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Recovering Access to Primary Care
09 May 2023
Lead MP
Steve Barclay
Debate Type
Ministerial Statement
Tags
NHSTaxationEmploymentForeign AffairsMental Health
Other Contributors: 34
At a Glance
Steve Barclay raised concerns about recovering access to primary care in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
The Minister announced the primary care recovery plan, highlighting the significant increase in GP appointments and staff since the pandemic. The plan aims to tackle challenges such as the 8 am rush by providing new digital tools for GPs; freeing up GP appointments with a 'pharmacy first' approach funded at £645 million over two years; and increasing staffing levels to meet manifesto commitments. NHS England will invest over £1.2 billion in support of these initiatives, building on previous efforts like the elective recovery plan and urgent and emergency care plan. The minister also detailed improvements in technology for GP practices and reductions in bureaucratic tasks to enhance efficiency.
Mark Logan
Con
Lincoln
Question
The MP asked how today’s proposals would address local challenges such as reduced GP numbers in his constituency, the impact of a lack of GPs and locums on access to care for residents, and whether there was any plan to tackle waiting times for urgent cancer referrals.
Minister reply
The Minister responded by emphasising the primary care recovery plan's focus on reducing the 8 am rush through new technology, improving patient appointments with pharmacists, and increasing staffing levels. He assured that these measures would help alleviate pressures in general practice and stressed the importance of addressing urgent cancer referrals.
Kiran Mishra
Lab
Hayes and Harlington
Question
The MP questioned why the Government was announcing new plans without a robust assessment, citing specific examples from her constituency where patients are struggling to get appointments. She asked if there were any details on how the new funding would specifically help GP surgeries.
Minister reply
The Minister acknowledged local challenges but emphasised the comprehensive nature of the primary care recovery plan, which includes substantial investments in technology and staffing. He assured that the plan is designed to support all aspects of general practice and improve patient access.
Helen Whately
Con
Faversham and Mid Kent
Question
The MP asked about the practicality of implementing the new technology and whether there were any concerns that patients might not use it effectively.
Minister reply
The Minister clarified that the plan includes support for GP practices to transition smoothly to new technologies, ensuring they have sufficient training and staff coverage. He emphasised the positive impact seen in early adopters and highlighted patient feedback indicating improved access.
Sandy Martin
Lab
Hastings and Rye
Question
The MP questioned the effectiveness of the plan given that many GP practices are struggling due to staff shortages, and asked for a commitment on recruiting more GPs as promised.
Minister reply
The Minister reiterated the Government's commitment to meeting manifesto pledges regarding staffing levels. He highlighted ongoing recruitment efforts and reforms to retain senior GPs, stressing the importance of these measures in addressing current challenges.
Wes Streeting
Lab
Ilford North
Question
The MP questioned the timing and content of the announcement, highlighting under-delivery on GP recruitment promises. He criticised the Government's lack of clear dates for improvements in patient access and challenged claims about the effectiveness of direct referral policies. The shadow also emphasised Labour’s focus on mental health support, more care at home, and training additional healthcare workers.
Minister reply
The Minister responded by citing positive feedback from industry figures regarding the plan's benefits to patients and pointed out better performance in reducing waiting times compared to Wales under a Labour government. He highlighted increased funding for mental health and recruitment of specialist roles within primary care, emphasising the Government’s commitment to utilizing pharmacists' clinical expertise more effectively.
Question
The MP asked about the timing of investments in reducing GP appointment wait times and improving cloud telephony access for patients. He specifically sought clarification on how quickly these changes could be implemented.
Minister reply
The Minister confirmed that many practices already have cloud telephony systems, with half of GP practices currently using them. The plan aims to roll out improvements this year, acknowledging the importance of deliverability and patient feedback supporting new booking methods.
Margaret Hodge
Lab
Barking
Question
The MP expressed dissatisfaction with the minister's announcement, citing specific issues in her constituency such as high A&E attendance rates and low GP availability. She asked when the promised extra GPs would be delivered and what actions are being taken to increase GP working hours.
Minister reply
Acknowledging the situation, the Minister emphasised that there have been 37,000 more doctors since the government came into power, including a pension change affecting 9,000 GPs. He also highlighted an increase in training numbers and additional roles being funded. The plan includes expanding pharmacy services to relieve GP workload and improve face-to-face appointments.
Thurrock
Question
The MP welcomed the announcement on enhancing pharmacy roles and asked if pharmacists would receive additional rewards for their increased responsibilities.
