'More GPs plea' to meet needs of growing city of Lancaster

A motion from the new Conservative group leader, Coun Richard Austen-Baker, will be discussed at the full council meeting today, Wednesday September 29.

It refers to ‘some disquiet’ among residents about recent mergers of GP practices and the future construction of new homes south of the city, which is expected to increase demand for primary care clinics and GP surgeries.

But council officers are asking if the purpose is simply to use the council’s influence generally or to refocus its work and officers’ time to more actively push for new primary care facilities. They also say some of the finance needed for new facilities would probably have to be sought from other sources, such as funds or grants.

Coun Austen-Baker won Lancaster City Council’s Conservative group leadership election earlier this summer. He is putting forward a motion for discussion at this month’s full council meeting, which takes place at Morecambe Town Hall at 6pm.

The motion is supported by fellow Conservatives councillors Adrian De La Mare and Joan Jackson.

It states: “There is some disquiet among residents at the service provided to primary care patients since the merger into one of several hitherto independent primary medical practices in Lancaster.”

He proposes that "the council, by its cabinet and its executive officers, will take all such steps, working with its partners to bring about or facilitate new primary medical care facilities for NHS patients within a new practice, independent of existing practices, and will take a proactive approach to attracting provision of primary medical care services (general practice) for private patients in the district."

Officers’ feedback on the agenda states: “As a strategic partner, the council regularly meets with the primary care community and would be able to express the views of the council in those. However we have no direct or indirect powers on these matters.

“Health provision and requirements are one of the key considerations for the planning authority, factored in to development planning, from the Local Plan through to individual significant developments. However, it is generally not a matter that would result in the use of planning gain and any lack of sufficient provision rarely outweighs the more general need for additional

housing in making a balanced planning decision.”

‘Planning gain’ is the term for when councils achieve additional public benefits from developments which are given planning consent.

The officer notes add: “The NHS has its own arrangements for using and understanding population forecasts and likely service pressures, to plan and put in place adequate provision based on agreed plans and their population impacts.

“However, responsible bodies are rarely fully-funded to deliver on any duty they may have, and therefore the quality, scale and timing of infrastructure and amenities is funding-dependent.

“Some unitary and upper tier local authorities (county councils) have used public health funding and duties to create programmes which incentivise primary care growth, or have co-developed integrated projects with the primary care sector around public health and adult social care.

“Generally, district authorities (such as Lancaster City Council) have the opportunity to input into the shaping of proposals with the county. As a district authority, we do not have these duties or powers and so engagement with the county council may be relevant. This already happens with regard to any projects likely to take place in Lancaster.”

The officers notes add: “Regarding primary care mergers and growth of existing providers, we would not normally seek to intervene on whether services are expanded or extended, or if new providers may come.

“These are subject to commissioning and competition aspects that are outside the council’s remit and subject to fair competition rules that commissioning bodies are expected to abide by. It is also important to bear in mind that there is a general skills and capacity shortage in primary care.

“We understand the purpose of this motion is to agree that council should use its influence to encourage an increase in primary care provision in the areas of significant housing growth and express a preference for a diversity in offer and number of practices, rather than a further consolidation.

“Private provision would be a policy matter for council. Should it determine that growth in private provision is an important priority and if more specific tasks are proposed, this could have significant budgetary impacts with council officers’work on issues such as planning gain or other funding.”

The motion follows Lancaster City Council’s agreement last month with Lancashire County Council for a Government funding offer linked to plans for more than 9,000 new homes south of Lancaster.

The housing infrastucture funding agreement was opposed by some councillors, including Green councillor Caroline Jackson, who is leader of the council, but gained enough support from other councillors to be passed last month.

More widely, a nationwide reform of primary care and social care is due with the introduction of integrated care systems. The Westminster Government wants integrated care systems established between NHS organisations and local councils in every area.

The change aims to move towards closer working and co-operation in health and care, rather than previous emphasis on competition in buying and providing services, the Government has suggested.