To consider any requests received in accordance with Part 4, Section B, Paragraph 29 of the Council’s Constitution.
Minutes:
As set out above the Chair noted that a deputation and two public questions had been accepted in relation to Item 10: ‘GP Access in Tottenham Hale: Capacity Study’. These had been received from:
Deputation
From Ms Vicky Ladizhinskaya
Public Questions
Michael Polledri, Chairman of Lee Valley Estates (represented by Chris Shellard)
NualaKiely, Service User Engagement Coordinator, Mental Health Support Association
Deputation
Ms Ladizhinskaya began by thanking the Board for hearing her deputation and noted that in addition to the people that had signed the original deputation request, over seventy additional people had also signed her deputation statement noting their support for this. For residents living in Bream Close, Hale Village and Ferry Lane, the difficulties attached to obtaining a GP appointment and the quality of the service provided by the local practice had become acute.
Ms Ladizhinskaya stated that new developments, including the Hale Village scheme, had seen the population of Tottenham Hale rise by 32% in the last three years and during this time there had been no increase in the provision of GP practices. In addition, the area’s largest practice, Tynemouth Road, was, by the NHS’s own admission, in the bottom ten practices in the country according to a survey undertaken in 2014. The same survey also showed that 42% of patients were unable to make an appointment when they telephoned the practice.
Ms Ladizhinskaya noted that prior to the new development at Hale Village being built there was an existing problem with the quality and provision of GP services in Tottenham Hale and that this had been compounded by a significant rise in the local population. It was noted that as part of the original planning permission granted by the Council for the Hale Village development it had been specified that a GP practice should be included within the scheme and that Lea Valley Estates had worked with the NHS to secure this. However, it had not been possible to find GPs willing to set up a practice in the area and as a consequence the space allocated for health care had been used for a kidney dialysis unit serving the wider north London area rather than addressing the primary care needs of the local community. Given the likelihood of further significant development in the area in medium to long term Ms Ladizhinskaya argued that it was essential that provision for primary care was properly considered and reflected in the plans currently being developed in order to prevent the problem worsening.
Ms Ladizhinskaya recounted her own experiences of attempting to obtain a GP appointment at the Tynemouth Road practice and a series of errors that had led to her test results being delayed by six weeks. She noted that many of her neighbours had experienced similar difficulties in obtaining a GP appointment and delays in hospital referrals. There was a general lack of communication and follow up from the Tynemouth Road practice and that was putting patients at unacceptable risk. She noted that the recent Healthwatch report had highlighted the issues at the Tynemouth Road practice, the lack of GP practices and quality of primary health care in Tottenham Hale. In conclusion Ms Ladizhinskaya noted that residents did not want preferential treatment and that they simply wanted GP provision across the borough to be equal and of the standard enjoyed by the majority of people living in the UK.
The Chair thanked Ms Ladizhinskaya for her deputation and for sharing her personal experiences with the Board and invited Councillor Reith, one of the local Ward Members, to set out her concerns.
Councillor Reith began by noting that the lack of GP services and the quality of existing GP services had been an issue that pre-dated the development of Hale Village. In her previous role as Deputy Leader of the Council she had attended meetings with the former Primary Care Trust (PCT) where the need for improved services in the area had been discussed along with the specific provision of a GP practice within the Hale Village development.
Councillor Reith reminded the Board that NHS England was responsible for commissioning GPs and ensuring that there were adequate GP services in place. This was a challenge that NHS England had to resolve both in the short and longer term. She contended that NHS England and the Clinical Commissioning Group (CCG) should, as a matter of urgency, map need in the area and put together proposals around how they intended to meet this. She underlined that although the Local Authority could lobby for this work to be undertaken it had no power to require this to happen.
Councillor Reith noted that her own experience of obtaining an appointment at the Tynemouth Road practice echoed that of Ms Ladizhinskaya’s and the issues highlighted within the Healthwatch report. She noted that poor primary care significantly impacted on people’s health and advised that there had been cases where people had presented at Accident and Emergency (A&E) in the advanced stages of cancer because their symptoms had either not been picked up by their GP or because of a failure to obtain an appointment with their GP. There had also been instances where women had received no ante-natal care and had presented at A&E in labour.
In conclusion Councillor Reith noted that without the necessary provision of primary health care services in the area the expected growth in population and regeneration of the Tottenham would be impaired. She underlined the need for partners to work together to resolve this issue and suggested that a Working Group ought to be established as soon as possible to address the immediate lack of GP facilities.
The Chair formally responded to the deputation and noted that this was an issue that was of concern to her both in terms of the impact this was currently having upon residents and in the medium to long term as the population of the area was likely to grow significantly. The success of the Council’s aspirations for the regeneration and development of the area would rely upon services of this type being in place to serve residents and the Council’s planning policy documents reflected this; however, the commissioning of GP services was not in the gift of the Council or the Clinical Commissioning Group (CCG). The power and responsibility to resolve these issues lay with NHS England and the Council would support residents in their calls for action.
As set out above two questions (set out in Appendix 1) had been formally submitted to the Board from Mr Michael Polledri, Chairman of Lea Valley Estates (represented by Mr Chris Shellard) and Ms Nuala Kiely, Service User Engagement Coordinator, Mental Health Support Association. The Chair asked both Mr Shellard and Ms Kiely to read their questions to the Board and members of the public present.
In response to the first question from Mr Polledri the Chairman of Lea Valley Estates, the Chair reiterated that NHS England held the power to commission GP practices and that the Council had no authority to compel them to do so. She noted that NHS England had agreed to explore the feasibility of establishing a GP practice at Hale Village; however, this would take between twelve and fifteen months and, given the acute need for GP services in the area, this was not satisfactory.
In response to the second question from Ms Kiely the Chair noted that as suggested by the question there was a postcode dimension to the discharge of patients from secondary to primary health care; however, this was a complex issue that primarily needed to be addressed by the relevant health care providers.