Health Services: Witham

Steve Brine Excerpts

Tuesday 13th November 2018 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

I congratulate my right hon. Friend the Member for Witham (Priti Patel) on putting a lot of things on the record in a very short space of time and on securing the debate.

My right hon. Friend and I entered the House together eight and a half years ago and have known each other for even longer; I know that she is a strong campaigner and has been for years, and was delighted when she got the seat of Witham. She has been an incredibly strong voice for her constituents, alongside her work for our country and Government. Like me in Winchester, she wants to do all she can to make sure her constituents have the very best health services. I know that the development of the Witham primary care centre is a cause that has been close to her heart for a long time; she has mentioned it in this House a number of times, and I am sure she will mention it again.

The Mid Essex clinical commissioning group and the local GP practices are best placed to know how to organise the local health services; it is right that they are making decisions about how people in Witham can have access to the high-quality general practice that I know my right hon. Friend wants them to have, and that they get it when and where they need it. But it is absolutely her place and her right to press them for the outcome and the results that her constituents want and expect, and that she wants and expects as their representative.

I understand that Mid Essex CCG wrote to my right hon. Friend last week outlining its full commitment to the creation of a health hub in Witham and reiterating that developing multidisciplinary centres—which is where we want to see primary care move—to promote the health and wellbeing of the population is a central tenet of the Live Well strategy for her area; so far, so good. I understand that local GP practices also support the multidisciplinary hub, but are concerned about the possible impact of the potential relocation into a new building on the financial stability of their practices.

I have seen the correspondence between my right hon. Friend and the CCG. The CCG feels that it is important to distinguish between the support of GP practices for the new hub and a commitment to wholesale relocation into it. That is why the CCG is working with local GP practices to explore and understand the potential impact on their businesses—these are of course businesses that we contract to the NHS—and to find the right solution to meet the growing needs of the town, as my right hon. Friend outlined.

As my right hon. Friend also said, the Fern House surgery is exploring opportunities to redevelop its existing surgery, and I understand that the surgery’s partners support those plans. The CCG intends to explore them further, but very much hopes that such development might, should it go ahead, give Fern House additional financial security to consider later relocation into the new hub. I further understand that any redevelopment of Fern House should not present a risk to the development of the new hub.

Dr Salau, a GP at the Douglas Grove surgery and a member of the CCG board, tells me that there is sufficient interest from other local GP partners in taking space in the new development, and that it might proceed without wholesale relocation from other practices. The CCG will be undertaking a piece of work with Dr Salau over the next four weeks to understand the viability of his proposal, and I know my right hon. Friend will follow that work closely. The CCG has made it clear to me ahead of tonight that it is working closely with her and ensuring that she is kept fully abreast of developments—although I suspect she would be regardless. I know that she will take the opportunity to keep her foot on the pedal and will not be shy in raising this issue again locally and here in Parliament if things do not go as she wants.

I can say the following, however. The health system in England is devolved; that is what we decided to do under the Health and Social Care Act 2012. We want the NHS locally to structure itself to create multidisciplinary teams. However, when we talk of structures and who has the keys to new buildings, it is important to get that bit right. That is a necessity, of course, but not as a replacement for improved services for our constituents. I think the message that my right hon. Friend has given to the House tonight, which I am happy to echo, is: let us get it right, but let us get on with it. It sounds as though this has been a bit of an old chestnut for her and her constituents, and that it has gone on for way too long. I will support her in saying that we should get on with this, and I can assure her that I will be taking an interest in the work of Dr Salau over the next four weeks.

In addition to talking about the Witham primary care centre, my right hon. Friend has reiterated the need for improved access to GP services for her constituents. As the Minister with responsibility for primary care, I know that primary care literally comes first in our health service, and rightly so. It has always been the bedrock of the NHS, and it always will be as long as we are in office. The Secretary of State and I have made that absolutely clear, but we know that primary care is under more pressure than ever, and we are taking steps nationally to address that. I think that those steps will benefit her constituents and mine, and I take very seriously the ratios that she has put on record tonight. I want to outline a couple of the things that we are doing.

Because we recognise the pressure that general practice is under and the shortage of numbers, we are investing an extra £2.4 billion a year into general practice by 2021. We also have the new investment announced in the Budget at the end of last month. The Government have also recently announced additional medical places at Anglia Ruskin University to train the next generation of Essex doctors. We do not mandate our trainees to remain in the towns and cities where they train, but I am sure that my right hon. Friend will be reassured to hear that doctors are much more likely to stay in the areas where they have trained, and I hope that many will see their long-term future in Essex.

