Oral Answers to Questions

Amy Callaghan Excerpts

Tuesday 5th March 2024 Commons Chamber

[Mr Speaker]

I call the SNP spokesperson.

[Amy Callaghan (East Dunbartonshire) (SNP)]

I have asked the Secretary of State a number of times how she intends to recruit and retain social care staff, particularly with the visa changes coming into effect next Monday, stopping those from overseas coming to fill skills gaps from bringing their spouse or dependants with them. I ask again: how does the Secretary of State intend to improve the recruitment and retention of staff in the social care sector while her colleagues effectively work to undermine her?

[Helen Whately]

We are grateful to international workers coming to support us in social care and improving supply, but we have to get the balance right between international recruitment and our domestic workforce. In England, we are reforming social care careers to make social care work a career for our homegrown workforce, and I encourage her to make sure the SNP does the same in Scotland.

--- Later in debate ---

[Mr Speaker]

I call the SNP spokesperson.

[Amy Callaghan (East Dunbartonshire) (SNP)]

Later this month I will be 10 years cancer free, having survived melanoma first as a teenager and again in my early 20s. Can the Secretary of State look me in the eye and guarantee that she is doing all she can to prevent others from getting the same diagnosis ?

Tackling Obesity

Amy Callaghan Excerpts

Tuesday 27th February 2024 Westminster Hall

[Amy Callaghan (East Dunbartonshire) (SNP)]

It is a pleasure to serve under your chairship, Mr Dowd. I congratulate the right hon. Member for Bexleyheath and Crayford (Sir David Evennett) on securing this debate. In the context of the ongoing Tory cost of living crisis and an increasingly unhealthy population, it is important that it takes place, so I welcome his bringing it to the Chamber. Huge financial pressure and high food prices are forcing families to eat less healthily, getting cheaper calories from unhealthy foods. There is a clear link between deprivation and obesity, which is why tackling health inequalities and poverty are top priorities for the SNP Scottish Government.

We have heard lots of interesting contributions. The right hon. Member for Bexleyheath and Crayford touched on junk food advertising, and I discussed that exact issue with the University of Glasgow earlier this afternoon. We need to be incredibly mindful of where, what and when we are advertising; otherwise, we will have an often detrimental impact on health inequalities.

The hon. Member for Somerton and Frome (Sarah Dyke) spoke a great deal about child obesity, which I will come on to. I very much agree with her on that point, but I would welcome an intervention from her on how the Liberal Democrat party’s abandonment of free tuition is impacting household budgets, and thus people’s ability to access healthy foods.

It was hugely welcome that the hon. Member for Putney (Fleur Anderson) mentioned the Daily Mile, which originated in Stirling. It was nice to hear a non-Scottish Member cast light on a project that originated in Scotland, so I certainly welcome that comment.

Obesity is a problem that is escalating on a global scale, but sadly the effects are being felt severely in Scotland. According to a survey, 67% of adults are deemed overweight and a third of children are at risk of becoming overweight. That same survey found that obesity was more common in households with lower incomes—a correlation we know and recognise all too well. That is why I and my SNP colleagues are consistently calling on the UK Government to take action to tackle the cost of living crisis, improve universal credit and reverse their policies that deny families crucial support.

The Scottish Government do not have the levers to be able to do those things at the moment. They therefore mitigate the bad political decisions made in this place, reducing family household costs by providing free prescriptions, free school meals, free childcare, free period products, free university education and free bus travel for those under 22 and over 60; freezing council tax; providing the young carer grant, the Scottish child payment, and both adult and child disability payments; and mitigating the bedroom tax, the rape clause, the benefits cap and real-terms cuts to social security.

Earlier today I met Professor Iain McInnes of the University of Glasgow, whose project, “Creating Healthier Places: A Place-Based Approach to Research & Partnership”, factors access to healthy foods into its research on 20-minute neighbourhoods. It is a fascinating project, and I urge the Minister to have a look at it—I think she would be just as impressed as I am.

Through the best start grant and best start foods applications, the Scottish Government have also provided over £180 million to low-income families to help with expenses during their children’s early years. The eligibility for best start foods will be expanding so that a further 20,000 people can access support to buy healthy food. Such steps are essential to ensure that support is there for the least well-off families to be able to make healthy food choices.

In my constituency, new data from Cancer Research has shown that 22.5% of four to five-year-olds are overweight or obese—that is four to five-year-olds who are already increasing their risk of serious illnesses. That is not a choice by those children or their parents, but a symptom of families not having the resources to provide healthy options. It is a symptom of 14 years of austerity. It is a symptom of being tied to this broken Westminster system.

I know that the Minister cares deeply about these issues and will give a compassionate and considerate response. I simply urge her to mirror some of the policies the Scottish Government are taking on tackling health inequalities. That is why in Scotland, all pupils in primaries 1 to 5, all children in additional support needs schools, and eligible pupils in primary 6 through to S6 can benefit from free school meals—the most generous free school meals offer anywhere in these isles, saving families—

[Peter Dowd (in the Chair)]

Order. I call Preet Kaur Gill.

Heart and Circulatory Diseases: Premature Deaths

Amy Callaghan Excerpts

Thursday 22nd February 2024 Commons Chamber

[Amy Callaghan (East Dunbartonshire) (SNP)]

I congratulate the hon. Member for Watford (Dean Russell) on securing this debate on such an important and prevalent issue. He and I have a shared interest in health inequalities, largely due to our personal experiences. He and I joined the House at the same time. I remember sitting in this very Chamber for his maiden speech, in which he quoted Sir Elton John’s song “I’m Still Standing.” I am absolutely delighted that we are both still standing. [Hon. Members: “Hear, hear!”] Just a few short months after my hon. Friend’s maiden speech—I will call him my hon. Friend— I was in rehab recovering from a stroke. “I’m Still Standing” was one of the songs that we ironically listened to while doing physio—a dark sense of humour can be a powerful tool in the face of adversity, but of course we need to equip people with more than just a sense of humour to get through these very difficult conditions.

This issue is one that my party and I are deeply concerned about, with nearly three in 10 Scots dying from heart and circulatory diseases, equating to about 50 people per day or 1,500 people per month. Preventing those deaths, and in particular premature deaths, is something that the Scottish Government are committed to. The hon. Member for Watford outlined the signs and symptoms of many heart and circulatory conditions. I commend him for shining a light on them. We cannot overestimate the impact that a debate like this will have. Support for the mind after a health trauma is necessary, as he also outlined. After my stroke, I did not realise that I needed help for my mental health until I reached a crisis point. Getting help was the best thing that I could have done for myself. That support needs to be there for everyone.

As we have heard, there are clear risk factors for developing cardiovascular diseases centring around people’s lifestyles. We can call them lifestyle choices, but the choices are often heavily influenced by inequality and poverty. We know that people in poverty have poorer health outcomes, and improving people’s ability to make healthier choices on diet, smoking and alcohol consumption are essential to change that. We know that sadly the prevalence rates for circulatory and cardiovascular diseases are significantly higher in the most deprived areas. We also know that poverty rates are higher for some minority ethnic groups, and therefore they are often disproportionally vulnerable to health inequalities.

That is why improving health and reducing health inequalities across Scotland are clear priorities for the Scottish Government, especially in the face of UK Government austerity measures. The British Heart Foundation says that there has been

“a lack of meaningful action”

from the British Government

“over the last 10 years to address many of the causes of heart disease and stroke, such as stubbornly high obesity rates”.

Obesity and unhealthy lifestyle choices are intrinsically linked to poverty. That is why the SNP’s action to mitigate the effects of this Tory Government’s cost of living crisis are so important to today’s debate.

