Health Services in Essex

Part of the debate – in Westminster Hall at 11:00 am on 17th April 2018.

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Photo of Priti Patel Priti Patel Conservative, Witham 11:00 am, 17th April 2018

My hon. Friend is absolutely right. I will come on to the primary care side and GPs, because we face strong pressures on GPs, especially in relation to succession planning.

I also welcome the new investment to support the transformation and improvement of hospital services, including £69 million to support the Colchester and Ipswich merger. The NHS in Essex has also done remarkably well in cutting enormous swathes of bureaucracy. When I first spoke in Parliament about the NHS, I highlighted the enormous growth in the number of bureaucrats and managers in the primary care trusts and strategic health authorities under Labour, which took precious resources away from the frontlines. We need only go back to some of the records and even some of my own comments in this House to see the horrific numbers. Hundreds of millions of pounds were spent just on recruiting managers. We should be pleased that that bureaucracy has now been cut out, but there are challenges in the NHS that need addressing.

My constituency is served by two clinical commissioning groups, Mid Essex and North East Essex. The two hospital trusts are Mid Essex, which runs Broomfield, and the Colchester Hospital University NHS Foundation Trust, which is about to merge with Ipswich. The recently established Essex Partnership University NHS Foundation Trust provides mental health services, and we have the East of England Ambulance Service NHS Trust, which has also seen enormous change over the last seven to eight years.

Representing a constituency in the east of England, my hon. Friend the Minister will be familiar with some of those challenges. My constituency does not have a hospital of its own, but he will be relieved to hear that I am one Member of Parliament who is not calling for a hospital in my constituency. Colchester general hospital provides acute services to residents in the north-eastern part of the Witham constituency, and Broomfield hospital in Chelmsford provides acute services to residents in the rest of the constituency. Some services are provided in Braintree community hospital, but in Witham town itself and the whole constituency there is no NHS hospital and no significant out-patient service, just GP practices.

My part of Essex received no significant investment under Labour—a point worth labouring, particularly in light of the points I made earlier on. We now need new investment to meet the growing demand brought by a population increasing in age and in numbers. The area I represent is increasing in population and, in terms of demographics, the proportion of the population aged over 60 is increasing and the number aged over 85 will double. Across Essex as a whole, the proportion of residents aged over 65 is now 21%, higher than the 16% national average, which naturally adds pressures to health and social care services.

The three local planning authorities that cover parts of the constituency are Braintree District Council, Maldon District Council and Colchester Borough Council. Local plans adopted by those councils or going through public examination could add a total of at least 37,000 new dwellings by the early 2030s. In Witham town the population of 26,000 is set to grow by 20% over the next 20 years, and sites have rightly been identified in the town that will accommodate more than 2,000 dwellings, but the increases in population seen in recent years have not been matched by proportionate increases in the health economy. As a result, there are naturally strains on primary care.

Branch surgeries in Tolleshunt D’Arcy and Birch have closed. In both instances, leases on premises were expiring and, even though the local community proposed alternative options to maintain some GP coverage in those villages, a solution could not be arranged. Notification of closure plans was made fairly late, which limited the time available to find a solution. I encourage the Minister to review how branch closures are managed and to ensure that sufficient time and effort is put into finding alternative facilities to provide a regular GP presence, particularly in rural locations.

The Sidney House Surgery in Hatfield Peverel is one the Minister may know about, since we have corresponded over it. It is full and over-subscribed, yet as new development is planned for the village the NHS simply asks for a sum of money for capital improvements based on a mathematical formula, which has no regard for the real costs involved in upgrading GP services to meet demand. Ultimately, that means that developer contributions will either be used elsewhere in the NHS or not used at all and returned.

In Tiptree, a growing village that the Minister may know of because it is where the world-famous Wilkin & Sons is based, we can see what happens when housing growth is simply not matched by new GP provision. The ratio of patients to GPs is over 3,500:1, which leads to severe difficulties with patients waiting for appointments. In fact, not a day goes past when I am not contacted by a constituent in that village highlighting some of the pressures on waiting times and the difficulty in making appointments.

I hope that the Minister will consider how the NHS can secure developer contributions that genuinely reflect the costs involved in delivering new GP provisions that are relative to local needs. This is a really important point. We are not against growth in our villages—we understand that they need to grow—but it increases pressures, and our GPs and local surgeries must be supported in planning that growth in this part of Essex with existing communities, because they need to be confident that investment will be provided to ease the pressures that they experience.

We also need to see action on expanding hours so that people can access GP services, and on reducing the number of vacant GP posts in the county. That is why a new university is vital; it will help in securing and training GPs to fill those vital posts—succession planning, as I like to call it.

With the Witham constituency, and indeed Chelmsford, being part of the London commuter belt, it is difficult for people who work or who have caring commitments to children or elderly relatives to make GP appointments for early on in the day. New investment to support longer GP hours and seven-day access would be welcome, including more primary care access funding. This part of Essex is always open to any new pilots or initiatives to deliver the Government’s ambitions on improved GP access.

I am sure that the Minister has heard of my campaign for a new multi-purpose healthcare centre to be built in Witham town. I have already mentioned that Witham is a growing town. It is a great place to live and a fantastic place for many of the new housing developments that we are seeing. It is a commuter town. New healthcare services, including primary care, are vital. A new facility would ease burdens, which we of course want to see—particularly with the population growth that we are seeing.

The national average ratio of patients to GPs is around 1,700:1. The average in mid Essex is around 1,800. In Witham town, we have four surgeries and more than 30,000 registered patients covered by only 13 full-time equivalent GPs. That gives a ratio of 2,300—a third higher than the national average. The pressures are pretty stark and clear, and residents who are seeing new homes built obviously want to see this new centre built.

Our district council is being supportive and making funding available. Mid Essex CCG has put resources in place to develop a business case, and to its credit is working with me and all stakeholders to deliver the centre. We are now at the final hurdle. We want to get all GPs on side and ensure that they are all signed up so that we can get bricks on the ground. It would be helpful if the Minister and the Government would back the project, which would also give all local GPs the confidence to sign up to the healthcare centre as well.

I will quickly raise two other issues. First, on mental health services, the Minister will be aware of the situation with Essex Partnership University NHS Foundation Trust, which was established last year from a merger of two separate mental health trusts covering north and south Essex. Some legacy issues have recently been well documented in the media, but I have a constituent, Mrs Melanie Leahy, who lost her son, Matthew, in the most tragic circumstances while he was being treated by the trust. I have raised this case over a number of years, and the Government will know all the background to it. Police inquiries are being made into his death and into several other deaths as well. I urge the Minister to keep the historical cases under review, so that affected families are supported, we learn from past mistakes and robust action takes place where there has been neglect.

Winter led to unprecedented demands on the East of England Ambulance Service. Five years ago the trust suffered from poor leadership, but I pay tribute to everybody in the ambulance trust. It has been an absolute privilege to meet the paramedics in Witham and on the frontline who every day do amazing and brilliant work. The events of the winter remind us that the pressures are severe. The county council has helped with reducing pressures on social care and getting people out of hospitals and living independently back at home. I would welcome some words from the Minister on the action that the Department is taking to support our quite remarkable East of England Ambulance Trust to improve preparations for future winters and to give it the support that it needs.

Finally, although reforms, working practices and innovation have really helped to reduce pressures in the NHS, it is fair to say that, when it comes to funding, Essex has been historically underfunded compared with other parts of the country, which is down to challenging and changing funding formulae. I welcome the great deal of work undertaken by the Department of Health and Ministers to review funding, but I want to see more support, more reform and more investment in greater performance. Better performance should be rewarded through investment. I hope that the Department and the Minister will work with me to secure local funding and to secure a new facility in Witham. I thank the Minister for the time and attention he has given to discussing healthcare in Essex.