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Public Services

Part of Debate on the Address – in the House of Commons at 2:48 pm on 16th October 2019.

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Photo of Anne Milton Anne Milton Independent, Guildford 2:48 pm, 16th October 2019

I welcome the measures the Government are bringing in to improve patient safety. I trained as a nurse and worked in the NHS for 25 years, and to this day I remain proud of the training I received at St Bartholomew’s Hospital. That training has stayed with me to this day; it was about standards and demonstrating respect not just for the patients in our care, but everyone we work with. It was about an understanding that nothing but the best will do. Therefore, adopting a similar approach, as the airlines do, to safety is not before time. There should be no circumstance where patient safety is compromised in any way at all.

I also welcome not only the measures on mental health but the changing attitudes to mental health that I have witnessed since I was first elected in 2005. I well remember my hon. Friend Sir Charles Walker and Mr Jones speaking movingly in 2012 about their own mental health problems. Anything we can do to ensure that we have freely available mental health services delivered in a timely fashion is to be welcomed, in the community, in our prisons and in schools. I welcome all the legislation that will improve this.

While money for hospitals will be welcomed, hospitals are not the whole story as far as our NHS is concerned. The Royal Surrey County Hospital in my patch does an excellent job. It has done a superb job in raising standards of care, and nowadays, rather than receiving letters of complaint, I receive letters and emails praising the staff there. This week, I was at a Guild of Nurses event, surrounded by nurses many of whom were of a similar age to myself—really quite young—but who had, in effect, trained on an apprenticeship. I was proud, as the Minister for apprenticeships, to have reintroduced nurse apprenticeships and a pathway for all to train up to the level of registered nurse. The university route might be right for some, but if we use only that route, we will miss many women and men who would make exactly the sort of nurses we want to see—caring, compassionate and with a real sense of vocation. I urge the Secretary of State for Education, who is sitting on the Treasury Bench, to continue the apprenticeship programme without restriction and to ensure that there are sufficient funds to do so.

However, money for hospitals is not in itself sufficient. Hospitals rightly grab the headlines because of the phenomenal work they do, but although most of the costs in the NHS are incurred in hospitals, the vast majority of patient contact occurs in the community. I think 80% of patient and people contact occurs in the community, and all our community healthcare services need help. That activity in the community goes on without headlines, carried out by committed and skilled NHS staff, and it is struggling with budgets. I have recently seen some of my local GPs. My local GPs have almost never contacted me. They provide good services, but they are extremely concerned about the crisis they are facing in general practice. It is now almost impossible to recruit new partners. Ten years ago, they would have expected around 100 applicants when they advertised for a new partner; they are now getting no applicants at all. Guildford is an attractive place, and even when other places have had issues with recruitment, it has never done so. This stark reduction in the number of applicants is of note.

The practices can and do employ salaried GPs, but they charge high rates and the GP partners are still left with the problem of who will continue to run the practices when they retire. Younger doctors simply do not want to take on those responsibilities. All this is exacerbated by the limits on pension pots and the taxation changes that make early retirement an attractive proposition. It is high time that the Treasury recognised the impact of its policies on public sector staff. My GPs understand that integrating practices is the right thing to do, and they have done it. They take many of the risks but do not get many rewards. This is not just about money; it is about de-risking things such as leases, which would certainly help to demonstrate that the Department understands some of the issues that GPs and other community services are facing.

New technology improves access for many people and saves them time, but it does not necessarily save the GPs time. In fact, many telephone appointments can take longer than those held in the surgery. My local A&E finds the local GP services extremely valuable in reducing the A&E workload considerably. GPs are the place of first, and often last, resort. However, despite all the valid and positive changes that have taken place in the NHS, I am afraid that we are probably about to see the baby run down the plug hole with the bathwater. We have a surgery in Burpham that is probably going to close due to loss of premises, and I have also received concerns from St Catherine’s Village Association about primary health care in south Guildford. This is on top of the issues that the university and students have raised with me about new students being unable to register with GPs because they have closed their lists. The clinical commissioning group is working hard to resolve these issues, and it has been extremely helpful, but amid the good announcements and good Bills in the Queen’s Speech, I urge the Government to be aware of how much hospitals depend on our community health services.

The mental health of our young people is now well recognised, and the online harms Bill is very welcome. The Government are doing much to improve awareness and support in schools. However, concerns were recently raised with me by a local councillor, Steven Lee, about the real crisis in the health and wellbeing of young people in schools today. I welcome the investment in mental health services, particularly in children’s mental health services, but this is still a long way from getting to the frontline. There is a historical shortage of staff that we have to do something to address.

I welcome the money and I welcome all the measures in the Queen’s Speech, including the online harms Bill, the legislation on patient safety and the money going into mental health, but I urge the Government to do everything in their power to ensure that these things become a reality on the ground. They need to move away from the tabloid headlines and put the money where the contact is and where the care is carried out.