Health Services in Essex

Steve Barclay Excerpts

Tuesday 17th April 2018 Westminster Hall

[The Minister for Health (Stephen Barclay)]

It is a pleasure to serve under your chairmanship once again, Mr Howarth. I congratulate my right hon. Friend the Member for Witham (Priti Patel) on securing the debate and on her wider commitment to championing Witham and the health issues within her constituency, particularly her work on the health centre in Witham. I am pleased that she is not calling for a new hospital in the constituency, but she is absolutely right to highlight the changing demographics within her constituency—in particular, a growing elderly population—and how that requires local health services to adapt. As both an east of England MP and an MP representing a rural constituency, I recognise many of the issues to which she referred.

I thank my right hon. Friend for acknowledging the additional medical places to train the next generation of Essex doctors. Our hon. Friend the Member for Chelmsford (Vicky Ford) rightly spoke about local demand for the places: there have been 400 applicants already, which signals why it was the right decision to place a medical school in Chelmsford and how important it will be to meeting the health needs of patients in the Essex area.

My right hon. Friend was also right to highlight the importance of developer contributions. As the Government meet the challenge set by the Prime Minister to increase the amount of housing, it is right that developers contribute to meeting health needs. Following a constituency case of my own that brought this issue to light, I commissioned a paper in the Department to ensure that we look again at how NHS England and CCGs secure the right contribution from developers into local health services. My right hon. Friend also mentioned a specific constituency case. I absolutely agree that we need to learn from past issues where they arise. As she will know, the Secretary of State has given great leadership on patient safety. It is something that he has personally challenged within the NHS family, and he is rightly putting it at the heart of the Government’s agenda.

My right hon. Friend also mentioned the ambulance trust. A huge amount of work has gone on to support the East of England Ambulance Trust after issues were raised by a number of our colleagues over the Christmas period, including by the right hon. Member for North Norfolk (Norman Lamb). Members from all parts of the House will wish him a speedy recovery from his recent minor stroke. He held an Adjournment debate on the East of England Ambulance Service and raised issues that we have been addressing, including the risk summit, which I know is a priority for NHS England and NHS Improvement. I have met ambulance bosses, and my own constituency is served by the East of England Ambulance Service. It is right to put on the record that, under this Government, there has been a 30% increase in the number of paramedics, which signals the commitment that we have made to the ambulance service. However, it is also right that we look at issues such as the handover of ambulances and how we get that process working better.

I thank my right hon. Friend for her support for the Witham primary care centre, which will strengthen Witham’s primary care services. I understand that site options appraisals have been completed and agreed by the Mid Essex CCG, and discussions are ongoing with the developer and local practices to secure agreement. The CCG is hoping to finalise the business case by the end of June, although I understand that it is subject to final agreement by the local practices involved. She is absolutely right that local practices need to recognise the way that the constituency and Witham are developing and to adapt with that development in order to meet the growing needs of the town.

The health hub will offer primary care services, community health provision and elective care activity, replacing the majority of current GP facilities in Witham. The hub will use a greater skills mix, which has been identified as key to releasing capacity in general practice. The Government are committed to recruiting more GPs, but we are also looking at the skills mix that supports GPs—those who work with GPs—so that we address the way patients now present. They often present with a number of conditions, which requires a multitude of support and intervention. What matters, therefore, is the recruitment not just of GPs, but of physician assistants, the wider nursing team and the other support alongside GPs that is part of addressing the health needs of constituents in Witham and elsewhere. That is at the heart of what I understand is my right hon. Friend’s vision for the health centre, and is exactly where the Government are trying to take primary care—offering a broader suite of support and services to patients, who, as I said, often present with more than one condition. That requires a wider team.

