Parliamentary update – May 2023

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May saw the launch of Labour’s health plan, the Government’s Primary Care Recovery Plan and questions in Parliament about London’s GP workforce.

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. 

Labour’s plans for general practice

22 May | Click to read the full speech and briefing document. 

Sir Kier Starmer (Lab: Holborn and St. Pancras) launched Labour’s health plan, giving a speech which committed to two goals: 

  1. “The next Labour government will deliver an NHS that is there when you need it.” 
  2.  “We will improve healthy life expectancy for all and we’ll halve the inequality gap between different regions of England.” 

The speech also gave other measurable commitments including: 

“Ambulances – seven minutes for cardiac arrest; A&E – back to the four hour target; GPs – the highest satisfaction levels on record; waiting lists – down; planned treatment within 18 weeks.” 

Sir Kier identified “three killers” that need addressing: 

  1. “Cardiovascular diseases: heart attacks and strokes – we will get them down by a quarter, within a decade.” 
  2. “Cancer: we will make sure 75% of all cancer is diagnosed at stage one or two.” 
  3. “Suicide is the biggest killer of young lives in this country… Our mission – must be and will be – to get it down.” 

The section on general practice is reproduced here: 

“We’re going to improve GP access – end the 8am scramble. We’ll train more GPs, but we’ll also make the future of general practice more sustainable. 

“As the contractor model declines in some communities, we won’t let patients go without the care they need. We’ll bring fragmented services together, make sure salaried GPs serve all communities. 

“And we’ll modernise the appointments system. For those who want real continuity of care – we’ll bring back the family doctor, that’s what people with long-term conditions need. But for those who just want a quick appointment at their convenience, who want a digital consultation, we’ll give those patients a different route. Seriously – it can’t be beyond us to offer different options for different people. We’ve just got to roll up our sleeves and get it done. 

“We’ll make good on the integration of health and social care. Backing successful community models like the centre at Bromley-by-Bow where they bring together in one place – doctors, nurses, physiotherapists, social carers – to provide joined up care in the community, keeping people out of hospital.” 

The briefing document states that ‘retention is as important as recruitment’. The party commits to introduce a targeted pension allowances scheme for senior doctors, but will reverse the recent ‘sweeping’ changes the government have made on the same issue. The party suggested they will give ‘time for research to staff who are interested’ to enhance retention.

Recovering Access to Primary Care

9 May | Click to read in full. 

The Secretary of State for Health and Social Care announced the government’s plan to improve primary care. The plan focuses “on three key areas: tackling the 8 am rush by giving GPs new digital tools; freeing up GP appointments by funding pharmacists to do more, with a “pharmacy first” approach; and providing more GPs’ staff and more appointments.” 

In his response, Shadow Health Secretary Wes Streeting (Lab: Ilford North) noted that the government have admitted they won’t achieve their target of recruiting 6000 new GPs. He also criticised the absence of continuity of care or letting patients choose to be seen face-to-face in the plans. 

The Secretary of State then took questions from MPs. 

Q Margaret Hodge (Lab: Barking) 

“I would like to take the Secretary of State out of the bubble of Westminster and into the reality of what is happening on the ground in my constituency. We have the second highest number of A&E attendances for minor injuries—people who should be going to their GP. We are the most under-doctored and second most under-nursed area in north-east London and, last year, just under 9% of patients could see their GP within 14 days of requesting an appointment. When will he, not plan, but deliver the 6,000 extra GPs promised? What work is he doing to move GPs from working part time to putting in more hours at the frontline with their patients? Where is the commitment to deliver face-to-face appointments for those who want them in my constituency? Only when I have answers to those questions will I feel confident that there really is a plan for GP services in Barking and Dagenham.” 

