Patient-Centred, Accessible and Preventive: A Liberal Vision for Primary Health Care (Primary Healthcare Policy Paper)

Chair: Eleanor Kelly (Vice Chair, FCC); Aide; Baroness Kitching; Hall Aide; Jess Brown-Fuller MP

Submitted by: Federal Policy Committee 
Mover: Helen Maguire MP (Spokesperson for Primary Care and Cancer) 
Summation: Dr Kate O’Kelly (Chair of the Policy Working Group)

Conference recognises that NHS primary healthcare services play a frontline role in treating patients and that their visible shortcomings are both a representation of the failings that exist throughout the entire system and a problem in and of themselves.

Conference notes that:

1. Primary care is where most patients first seek help and where early treatment prevents illness from escalating into a problem that adds to demands on hospitals.
2. General practices, dentists and pharmacies are the front door to the rest of the NHS and they collectively deliver 90 per cent of the interactions between the NHS and the public.
3. Health has been the second most important issue to voters over the past 15 years, behind only the economy.

Conference notes with anger that the Labour Government has utterly failed NHS primary healthcare services, and that since entering office ministers have chosen to make hospital waiting lists the political test of NHS recovery, while treating the front door of the health service without the same urgency, grip or guarantee of improvement.

Conference further notes that the Labour Government’s claim to be fixing ‘the front door’ of the NHS is both inaccurate and insulting, with nearly half the public delaying or avoiding contacting their GP about a health concern, 4.1 million GP appointments in October 2025 taking place more than 28 days after booking, and 41 per cent of patients not being offered a choice of appointment time, day or location, despite patient choice being strongly linked to satisfaction with care.

Conference deplores the fact that successive Conservative governments presided over a decade in which primary care became harder to access, more unequal, and less sustainable; under their mismanagement, general practice was left with fewer fully qualified general practitioners per patient, dentistry became out of reach for millions, community pharmacies closed in record numbers and the share of NHS spending going to primary care shrank even as demand rose.

Conference believes that a Liberal NHS primary care system should:

1. Transform formal rights into real freedoms by giving people the capability to be healthy, which is largely determined by the quality of the NHS primary care system.
2. Treat people as individuals with individual needs rather than as a number in a backlog that needs to be cleared.
3. Respect the fact that quality means different things to different people, and that everyone would prioritise speed, continuity, face-to-face care, digital access, prevention, reassurance or a trusted long-term relationship differently.
4. Never wait for people to reach crisis point before becoming available, because a health service that waits until people are acutely ill fails to empower people to live a life of their choosing.

Conference notes with concern that:

1. Only 26 per cent of Britons are satisfied with how the NHS runs.
2. 53 per cent of Britons expect care to get worse in the next five years.
3. Over a quarter of Britons think the NHS is inherently broken and cannot be improved.

Conference therefore endorses policy paper 166, PatientCentred, Accessible and Preventive: A Liberal Vision for Primary Health Care, and its flagship policies that would rapidly and reliably reverse this Labour Government’s neglectful mismanagement of NHS primary healthcare services and restore the confidence of voters, including:

1. Giving patients more choice when booking general practice appointments, including the option to either have an appointment within a week at a time most convenient for them (or within 24 hours if urgent), or for a longer duration appointment with a healthcare professional with whom they already have a relationship.
2. Expanding the Pharmacy First model to include new services, and better integrate pharmacy into the NHS App.
3. End dental deserts including by removing the administrative barriers that are preventing qualified overseas dentists that are already living in England from entirely filling the 2,500 dentist vacancies, with appropriate safeguards and without impacting quality or safety.

Conference in particular endorses the paper’s proposals to:

1. Empower patients by keeping online booking open 24/7 for non-urgent requests, maintaining non-digital routes, setting standards for usability and accessibility, strengthening patient choice, improving shared care and ending the GMC five-year rule for serious fitness-topractise concerns.
2. Get general practice, community and neighbourhood services, and hospitals working together under a patientcentric model of primary and community care, including by:
   1. Better utilising spare 111 capacity to support GP receptions at peak times and create pathways for senior paramedics to join GP teams.
   2. Reforming the Carr-Hill formula so that funding more fairly reflects need.
   3. Requiring developers to ensure there are enough healthcare professionals when people move into new developments.
   4. Expanding support for low-income patients to access primary care.
3. Put community pharmacy on a sustainable footing by properly rewarding an expanded Pharmacy First service, making it fairer for rural and coastal communities, allowing NHS App booking, improving medicines safety information and reviewing prescription charge exemptions.
4. Repair NHS dentistry by replacing the Units of Dental Activity contract with a prevention-focused model, guaranteeing urgent and emergency appointments, protecting check-ups for children and vulnerable groups, supporting supervised toothbrushing, and expanding dental recruitment and retention incentives in underserved areas, which would especially benefit ethnic minority communities.
5. Care for healthcare professionals as people themselves, by making general practice more sustainable and rewarding, freeing up GP time, supporting GPs to lead multidisciplinary teams, embedding clinical pharmacists and other qualified professionals safely, and creating routes for experienced paramedics to join GP teams.
6. Support community optometry and high street providers to deliver eye and ear care closer to home, including glaucoma monitoring, cataract pathways, urgent minor eye care, hearing aid fittings and minor ear infection treatment, reducing unnecessary GP and hospital appointments and helping people stay independent for longer.

Applicability: England

Mover and summation combined: 16 minutes; mover and summation of amendments: 4 minutes; all other speakers: 3 minutes. For eligibility and procedure for speaking in this debate, see page 10 of the agenda. You can submit a speaker's card online here or in person.

In addition to speeches from the platform, voting members will be able to make concise (maximum one-minute) interventions from the floor during the debate on the motion. See pages 10-11 of the agenda for further information.

The deadline for amendments to this motion is 13.00 Monday 7 September; see pages 11-12 of the agenda for more information.

Those selected for debate will be printed in Conference Extra and Monday’s Conference Daily. The deadline for requests for separate votes is 09.00 Sunday 20 September; see page 9 of the agenda for more information.