With your permission, Mr Speaker, I will answer Questions 1, 4, 6, 11 and 20 together. [Interruption.] General practice is a popular subject.
We will create an extra 50 million appointments a year in primary care so that everyone can go to the GP when they need to.
There are many families with children in Gedling. What is being done to ensure that patients, particularly families with young children, can access GP appointments when they need them?
Obviously this is an incredibly important subject, and I know the frustration many families feel at not being able to access a GP appointment when they need it. We have a whole-scale programme of work to improve access. This includes recruiting 6,000 more GPs and 26,000 primary care staff other than GPs— increasingly patients at GP surgeries can be treated by nurses—and increasingly enabling people, especially those who find it difficult to travel, to use technology to get the treatment they need.
My hon. Friend is right to ask. It is incredibly important that we get the right number of GPs, not least to reduce the amount spent on locums, who can be very expensive and often do not know the local population as well as salaried GPs. Her local clinical commissioning group is developing a new-to-practice fellowship in Hastings for GPs starting out in practice in order to encourage more doctors into practice and then to support them. It is also working with primary care networks so that more can become GP trainers and take on students. We are expanding the numbers going into GP training—there were record numbers last year—but I want the numbers to go up again and to make sure that Hastings gets the GPs it needs.
As part of the council area with the second-largest population increase in the country, the people of Biggleswade, Sandy, Arlesey and Stotfold are at their wits’ end over access to GP appointments. What special attention will the Secretary of State pay to those areas of large population growth to make sure that increases in housing are matched by increased access to GPs?
That is an incredibly important point. We have a manifesto commitment to ensure that where there is new housing there is also new primary care. Just as a new housing estate will often require a new primary school and new transport links, so we need to put in the GPs as well.
Yes. My hon. Friend has already become an incredibly strong voice for Wolverhampton, and it was a pleasure to visit Tettenhall medical practice, which has joined with other GP practices to form a primary care network, which I hope will strengthen its resilience and enable it to provide extended access to appointments, which is what he is campaigning for. I am pleased, too, with the extra 16,000 appointments in Wolverhampton in the last quarter. As this shows, we are driving up the number of appointments, but we also appreciate, understand and feel the frustration people feel when they cannot get decent access to GP appointments.
Changes to pension contributions mean that some senior GPs, including in Newbury, are being hit with extra tax charges if they work overtime, which is leading to the paradoxical situation of GPs paying to work and so reducing their hours or taking early retirement. What steps is the Secretary of State’s Department taking to address this situation?
Tax is, of course, a matter for the Treasury, and the Chancellor would not be thrilled if I announced tax policy in the middle of health questions, tempting as that may be. However, we have been working with the Treasury, and also with the Academy of Medical Royal Colleges, the British Medical Association, employers in the NHS and others, to deliver on our manifesto commitment to sort this out.
You rather surprised me then, Mr Speaker!
The Secretary of State mentioned primary care networks. As he will know, two weeks ago GPs rejected the new service specifications in those networks. This has been described as a debacle, and as leading to more red tape and taking GPs away from patients. If the Secretary of State is going to fix these contracts, can he tell us how he is going to do it—or is he content to see more GPs walk out of primary care networks before they have even got off the ground?
Primary care networks have been an incredibly successful innovation, covering the whole country and allowing practices to work together. Of course, the negotiations with the BMA over the GP contract are always tough: they have been in every year in which they have taken place. The hon. Gentleman will understand why I want to get the best possible value for the money that the NHS spends, but I also want to see a successful conclusion to this negotiation, and we are working with the BMA to that end.
The Secretary of State describes primary care networks as a great success, but a local medical committee in Buckinghamshire and Berkshire has just warned that they will cost each practice £100,000 more. Having failed to deliver the 5,000 extra doctors that the Government previously promised, having failed to recruit more GPs in the poorest areas, having now bungled the negotiations over this contract, and having failed to fix the pension tax changes for which he was partly responsible, how on earth can the Secretary of State be trusted to deliver on the Prime Minister’s promise to cut GP waiting times to less than three weeks?
It is a bit of a disappointment to hear the hon. Gentleman talk down primary care. We are making record investments in primary care, we have record numbers of GPs in training, we are seeing an increase in the number of appointments in Wolverhampton and across the country, we are negotiating with GPs to strengthen general practice, in the last year we have introduced primary care networks that help to make primary care more sustainable, we are improving the technology that is available in primary care, and, for the first time in a generation, the proportion of the total NHS budget going into primary and community care is rising, whereas there were cuts under Labour. I think the hon. Gentleman should be standing up and saying thank you.
Hanwell health centre, which works hard to serve many of my constituents, has told me that it has been trying to appoint a salaried GP for three years, as well as a large number of nurses. There is generally a four-week wait for an appointment, although the centre has provided 75 more appointments to cope with demand. Under the Secretary of State’s plans, when will those waiting times come down?
This is precisely why we need to recruit more GPs, in the hon. Gentleman’s constituency and across the country, and also recruit more other clinicians to general practice. [Hon. Members: “How?”] I will tell you how, Mr Speaker. In the first instance, the record numbers of GPs in training will help, but that is not the entirety of the plan. I urge the hon. Gentleman to get on board and support general practice.
In 2015 the Secretary of State’s predecessor promised 5,000 more GPs by 2020. The Secretary of State repeated that promise when he took over the job, but my constituents are finding it increasingly difficult to get a GP appointment within three weeks. Will the Secretary of State now apologise to everyone who is waiting for failing to keep his promises?
The commitment that we have made is that we will have 6,000 more GPs and 26,000 other clinical staff in general practice. That is the commitment that we have made, and that is the commitment on which we will deliver.
In rural communities such as mine, GP surgeries often serve huge geographical areas with relatively small patient numbers. Coniston, for example, has a roll of about 900 patients, yet the next nearest surgery is two lakes away. Will the Secretary of State commit to establishing a strategic small surgeries fund to ensure that small surgeries in rural communities remain sustainable for the long term?
The hon. Gentleman makes an incredibly important point. General practice, where 90% of all NHS appointments take place, needs to reach every part of this country, including his beautiful constituency, which is, as he says, very sparse. Of course we need to ensure that the practices there are sustainable, and again this is an area in which technology can be of particular help. There is great enthusiasm for using technology so that the travelling times of patients and sometimes of GPs can be reduced.