I, too, congratulate my right hon. Friend Sir Hugo Swire on securing the debate. Over the next few moments, I want to concentrate on NHS England’s proposals to close three GP surgeries in my Plymouth, Sutton and Devonport constituency and how I hope we can take some pressure off the principal acute hospital at Derriford in the constituency of my hon. and gallant Friend Johnny Mercer.
I am told that the reason why NHS England is considering the closures is the size of the GP practices. The Cumberland GP practice has 1,800 patients, Hyde Park 2,800 and St Barnabas 1,700. They are considered by NHS England to be unsustainable and too small. It also tells me that closing those practices is not down to saving money, but to deliver better value for money. However, before I speak about those issues, let me put my constituency in context.
Plymouth, Sutton and Devonport runs from the A38 down to the sea and from the River Plym to the River Tamar. It is the home of one of the largest universities in the country, with more than 27,000 students, thousands of whom live in the city centre, and it is a naval and Royal Marine Commando garrison city, as my hon. Friend the Minister, for whom I was a Parliamentary Private Secretary in a previous life, knows only too well.
The city’s population is growing. Although it has a global reputation for marine science and engineering and research, it is a low-wage and low-skills economy. It is an inner-city seat. I do not have a single piece of countryside in my constituency, unless we include the Ponderosa pony sanctuary, which is a rather muddy field. Between Compton and Peverell in the north-east of my constituency and Devonport in the south-west, there is an 11-year life expectancy difference. Compton and Peverell is where many of the university lecturers and hospital consultants live. In the run-up to the 2010 general election, when I won the seat on the third attempt, the Conservative party pledged to do something about healthcare in deprived inner cities.
We have started to make good our word. In 2014, our hon. Friend Dr Poulter, one of the Minister’s ministerial predecessors, came to Devonport to open the Cumberland GP practice, which is now under threat. Other facilities on the Cumberland campus include a minor injuries unit, the new Devonport health centre and a pharmacy. The Cumberland GP practice was set up by Plymouth Community Healthcare—now Livewell Southwest—and the Peninsula medical school. There was and is a desperate need to provide a tailor-made alternative service to the existing GP practice—then the Marlborough Street practice; now the Devonport health centre—for this deprived Devonport community, and a need to look after drug users and the city’s homeless in hostels such as the neighbouring Salvation Army’s.
The practice also offers practical placements to students at the Plymouth medical school. Until earlier this year it was funded by Livewell Southwest, a social enterprise, which found it too expensive to maintain. Despite Devonport’s real deprivation, NHS England did not want to get involved in providing a contract to the Cumberland GP practice, which has consequently been operating without a formal contract and is managed by Access Health Care.
I understand that in the past the neighbouring Devonport health practice has not been interested in offering facilities to homeless people and drug users. Indeed, I understand that some of the Cumberland practice’s patients were not keen to transfer back to the Devonport centre, which is where they came from in the first place.
NHS England’s reason for putting the Cumberland GP practice under threat is because it considers it to be too small and is operating in unsuitable, cramped premises. Unless we are very careful, we could potentially put more pressure on Derriford’s acute emergency unit, which is under enormous pressure. I became aware of NHS England’s proposals for the three GP practices in August, during the summer recess, when no doubt NHS England expected me and other MPs to be away on parliamentary trips or taking a holiday. I immediately put together a series of meetings with the city council’s director of public health, the leader of the council and the cabinet member for adult social care, people from NHS England, the dean of the medical school and Dr Richard Ayres, who runs the Cumberland GP practice.
At the meeting I suggested that the Cumberland GP practice could share Devonport health centre’s brand-new building, which has space and operates as a federation, sharing receptionists and back-room staff. This was supported by everyone present. Indeed, the city council’s health and wellbeing board also supported it following an inquiry that recommended measures to allow the Cumberland GP practice to continue. However, I understand that Devonport healthcare might not be willing to do this, and it appears that the Devonport community may be deprived of a second GP practice and that patients will have no choice in which doctor they can go to.
I have also had representations from patients at both Hyde Park and St Barnabas surgeries. At Hyde Park, although Dr Stephen Warren is keen to continue as a GP following a heart attack, he has transferred the ownership of his practice to Access Health Care, as he no longer wishes to deal with the back-room tasks of administration, which is part of running a practice. He argues that his and his partner’s growing 2,800 practice—the Cumberland is growing as well—has attracted outstanding reviews and he would not be able to inform his patients where he was going if he relocated to another practice. He also thinks that some patients like to have a relationship with an individual doctor who they can see speedily rather than having to wait weeks.
The St Barnabas surgery, which is also run by Access Health Care, was set up in a new development next to a residential care home for the elderly where patients do not have to walk far to get to it. In all three cases, NHS England, for supposedly technical reasons, gave patients only 24 hours’ notice of their initial engagement. I must say I found the public consultation process utterly appalling. I wrote to NHS England asking it to give more time to engage with local communities, and I am grateful that it bothered to listen.
On Friday, at my weekly constituency surgery, I was asked to write to NHS England to ask whether it had engaged with other GP surgeries and with Derriford hospital and whether it had consulted them, because some GPs will have to accommodate more patients. That is a big issue.
There are wider issues in all this. At the moment, commissioners in north, east and west Devon spend a higher amount of money in east Devon than in the more deprived western locality. The Government’s success regime is keen to correct that, so that resources are focused on deprived communities such as Devonport. Finally, we need to make much more use of pharmacies. As my hon. Friend the Minister knows, I am the Government’s pharmacy champion. What are we going to do to make sure we have pharmacy funding and how will that operate?