Minister reply
Acknowledging the importance of pharmacies, particularly during the pandemic, the Minister confirmed that funding will cover the new responsibilities. The plan aims to leverage the skills of degree-qualified clinical professionals in pharmacy to reduce GP workload.
Clive Betts
Lab
Sheffield South East
Question
The MP thanked GPs for their hard work and raised concerns about the pressure they face, including overbearing workloads from NHS England, leading some to leave. He asked when a workforce plan would be delivered.
Minister reply
The Minister agreed that workload is a key issue affecting GP retention and highlighted measures in the recovery plan to reduce bureaucracy and streamline unnecessary tasks for GPs. The announcement also aims to cut targets from ten to five for more manageable workloads.
Bernard Jenkin
Con
Harwich and North Essex
Question
The MP praised the statement while questioning how pharmacy-first plans would be implemented in rural areas like his constituency. He also mentioned issues with empty NHS premises due to PFI projects.
Minister reply
Acknowledging the importance of pharmacies, particularly in rural settings, the Minister stated that investment aims to make it more viable for pharmacies to provide services such as prescribing and out-of-hours cover. Regarding empty NHS premises, he suggested each integrated care board would consider estate planning issues.
Taiwo Owatemi
Lab
Coventry North West
Question
As a pharmacist herself, the MP welcomed the announcement but raised concerns about funding and workforce investment. She inquired if pharmacists would be competitively paid for their prescribing skills.
Minister reply
The Minister confirmed that additional funding will support pharmacy business models and workforces. He highlighted improvements to IT infrastructure to better empower patients through the NHS app.
Question
Welcoming the announcement, the MP suggested investing in point-of-care diagnostic testing at pharmacies and GP surgeries.
Minister reply
The Minister expressed strong support for expanding home and pharmacy-based diagnostics to improve early detection and reduce waiting times.
Daisy Cooper
Lib Dem
St Albans
Question
Liberal Democrats and many others in this House have called for a pharmacy first approach for a long time, but there appear to be two major problems with today’s announcement. The first is that the Government’s own plan says that the money will be re-targeted; I would be grateful to know from the Secretary of State which other service will miss out. In my constituency two pharmacies have already closed, and across England 16% of pharmacies have said that they do not think they will survive another year. How does the Secretary of State expect people to access a pharmacy first if their pharmacies continue to close?
Minister reply
As I said, there are more pharmacists than in 2010 and more people working in the pharmacy sector—the numbers have gone up by 24,000 since 2010—so to address the hon. Lady’s second question, there are more. On funding, as I said in my statement, this is new funding for primary care. That is the commitment that we made, and it should be welcomed in the primary care sector.
Bob Seely
Con
Not specified
Question
I welcome the statement. I notice the difference in opinion on the Opposition Benches between the people who know what they are talking about and the people who do not. Pharmacy First is a brilliant idea, and I thank the Secretary of State. I very much hope it will be welcomed by pharmacies in my patch. I want to reiterate some of the points that have been made. First, some of my pharmacies have been under a lot of financial pressure recently. Will the financial package be able to support them and make them feel valued, considering what extraordinarily good value for money they are? Related to that, will any financial support or grants be made available to pharmacies—especially the smaller ones in some of my rural areas and small towns—so that they can have a room to see patients and take advantage of this great Pharmacy First scheme?
Minister reply
I welcome my hon. Friend’s comments. There is £645 million of funding over the next two years to support the expansion of this work through Pharmacy First. As I said a moment ago, the estates programme is more an issue for the integrated care boards. We should not try to determine all the decisions on estates from Westminster; it is right that we let the 42 ICBs have more discretion over what is the right estate strategy in their area. I am sure that his local ICB will hear his representations.
Chris Bryant
Lab Co-op
Rhondda and Ogmore
Question
I completely support the idea of pharmacists being able to do more. For instance, it makes more sense that someone with shingles can go to a pharmacist today to get antivirals prescribed. My fear is that what has been announced today does not fully understand the crisis in primary healthcare. According to the numbers given by the Government’s own Ministers, in September 2015 we had 29,364 fully qualified GPs in England, but last September we had 27,556. By the Government’s own numbers, that is 2,000 fewer. Community pharmacies have gone from 11,949 in 2015 to 11,026—a nearly 10% fall. Do we need to do more to enthuse people to work in our NHS across the whole of primary healthcare? Would it be a good idea to change the model for GPs, so that we have more salaried GPs?
Minister reply
I have touched on the numbers a few times, but let me give the hon. Gentleman the precise figures. There are 335 more pharmacists than there were in 2010, so it is simply not the case that there are fewer. There are 2,000 more doctors in general practice, and there are also the extra 25,000 in additional roles. As I have said, someone who wants a prescription review should see a pharmacist, and someone with back pain should see a physiotherapist; not everything has to go through a GP, and it is better for GPs’ time to be used more effectively. There are also more doctors in training: 4,000 are receiving training in primary care, as opposed to 2,600 in 2014.
