General practice issues in Parliament – April 2022

On 26 April, MPs held a Westminster Hall debate on a potential National Strategy for Self-Care.

Leading the debate, Sir George Howarth, Labour MP for Knowsley,  noted ‘the important role self-care can play in reducing the burden on GPs and A&E departments’. Sir George suggested a number of proposals, including a greater role for pharmacists.

Both the Shadow Minister Karin Smyth and the Minister for Health and Social Care Edward Argar, supported the notion. Mrs Smyth described self-care as ‘essential for the future sustainability of the NHS’ while the Minister stated that the government recognises ‘how important self-care is for individuals… and our healthcare system’.

On 19 April, the Secretary of State and Ministers for Health and Social Care answered questions in the House of Commons.

Bell Ribeiro-Addy, Streatham (Lab)

Dementia | Since February 2020 my local borough of Lambeth has seen a 14% drop in dementia diagnosis. That means people are not getting the support that comes from diagnosis. We also know that so far none of the announced £8 billion backlog funding has been dedicated to addressing the stagnation of diagnosis rates. Can the Secretary of State explain what exactly he is going to do to make sure that people get diagnosed on time?

A: We want a society in which every person with dementia and their families and carers receive high-quality, compassionate care from diagnosis through to end of life. We have provided £17 million this financial year to NHS England and NHS Improvement to increase the number of diagnoses. That funding was spent in a range of ways, including investing in the workforce to increase capacity in memory assessment services.

Helen Hayes, Dulwich and West Norwood (Lab)

CAMHS | A survey by the charity stem4 has found that 95% of GPs believe that children and adolescent mental health services are in crisis, with children and young people waiting up to two years for treatment after referral. Will the Secretary of State stop treating children as an afterthought and act to provide open access mental health hubs for young people in every community, to put an end to these agonising waits?

A:  I know that children’s mental health services are treating more young people than ever. However, the demand has quadrupled since the pandemic and that is why we have invested £79 million in these services. By 2023-24, an extra 345,000 more young people will be accessing support. I mentioned the call for evidence. It is important that we work through our vision for our 10-year plan. We are also introducing mental health support teams in schools, which will help, plus access to community and mental health hubs, and more young people will have access to eating disorder services, but there is a lot of work ongoing.

Sir David Evennett, Bexleyheath and Crayford (Con)

Funding | Could I ask the Secretary of State to look carefully at public health funding for my borough of Bexley, as we are seriously underfunded compared with similar boroughs in London?

A: I would be very pleased to meet my right hon. Friend to discuss that further. I am sure he will welcome the publication of the upcoming health disparities White Paper.

Rushanara Ali, Bethnal Green and Bow (Lab)

Inequalities | What steps are being taken to tackle regional health inequalities, given constituents such as mine are twice as likely to end up on a waiting list for treatment for more than a year as those in better-off areas?

A: I am determined to tackle unfair disparities in health outcomes. That is why I launched the Office for Health Improvement and Disparities. OHID’s regional directors of public health will work with local government and the wider health system to empower local partners with the tools they need to respond to disparities in their regional and local areas. We will also publish a Toggle showing location of health disparities White Paper later this year, with a strong focus on prevention, to improve health for the whole population. It is wrong of her to suggest that some of the current challenges we face are because of under-investment or because of a smaller workforce than otherwise.

On 5 April, the Health and Social Care Select Committee published a report for their inquiry on cancer services.

The report reiterated the Committee’s belief that face-to-face appointments are important in cancer diagnosis. The report included evidence from a mother who felt her 27-year-old daughter’s diagnosis would have been made earlier if she had been offered a face-to-face appointment, potentially meaning she would have survived.

Dr Richard Roope, RCGP clinical adviser for cancer explained the problems GPs face with delays in two-week-wait referrals and pressures not to refer due to limited capacity, which is included in the report.

The report says that more Rapid Diagnostic Centre pathways proposed by the Government may help GPs with this issue, although it notes there have been delays in the rollout of these.

On 31 March, Layla Moran, Lib Dem MP for Oxford West and Abingdon and Chair of the All-Party Parliamentary Group on Covid-19, led a debate in the House of Commons on the impact of long Covid on the UK workforce.

Ms Moran began the debate by welcoming the Government’s spending of £18.5 million for research into long covid. She also praised the new dedicated long covid clinics and the publishing of guidance to medical professionals by NICE and the RCGP. However, she felt that despite these steps ‘over the past eight months… long covid has totally dropped off the radar’.

