NHS (Government Spending)
Eilidh Whiteford Excerpts(9 years, 3 months ago)
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Dr Eilidh Whiteford (Banff and Buchan) (SNP)
I apologise for not being in the Chamber for the beginning of the debate.
The issues raised in today’s debate about the challenges of providing health care for a population that is ageing and living longer with complex health conditions in a context of fiscal austerity and rising costs are some of the most pressing ones facing us as policy makers. We all acknowledge that it is difficult and there is no easy soundbite solution to the long-term challenges, but I do not believe that those challenges are insurmountable if we are prepared to prioritise health spending and address pressure points in the system.
Lilian Greenwood
It is interesting that the hon. Lady was talking about the costs of an ageing population. Is she aware of Monday’s report by Action on Hearing Loss, which showed that as a result of budget cuts and rising demand two out of five audiology departments offer patients a reduced service? The chief executive of Action on Hearing Loss described that as having a cruel and senseless impact on people with hearing loss. Should the Government not respond to that?
Dr Whiteford
I was not aware of that report, so I am grateful to the hon. Lady for pointing it out.
We all know that we do not have one NHS in the UK—we have national health services in each of the home nations that operate independently of one another and are accountable to the devolved institutions—but it is worth noting that in recent years our distinct national health services have gone down divergent policy paths. Those of us who remain committed to comprehensive health care, available free at the point of need, understand that the model is under ideological threat. I have been horrified by the NHS reforms in England that have removed the statutory duty of care, and that, as we speak, are enabling the creeping privatisation of services. For the sake of the peoples of these islands, those reforms need to be reversed, because the reality of devolution is that Westminster still holds the purse strings. The funding formula by which the devolved Governments receive their block grants is directly related to budget decisions made for England in devolved policy areas, so decisions to cut spending in NHS England, or to privatise services, have a direct knock-on effect on the money made available to the Scottish Government.
There has been a 10% cut in Scotland’s fiscal resource budget since 2010, and a 26% real-terms cut in Scotland’s capital budget. Nevertheless, the Scottish Government have increased the health resource budget by 4.6% in real terms, and every penny of additional budget consequentials accruing from health spending has been spent on health. This coming year, health spending in Scotland will break the £12 billion barrier for the first time.
The practical consequences of increased health spending in Scotland can be seen in record staffing levels—up 6.5% overall, with record numbers of consultants, over 1,700 more nurses and a 7% increase in GPs. We have cleaner hospitals—cases of MRSA are down 88%, and C. diff is down 81% in elderly patients since 2007. Our waiting times for in-patients and out-patients have improved dramatically. More than 97% of in-patients were treated within the 12-week target in the last quarter, and 90% of patients are now being seen and treated within 18 weeks of initial referral. Perhaps most telling of all, there has been a drop in the hospital standardised mortality ratios of almost 16% since 2008 and a sizeable reduction in premature deaths in the most deprived areas. And we have honoured our pay commitments to our NHS staff.
The Minister and other Members have today made many comparisons between the NHS in England and the NHS in Wales, but there have been no comparisons with the NHS in Scotland. That is because across a range of indicators the Scottish NHS is outperforming the NHS elsewhere, precisely because we have not gone down the privatisation route.
Just yesterday the brand-new Southern general was handed over to the NHS—an NHS hospital, paid for without the use of discredited private finance initiative or public-private partnership schemes that have been an atrocious waste of public money and are still costing NHS Scotland over £225 million a year. In the north-east, anyone visiting Foresterhill can see all the building work that is going on to improve facilities. Under previous Governments, NHS Grampian was severely short-changed by the funding formula, but the SNP Government have been closing that gap and next year will put in an additional £49 million, a 6% funding increase to bring it into line with other health boards.
We cannot be complacent about the pressures on our NHS. Despite the best efforts and commitment of staff, our NHS is under strain and it does not always get it right. As MPs we often see when things go wrong, but we need to see that against a background of increasing patient satisfaction overall and continuing improvement in patient care, despite enormous pressures. We heard earlier today that some of the pressure on A and E emergency care is a consequence of people having problems accessing primary care. Another area where pressure in one part of the NHS has extensive knock-on impacts is in relation to delayed discharge, which puts tremendous strain on patients, whether they are stuck in hospital desperate to get home, or stuck at home desperate to get into hospital for treatment, because no beds are available.
