Parliamentary update – December 2022

Oral questions

On 6 December, the Secretary of State for Health answered oral questions in the House of Commons. Read and watch in full. Selected questions are below. All answered by the Secretary of State unless otherwise stated.

Labour Shadow Health Ministers

Feryal Clark MP, Enfield North (Lab) – Shadow Minister for Primary Care

Q: Members on both sides of the House will have been shocked and appalled by the recent deaths of children from streptococcus A, and our thoughts are with all the families affected. Cases are on the rise, and as we head into winter it is vital for parents to be able to secure for their children the care that they so desperately need. The shortage of GPs means that too many are struggling to see a doctor, and now there are reports of shortages of antibiotics as well. What advice can the Secretary of State give parents whose children are exhibiting symptoms but who cannot obtain a GP appointment, and what assurances can he give on the supply and availability of antibiotics?

A: This is an important issue which I know is of concern to many families throughout the country, so I am pleased to be able to reassure the House about our response. While GPs are important in this regard, so are directors of public health, who are leading the response in respect of, for example, liaison with schools. We are seeing a peak in cases earlier than usual, which we believe is due to lower exposure during the pandemic, which in turn has led to lower immunity. There is no new strain, and that is one of the key points of reassurance, but the UK Health Security Agency has declared a national standard to improve the co-ordination of our response, including what is being done in schools.

London MPs

Ruth Cadbury MP, Brentford and Isleworth (Lab)

Q: What progress has been made on the commitment to recruit 6,000 additional GPs by 2024?

A: In September 2022 there were nearly 2,300 more full-time equivalent doctors in general practice than there were at the same time in 2019, and more than 9,000 GP trainees.

Q: A constituent of mine, a full-time GP in her 50s, told me that the pension rules mean she has to retire, work part-time or emigrate, which is hardly likely to help her patients to obtain appointments with her. Having hinted at a change in doctors’ pension rules last summer, the Government are only now announcing a consultation that will last until next spring, so there will be no change in these crazy rules until next summer at the earliest. Is this not too little, too late?

A: It is worth reminding the House that there are 3% more doctors this year than last year. As I have said, we have 2,300 more full-time GPs, and we are recruiting more. However, the hon. Lady is absolutely right about doctors’ pensions; that is a material issue, which is why we launched the consultation, and we are working with Treasury colleagues to address these concerns as quickly as possible.

Clive Efford MP, Eltham (Lab)

Q: Parents are becoming increasingly worried about the current prevalence of strep A. It is a time of year when parents are going to have children with high temperatures and sore throats, so concern is likely to be very high. There are also concerns about the availability of antibiotics. Does the Secretary of State believe that this is a moment where the Government need to make a statement and show clear leadership to calm people down and reassure them about the situation?

Maria Caulfield MP – Parliamentary Under Secretary of State 

A: We held a cross-party briefing last night on strep A. We want to reassure parents, and if their children have symptoms and they are concerned, please seek help. GPs are ready and A&E departments are ready, and we have directors of public health proactively going into schools where there are cases. There is no shortage of antibiotics—we want to reassure people on that—and we are keeping an eye on that on a daily basis.

Other MPs

Alexander Stafford MP, Rother Valley (Con)

Q: Several GP practices in Rother Valley, such as Swallownest Health Centre, operate a policy of having to ring the doctor’s surgery at 8 am for an appointment. Residents find themselves being placed 50th or 60th in the queue, and are then told that no appointment is available and to call back the next day. This is clearly an unacceptable way to offer appointments. What steps are my hon. Friends taking to stop the current failed booking system and instead guarantee a system of pre-booked appointments at all GP surgeries?

Neil O’BrienMP – Minister for Primary Care

A: That is something that we are working on very actively. As well as financially supporting GPs to roll out new and better ways of managing their appointments, we are looking at what criteria we expect from GPs. We already set out some moves in our summer action plan, but we will be looking further at preventing the lamentable situation my hon. Friend describes of people being asked to ring back or being held in long phone queues. That is not acceptable.

NHS workforce debate

On 6 December, Wes Streeting MP, Shadow Secretary of State for Health and Social Care (Lab: Ilford North) led a debate on the NHS workforce. Read and watch in full.

London MPs made the following contributions:

Helen Hayes MP (Lab: Dulwich and West Norwood):

I was looking at a message from a constituent this morning who told that he went to A&E having waited four weeks for a GP appointment. Does that not speak to a lack of investment in the NHS workforce over 12 years and a lack of adequate planning? I know how hard GPs work in my constituency, but the lack of GP availability to staff surgeries and provide those appointments is placing unneeded pressure on A&E. That is on this Government’s watch.

Munira Wilson MP (Lib Dem: Twickenham):

One bit of feedback that my colleagues in outer London constituencies and I have had from health leaders in our area is that the high-cost area supplement, which is available for many inner-London boroughs but is not available for outer London boroughs, is causing huge problems with recruitment and retention. For example, somebody can earn £2,000 more for the same job in Wandsworth than they can in neighbouring Richmond or Merton.

