Building an NHS Fit for the Future

Debate between Wendy Chamberlain and Amy Callaghan

Monday 13th November 2023 Commons Chamber

[Amy Callaghan (East Dunbartonshire) (SNP)]

It is of course an absolute pleasure to follow the maiden speech of the hon. Member for Uxbridge and South Ruislip (Steve Tuckwell). He made a very compelling maiden speech, although maybe not quite as compelling for me as a nationalist following him.

It is always a pleasure to rise on behalf of my party in a debate centred on our NHS. Few know more about the NHS than the man who contributed to its present-day financial struggles, the new Foreign Secretary, who obviously is not here because he is not elected to this place. It is incredibly unfortunate that this big set-piece event in the parliamentary calendar did nothing to address the increased privatisation in NHS England. Perhaps that is something we can look forward to being addressed in the autumn statement, but for now I will summarise the issue that was overlooked in the King’s Speech.

Privatisation is creeping in through the back door in NHS England, and while health is devolved and we have our own NHS in Scotland, this has dire consequences for our NHS in Scotland through Barnett consequentials. The reality is that money spent by the British Government on England’s NHS dictates how much the Scottish Government have to spend on our NHS up the road. Despite cuts to Barnett consequentials for our NHS in Scotland, the Scottish Government are continuing to invest in new and innovative ways to reduce health inequalities and to protect our NHS for future generations.

[Wendy Chamberlain (North East Fife) (LD)]

My colleague in the Scottish Parliament, the MSP for North East Fife, Willie Rennie, has raised the issue of a £10.9 million funding shortfall in NHS Fife, and that is before we see the winter surge. Does the hon. Member agree that, although we might see higher spending in Scotland, there are failures in how the SNP is delivering for our health services there?

[Amy Callaghan]

I thank the hon. Member for her contribution, but I would say that there are definitely structural funding issues because of being tied to this financial Union, which is the point I was just about to make. I hope she recognises that, and will maybe reflect on the fact that being part of this Union does have dire consequences.

--- Later in debate ---

[Wendy Chamberlain (North East Fife) (LD)]

I know that we say “the Government of the day”, but this Government seem to be taking that term to new heights.

The NHS is top of what I hear about on the doorsteps. People talk about how long it will take to see a GP, whether their children will get support with complex and little-understood conditions such as paediatric acute-onset neuropsychiatric syndrome and paediatric auto-immune neuropsychiatric disorders associated with streptococcal infections, whether specialists are available for support when things go wrong, and how they access mental health needs.

I understand that day-to-day decisions by NHS Scotland are not made here, as NHS Scotland’s running is within the devolved competence of the Scottish Parliament, but, from listening to the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar), we would think that everything was great in Scotland. It is right that our spending on the NHS is higher per capita, but that has nothing to do with the generosity of the Scottish Government. We get more money per head to reflect the high cost of delivering services over large rural areas in Scotland—it is simply more expensive to deliver our services. When I look at the GP services in North East Fife, I see them crumbling under the SNP.

[Amy Callaghan]

Does the hon. Member recognise that the lack of capital spending by the British Government in NHS England and its Barnett consequentials mean that the Scottish Government get less money to spend on NHS Scotland, so we are suffering as a result of being tied to this Union?

[Wendy Chamberlain]

Part of that comes from the fiscal framework that the Scottish Government have signed up to. The Barnett consequentials have always recognised that services in Scotland are more difficult to deliver because of our geographical size. In North East Fife our NHS board’s finances are stretched beyond the limit, as I raised earlier. Also, we no longer have any specialist A&E support, because no one in Scotland does.

Health services include caring services. My priority for North East Fife is for anyone who needs support to live independently to get it. No one should be left taking up a hospital bed or be on a waiting list because of a lack of carers. A lack of carers has not been addressed by either Government, which is why it is my party’s policy to introduce an elevated statutory minimum wage for social care workers, which will instantly help recruitment and place value in that vital profession.

I regret that, once again, the UK Government have failed to support the estimated 10.6 million unpaid carers across the UK. Whether they are helping with washing or arranging appointments, our unpaid carers sacrifice their time and, too often, their own health and wellbeing as they care for their loved ones and others. Carers UK research has found that almost a third of all unpaid carers—3.6 million—are struggling to make ends meet, while 75% of those receiving carer’s allowance are struggling to cope with the cost of living crisis. They are worrying about money, how they will care for their loved ones, how to stay in work, and whether their work will result in losing their carer’s allowance. There is so much worry, it is no surprise that Carers UK has found that almost four fifths of carers feel stressed or anxious, and 65% agreed that the cost of living was having a negative impact on their mental or physical health.