I understand that the Sidney House and The Laurels practice has expressed a desire to be operationally involved in the scheme, although that option has yet to be fully explored. Funding support has been made available for the Sidney House and The Laurels practice, through the Mid Essex CCG’s primary care sustainability fund, to go towards the cost of additional staff to alleviate pressures. That funding is assisting the practice with a range of initiatives: training clinical staff, increasing the number of clinical staff and providing an additional 20 hours a week of administrative support. That additional support should enable the practice to increase capacity and access for patients. I understand that the new triage appointment system introduced at the practice has been well received by patients and is helping the practice to manage demand. That funding will continue, alongside more funding made available by the CCG through the recently established Primary Care Foundations programme. Mid Essex CCG is also supporting work across mid-Essex to alleviate pressures. That includes the roll-out of decision-making software designed to remove blockages in GP practices’ workflow.

My right hon. Friend raised the issue of GP access more widely in her constituency. We recognise that an ageing population and more people living with long-term conditions mean that primary care is under more pressure than ever, and we are taking steps to address that. That includes the additional funding to which my right hon. Friend referred. Funding will increase by £2.4 billion by 2020-21, going from £9.6 billion in 2015-16 to more than £12 billion by 2020-21. That is a 14% increase in real terms, which has been put in place by this Government. We have announced our ambition to expand the medical workforce, with an extra 5,000 full-time equivalent doctors working in general practice by 2020 as part of a wider increase to the total workforce in general practice of 10,000. We recognise that that is an ambitious target of double the growth of previous years, but it shows the commitment of this Government to our NHS.

As both my hon. Friend the Member for Chelmsford and my right hon. Friend the Member for Witham said, Anglia Ruskin University’s new school of medicine will have 100 publicly funded student places following the announcement by my right hon. Friend the Secretary of State on 20 March. The £20 million school of medicine, currently being built on the Chelmsford campus, is the first in Essex. It not only is a physical representation of the effective lobbying by my right hon. Friend, my hon. Friend and other colleagues from across Essex and the east of England, but shows the physical commitment of this Government to addressing the health needs of constituents in Essex. The building, which is nearing completion, will feature state-of-the-art skills facilities, specialist teaching space, a lecture theatre and an anatomy suite.

Nationally, Health Education England has made 3,250 places in GP specialty training available per year since 2016. A suite of measures is being taken to assist primary care, sitting alongside the work my right hon. Friend has spoken about. I am talking about how we look at the health estate, how we bring services together and how we do that in a hub that adapts to the changing needs of communities such as the ones that she represents. Nationally, 52% of the population are benefiting from extended access to general practice, including evening and weekend appointments. That reflects the fact that many people in Witham and across Essex work and want greater flexibility of access to primary care. In the old model, people might be at home during the day and have time to go to the GP; today, people need a service that is adapting to the current workplace and the way families live and wish to access primary care.

The “General Practice Forward View” committed to investing £45 million in a national programme, to run over three years, to stimulate uptake of online consultations systems for every practice, and taking actions to support practices to offer patients more online self-care and self-management services. The issue is not just the hours of access to primary care, but the channel of access. That may be through the improvements in clinical service offered through the 111 helpline—the doubling of the number of clinicians answering those calls—but it is also about primary care having different ways of serving their constituencies through online platforms.

NHS England and Health Education England are working together to boost recruitment, to address the reasons why GPs are leaving the profession and to encourage GPs to return to practice. Furthermore, the Government have committed to developing the wider primary care workforce and supporting improved access in terms of both GP numbers and how patients can access those services. In Essex, the Witham primary care hub is expanding access within the community for patients, integrating care within the community setting, and the Sidney House and The Laurels practice is using CCG funding to improve its primary care appointments system and its IT.

I commend my right hon. Friend the Member for Witham for raising these issues. She is absolutely right to recognise that, as Witham grows and its health needs evolve, it is important that primary care in the town adapts to the changes in her constituency. In putting these issues on the record today, she has signalled the importance of that to Witham, and how the investment that this Government are making in medical school places at Chelmsford, in primary care nationally and in the ambulance service is addressing the needs that she has articulated today.

Question put and agreed to.