Moles and Skin Tags: Testing for Cancer debate

On 12 December, Bob Seely MP (Con: Isle of Wight) led a debate on testing mole and skin tags for cancer. Read and watch in full.

House of Commons: Health and Social Care Committee

On 6 December, the committee held an oral evidence session on integrated care systems. The session can be watched here.

House of Commons: Westminster Hall

On 30 November, Sir Mike Penning MP (Con: Hemel Hempstead) led a debate on accountability in the NHS. Read and watch in full.

On 24 November, Rt Hon Damien Green MP (Con: Ashford) led a debate on Social Care. Read and watch in full.

On 22 November, Margaret Greenwood MP (Lab: Wirral West) led a debate on NHS staffing levels. Read and watch in full.

Written Parliamentary Questions

Wes Streeting MP, Ilford North (Lab) – Shadow Health Secretary

Recruitment (26/10) What progress has been made on recruiting an additional 6,000 GPs?

(16/11) A: As of September 2022, there were approximately 2,300 additional full time equivalent doctors working in general practice compared to September 2019. We are working with NHSE and HEE to increase recruitment, address the reasons why doctors leave, and encourage them to return to practice.

We have increased the number of GP training places to 4,000 per year. The 2020 updated GP Contract Framework announced a number of new retention schemes alongside continued support for existing schemes for the general practice workforce. Since 2019 we have also recruited over 19,305 additional staff into general practice covering a range of roles, such as clinical pharmacists.

Feryal Clark MP, Enfield North (Lab) – Shadow Minister for Primary Care

Recruitment (11/10) What estimate has been made of the potential cost of employing 1,000 additional GP assistants as outlined in the Government’s Plan for Patients?

(3/11) A: General practice assistants (GPAs) were included in the ARRS in October 2022. Through the Scheme, PCNs claim reimbursement for the salaries and some on-costs of defined roles in the Network Contract Directed Enhanced Service.

Each PCN is entitled to a share of the total national budget, based on the size and needs of the local population and selects the roles to recruit within these budgets. The introduction of new roles such as the GPA provides PCNs and commissioners with more choice, flexibility and opportunity to utilise ARRS funding entitlements, increasing the number of patient-facing staff in local general practice teams.

The national budget for ARRS is currently approximately £1 billion and is expected to rise to over £1.4 billion next year. Information on planned PCN recruitment and expenditure of allocations indicates there is sufficient funding to meet expected demand for GPAs.

Ruth Cadbury MP, Brentford and Isleworth (Lab)

Retention (17/10) What assessment has been made of the potential impact of the Government’s policy on trends in the level of early retirement of GPs?

(2/11) A: A GP’s decision to retire can be influenced by many factors. We are working to support and grow the general practice workforce, address the reasons why doctors leave the profession, and encourage them to return to practice.

Fees (31/10) In what circumstances are General Practices unable to charge a fee for the issuing of letters confirming an individual’s health condition?

(7/11) A: The circumstances in which general practices must not charge for issuing medical certificates confirming an individual’s health condition are set out in regulation. The inclusion of a medical certificate in this is subject to consultation with the BMA’s GPC.

Sir Stephen Timms MP, East Ham (Lab)

F2F (1/11) What estimate has been made of the number of GPs in the North East London ICS catchment area; and what assessment he has made of the effectiveness of retention initiatives?

(8/11) A: NHS Digital’s National Workforce Reporting Service reports that there are 1,600 GPs in the North East London ICB catchment area.

No format assessment has been made. However, in 2021/22 the ICB introduced mid-career fellowships; the development of peer support groups for GPs at different career stages; and primary care mentorship and work experience. In 2022/23, North East London ICS will invest in ongoing retention schemes and in practices with fewer doctors and/or a smaller patient base.

Clive Efford MP, Eltham (Lab)

Recruitment (12/10) What steps are being taken to ensure that surgeries in Eltham constituency can fill GP vacancies?

(3/11) A: We are working with NHS England, Health Education England and the profession to increase the general practice workforce in England, including in Eltham. This includes measures to improve recruitment, address the reasons why doctors leave the profession and encourage them to return to practice.

Kate Osamor MP, Edmonton (Lab)

Practice Closure (26/10) How many GP practices are open in Edmonton today; and what was number that in 2013?

(3/11) A: In September 2013, there were 24 practices registered in Edmonton, with 17 practices registered in October 2022.

Rupa Huq MP, Ealing Central and Action (Ind)

Telephone Appts (18/11) Are steps being taken to encourage general practices to call patients a second time when they miss an initial telephone appointment?

(24/11) A: Individual GP practices are responsible for managing appointment booking systems to meet the reasonable needs of registered patients. NHS England’s guidance advises GP practices to provide a specific timeframe or exact appointment time for telephone or video appointments.

Chris Bryant MP, Rhondda (Lab)

Workforce (31/10) How many fully qualified full time equivalent GPs there were in England in each year since 2015?

(16/11) A: