Parliamentary update – July 2023

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This month has seen questions asked on general practice access, primary care workforce and a Select Committee session on vaccination rates.

Where quote marks appear the words have been directly transcribed from what was said in the Commons chamber or in a written response, where they are not used the content of what was said has been summarised for brevity. 

Health Questions 

11 July | Click to read in full. 

Health Ministers took questions on waiting times, brain cancer treatment, health inequalities and depression in people with low vision from London MPs. Questions of particular interest are reprinted below: 

Q John Cryer (Lab: Leyton & Wanstead) 

“Given the national shortage of GPs, does the Minister recognise that there is a potential danger in asking pharmacists to take on the duties of GPs—duties that they are not necessarily qualified to undertake—especially given the already large workload undertaken by pharmacists?” 

A Neil O’Brien (Con: Harborough) – Minister for Primary Care 

“We absolutely recognise the need for patient safety, which is why there will be clear patient group directions and clear pathways about what pharmacists do. They are not taking on the role of GPs, but are providing additional services that will make things more convenient for all of our constituents.” 

Q Daisy Cooper (Lib Dem: St. Albans) 

“What assessment he has made of the potential impact of guidance issued by District Valuer Services on the availability of city-centre GP premises?” 

A Minister for Primary Care 

“While it is a very long-standing system, we keep the approach to funding for GP premises under review. We have taken action in the primary care recovery plan to improve access to section 106 funds, so that new homes always come with the GP infrastructure that is needed.” 

Q Daisy Cooper (Lib Dem: St. Albans) 

“Integrated care boards, GPs, and now the medical property sector are all telling me that the Treasury rules are out of date and are a massive block to securing much-needed primary care premises in the right places, particularly in city centres such as St Albans. When I have asked the Department via written parliamentary questions for its assessment of how much of a problem this issue is, the Department has told me that it just does not know. Could the Minister please tell us when he will be speaking to colleagues in the Treasury to resolve this issue, so that we can make sure that GP premises are secured where people need them most?” 

A Minister for Primary Care 

“I am conscious that there are 60% more full-time patient-facing staff in the hon. Lady’s constituency than there were in 2019, which of course puts pressure on premises. The capital allocation for her local ICB between 2022-23 and 2024-25 was £200 million, so the money is there, but I am happy to continue the conversation about how we get the premises in the places where we need them.” 

Q Ian Byrne (Lab: Liverpool, West Derby) 

“What assessment has been made of the potential impact of primary care service closures on public health?” 

A Minister for Primary Care 

“Each integrated care board is required to ensure access to GP services for all. Overall, more people are being seen in general practice than ever before—about 10% more than before the pandemic—but where some practices close, the local ICB has to ensure that patients are transferred smoothly to other practices.” 

Q David Johnston (Con: Wantage) 

“I have campaigned for more health services for my constituents since I was elected, and 97% of those who responded to my recent health services survey felt that we did not have enough doctors for the number of people in the constituency.” 

A Minister for Primary Care 

“We are conscious that more is going on in general practice than ever before. There are 10% more appointments than before the pandemic, as well as 29,000 extra clinicians and nearly 2,000 more doctors, but we are conscious of the pressures that puts on the estate locally.” 

Q Karin Smyth (Lab: Bristol South) – Shadow Minister for Primary Care 

“People across the country rely on local, accessible pharmacies, but whether it is high street closures or supply problems leading to the absurd situation where women are phoning or visiting multiple pharmacies for a prescribed dose of hormone replacement therapy and other drugs, the Government are again letting people down. They have repeatedly announced plans to expand the role of community pharmacies, but have failed to update legislation that could possibly help. They keep collapsing the business in this place, so we have time to sort it. Why will they not do so?” 

A Minister for Primary Care 

“There are more pharmacies in England than there were in 2010, there are 24,000 more pharmacists in England than there were in 2010 and we are putting in £645 million to provide a bunch of services that were not there when Labour was in office.”  


NHS Long-term Workforce Plan 

3 July | Click to read in full. 

Steve Barclay (Con: North East Cambridgeshire), Secretary of State for Health and Social Care set out NHS England’s first long-term workforce plan. The plan aims to ‘increase the availability of GPs being trained by 50%’ 

The Secretary of State then took questions. Relevant ones from London MPs are reproduced here: 

Q Clive Efford (Lab: Eltham) 

“We went into covid with 2.4 million people on waiting lists, which was a record. It is now up to 7.4 million. The report itself says that we have 154,000 fewer staff than we need today in the NHS. After 13 years in government, if the Tories really cared about the NHS, it would not be in the state it is in, would it?” 