More widely, we know that the NHS needs more GPs, and we are still determined to deliver the commitment to recruit 5,000 additional GPs. That will take longer than we had initially hoped, but we are training more GPs than ever. More than 3,000 doctors are expected to be recruited into GP training this year, following record numbers of recruits last year, so that is positive.

Let me touch on the GP partnership review, which my good friend Dr Nigel Watson is doing for us in Government. We are committed not only to recruiting more GPs but to making general practice a more attractive place to work. The GP partnership review, which the previous Secretary of State set up, will consider how best to reinvigorate the partnership model. We in England believe in the partnership model. We think that it has brought much to general practice and we want to support it, but we understand that it has to change in order to make general practice a better and more attractive place to work. The partnership review has announced its initial findings, and it is now working with Ministers towards its final conclusions. I very much look forward to seeing them.

My right hon. Friend talked about the Silver End surgery and Virgin Care. I feel that I should begin by flagging up the fact that 96% of GP surgeries in England have been rated good or outstanding in the recent Care Quality Commission reports. That shows the excellent work not that we as Ministers are doing but that GPs and their multidisciplinary teams are doing every day, given the pressures on the frontline. However, where quality and safety standards are not in place, robust steps should of course be taken. My understanding is that NHS England and the Mid Essex CCG are having regular improvement board meetings with senior managers from Virgin Care Services Ltd to closely monitor the remedial actions agreed through their overall improvement plans. That includes addressing outstanding areas of concern from the CQC and is all with the aim of ensuring compliance in advance of the next CQC follow-up inspection.

I was very concerned to hear what my right hon. Friend said about the flu vaccine. It is absolutely mission-critical for me, for the Government, for the country and for the NHS that we get the flu vaccination numbers up to where they were last year and beyond, because that is absolutely the best way of protecting against what can be a very dangerous virus as we move into December and the new year.

My right hon. Friend talked about Allied Healthcare, and I can tell her that there is no disruption to any services that it currently provides. Her constituents and those in other affected areas can be reassured that the CQC’s decision allows local authorities the time they need to ensure continuity of care and support. The Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage), is speaking to the key parties involved on an ongoing basis to stress the importance of them working together to ensure continuity of care and to provide reassurance to individuals and their families and to staff. My officials and those of my ministerial colleague are working closely with the Association of Directors of Adult Social Services and the Local Government Association to establish whether local authorities need any help to prepare to meet individual care needs if services are disrupted due to business failure.

My right hon. Friend the Member for Witham also highlighted the importance of social care funding. We have given councils access to up £3.6 billion more dedicated funding for adult social care in 2018-19 and recently announced an additional £650 million of new money for social care in 2019-20. That includes an additional £240 million for adult social care to alleviate winter pressures on the NHS next year. She was right to say that we must of course ensure that our care and support system is sustainable in the long term, and our social care Green Paper, which will be published shortly— I cannot be more definitive than that—will set out how we will do that.

My right hon. Friend talked about mental health services, which are a priority for the Prime Minister and this Government. She gave an update on the investigation into the serious incidents reported at the Linden Centre. As the House will appreciate, it would be inappropriate for me to comment on the specific issues of the case, but I do of course extend my sincere condolences to the families who have lost loved ones. Our thoughts are with them. The police investigation has concluded, but the Health and Safety Executive investigation into the care of some patients by the former North Essex Partnership University Foundation Trust is ongoing, and we will of course follow that closely and respond in due course.

I am pleased that my right hon. Friend highlighted the important role of social prescribing. It is playing an increasingly important role in the health service, in primary care in England, and in her constituency. I am huge believer that social prescribing can play a big role in our prevention agenda. We launched the prevention strategy last week, and we are now working on the prevention Green Paper for next year. We recently published our vision to help people live well for longer, because prevention truly is better than cure, something that the new Secretary of State and I passionately believe to our cores. I hope that my right hon. Friend and her constituents will contribute examples of excellent social prescribing practice in Essex to our forthcoming Green Paper. We are all ears and want to hear more about it.

I hope that I have addressed many of the issues that my right hon. Friend touched on. As I said at the start, options for the development of the Witham primary care centre are a matter not for Ministers but for the local NHS, which is best placed to take the important decisions that matter to local people, for the benefit of local patients. However, I reiterate that structures are important but services trump all, and we need to see the situation resolved. I have every confidence that local commissioners and GPs will make the right choices, but they should know that my right hon. Friend and I are watching closely to ensure that every one of her constituents has access to high-quality, modern primary care provision. I have no doubt that my right hon. Friend will stay on their case. I thank her for bringing these matters to the House this evening.

Question put and agreed to.