PARLIAMENTARY DEBATE
GP Appointments - 6 June 2023 (Commons/Commons Chamber)

We are taking action to increase the workforce in general practice. We have managed to hit our target of recruiting 26,000 extra clinicians a year earlier. In fact, we have 29,000 extra clinicians in GP surgeries as well as nearly 2,000 more doctors. Of course, we will go further: as well as increasing the training of GPs to a record level—up from about 2,600 to 4,000 a year—we are also taking action to improve technology to take the burden of bureaucracy off GPs through our primary care recovery plan.

Although I appreciate the Minister’s response, Sittingbourne and Sheppey still has one of the highest patient to GP ratios in the country. Without more GPs, no initiative to increase appointments will succeed. Our local integrated care board is doing its best to bring more doctors to our area. What help can my hon. Friend give to the ICBs so that they can provide my constituents with the GPs they need?

My hon. Friend is quite right that we absolutely need to go further. That is why, through the primary care recovery plan, we are taking some of the pressure off general practice, investing £645 million in the new Pharmacy First service, which will free up about 10 million GP appointments a year. That is why we are investing about £60,000 per practice in new IT and modern online systems. None the less, he is totally right: we need those doctors in general practice. We have about 2,000 more now than we did in 2019, but we will go further. We have already increased GP training and we are looking at building on that further.

Can the Minister clarify when Oldham will receive its share of the 6,000 additional GPs that were promised in the Conservative 2019 general election manifesto? Today we are running with fewer GPs, and that is not helpful to anyone.

I have already noted that we have increased the number of doctors in general practice by nearly 2,000 since 2019 alone. The number of direct patient-facing staff in general practice is 50% higher in total than in 2019, and that is up right across the country. However, of course we will go further and grow the number of clinicians in general practice, building on what we have already done.

The primary care recovery plan includes excellent measures to extend visas for international medical graduates, but can my hon. Friend say whether that extension will be automatic, answering the concerns of the Royal College of General Practitioners, and whether it will be in place for the 1,000 or so graduates coming this June and August?

My hon. Friend modestly does not mention his role in advocating for that important reform, which will help to increase the number of highly qualified GPs coming from other countries to work in the NHS. We will ensure that that extension is automatic, so that people have extra time to make sure they get the right placement in general practice.

There was a net loss of 577 full-time equivalent GPs last year. A contributing factor in rural communities was the Government’s decision a few years ago to remove the minimum practice income guarantee, making it unsustainable for small surgeries—and many rural surgeries are necessarily small—to survive. Will the Minister consider whether it is time to reintroduce a strategic small surgeries fund, to allow smaller rural surgeries in communities such as mine to survive and thrive?

The funding formula already takes account of rurality. I hear the hon. Gentleman’s argument, but it is worth noting that our GPs are doing more than ever before. In the year to April there were nearly 10% more appointments than before the pandemic, or 20 more appointments in every GP practice per working day. GPs are working incredibly hard, as well as putting in extra staff, and I pay tribute to them for the sheer amount of work they are doing.

The Minister recently joined me at the Thistlemoor medical centre at the heart of my constituency. Led by the inspirational Modha family, the team prioritise making face-to-face appointments available for patients by having amazing admin and support staff who speak a variety of languages. That means that, by the time the patient sees the GP, all the relevant checks have been done and the GP has all the relevant information. How can we better use admin and support staff at GP surgeries so that doctors can maximise their time and operate at the very top of their licences?

It was an absolute pleasure to meet the Modha family and see the inspirational work happening in my hon. Friend’s constituency. In our primary care recovery plan we are learning some lessons from that work, particularly about focusing GPs’ time on the jobs only they can do—hence the investment in the extra 29,000 additional roles reimbursement scheme staff, the detailed plan in the primary care recovery plan to improve communication between hospitals and GPs, the cutting back of unnecessary bureaucracy, and the freeing up of resources by simplifying the investment and impact fund and the quality and outcomes framework. It is brilliant to learn from the inspirational work happening in his constituency.

Recent research from the Nuffield Trust shows that Brexit—a Brexit supported by both the Government and the Labour party, it has to be said—has worsened the shortage of NHS staff across the UK. Indeed, it has led to more than 4,000 European doctors choosing not to work in the national health services across the UK, due to higher costs, increased bureaucracy and uncertainty over visas. Can the Minister tell me whether that is one of the success stories of Brexit that we keep hearing about?

International recruitment is up. In fact, we have 38,000 more doctors and 54,000 more nurses in the NHS than in 2010. In England at least, we are taking every step we can to draw on that international talent and we are using it to grow staffing in the NHS.

I call the shadow Minister.

From Sittingbourne via Bristol and Oldham, people are fed up with not being able to speak with a GP when they need to. GPs are warning that rising demand and increased costs may lead to workforce cuts or even closures. They are fed up with the bamboozling of numbers—more of which we have heard this morning—whether on GPs, full-time trainees, locums and now appointments. Whatever the metric, can the Secretary of State or the Minister tell us how many more GPs or GP appointments they think are necessary for people to access the care that they need?

We committed in our manifesto to increasing the number and availability of appointments by 50 million. We are well on our way to meeting that target, as I have mentioned—we had 10% more appointments in the year to April than in the year before the pandemic. That is the result of the additional staffing that we are putting in: the extra 29,000 other clinicians and the nearly 2,000 more doctors in general practice. We have made that investment, but the reason why GPs are doing more appointments is not just that we have provided a fifth more funding since 2017 up to 2021; it is also that GP teams are working incredibly hard, and I pay tribute to them for all they are doing.