Ms Moran stated that in order to live with covid, we must also learn to live with long covid. She reported that 1.5 million people have the condition, with around 19% of those stating that their ability to undertake their day-to-day activities had been “limited a lot”. It was clear, therefore, that ‘the Government need urgently to prioritise research treatments for long covid patients’. The MP also highlighted the importance of testing, pointing out that ‘people get long covid from covid, but if they cannot get a test, how do they know if they have had covid?’.

Debbie Abrahams, Labour MP for Oldham East and Saddleworth, argued for ‘long-term funding for long covid clinics providing evidence-based therapies’. She also asserted that long covid should be recognised as an occupational disease.

Fleur Anderson, Labour MP for Putney in the London borough of Wandsworth, raised the concerns of her constituents with Myalgic Encephalomyelitis (ME). She claimed they had been ‘underestimated, not believed and not supported. When they have gone to their GP, they have been told the wrong advice—advice that makes their ME worse.’

Wendy Chamberlain, Lib Dem MP for North East Fife, stated that ‘when GPs are looking at a list of symptoms that can only be long covid, there should be an acceptance that that is what people are suffering from.’

On 30 March, Elliott Colburn, MP for Carshalton and Wallington, which falls within the London borough of Sutton, led a Westminster Hall debate on healthcare outcomes in his constituency.

Mr Colburn began by outlining four areas of health of which he is particularly concerned: cancer, dementia, obesity and mental health.

Mr Colburn described the facilities at St. Helier Hospital as ‘anything but modern’, with the limitations of the building becoming ‘glaringly obvious’ during the pandemic. As such, he praised the Government’s £500 million investment in the NHS in his area. The funding will be spent on improving St. Helier and Epsom hospitals, as well as the building of a new hospital in Sutton by 2026.

This ‘new specialist emergency care hospital will treat the sickest 15% of patients’ in Carshalton and Wallington, with the specialist team available ‘24 hours a day to diagnose patients more rapidly, start the best treatment faster and help patients recover more quickly’.

Mr Colburn quoted two GPs during the debate. Dr Andrew Murray, a GP and clinical chair of NHS South West London clinical commissioning group commented: “Covid-19 has shown that there’s no time like the present to invest in our hospitals. Now more than ever we need to ensure the right healthcare services for local people”. Surrey Downs integrated care partnership clinical chair and GP, Russell Hills, said: “This pandemic shows we cannot afford to delay improving and modernising our local health services for the benefit of both patients and staff—and the independent analysis of feedback shows there is clear support for this vital investment.”

Maggie Throup, Minister for Vaccines and Public Health, responded to the debate. She listed several investments being made in Epsom and St Helier University Hospitals NHS Trust, including £6.1 million for the expansion of the emergency department and same-day emergency care unit at St Helier Hospital and the extension of waiting room space and mental health cubicles at Epsom hospital and £7.4 million for the relocation of services from the New Epsom and Ewell Cottage Hospital to Epsom General Hospital.

On 29 March, Andrew Selous, Conservative MP for South West Bedfordshire, led a Westminster Hall debate on general practice and large housing developments. The debate was well attended by MPs from across the country.

Mr Selous began by noting that despite GPs delivering more appointments, he ‘regularly’ hears from his constituents about the difficulties of getting ‘timely appointments’. He argued that indicative levels of the number of patients a GP should have should be put in place, enabling the service in any area to ‘expand as the population rises’. He also stated that the local Director of Public Health should be consulted on planning applications, further ensuring the necessary general practice staff are employed and accommodated for the proposed population. Mr Selous also proposed that additional primary care funding should be guaranteed for each 1,000 new homes.

Theresa Villers, Conservative MP for Chipping Barnet, noted that providing GP premises alone would not resolve the problem, as the root of the issue is a shortage of qualified GPs. To solve that, ‘we need to accelerate efforts to train, recruit and retain’.

Matthew Pennycook, Shadow Minister for Housing and MP for Greenwich and Woolwich, affirmed that ‘the planning system is exacerbating the crisis in primary care’.

Stuart Andrew, the Minister for Housing and MP for Pudsey, began his response to the debate by stating ‘everyone will agree that waiting weeks to see a GP is simply unacceptable’. He encouraged planning authorities to consult local Healthwatch organisations when new homes are being built, so that ‘they can raise those all-important questions on the number of GPs needed’.

The Minister also suggested a system whereby local authorities would be allowed to borrow against the revenues of a new infrastructure levy so that they could bring forward improvements such as expanding GP capacity, before a new development begins to be built.