Recent analysis from the British Heart Foundation shows that the number of people dying before the age of 75 in England from heart and circulatory diseases has risen to the highest level in over a decade. We know that 700,000 people in Scotland are living with circulatory diseases. We do not know how much that is affected by covid-19 or other factors, but it is clear that an increasingly unhealthy population plays a key role in these worrying statistics. This is why the SNP’s focus on tackling these inequalities and tackling poverty is such an important and proactive step in reducing these premature deaths.

The Scottish Government’s focus and commitment to tackling poverty and other risk factors relating to cardiovascular disease are despite this Tory Government’s austerity measures. The British Government’s austerity policies are harming the economies across these isles, driving more people into poverty and making our health outcomes worse. Health inequalities are rampant the length and breadth of these isles. I stand here as proof of that. I had cancer as a teenager and had a stroke in my mid-20s—an example of the health inequalities prevalent in the west of Scotland.

Economic austerity is to blame for the slowing progress in health outcomes over the past decade. The British Government would do well to cast their eyes up to Scotland and consider a focus on our wellbeing economy, with people at its heart, as we do. Funding—or, in this case, the lack of it—is a political choice. The UK has considerable wealth, so it is shameful that so many people are in poverty and that their health is suffering as a result. The levels of universal credit have been too low for too long. The SNP and the Scottish Government continue to call on the UK Government to introduce an essentials guarantee to ensure that social security benefits adequately cover the cost of essential goods and properly support our most vulnerable people. The Scottish Government have gone to great lengths to increase income for Scots by promoting fair work and improving the value of social security through bold measures such as the Scottish child payment and the real living wage.

I know that we are short of time, Madam Deputy Speaker, so I will bring my remarks to a conclusion. I urge the Government, and whomever forms the next Government, to consider taking the Scottish Government’s approach to tackling health inequalities by reducing poverty and guaranteeing that people have the resources to make healthy lifestyle choices. It is abundantly clear that while Scotland is tied to this place, Westminster and the British Government hold the purse strings, and any action that the Scottish Government take can be outdone by austerity measures in this place. Only with the full powers of independence will we truly be able to tackle health inequalities in Scotland and reduce the number of premature deaths from cardiovascular disease.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

First, may I congratulate my hon. Friend the Member for Watford (Dean Russell), and say how pleased we all are to see him fighting fit and in his place? I also say to the right hon. Member for Alyn and Deeside (Mark Tami) that we wish his son absolutely all the best and a speedy return to full health, and to the hon. Member for East Dunbartonshire (Amy Callaghan)—who has had so many health problems of her own—that we all wish her very well and a full recovery. Some very good contributions have been made to today’s debate. I would just like to mention a very, very dear friend of mine who died of a sudden cardiac arrest very unexpectedly aged 55. It was a tragedy for his young family, so I really do understand—thankfully not personally, but through very close friends—how terrible this is.

I will write to the hon. Member for North West Leicestershire (Andrew Bridgen) and my hon. Friends the Members for Shipley (Philip Davies) and Christchurch (Sir Christopher Chope) about the statistics. I do not have any information today; I wanted to focus on the Government’s strategy for preventing cardiovascular disease, but I will write to them. As ever, I thank the hon. Member for Strangford (Jim Shannon) for his thoughtful remarks, and say to him that I have already been in contact with the Minister in Northern Ireland about the smoking Bill. Meeting with him will be one of my early priorities.

My hon. Friend the Member for Watford is a vocal supporter of the British Heart Foundation. On behalf of the Government, I thank the BHF for all the incredible work it has done throughout Heart Month, including introducing online CPR training that takes just 15 minutes to complete—15 minutes that could genuinely save a life. I also pay tribute to the many other charities that work tirelessly to support people at risk of, or living with, cardiovascular disease.