Caroline Johnson
Con
Sleaford and North Hykeham
Question
I am pleased that the Government are looking at how they can best support GPs and improve access to primary care, but how will these plans protect and enhance the role of GPs who dispense in their own practices? How will my right hon. Friend deal with concerns about antibiotic resistance, and how will he solve the root cause of the problem, which is the fact that there are not enough GPs?
Minister reply
In respect of my hon. Friend’s first point, these plans will not make any changes. As for the second, about prescribing, that will be part of the consultation, and we will be learning lessons from what is being done elsewhere: for instance, Pharmacy First is already up and running in Scotland.
Seema Malhotra
Lab Co-op
Feltham and Heston
Question
The steps proposed in the statement reflect what Labour has been calling for, and are well overdue. I am glad that at least some steps are being taken, but they fall well short of the scale of the challenge that we face. Pharmacists need to work in a strong primary care environment. We need to see more GPs, an increase in primary care services, and more tests, diagnoses and minor procedures carried out in the community, speeding up primary care and taking the pressure off secondary care. Three years ago, I met Ministers and officials in the Department to seek advice on and support for the rebuilding of the rundown Heston health centre in my constituency. What is the Government’s strategy on the rebuilding of rundown primary care facilities, not only to assist the recruitment and retention of GPs but to better facilitate the work taking place between GPs, pharmacies and other community healthcare services?
Minister reply
There seems to be a slightly confused response from the Opposition. They challenge this announcement on the grounds that they are not happy with it, and in the same breath claim that it is part of Labour’s plan or a step in the right direction. They need to make up their mind. As I said in response to two earlier questions, it is for the integrated care boards to adopt estate strategies in their areas.
Lichfield
Question
As the hon. Member for Coventry North West will know, it takes five years to obtain a master of pharmacy degree and to become fully qualified. Training continues as pharmacists continue in their work, so they are a valuable resource, and I welcome the statement. As my right hon. Friend the Secretary of State will know, in France, for instance, where it costs €26.50 to see a GP, most people would choose to see a pharmacist first, but is he sure that by taking pressure off general practices, he will not overwhelm pharmacists such as mine in Lichfield and Burntwood?
Minister reply
My hon. Friend is right to draw attention to the practice in other countries, and the fact that patients are very happy to visit pharmacists when that is more appropriate for the treatment that they are using. That is what the Pharmacy First strategy and the learning of lessons are all about, although we must also think about how to mitigate some of the risks connected with antimicrobial resistance.
Rachael Maskell
Lab Co-op
York Central
Question
The impact of today’s announcement will be miniscule compared with the scale of the challenge facing primary care right now. In York, our GPs are innovative and ambitious—far more ambitious than the Secretary of State—and want to bring real change to the way pathways operate. In light of that, will additional money be available for innovation in primary care, so that GPs can meet the challenge and lead the change that is needed?
Minister reply
There is funding in other parts of the Department’s budget, not least for tech innovation and the work we are doing on artificial intelligence. There is further scope to use AI in demand management, for example to relieve pressure on GPs by looking at changes in the behaviour of frail or elderly patients and picking up changes early.
Paul Bristow
Con
Yeovil
Question
I am pleased to inform the House that my mother has moved in with my wife and me, from the Secretary of State’s constituency. One of the joys of living with my mother is helping her with Tesco orders and Amazon deliveries and with surfing what she calls the interweb, and I am looking forward to helping her with the new NHS app. Does my right hon. Friend agree with me that enabling many more people to use the NHS app, including Mrs Bristow, and having many more services available on the NHS app is more convenient for patients and will free up GP time, so that GPs can do what they should be doing?
Minister reply
I am happy to recognise the scope for Mrs Bristow and many others to make more use of the NHS app. That app is all about empowering the patient and enabling them to get the right care, in the right place, at the right time, whether from a pharmacist, one of the additional primary care roles we are creating or a GP where applicable.
John Cryer
Lab
Leyton and Wanstead
Question
In my constituency, GP surgeries have closed, leading to increased pressure on Whipps Cross University Hospital. The hospital is struggling with 100% bed occupancy rates. When will the Secretary of State announce the workforce plan for primary care and funding for the new Whipps Cross University Hospital?
Minister reply
The Secretary of State has visited Whipps Cross and plans to make an announcement about the hospital programme and workforce plan shortly, in addition to today's primary care recovery plan. The plan includes proposals to address pressures on primary care from housing developments.
