Recovering Access to Primary Care

Wes Streeting Excerpts

Tuesday 9th May 2023 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of his statement. This announcement was meant to be the Prime Minister’s relaunch after he received a drubbing in the local elections. Unfortunately for Conservative Members, it seems that the Prime Minister is bouncing back in true Alan Partridge-style.

Having read that Downing Street had drawn up plans for a health-focused mini relaunch, I eagerly tuned into the radio this morning to hear the Health Minister, the hon. Member for Harborough (Neil O’Brien). What was the Conservatives’ message to the public this morning, following their worst defeat since 1997? They are breaking their manifesto commitment to recruit 6,000 new GPs. Once again, the Conservatives have over-promised and under-delivered.

I think the Secretary of State just admitted to missing his target to eliminate 18-month waits by April. Is that the second broken promise of the day? It is hard to keep up. Millions of patients are waiting a month to see a GP, if they can get an appointment at all, in pain and discomfort, unable to go about their normal lives. That is the price patients are paying every day for 13 years of Conservative failure. The Prime Minister has no idea what it is like to be most people in this country. He is completely out of touch with what NHS patients are going through, and that is why he cannot offer the change the country is desperately crying out for.

The Health Secretary has called this announcement the GP access recovery plan. What is this a plan to recover from, if not his party’s appalling record of under-investment and failure to reform? Does he now regret the 2,000 GPs cut since 2015, the 350 GP practices that have closed in the same time, and the 670 community pharmacies that have shut up shop on their watch? Is expecting the Conservatives to fix the NHS after they broke it not just like expecting an arsonist to put out the fire that they started? It is just not going to happen.

It is not just the voters who are turning to the Labour party for answers; the Government are, too. In January, we set out our plans for the future of primary care, including allowing pharmacies to prescribe for common conditions, opening up self-referral routes into things such as physiotherapy, and ending the 8 am scramble. Sound familiar? The problem is, that is where the similarities end, because what the Conservatives offer today is a pale imitation of Labour’s reform agenda. Where is the plan to give patients real choice? There is nothing on enabling patients to see the same doctor at each appointment, when doctors themselves tell us that continuity of care is important. There is nothing on allowing patients to choose whether they are seen face-to-face or over the phone, merely the promise of better hold music and the “invention” of things such as call-back, which has existed for many years. In fact, where is the plan for better mental health support, more care in the community and in people’s homes and more health visitors to give children a healthy start in life, or have all those issues been dumped into a box marked “Too difficult”?

The Secretary of State says that patients will get an appointment within two weeks as if it is some kind of triumph. When we were in government, we delivered GP appointments within two days. When will this pitiful promise be delivered? There is no date or deadline. By when can patients expect the 8 am scramble to end? There is no date or deadline. When will patients with urgent needs be seen on the same day? There is no date or deadline. In fact, I wrote to the Minister and asked him how many patients are currently not seen on the same day. He said he did not know and that the Department does not hold that information. What is the point of these pledges if Ministers do not know whether they are being met? The document says that the NHS and the Department have “retargeted over £1 billion” to pay for the announcements, but not where that money has come from. Where has the Secretary of State cut NHS services to pay for these announcements?

The Secretary of State’s plans for patients to refer themselves to physios for back pain, bypassing GPs, could lead to 5,000 cancer patients missing their diagnosis. That, as perhaps he remembers, was according to—that is right—the Conservative party back in February. Three months later it is the Government’s policy, so perhaps the Secretary of State can clarify: was the Conservative party telling porkies back in February, or does he simply not know what on earth he is doing? Given that this is meant to be a primary care recovery plan, where is dentistry? NHS dentists are in even shorter supply than Conservative council leaders.

Finally, let me turn to the super-massive black hole at the heart of today’s announcement: where is the plan to train the doctors and nurses the NHS is so desperately short of? Labour has set out our plan to train 7,500 more doctors and 10,000 more nurses each year, paid for by abolishing the non-dom tax status. When will the Secretary of State finally admit he does not have any ideas of his own, and adopt Labour’s plan? After 13 years, the Conservatives have no plan to give the NHS the staff it needs, they have broken their promise to recruit 6,000 new GPs and they have missed a golden opportunity to give patients real choice. Only Labour has a plan to rebuild and renew the NHS, and that is why people across the country are coming home to Labour.

[Steve Barclay]

The hon. Member started with the message to the public, and the message to the public can be seen by what key figures in the sector say about this recovery plan. Let me just share that with the House. The Pharmaceutical Services Negotiating Committee says that the plan is

“the most significant investment in community pharmacy in well over a decade”.

The Boots chief executive says that this is

“great news that they’ll be able use their clinical expertise more widely”.

The Company Chemists Association says that it is a

“real vote of confidence for the future profession”.

The message to the public from the industries in this sector is clear that this is a well thought through plan which will have a beneficial impact for patients. I will give one final quote: the chair of the Royal Pharmaceutical Society says that this plan will be

“a real game-changer for patients”,

and that is what our focus has been.

The hon. Member raised the issue of our delivery against the 18 months target. It is very generous of him to give me the opportunity to share once again with the House the contrast with Wales, but perhaps he missed it first time around. We have reduced the wait for 18 months by over 90%, yet Wales still has vastly more—over 80,000 waiting there—and that is from a much smaller population. Wales still has over 40,000 waiting more than two years, a target that we virtually eliminated as long ago as last summer. Those who want to see what a Labour Government would mean for the NHS can see it with the performance against the two-year waiting list and the 18-month waiting list in Wales, so it is very generous of him to give me the opportunity to share that once again with the House.

The hon. Member talks about what the recovery plan is for. Clearly, the pandemic has placed huge pressure on primary care, and we can see that just from the increased volumes of appointments that primary care faces. Again, I touched in my opening remarks on the fact that GPs and primary care are seeing more than 10% more appointments than before the pandemic—1 million appointments a day. It is clear why we need to invest in new forms of working, online booking technology and cutting bureaucracy: it is so that GPs can focus on the aspects of their role that apply purely to GPs and we can better use the 25,000 additional roles that are being recruited into primary care.

The hon. Gentleman talked about his direct referral policy. We actually announced our policy guidance in December, a month before his announcement, so it is something of a stretch to say that we are following his approach. He again kindly raised the issue of mental health, which gives me the opportunity to remind the House of the increased funding that this Government are making in mental health. That was a key priority when my right hon. Friend the Member for Maidenhead (Mrs May) was Prime Minister and a cornerstone of the long-term plan, with an extra £2.3 billion going into mental health. But we did not stop there. At the Budget, the Chancellor further prioritised mental health—for example, mental health digital apps were a cornerstone of the measures for economically inactive people. We are recruiting an additional 25,000 roles into primary care in recognition that specialists are needed, whether physios, pharmacists, paramedics or specialists in mental health support.

The hon. Gentleman spoke about other aspects of primary care such as dentistry. We have said frequently that we have a recovery plan for dentistry that we will announce shortly, so that should not be news. On funding, it is slightly bizarre that, although this plan announces more than £1 billion of new funding for primary care, investment in tech, new ways of working, additional staff and empowering our pharmacists, who bring great clinical expertise that we can better harness, the hon. Gentleman, rather than welcoming that, went back to the hackneyed non-dom funding. We have heard that so much before and it has been spent so many times. We have set out ways of best using the skills of our GPs and of the additional roles, where we are delivering on our manifesto with an extra 25,000 already recruited. Above all, we have set out ways of best using our pharmacists, who are a huge resource that we can better use. That is why we are targeting more than £600 million additional funding into pharmacists, which will allow people to better access the care they need in a timely fashion.