Over the last decade, the Government have taken significant action to prevent cardiovascular disease and its causes. Just over 10 years ago, we launched the NHS health check, which is our CVD prevention programme. Health checks play a key role in preventing heart disease, stroke, type 2 diabetes, and some cases of dementia and kidney disease. The numbers show that, through health checks, people have a lower likelihood of being admitted to hospital for CVD and type 2 diabetes, and for all causes of death one, three and five years after attending a check. So far, well over 10 million checks have been delivered, and data shows more people are receiving checks than before the pandemic. We are now investing £17 million in the creation of a digital NHS health check.

In fact, we are looking at every opportunity to prevent CVD throughout the course of a person’s life. Two years ago, the NHS published its CVD prevention recovery plan, setting out four high-impact areas for every part of the health service to focus on risk factor detection and management. This began by rolling out blood pressure checks in high street pharmacies and helping people measure blood pressure at home, and we are now helping thousands more people detect hypertension earlier. Our forthcoming major conditions strategy will focus on prevention throughout the life course, which is essential in creating a more sustainable NHS. It aims to improve care and health outcomes for those living with multiple conditions and an increasingly complex set of needs.

We are tackling salt, sugar and calories through the voluntary reduction and reformulation programme. Working with industry, we have already delivered reductions of up to 20% in some foods. The second pillar of our prevention plan is smoking cessation. I am proud to be part of a Government who will introduce the ground- breaking smokefree generation, so that children aged 15 and younger will never legally be sold cigarettes. This will be the most significant public health intervention in a generation.

I now turn to managing risk factors. Once we have diagnosed hypertension, it is vital that we properly manage it, and we are doing more than ever before. Among those under the age of 80 with GP-recorded hypertension, 170,000 more people had their condition managed to safe levels by March 2023 compared with the same month in 2020. The NHS has set hypertension management as a key priority, investing over £3 million to bring CVD leadership roles within every integrated care board.

We recognise that outcomes are often worse in different parts of the country, and understanding why variations occur is critical so that the NHS can take the right action. I support it in its launch of CVDPREVENT, a national primary care audit, which will provide data to highlight gaps in diagnosis, identify inequalities and find room for improvement. I am confident that the programme will help integrated care systems make real change in their areas.

A heart attack is a medical emergency, and recognising the symptoms can be a matter of life or death. People’s chances of surviving a heart attack are far greater if they seek care as soon as possible. In August last year, the NHS launched a lifesaving campaign, helping people to recognise the common signs of a heart attack that are often dismissed or ignored, and to seek help by calling 999. I absolutely applaud my hon. Friend for raising his specific symptoms in this Chamber so that others can understand more about what to look out for. Of those who reach hospital early to receive treatment, about nine in 10 survive a heart attack, compared with only seven in 10 of those who do not. That is why raising public awareness is so critical. To improve survival rates for out-of-hospital cardiac arrest cases, the Government have announced a new £1 million fund to expand defibrillator access in the community. We have already delivered over 700 defibrillators towards an estimated total of 1,000.

We are also taking huge strides in making our NHS simpler by providing for patients at home, because we know that patients prefer to avoid hospital if they can be safely supported in their own homes. The NHS programme “managing heart failure @home” is pioneering this approach, and addressing health inequalities as a key aim. Thanks to record funding, we are rolling out up to 160 community diagnostic centres, which will provide echocardiography services by March 2025, and I am pleased to update the House that 153 CDCs are live at this time.

[Amy Callaghan]

Will the Minister join me in congratulating East Dunbartonshire Council on its good work in getting so many community defibrillators for use across East Dunbartonshire ?

[Dame Andrea Leadsom]

Absolutely. I am happy to do that, and I would encourage all local authorities across the country to make best use of the funds that are available to them.

Let me turn to mental health and counselling services. As my hon. Friend the Member for Watford discussed, surviving a heart attack can have significant psychological impacts on individuals and their families, and I am grateful to him for sharing his own experience so powerfully. Integrating NHS talking therapies with physical health services can provide better support to people with combined physical and mental health needs, including people with cardiovascular disease.

