Part of the debate – in the Senedd at 4:25 pm on 20 September 2017.
This report is particularly timely for my constituents in Caerphilly: Bargoed Hall surgery closes its doors next week due to the ending of the practice by the GP there. I’ve had many communications with constituents over the summer, but particularly useful has been communication with the health board, and I have to praise the Aneurin Bevan Local Health Board for what has been improved communication with me with regard to this issue, and I’ve been able to, therefore, give my constituents as much information as I can give them as we had it, and that information has been emerging as we’ve been able to get it. Patients have been moved to a surgery in Bryntirion nearby, but it has not been without difficulties, and we’re still in an emerging situation. I’d therefore also like to thank the Cabinet Secretary for visiting Bryntirion Surgery with me to discuss some of these issues, and also thank the committee for the depth and breadth of evidence that they’ve gathered, which will go some way to helping resolve or prevent these issues from occurring in my constituency and other constituencies in Wales in the future.
I’d particularly like to make reference to page 49 of the report. There’s some very stark evidence there with regard to GP recruitment and the feelings that new GPs may have. Paragraph 164 says:
‘While Dr Heidi Phillips, representing GP Survival, told us that, according to a survey of Swansea medical students, general practice was not seen as an attractive option because: “…they see what we see, which is a 10-minute revolving door, starting at 8.30 a.m. through to 6.30 p.m., with no protected time for education, no protected time for the expansion of other interests, and no protected time even for administration. It’s relentless. When you look at the other side of it, you see the GPs—our role models—who, from the evidence I submitted, are burnt out, exhausted, demotivated and demoralised”.’
Of course, that is no advert for anyone wishing, then, to go into GP practice. But the report is constructive, and says, at paragraph 168:
‘Developing new models of care will be a key part of tackling these workload and sustainability issues: we believe the pace, visibility and focus of this development needs to be stepped up, which will need strong and structured direction and leadership.’
Key in that paragraph is ‘new models of care’, because what the health board have suggested, in order to attract GPs to Bryntirion Surgery—which needs new GPs as Bargoed Hall closes—is they’re going to have to introduce a new model of primary care. The real difficulty is: how do you explain to the public in Bargoed what a new model of primary care actually means? What it means is Bryntirion having pharmacists, having mental health care professionals and having nurses who are able to deliver standards of care comparable to GPs and ease the pressure on GPs. That is significant, but really key will be explaining that to patients who expect to see a GP. New models of primary care can take that pressure off GPs and ease the problem, but I’m yet to see that explained in a very convincing way.
The report also mentions locum doctors to fill GP vacancies, and when the Cabinet Secretary visited Bryntirion Surgery, he heard from the full-time GP there who said that locum doctors are all very well, but they leave behind a trail of admin work that the permanent GPs then have to pick up, and in addition to that, locum doctors are very expensive. So, it doesn’t really resolve the problem, it just puts a sticking plaster on it.
I’ve also been contacted by Dr Paul Edwards, through Allan Rogers—Allan Rogers used to be the MP for the Rhondda, he’s in his eighties now and still very active in politics—he wants to help solve this problem. He saw my video on Facebook with regard to Bryntirion Surgery and he put me in touch with Dr Paul Edwards who’s working with Guy Lacey, the principal of Coleg Gwent. They’re looking at ways in which the rich, untapped source of talent in the northern Valleys can be recruited to become GPs in the future. Many people growing up in areas of relative deprivation would make good doctors, but because of cultural issues of aspiration in education they’re not encouraged to apply for medical schools. Dr Paul Edwards signed his email to me: Dr Paul Edwards BSc, BM (Hons), PhD, Membership of the Royal Colleges of Surgeons of Great Britain and Ireland, Fellowship of the Royal Colleges of Surgeons, consultant surgeon, honorary senior lecturer, grade C and two Ds at A-level. So, this is a clear opportunity to recruit our future GPs from the areas of the northern Valleys that I always talk about. I’m therefore pleased to see that the report makes recommendations on this subject, and I sincerely hope the Welsh Government commits to working with all relevant stakeholders and experts to ensure that this potentially transformative change can be brought about.