To ask Her Majesty's Government what training NHS England provided for GPs to support those affected by gambling-related harm in (1) 2013, (2) 2014, (3) 2015, (4) 2016, (5) 2017, and (6) 2018; and what plans they have to increase the level of training provided.

To ask Her Majesty's Government what training NHS England provided for GPs to support those affected by gambling-related harm in (1) 2013, (2) 2014, (3) 2015, (4) 2016, (5) 2017, and (6) 2018; and what plans they have to increase the level of training provided.

To ask Her Majesty's Government how many patients presented to GPs in England with dental problems in each of the last five years; and, in each year, how many of them were prescribed antibiotics.

To ask Her Majesty's Government how many patients presented to GPs in England with dental problems in each of the last five years; and, in each year, how many of them were prescribed antibiotics.

To ask Her Majesty’s Government what progress they have made in the general practitioner contract negotiations for 2019–20 to end charges for the provision of evidence of domestic abuse.

To ask Her Majesty’s Government what progress they have made in the general practitioner contract negotiations for 2019–20 to end charges for the provision of evidence of domestic abuse.

My Lords, the Department of Health and Social Care has put this important issue forward as part of the general practice contract negotiations for 2019-20. While the progress of those negotiations is not discussed publicly until an agreement has been reached, I can reassure the House that the Government are committed to dealing with this issue.

My Lords, the Department of Health and Social Care has put this important issue forward as part of the general practice contract negotiations for 2019-20. While the progress of those negotiations is not discussed publicly until an agreement has been reached, I can reassure the House that the Government are committed to dealing with this issue.

I agree with the noble Lord. I feel uncomfortable with idea of these letters being charged for. They have been identified by the Ministry of Justice and MHCLG as barriers to accessing support for victims of domestic violence. That cannot be right, and we are seeking to end that situation. GPs are independent contractors and therefore have that freedom unless it is specifically prohibited in their contracts, and that is what we are seeking.

I agree with the noble Lord. I feel uncomfortable with idea of these letters being charged for. They have been identified by the Ministry of Justice and MHCLG as barriers to accessing support for victims of domestic violence. That cannot be right, and we are seeking to end that situation. GPs are independent contractors and therefore have that freedom unless it is specifically prohibited in their contracts, and that is what we are seeking.

I can reassure the noble Baroness that we will celebrate that day. I think this Prime Minister has done more than any to clamp down on domestic violence and to support victims. That was

shown in the £100 million that was set aside to support victims of domestic violence in a number of innovative ways. I can further reassure her that, as I understand it, the number of beds in refuges has increased over the past few years.

I can reassure the noble Baroness that we will celebrate that day. I think this Prime Minister has done more than any to clamp down on domestic violence and to support victims. That was

shown in the £100 million that was set aside to support victims of domestic violence in a number of innovative ways. I can further reassure her that, as I understand it, the number of beds in refuges has increased over the past few years.

I join the noble Baroness in condemning this type of crime, and it is disturbing that violence against older victims has risen. That is precisely the reason the Government have asked the Law Commission to look at the issue and bring forward suggestions on how to give the authorities greater powers to clamp down on those who perpetrate such crimes.

I join the noble Baroness in condemning this type of crime, and it is disturbing that violence against older victims has risen. That is precisely the reason the Government have asked the Law Commission to look at the issue and bring forward suggestions on how to give the authorities greater powers to clamp down on those who perpetrate such crimes.

I do not think that it is an issue of staffing per se, because it is not only doctors but other healthcare professionals who are able to provide letters of this kind. The evidence that has been gathered through consultation and indeed through the progress of the secure tenancies Bill is that the charges for these letters act as a barrier. That is the issue we are trying to address.

I do not think that it is an issue of staffing per se, because it is not only doctors but other healthcare professionals who are able to provide letters of this kind. The evidence that has been gathered through consultation and indeed through the progress of the secure tenancies Bill is that the charges for these letters act as a barrier. That is the issue we are trying to address.

The noble Lord speaks with great wisdom on this subject. That is precisely why the domestic abuse Bill is looking to provide stronger sentences where a child has been involved or has witnessed this kind of abuse, and why some of the money I mentioned earlier, around £8 million this year, has been put aside to support children in these situations.

The noble Lord speaks with great wisdom on this subject. That is precisely why the domestic abuse Bill is looking to provide stronger sentences where a child has been involved or has witnessed this kind of abuse, and why some of the money I mentioned earlier, around £8 million this year, has been put aside to support children in these situations.

The noble Baroness will appreciate that this is not a matter for the Department of Health and Social Care, but it is something that I will be happy to look into. What I do know is that the draft domestic abuse Bill is looking to establish a domestic abuse commissioner. It may be that it is through that route that support of that kind may be made available.

The noble Baroness will appreciate that this is not a matter for the Department of Health and Social Care, but it is something that I will be happy to look into. What I do know is that the draft domestic abuse Bill is looking to establish a domestic abuse commissioner. It may be that it is through that route that support of that kind may be made available.

My noble friend is right to say that domestic abuse can affect anyone, although of course it happens predominantly to women. The police, local authorities and the third sector are there to provide support for both men and women when they are abused.

My noble friend is right to say that domestic abuse can affect anyone, although of course it happens predominantly to women. The police, local authorities and the third sector are there to provide support for both men and women when they are abused.