National HIV Testing Week

Amy Callaghan Excerpts

Thursday 8th February 2024 Commons Chamber

[Amy Callaghan (East Dunbartonshire) (SNP)]

I congratulate the hon. Member for Warrington North (Charlotte Nichols) on opening this debate. She was an excellent stand-in for the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), approaching the subject with nuance and good grace. I thank my constituents in East Dunbartonshire and people right across Scotland who contacted me in advance of the debate, which has helped me to shape my remarks. I also thank the Terrence Higgins Trust for its very helpful briefing.

Just prior to Christmas, I popped into Charlotte Tilbury, where I purchased myself a nice new lipstick, which I am wearing today. The money from the sales of this lipstick goes to the Rocket Fund, powered by the Elton John AIDS Foundation, which seeks to end AIDS everywhere. I must say that I was delighted to be doing my bit just by treating myself to a new lipstick, even prior to this debate.

National HIV Testing Week serves as a reminder to us all of the importance of knowing our status, and provides amplified opportunities for people who would otherwise never test to do so. The scientific advances in HIV treatment and prevention are some of the biggest we have seen in modern medicine. An HIV diagnosis has gone from being a near death sentence for sadly too many people to being a manageable condition, with people living with HIV enjoying a normal life expectancy. Even more incredibly, we can now say with absolute confidence that someone on effective HIV treatment cannot pass on the virus to their sexual partner—undetectable equals untransmittable.

One of the key interventions and milestones that contributed to this progress was the implementation of the NHS-delivered national HIV PrEP programme in 2017. I am proud to recognise here today that Scotland was the first nation in the UK to make PrEP available, free to anyone at risk, on our precious NHS. There are now approximately 6,000 people using PrEP in Scotland at any one time. An estimated 500 people are living with undiagnosed HIV in Scotland, and a further 961 people have been diagnosed with HIV but are no longer considered to be receiving specialist HIV care. Reaching those people will be vital if we are to succeed in ending new cases of HIV by 2030.

Between 2010 and 2019, the most marked reductions in the annual number of first ever HIV diagnoses in Scotland were observed among gay, bisexual and other men who have sex with men. The reductions likely reflect a decline in the incidence and transmission of HIV infection in Scotland, associated with a range of public health measures over this period. However, that same progress is not happening across other groups, with slower reductions among women and minority communities. Other groups continue to be marginalised, such as sex workers and injecting drug users.

The number of people with undiagnosed HIV in Scotland is thought to be larger in heterosexual individuals, which emphasises the importance of considering HIV in people without identified current risk behaviours and the potential for greater impact of HIV-related stigma. Stigma still blights the lives of far too many. We must continue to fight the stigma still experienced by people living with HIV. Stigma and discrimination remain a reality for many people living with the condition. There is a need to increase awareness, fight prejudice and improve education about HIV.

That is why, on 1 December 2022, the Scottish Government published their report “Ending HIV transmission in Scotland by 2030”. To achieve the HIV transmission elimination goal in Scotland, a whole system and whole society approach will be required. The high-level activities required are primary prevention, detection and treatment. Indeed, National HIV Testing Week holds the opportunity to get tested. It can even be done at home, with a result in as little as 15 minutes. I am pleased to confirm to everyone here that I, as a heterosexual woman, have taken an HIV test. It is an important step that we as Members of Parliament can take for our constituents to show how important this matter is. The only HIV test to fear is the one you did not take. It is a privilege that so many in the ’80s and ’90s were never afforded.

Globally, thanks to the investment of countries such as the UK in aid through the UN Global Fund and research into vaccines through International AIDS Vaccine Initiative, millions more are receiving antiretroviral treatment and testing. In November 2020, the UK Government announced aid spending would fall from 0.7% to 0.5% of GNI as a “temporary measure”, in response to the effects of the covid-19 pandemic on the UK’s public finances and economy. I would like to express my concern to the Government on their lack of recommitting to 0.7% GNI spending on overseas development aid. I echo the comments of the Chair of the International Development Committee, the hon. Member for Rotherham (Sarah Champion), and reiterate her point on how the UK is failing on funding commitments and its ability to set or achieve meaningful targets on sexual and reproductive health. We have the tools to end HIV transmissions; we just need to use them, backed up by political will.