The Scottish Health Secretary announced an additional £100 million earlier this month to address delayed discharges, but the underlying issues are not just for the NHS. Back in 2010 the report of the Christie commission highlighted, among other things, the need for joined-up services between health boards, local authorities and others, and preventive early interventions to meet the challenges of rising costs and changing demographics in the context of tight public finances. In Scotland, much progress has been made since then, but nobody would pretend that there is not a lot still left to do, or that the process is straightforward. However, we just need to look at how the non-means-tested free personal care has enabled thousands of people to live at home to see the human benefits of what is increasingly being recognised as a cost-effective policy.
It is precisely those efforts to join up health and social care that are threatened by the austerity agenda and the promises of further cuts that both Front-Bench teams seem to have shackled themselves to. Local authority budgets are already under pressure, and further cuts to the public services that they provide, including social care and preventive early intervention work, risk driving up still further the acute pressures on our NHS. Our NHS is precious. Most of us depend upon it. We need to prioritise it and provide the resources that it needs to meet changing demands on it.
National Health Service (Amended Duties and Powers) Bill
Eilidh Whiteford Excerpts(9 years, 5 months ago)
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Dr Poulter
Let me make a little progress on the damage that the Bill might do. As I have said, the belief that removing the parts of the 2012 Act that relate to competition will stop competition law applying to our NHS is simply wrong. That important point goes to the heart of what the right hon. Member for Leigh has said.
Dr Poulter
If the hon. Lady will let me make some progress, I will come to her shortly.
The fact that such a belief is wrong was recently made clear in correspondence from Simon Stevens to the right hon. Gentleman—from one former Labour special adviser to another—which stated:
“We are, as appropriate, required to observe European procurement regulations, originally introduced in 2006, and related UK law. In everything we do we are also required to exercise our functions effectively, efficiently and economically. As a result we are advised that a blanket contracting ban would not be permissible.”
It would not be permissible because of regulations introduced by the previous Labour Government. That is another reminder that Labour introduced competition into the NHS.
As I explained earlier, under changes introduced by the previous Labour Government, health commissioners were subject to EU competition law for several years prior to the Act, and they would continue to be subject to it even if the Act was repealed.
Dr Whiteford
The points the Minister is making about competition take us back to the transatlantic trade and investment partnership. He must be aware that the NHS across these islands is developing in very different directions, and competition has not been at the heart of what has happened in other parts of the UK. I want him to give us cast-iron guarantees today that there will be no obligation on the NHS in Scotland to open up because of that trade agreement, even if the UK decides in its favour. What opportunities are there, if the treaty exposes the Scottish Government to—
Dr Poulter
Points were made about the voluntary and charitable sector supporting innovative new models of care. Through the Newquay pathfinder project Age UK has provided volunteer support to vulnerable older people considered at risk. Under the home scheme the British Red Cross provides volunteer support to patients in their homes, which is aimed at preventing admission to, or facilitating discharge from, hospital. The charity has care in the home contracts with more than 30 NHS trusts and social services departments, and the scheme enables reduced admissions, increased convenience to patients, and many other associated benefits.
My hon. Friend the Member for Stafford (Jeremy Lefroy) mentioned Macmillan. I like to talk about Macmillan, which has long provided vital support to patients right across the UK. It is collaborating with doctors in Staffordshire to transform cancer care and end-of-life care, and together they aim to commission care right across the patient journey. In cancer, that means commissioning prevention and health promotion, ensuring early diagnosis and prompt treatment through survivorship and improving end-of-life care.
In reality, the only route proposed in the Bill for recourse against unfair treatment by commissioners is to take us back to the previous Labour Government’s competition laws in 2006 and open up legal challenge through the courts. Only private providers with enough resource behind them are likely to be able to afford to exist in that court-based system, to pay high legal fees, and to invest in providing NHS care to patients, and smaller providers, especially charities, will lose out. Surely we do not want to see that in our NHS—an NHS in which, I hope we all agree, charitable and small local health care organisations have something important to contribute for the benefit of patients.