This would be for the discretion of the GP. I would be amazed if any GP would want to see someone who has come to them with a confidential matter, such as saying that they have been the victim of domestic abuse, in a group situation. That seems to be quite wrong. There is a role for group GP appointments for totally different issues, and indeed some of the emerging evidence shows that, for certain illnesses, they can be quite successful.

This would be for the discretion of the GP. I would be amazed if any GP would want to see someone who has come to them with a confidential matter, such as saying that they have been the victim of domestic abuse, in a group situation. That seems to be quite wrong. There is a role for group GP appointments for totally different issues, and indeed some of the emerging evidence shows that, for certain illnesses, they can be quite successful.

To ask Her Majesty’s Government what progress they are making in increasing the number of general practitioners in England.

To ask Her Majesty’s Government what progress they are making in increasing the number of general practitioners in England.

My Lords, the Government still intend to increase the number of doctors in general practice by 5,000, but we recognise that this will take longer than hoped. Last year we recruited the highest number of doctors into GP speciality training. There is also a broad offer for GPs to stay in the NHS, including a £10 million retention fund. Furthermore, since 2015, more than 3,000 other clinical staff are working in general practice.

My Lords, the Government still intend to increase the number of doctors in general practice by 5,000, but we recognise that this will take longer than hoped. Last year we recruited the highest number of doctors into GP speciality training. There is also a broad offer for GPs to stay in the NHS, including a £10 million retention fund. Furthermore, since 2015, more than 3,000 other clinical staff are working in general practice.

The noble Baroness is correct, unfortunately: she is using accurate figures. We have not achieved the GPs numbers that we wanted but we still intend and need to recruit those other 5,000 GPs. It is worth pointing out that the funding for general practice will have increased by around £2.5 billion over the five years between 2015 and 2020, so I do not accept her point about funding shortfalls. The money is there, but we need to recruit more GPs and keep them in the service.

The noble Baroness is correct, unfortunately: she is using accurate figures. We have not achieved the GPs numbers that we wanted but we still intend and need to recruit those other 5,000 GPs. It is worth pointing out that the funding for general practice will have increased by around £2.5 billion over the five years between 2015 and 2020, so I do not accept her point about funding shortfalls. The money is there, but we need to recruit more GPs and keep them in the service.

My noble friend will know that pension policy is not one of my areas. There are early retirements from general practice but, as he pointed out, a number of those GPs come back either as locums or as part-time doctors. It is important to entice more of them back. That is why we aim to have 500 people going through our refresher scheme to bring GPs back into the service.

My noble friend will know that pension policy is not one of my areas. There are early retirements from general practice but, as he pointed out, a number of those GPs come back either as locums or as part-time doctors. It is important to entice more of them back. That is why we aim to have 500 people going through our refresher scheme to bring GPs back into the service.

Some people will inevitably travel abroad after their training, but the vast majority of doctors who train in this country stay here. We have more GPs than ever in training. That is obviously the way to solve the long-term challenges of having the right workforce. However, the noble Baroness is absolutely right that we need to recruit from abroad in the short-to-medium term. The NHS has a recruitment target of 2,000 doctors via that route.

Some people will inevitably travel abroad after their training, but the vast majority of doctors who train in this country stay here. We have more GPs than ever in training. That is obviously the way to solve the long-term challenges of having the right workforce. However, the noble Baroness is absolutely right that we need to recruit from abroad in the short-to-medium term. The NHS has a recruitment target of 2,000 doctors via that route.

I agree with that recommendation. It is certainly being considered as part of the long-term plan, for which workforce is clearly critical. That is one reason why it is significant that there are 3,000 more clinical staff in general practice who are not doctors—nurses, pharmacists and others. Clearly the nature of general practice is changing. Doctors do not have to do everything, and other well-qualified professionals can carry out essential roles.

I agree with that recommendation. It is certainly being considered as part of the long-term plan, for which workforce is clearly critical. That is one reason why it is significant that there are 3,000 more clinical staff in general practice who are not doctors—nurses, pharmacists and others. Clearly the nature of general practice is changing. Doctors do not have to do everything, and other well-qualified professionals can carry out essential roles.

The noble Baroness raises what is unfortunately a sad fact. One of the areas I highlight is the increasing use of social prescribing, which uses means such as joining clubs and taking part in activities that often have a social dimension to alleviate the problems associated with loneliness. Our new Secretary of State has made social prescribing a priority, because clearly it enables us to change people’s lives for the better without resorting to appointments and medicines.

The noble Baroness raises what is unfortunately a sad fact. One of the areas I highlight is the increasing use of social prescribing, which uses means such as joining clubs and taking part in activities that often have a social dimension to alleviate the problems associated with loneliness. Our new Secretary of State has made social prescribing a priority, because clearly it enables us to change people’s lives for the better without resorting to appointments and medicines.

My noble friend makes an important point, and obviously she has first-hand experience of that. I am pleased to tell her that there is a targeted recruitment scheme that offers a £20,000 salary supplement for those who serve in hard-to-reach areas. In 2016, 122 places were offered on that scheme, and that number has now more than doubled in 2018, so we are putting more and more emphasis on that.

My noble friend makes an important point, and obviously she has first-hand experience of that. I am pleased to tell her that there is a targeted recruitment scheme that offers a £20,000 salary supplement for those who serve in hard-to-reach areas. In 2016, 122 places were offered on that scheme, and that number has now more than doubled in 2018, so we are putting more and more emphasis on that.