While advancements in medical science have transformed HIV, the persistent stigma, discrimination and lack of awareness surrounding HIV testing remain formidable barriers in our fight against it. National HIV Testing Week serves as a crucial reminder of the importance of early detection and diagnosis. So, as we commemorate National HIV Testing Week, let us reaffirm our commitment to ending the silence surrounding HIV, and to dismantling barriers to testing and saving lives. I would like to see a recommitment by the UK Government to ending HIV as a public health threat. By working together, we can achieve our goal of ending new HIV cases by 2030.

Internationally Recruited Health and Social Care Staff: Employment Practices

Amy Callaghan Excerpts

Wednesday 31st January 2024 Westminster Hall

[Amy Callaghan (East Dunbartonshire) (SNP)]

I thank the right hon. Member for Spelthorne (Kwasi Kwarteng) for securing this debate. He made balanced and measured remarks and I share a number of his concerns.

I will begin my contribution with a huge and heartfelt thank you to our NHS and social care staff in Scotland, many of whom looked after me during the four months I spent at the Queen Elizabeth University Hospital in Glasgow back in 2020 and who care for my constituents in East Dunbartonshire in our many care homes, GP practices, pharmacies and hospitals. This debate discusses a critical aspect of an issue that I continue to raise time and again: NHS workforce shortages. The Government’s latest draconian plan to curtail immigration, banning those who come to these isles to work in the care sector from bringing their families, including children and spouses, is another shambolic and cruel attempt by the Government to shift blame. Anti-migrant and quite frankly racist rhetoric has become symptomatic of contemporary Britain, largely fuelled by the Government’s culture war. In introducing the change in legislation, they have concocted a narrative that frames migrant workers as the problem. Let me be clear: this Government are the problem.

They have allowed our health and social care workforce to crumble in front of our eyes due to 14 years of austerity, starving it of much-needed investment. Preventing overseas care workers from bringing their families is a dehumanising move, viewing migrant workers as resources to be used for work rather than as the people that they are; people with families whom we need to come to these isles. Migrating to the UK for such arduous and underpaid work might be someone’s best bet for a better future, but in doing so they are forced to leave their dependants behind, having to leave their families to care for ours.

Overseas care workers have been treated appallingly by this British Government. Many sold everything to fund their move to the UK. The Home Secretary and the rest of the Cabinet clearly do not value the social care sector since they were content to sign off on the visa rule changes. Disappointingly, the Health Secretary has defended the visa changes too. The only thing the announcement will achieve is to break up families, scare workers and erode trust.

Now, social care workers who come here face a sentence of destitution, and it is far too simplistic to suggest that there are ample numbers of people already based here to fill the gaps in the health and social care workforce. It is not a sector that pays adequately and people do not want to fill the gaps in employment, so we need people to come from overseas too to fill the skills gaps. The sector is struggling, and struggling badly, due to terrible political decisions.

Skills for Care, the workforce development and planning body for adult care in England, estimates an average 9.9% of roles in adult social care were vacant in 2022-23. That is the equivalent of approximately 152,000 vacancies. What are the Government doing to address those vacancies? They are making it harder for people to come here and fill them. The number of vacancies decreased by around 11,000 between 2021-22 and 2022-23 partly because of increased recruitment of overseas workers, demonstrating how crucial those recruits are in tackling the shortages we face.

Donald Macaskill, the chief executive of Scottish Care, has said that workforce shortages are

“an enormous challenge, and one of the reasons for that is the legacy of Brexit”.

He went on to say that

“what we need is a flexible immigration policy, which isn’t as hostile and toxic as the one we have now”.

The fact of the matter is that the social care sector cannot function without overseas staff.

