Agenda item

This report sets out a response to an issue, raised by Councillor Freshwater, in relation to GP provision on the Hoo Peninsula.

Discussion

Councillor Freshwater introduced his Member item in relation to GP Provision on the Hoo Peninsula. He felt that there was a lack of transparency about the plans for GP provision on the Peninsula as the population increased and that Medway NHS Clinical Commissioning Group (CCG) was not providing information about how this demand would be met. There were 2,000 new homes in the process of being approved or built, with a further 2,000 to be approved before the new Local Plan had been approved. The total resulting population increase would be around 9,000. Councillor Freshwater was asking for additional information to be included in a Health Impact Assessment but had not received satisfactory responses to his requests. Health Impact Assessments were being considered as part of the Local Plan consultation which had been considered by Cabinet in March 2018. However, it was not adequate to wait for the Local Plan process to be concluded as houses would already have been built.

Councillor Freshwater was also disappointed that a number of questions he had raised in the report had not been answered by the CCG or by officers. CCG projections and planning assumptions to 2021/22 had been based on 267 new dwellings on the Peninsula equating to 641additional people. However, these estimates were considered to be well below the number of dwellings that would actually be built and this would have a significant negative impact on the provision of healthcare.

Councillor Freshwater requested the completion of a health impact assessment for all new planning applications of 25 or more dwellings on the Hoo Peninsula and questioned why there appeared to be resistance to undertaking a health impact assessment as part of a planning application.

The Director of Primary Care Transformation at NHS Medway CCG advised that the CCG used population projections based upon its joint work with the Council. It was acknowledged that a large number of houses were due to be built. Work would be taking place with the Council’s Planning and Public Health Services to ensure that this was fully taken into account when planning future primary care provision on the Peninsula. Initial discussions had taken place with a building consortium on the Peninsula in relation to healthcare provision and work was also taking place with the emergency services to consider wider service provision.

The CCG considered that there would be sufficient GP capacity on the Peninsula for the next two years. After this, there would need to be physical expansion. Councillor Freshwater had raised an issue which had resulted in patients of one practice on the Peninsula having to travel to Gillingham to access a GP. This had been a physical building issue and had now been resolved. All GP lists on the Peninsula were currently open for new patients to register and there were no capacity issues. Work would be needed to address workforce challenges in relation to the number of GPs and nurses required in order to maintain capacity but this was a Medway wide issue.

Councillor Freshwater was concerned that the rural location of the Hoo Peninsula made it difficult to attract GPs to the area. He said that some residents had not been able to register with a local GP and had been told to register on St Mary’s Island instead. He requested a meeting with the CCG and local practices to discuss capacity.

The Head of Planning acknowledged that there were infrastructure related challenges to address across Medway. Medway was growing, partly due to an increased birth rate and people living longer. Health issues were being considered via the Local Plan process, which included close working with the CCG. 800 to 1,000 new dwellings had been granted planning permission on the Peninsula in recent years. For any new developments over 10 units, consultation took place with the CCG and developers were asked for a contribution towards looking at measures to improve GP provision in the vicinity of the development. Wider consideration was being given in relation to how to meet the infrastructure needs of recent development and to look at how to make improvements in advance of growth. The Chief Operating Officer of the CCG added that the CCG would update its plans when growth projections were revised and that the CCG was fully engaged in the development of the new Local Plan.

A Committee Member expressed their support for the concerns raised by Councillor Freshwater and said that she had previously suggested that every motion to Council should have its public health implications considered. The wider impacts of development, such as on air quality, also needed to be taken into account. It was important for there to effective joint working to ensure adequate provision for the Hoo Peninsula and for the whole of Medway.

A Member said that some of the GP surgeries mentioned by the CCG in the report were not in Peninsula ward and that others covered less than half the ward geographically. The Director of Primary Care Transformation at the CCG advised that GP surgeries often served populations in multiple wards and that GP catchments were not aligned to ward boundaries. The CCG was looking at where future growth would take place and would look to target GP provision accordingly.

The Head of Planning noted the importance of improving the general health of the population in order to reduce the demand for GP services. Factors to consider included the layout and design of new developments, air quality and the provision of park and green spaces. The draft new Local Plan was due to be considered by Cabinet in December. This would include policies relating to health and although the Plan would be a draft at this point it would carry weight in determining planning applications.

Committee Members were concerned that Councillor Freshwater’s proposed request to Cabinet for health impact assessments to be completed for new planning applications of 25 or more dwellings on the Peninsula did not include details of potential benefits or cost implications.

Decision

The Committee agreed that the following matter be referred to Cabinet for consideration:

The Cabinet in the report 6th March 2018 - Medway Local Plan - Development Strategy Consultation - makes reference to the use of Health Impact Assessments to collect evidence-based information for planning and infrastructure needs for communities. Having regard to the current loss of evidence-based information for 2,000 homes already approved Peninsula homes, the Cabinet be requested to consider bringing forward the implementation of Health Impact Assessments for all Planning Applications of 25 or more new homes for the Hoo Peninsula and advise the Director of Public Health accordingly.