A Secretary of State  

“Since 2010, there has been a 25% increase in the NHS workforce… we also have beaten our manifesto target on primary care, with 29,000 additional roles in place. That means that people can get to the specialist they need, which in turn frees up GPs for those things that only GPs can do and ensures that patients can access care much more quickly.” 

Q Stella Creasy (Lab: Walthamstow) 

“Figures from the RCGP show that 53% of GPs think they cannot work in a flexible way to balance family and work commitments. It is little wonder that GPs aged 35 to 44 are the biggest group on the retention scheme who are leaving the profession—it does not take a rocket scientist to work out that it is the mums. 

We are losing brilliant staff and wasting billions of pounds, and we will have a delay before our constituents see the benefit of any workforce plan unless that changes. I have listened to him and looked at the statement that does not make a single mention of childcare, although he did refer to it in passing. What will he actually do not just for retirees but for doctors with families to get them back into the NHS so that we can all benefit?” 

A Secretary of State  

“…she does not seem to realise that there are three sections to the plan, with the second being all about giving greater flexibility to help retain our staff. So the plan addresses the points she raises; that just does not seem to be the answer she wants to hear. As for flexibility being important to mums, yes it is, and the NHS has a largely female workforce, but it is also important to dads. It is important to all NHS staff that we have that flexibility.” 


Quality and Outcomes Framework (QOF) consultation 

27 June | Click to read in full. 

Responding to a written question, the Minister for Primary Care stated that GPs and representative patient groups will be consulted on the Quality and Outcomes Framework and its future form in Summer 2023. 


Workforce report 

13 July | Click to read in full. 

Steve Brine (Con: Winchester), Chair of the Health and Social Care Select Committee, led a debate on the the committee’s workforce report and the government response. 

Catherine Hornsey (Lab: Hornsey and Wood Green) raised the iterative nature of the NHS workforce plan and its accomodations for an “ageing workforce and the acute nature of mental health needs among the younger population”. 


Physician Associates 

6 July | Click to read in full. 

Barbara Keeley (Lab: Worsley and Eccles South) raised the case of a constituent’s daughter who died after being wrongly diagnosed by a physician associate at the Vale Practice in Crouch End. 


Lung Cancer Screening 

26 June | Click to read in full. 

The Secretary of State for Health and Social Care announced the government’s plan to expand the national lung cancer screening programme for England. The programme will “use GP records to identify current or ex-smokers between the ages of 55 and 74 at a high risk of developing lung cancer, assessed through telephone interviews. Anyone deemed high risk will be referred for a scan, and will be invited for further scans every two years until they are 75.” 

Responding, the Shadow Secretary of State stated that because “patients today find it impossible to get a GP appointment” lung cancer patients are less likely to survive in the UK compared to Europe. 


House of Commons: Health and Social Care Committee 

On 12 July, the committee held an oral evidence session on the Long Term Workforce Plan. Professor Kamila Hawthorne, RCGP Chair and Charley Massey, GMC Chief Executive, were among those speaking. The session can be read here. 


House of Commons: Public Accounts Committee 

On 5 July, the committee published a report on the Department of Health and Social Care. The report found that the UK Health Security Agency was set up with no formal governance and weak financial controls. You can read the findings here. 

On 3 July, the committee held an oral evidence session on access to urgent and emergency care, hearing from NHS England CEO Amanda Pritchard, among others. The session can be read here. 


House of Commons: Other debates 

On 12 July, Daisy Cooper (Lib Dem: St. Albans) argued that the government should enact a quarterly report to assess primary care services. Click to read in full. 

On 29 June, Andrew Selous (Con: South West Bedfordshire) led a Westminster Hall debate on bladder and bowel continence care. Click to read in full. 


House of Lords: Integration of Primary and Community Care Committee 

On 18 July, the committee held an oral evidence session on the integration of primary and community care, hearing from former Health Secretaries Patricia Hewitt and Andrew Lansley among others. The session can be watched here.