We can and must do more to help. I was proud this year to see the passing of the Carer’s Leave Act 2023. Once it is fully enacted, carers will have, for the first time, the right to take leave from work for their caring responsibilities. However, we are not quite over the line yet, so I would be grateful if the Minister could confirm whether the Government programme will include time for the regulations under the Carer’s Leave Act, and set out when we can expect those to be laid.

Going forward, I want that leave to be paid. Carer’s allowance must be reformed to enable people to enter and stay in work, and to lift those who cannot away from poverty. At the moment, carer’s allowance is a disincentive to entering work. Given that it is supposed to be a priority for the Government to get people back into work, I hope that there might be some change in the autumn statement next week.

North East Fife is a wonderful place, often ranking highly for its hospitality and stunning scenery. Of course, it is the home of golf. I could not miss an opportunity to applaud St Andrews university, currently ranked the best university in the UK. It is no wonder that we are a top destination internationally. You would be welcome to visit any time, Mr Deputy Speaker. However, I must highlight the damage that has been done by the UK Government’s policies. The success of St Andrews university is down not just to student experience and outcomes but to its incredible research. However, the continual delays in the Foreign, Commonwealth and Development Office’s processing of academic technology approval scheme applications disincentivises the brightest minds from coming to our shores. The delays in gaining associate membership of Horizon have led to funding losses and frequent complaints that UK researchers were left out multinational proposals. Meanwhile, there have been cuts to official development assistance budgets, which help to fund vital research on how to tackle the greatest issues facing the world. I am looking forward to hearing from the new Foreign Secretary on that very issue, given his previous opposition to the cut in ODA funding.

Thinking about your visit, Mr Deputy Speaker, it would be a sad trip if the hostelries in North East Fife were shut or you had nowhere to stay due to persistent post-Brexit labour shortages. I would want to show you our brilliant distilleries—Lindores Abbey, Kingsbarns, Eden Mill and Daftmill—but, again, the Government seem to be intent on making it harder for such businesses. Their refusal this spring to include distilleries as high intensity energy users for support with their bills, while simultaneously hiking tax by 10.1%, was a betrayal of the Scotch whisky industry. That means that a responsible drinker of whisky will pay an extra £200 of tax per year compared with others such as cider drinkers. I urge the Government to stop their unfair treatment and the Chancellor to freeze duty on spirits in his statement next week. The Government said that they would do that, so it will be great if some of those long-term decisions for a brighter future were committed and kept to.

I wonder if the Chancellor will pick up the slack from the total failure to mention vital local services such as banking hubs and post offices in the King’s Speech. We have had seven post office closures in North East Fife alone. Post offices used be the heart of a community, where people could do basic banking, buy their stamps and apply for passports. Those needs have not gone away, particularly in rural constituencies, and neither has the need for physical banking. In Cupar, in the centre of my constituency, the last physical bank standing is Nationwide. It is great to still have a building society presence, but what about all those other customers in other banks and in the villages outside Cupar, too? I very much hope we will see from the Financial Conduct Authority a proper way to assess how a community will benefit from a bank hub that goes simply beyond the last bank in town being lost.

Mr Deputy Speaker, I would like briefly to take you back to the joy of a visit to North East Fife. The East Neuk coast is stunning and an inspiring sight for tourist and local alike, and, in summer, a favourite for swimming. That leads me to the failure to regulate water companies and the challenge in Scotland of the ongoing discharge of sewage into our sea. This is as much of an issue in Scotland as it is in other parts of the UK. Monitoring over the summer found that Lower Largo’s beach was at least 50 times above the recommended contamination limit at least three times, its filthiness a stain on any claim by decision makers to protect our environment. The challenge —this comes from a Liberal Democrat investigation earlier this year—is that only 4% of 3,500 outflows in Scotland are currently monitored, and the 1,000 additional monitors they want to put in will not be available until the end of 2024 at the earliest. That is also true in other places, such as Eastbourne, where Southern Water has lots to answer for.

To conclude on the point made by the hon. Member for Ellesmere Port and Neston (Justin Madders), yes a reshuffle slows things down. How much of the King’s Speech will we actually get through before a general election?