Access to Primary Healthcare
Shockat Adam Excerpts(2 months ago)
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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.
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.
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.
Mental Health Support
Shockat Adam Excerpts(2 months, 1 week ago)
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Shockat Adam (Leicester South) (Ind)
It is a privilege to speak under your chairmanship, Mr Dowd.
I concur with everybody in thanking the hon. Member for Ashford (Sojan Joseph) for securing this vital debate. I want to touch on something he said about ethnic minorities. According to all the information we have, people from all ethnic minorities are detained under the Mental Health Act 1983 at much higher rates than any other people. Furthermore, they have the worst experiences and the worst outcomes. Would the Minister please look into the issue and see to it that our fantastic healthcare workers, whether they are in the education sector or in the health service, look into this vital issue, and are culturally sensitive when dealing with people from ethnic minorities?
NHS Performance: Darzi Investigation
Shockat Adam Excerpts(2 months, 1 week ago)
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Wes Streeting
The hon. Member is right to raise the issues of recruitment and retention. My message to staff who are thinking of leaving the NHS, or who perhaps have left the NHS in recent years because of working conditions and because there was no light at the end of the tunnel, is to stay—or indeed return—and help us to be the generation that takes the NHS from the worst crisis in its history, gets it back on its feet and ensures that it is fit for the future.
On the workforce plan, let me just say that it was regrettable that it was only at 5 minutes to midnight that the previous Government published such a plan. We were highly flattered by the fact that so much that underpinned that plan was Labour party policy commitments, such as doubling the number of medical school places and increasing the number of nursing and midwifery clinical training places. We are committed to those headline commitments. We will inevitably want to update the workforce plan in the light of the 10-year plan and some of the analysis that underpins Darzi. We are clear that that kind of long-term workforce planning is essential, and we are committed—
Wes Streeting
I must make some progress; I will try to take more interventions shortly.
The public are clear that they do not want the NHS to be sacrificed. They gave Labour our marching orders at the general election to rescue the NHS and turn it around, and that is what we will do. I appreciate that the shadow Health Secretary must be embarrassed by all this, not just by the state that she and her Conservative predecessors left the NHS in, but by what Conservative Members have been saying. I was going to say, “Members who are sat behind her,” but they are actually not—I think they are hiding in shame. [Interruption.] The shadow Health Secretary says from a sedentary position that we have already had this discussion. The Conservatives would rather we just moved on and forgot their abysmal record. Well, I am afraid that we are not ready to do that just yet. At least some of her Back Benchers now say what they refused to say when they were in office: that the NHS is broken. Some of them even admit that only Labour can fix it.
When the shadow Secretary of State stands up, I wonder whether she can tell us whether she agrees with the hon. Member for Mid Norfolk (George Freeman), who said:
“I applaud Wes Streeting for having the political courage. I think only Labour can really say this. The NHS is sort of their thing…I really hope that we can get behind him”.
It is not just Back Benchers. What about the shadow Foreign Secretary, the right hon. Member for Sutton Coldfield (Mr Mitchell)? He said:
“I’m very supportive of what Wes Streeting is saying… The Conservative government put a lot of money into the NHS, the record is there for all to see… I’m not one of those who is seeking to attack…the Labour Party on the NHS.”
He is going for my vote, but sadly—or gladly—I am not qualified to vote in that particular election. Perhaps the shadow Health Secretary can tell us what the shadow Foreign Secretary meant when he said we were not—[Interruption.] She is clearly enjoying this. Was the shadow Foreign Secretary speaking for the shadow Cabinet? [Interruption.] No, he was not.
Let me move to my favourite comments on the NHS from a Tory MP. This right hon. Member said:
“We were not obsessed with how we can ensure that it actually delivers the experience that patients actually deserve…Out of fear of our opponents mischaracterising our efforts, we shirked the difficult decisions…If Wes Streeting comes forward with genuine reforms I think we should back him.”
Those are the words of the candidate that the shadow Health Secretary is backing to lead her party, so does she agree with the right hon. Member for Newark (Robert Jenrick)? Will she finally apologise for her part in the Tories’ abysmal record and have the humility to admit that when it came to NHS reform their cupboard was bare, and that actually they quite agree with our efforts to clean up the mess that they left behind?
For all the agreement with our diagnosis and praise of our plans, the problem is that there is no apology. Of the four leadership candidates and eight former Health Secretaries, not a single one has apologised for the state they left the NHS in. Would the shadow Health Secretary like to correct that record today and finally say sorry? I expect that we might have to wait a long time. While the Conservatives continue the longest leadership election in history, we are getting on with the job of cleaning up their mess.
Wes Streeting
My hon. Friend is absolutely right, and that brings me to our reform agenda.
To deliver the Government’s reform agenda, we will have to take on both left and right-wing orthodoxies—for simplicity’s sake, we will call them The Guardian and the Daily Mail. The Daily Mail agrees on the need for health service reform, but attacks proposals for public health reform as “nanny state”. The Guardian loves prevention, but all this talk about health service reform makes it very nervous. The truth is that the Daily Mail and The Guardian are half right and half wrong. We all need to face up to the challenges of today. Our society is getting older and living longer but becoming sicker sooner. Those rising tides of demands and costs are combining to form a perfect storm that threatens to shipwreck the NHS.
Wes Streeting
I must make progress.
The right must accept that without reform on public health, we will pay a heavy price, with higher taxes and poorer quality of life—exactly the sort of dependency culture that the right rails against. The left must accept that investment without reform of the health service would be killing the NHS with kindness, with more cash and poor results until the public give up altogether.
Wes Streeting
I must make more progress.
That is the choice: public health reform or higher taxes; NHS reform or no NHS. The Tories did neither; Labour will do both. It really is reform or die, and we choose reform. That is why this month we will begin formal engagement with NHS staff and patients, who will help to write the 10-year plan for our NHS—a plan that will deliver the change and modernisation that our health service is crying out for—with three big shifts in its focus.
First, a shift from hospital to community will turn the NHS into a neighbourhood health service as much as a national health service, so that patients get more of their tests, scans and healthcare on high streets and in town centres in their own community, and from the comfort of their own home. It will ensure that patients can easily book appointments to see the GP they want to see in the manner that they choose, and it will bring back the family doctor, rebuild NHS dentistry and build a national care service.
Wes Streeting
I must make progress. There are lots of speakers and little time.
Secondly, there will be a shift from sickness to prevention. It will mean that we take action to give our children a healthier and happier life, flattening the curve of rising pressures that threaten to overwhelm the NHS by building a healthier society, which will help to build a healthier economy.
Thirdly, there will be a shift from analogue to digital. Upgrading the NHS app will give patients real choice and control over their own healthcare, creating a single patient record owned by the patient and shared across the system so that every part of the NHS has a full picture of the patient that they are treating. Getting the NHS working hand in glove with our country’s leading scientists will put modern technology and equipment in the hands of NHS staff, and patients at the front of the queue for the latest treatments.