A Steve Barclay (Con: North East Cambs), Secretary of State for Health and Social Care: 

“We have 37,000 more doctors than when the Government came to power. Directly, the changes to pensions lift about 9,000 GPs out of the tax changes. It is also about training more—4,000, compared with 2,600 in 2014. It is also about the additional roles that we are funding, the 25,000 and the manifesto commitment of 26,000. Also, the pharmacy announcement is all about freeing up GP capacity for face-to-face appointments for those who want come in. If we look at last year’s patients survey, we see that about two fifths of patients hugely valued continuity of care and face-to-face, which means about three fifths preferred to prioritise speed of access, rather than seeing the same GP or seeing someone face to face. So it is about tailoring the offer to what the patient wants, and patients do not always want the same thing. Some want speed and pharmacies can deliver that.” 

Q Seema Malhotra (Lab: Feltham and Heston) 

“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?” 

A Health Secretary 

“It is for the integrated care boards to adopt estate strategies in their areas. Not all decisions about estates should be made centrally. However, one of the changes that we are setting centrally involves embracing more modern methods of construction and a more modular approach. The unit cost of that approach is much lower, and when the level of confidence is higher, the contingency cost is much lower as well.” 

Q John Cryer (Lab: Leyton and Wanstead) 

“In my constituency, we have lost GPs and surgeries. There are increasing numbers of people on fewer and fewer lists. Community pharmacies are under pressure and some have closed, so people then go to the local hospital, Whipps Cross University Hospital, which is struggling, with 100% bed occupancy rates. The Secretary of State has been ducking making an announcement about funding for the new Whipps since he took on the job, but that hospital is struggling every day. My question is twofold: when will the Secretary of State announce the workforce plan for primary care, and when will he finally get around to making an announcement for Whipps Cross University Hospital?” 

A Health Secretary 

“Far from ducking Whipps Cross, I have actually been and visited in person, so I am very familiar with the issue and I recognise the importance of the new hospital programme. I hope to make an announcement about that programme and about the workforce plan shortly.” 

Other questions and debates

Prime Minister’s Questions 

24 May | Click to read in full. 

Andrew Selous (Con: South West Bedfordshire) asked how quickly pharmacists would get the extra money outlined in the government’s plans and how soon SAS doctors will begin working in GP surgeries.

The Prime Minister said the additional funding will be ‘released later this year’.

Health Inequalities: North-west London 

15 May | Click to read in full. 

Rupa Huq (Lab: Ealing Central and Acton) set out a series of health issues in North West London and their disproportionate presentation among particular demographics. The MP also suggested how the problems can be fixed. On GPs, she said: 

“London has a GP crisis, which needs addressing. That should be done by consulting the GPs rather than by imposing solutions in the face of their rising workload and shrunken workforce. One local practice in Ealing had architect costings and planning permission to renovate their premises to bring it up to scratch to accommodate the rise in their patient numbers—from 3,000 to 9000 in a decade. However, under current regulation, although the practice is at capacity, it is not allowed to refuse anyone and NHS Estates says it cannot pay the rent. One partner there said: ‘Frankly, there is no estates strategy, we’re just being asked to ‘suck it up’ at full capacity until reaching breaking point… In the meantime, our landlord could serve us notice at any time, putting nearly 10k patients at risk.’” 

Primary Care minister Neil O’Brien (Con: Harbrough), responded to this: 

“We see primary care doing more than ever. GPs are doing about 10% more appointments every month than they were before the pandemic, in 2019. That is the equivalent of about 20 extra appointments per practice per working day, which is a huge increase in output. That is partly because of the extra resource and partly because GPs are working extremely hard, and I pay tribute to everyone in general practice for doing that. That activity in general practice is a big part of the prevention story, helping people to stay healthy and to stay out of hospital.” 

House of Commons: Health and Social Care Committee 

On 9 May, the committee held an oral evidence session on industrial action in the NHS. The session can be read here. 

House of Commons: Westminster Hall 

On 17 May, Marsha de Cordova (Lab: Battersea) led a debate on eye health. Click to read in full. 

On 23 May, Elliot Colburn (Con: Carshalton and Wallington) led a debate on healthcare services in his constituency. Click to read in full.