really play a role in reducing the strain on primary and secondary care.

[Helen Morgan]

I thank the hon. Gentleman for his intervention. That is an important point and I apologise for not making it in my speech. Optometry is really important, and as somebody who spends their whole life looking for their other glasses, I can absolutely appreciate his point.