Before I conclude, I must briefly address some of the misleading commentary that has surrounded TTIP, which is serving only to distract from the real debate about our NHS. First, may I state that there is absolutely no agenda whatsoever to privatise our NHS through the back door? TTIP cannot force the privatisation of public services by EU member states. This position has been made explicitly clear by us and by the relevant negotiating parties. To suggest otherwise would be disingenuous and, frankly, wrong. I encourage Members to look at the recent negotiating mandate published by the European Commission, where this position is made absolutely clear. I note the comments of Ignacio Garcia Bercero, EU chief negotiator, on the record at the end of round 7 negotiations—
Dr Poulter
I am addressing the hon. Lady’s point, so I hope she will let me do so. Ignacio Garcia Bercero said:
“I wish…to stress that our approach to services negotiations excludes any commitment on public services, and the governments remain at any time free to decide that certain services should be provided by the public sector.”
That is a very clear reassurance, and I hope it will be accepted by all hon. Members. I will give way just once more, because I do not want to test Mr Deputy Speaker’s patience as I come to a conclusion.
Dr Whiteford
I am grateful to the Minister, but my understanding is that the Commission has said that if one part of the UK market is opened up through privatisation—perfectly democratically, as it could be—then all parts will be opened up. I want his assurances that Scotland will not be forced, by the back door, to privatise its NHS on the coattails of this House.
Social Care Funding
Eilidh Whiteford Excerpts(11 years, 3 months ago)
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Mr Hunt
We have funded these proposals until 2020 on plans that have been agreed by the Liberal Democrats and the Conservatives. We hope very much that we will have the support of the Opposition for these plans as well. Then we can have a national consensus around them, which is what we need because in the end, if we are to create that certainty in the markets, people need to know that whichever Government are elected, they support the basic approach that we are endorsing.
Dr Eilidh Whiteford (Banff and Buchan) (SNP)
These proposals will not apply in Scotland, where people already receive personal and nursing care as they need it, when they need it, regardless of their income. Is the Secretary of State aware that this approach has helped to reduce substantially the number of people requiring long-term hospital beds, has also helped to reduce NHS bed-blocking, and has enabled thousands of elderly, frail people in Scotland to live in their own homes, rather than face the crippling costs of moving into residential care?
Mr Hunt
There are some things that we can learn from Scotland and some things that we cannot learn. Scotland has a very good record in identifying people with dementia, and the point that the hon. Lady makes about helping people to live at home for longer is a very good one. Care costs incurred in domiciliary care for people who are living at home will count towards the £75,000 cap, so we hope to have many more flexible ways for people to provide for themselves and be able to live at home happily and healthily for longer.
084 Telephone Numbers (NHS)
Eilidh Whiteford Excerpts(12 years, 3 months ago)
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Mr Ainsworth
The 03 number would give people an opportunity to use the system for no enhanced charge, and the GP should, if they are not prepared to migrate to an 03 number, provide a landline alternative. Since I first raised this issue, most of the people who have contacted me have been pensioners. They have told me that they have contracts with their telephone provider and have found that, at the end of the quarter, the charges under discussion are additional to the contract and therefore to their bill. People who use mobile phones are probably not as ready to contact a Member of Parliament, or do not listen as closely as pensioners to such debates. People who use mobile phones—overwhelmingly poorer people—are being charged extortionately for access.
Dr Eilidh Whiteford (Banff and Buchan) (SNP)
This is a very important issue, because it affects all parts of the UK. A much smaller percentage of people in Scotland are affected by 084 numbers, but more than half of them are in the Grampian health board region. I am concerned, because although I share the right hon. Gentleman’s sentiments on the difficulties faced by people in lower income groups in relation to 084 numbers, if we secure a ban on them, how will we prevent the goalposts from shifting and another revenue-sharing number from taking their place?
Mr Ainsworth
We can do that only if the Department of Health is determined, right up to ministerial level, to enforce the contract. The terms of the contract are clear, as I hope the Minister will say when he responds. No one should pay enhanced charges to access their GP.