Andrew Selous
Con
Carole
Question
My constituency needs more primary care facilities due to new housing developments. Will the Secretary of State make it his personal mission to ensure that extra primary care facilities are built with certainty as new schools are, thus serving a huge service to the nation?
Minister reply
The Under-Secretary of State for Health and Social Care plans to change planning guidance this year to address the issue. The Secretary of State has visited Selous's constituency and resolved one issue in relation to the estate.
Emma Hardy
Lab
Kingston upon Hull West and Haltemprice
Question
There is a shortage of GPs in my area due to the low GP to population ratio. Will the Secretary of State support our campaign for more doctors at Hull York Medical School and training facilities for pharmacists and dentists?
Minister reply
The Government is increasing doctor training, retaining existing GPs through pension changes, and looking into additional roles in primary care.
Luke Evans
Con
Hinckley and Bosworth
Question
Primary care faces significant bureaucracy. Will the Secretary of State comment on further cuts to bureaucracy as suggested by the Health and Social Care Committee?
Minister reply
The Government is reducing non-clinical workload through NHS app reminders, triaging people to the right place, self-referral for low-risk conditions, and considering additional roles.
Debbie Abrahams
Lab
Oldham East and Saddleworth
Question
Primary care waiting lists have increased threefold since 2010. When will we get our fair share of the promised 6,000 GPs?
Minister reply
Primary care is treating more patients due to demographic changes, pandemic impacts, and public expectations of medical advances. Additional roles and technology investments are being made.
Siobhan Baillie
Con
Stroud
Question
A local GP believes a national education campaign is needed to advise patients on when to access general practice versus other services. Will the Government take it up?
Minister reply
The Government plans to have a communications campaign linked to Pharmacy First and technology innovations like the NHS app.
Kim Johnson
Lab
Liverpool Riverside
Question
600 pharmacies have closed since 2015, impacting disadvantaged communities. Does he agree more funding is needed to prevent closures and fix the broken NHS?
Minister reply
Pharmacies and pharmacists are increasing capacity compared to 2010. Additional £645 million investment in pharmacies over two years.
Matt Warman
Con
Boston and Skegness
Question
The plan is littered with examples of technology use. Will the Secretary of State target tech help at practices that need it most, such as those in coastal constituencies?
Minister reply
Tech adoption funding will be targeted at smaller GP practices and coastal communities for easier transition to digital telephony.
Diana R. Johnson
Lab
Kingston upon Hull North and Cottingham
Question
We are short of GPs, pharmacists and dentists in Hull. Will the Secretary of State consider setting up a dental training school, pharmacy school and ophthalmology school at Hull York Medical School?
Minister reply
A workforce plan will be published shortly, following expansion of medical undergraduate places by 20% previously.
Jack Brereton
Lab
North Staffordshire
Question
Welcoming the plans to improve primary care, particularly addressing poor practices in some GP surgeries and advocating for more transparency.
Minister reply
Confirming that measures will provide greater transparency on variations between primary care settings within constituencies, aiming to publish more information showing differences in services offered.
Jim Shannon
DUP
Strangford
Question
Acknowledging the primary care recovery plan and asking about discussions with the Department of Health in Northern Ireland regarding access to medical records via an NHS app.
Minister reply
Expressing willingness for discussions with Northern Ireland on shared practices, while noting that current improvements through the NHS app are focused on England.
Simon Jupp
Con
East Devon
Question
Inquiring about how pharmacies in East Devon will be able to access funding and support for prescriptions under Pharmacy First.
Minister reply
Confirming that the £645 million over two years is targeted at funding for seven common conditions through Pharmacy First, with further discussions planned on roll-out.
Greg Smith
Con
Mid Buckinghamshire
Question
Welcoming the recovery plan and urging efforts to find funding for the construction of Long Crendon’s innovative model primary care facility.
Minister reply
Encouraging the ICB to engage closely with Greg Smith, advocating for visibility on estate plans that address constituent needs in rural communities.
Shadow Comment
Wes Streeting
Shadow Comment
The Shadow Secretary of State criticised the announcement, citing missed targets and under-delivery on promises. He highlighted Labour's previous record of delivering better patient care compared to Conservative failures since 2015. The shadow also pointed out that many elements of today’s plan mirror Labour’s proposals but lacked specifics such as real choice for patients, continuity of care, and mental health support. Additionally, the response questioned the lack of concrete dates or deadlines for promised improvements and raised concerns about potential negative impacts on cancer diagnosis rates.
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