Plans to prevent overseas care staff from bringing family members with them to the UK risk worsening the sector’s already significant shortages. If care workforce numbers fall, unmet needs will continue to escalate. Too many people in need struggle to access good care as it is. The plan to curb migration for care sector workers will undoubtedly only make that worse. We have an ageing population, which will need more care and we will struggle to provide that care without international recruitment. Those needs are being undercut by this British Government. Social care requires a major fix, but this certainly is not it. Without migrant staff, care homes could close and support would disappear for the vulnerable living in their own homes. The Minister must rethink this cruel visa plan before permanent damage is done.

There is another area in which this British Government cause a headache for our constituents. If the new restriction reduces the number of people who are migrating to the UK to work in the already understaffed care sector, it is unpaid carers who will bear the brunt. Those unpaid carers are already in a dire situation, with evidence suggesting that they are more likely than non-carers to live in poverty, to be isolated and to be depressed. Although many family members would continue to care for loved ones, even with more paid help, we should not underestimate the importance of paid care workers in providing support and respite.

Today in the UK, if someone performs unpaid family care for 35 hours or more a week and earns under £139 a week from paid work, they can claim carer’s allowance to help them get by, but that allowance is only £76.65 a week. The Minister is already struggling to attract workers within the UK to work in the care sector, and now she is facing additional barriers to overseas recruitment. That is all due to colleagues who are so obsessed with decreasing net migration that they will happily watch an understaffed health and social care service fall into further ruin.

How does the Minister justify dissuading social care workers from immigrating to these isles, when they are quite literally keeping our system afloat? When will the Government finally commit to solving the underlying problem by making care work a more attractive career path and by training, retaining and reforming in the health and social care sector? That last point was explored in depth by the hon. Member for Strangford (Jim Shannon).

This Government fundamentally are not acting in Scotland’s best interests. We want and need more people to come and work in our health and social care services, not fewer. The alleged problems that this British Government are trying to address with their new policies on overseas recruitment are not issues for Scotland. We strive to create a warm and welcoming environment that encourages people from overseas to make Scotland their home. We want and need overseas recruits here. The Tories’ hostile environment is not working, but there is another path for Scotland. The Scottish Government have outlined their vision in the policy paper, “Building a New Scotland: migration to Scotland after independence”. That policy will make it easier for people with skills and expertise to come to Scotland and contribute to our businesses, communities and economy. We would set visa fees at a fair level and offer family schemes to encourage those who come to Scotland to put down roots and make Scotland their home.

The Scottish Government are also supporting international recruitment with a pilot project that was launched in summer 2023 to support providers with sustainable and ethical international recruitment and to gather information on how we can best support both providers and the workforce through the visa sponsorship process and develop supporting materials to be shared across Scotland. We will not ask overseas workers to abandon their families to come and care for ours; that is not what Scotland is about.

Only once these decisions can be made by Scotland, for Scotland and in Scotland can we have the full power to ensure that our health service is well staffed and well looked after. It is clear that whatever party forms the next Government in this place will not make decisions based on Scotland’s specific needs, and it is only once we achieve independence that we can ensure that our NHS and the health and wellbeing of our ageing population and our population more generally are in safe hands.

--- Later in debate ---

[The Minister for Social Care (Helen Whately)]

I am grateful to my right hon. Friend the Member for Spelthorne (Kwasi Kwarteng) for opening the debate and setting out some of the challenges we face in international recruitment in health and social care. I pay tribute to our international health and care workers, who play an important part in our health and care system, looking after people and bringing their skills, equipment and compassion to look after loved ones. We benefit enormously across the UK from their knowledge and skills. In return, it is imperative that employers, whether in health or social care, provide a safe and supportive environment for their staff to work in.

I want to be clear that international recruitment is not the long-term answer to our health and social care workforce needs. We have been clear about that as a Government, and I have been clear about that personally. That is one of the reasons why, on the NHS side, we have our long-term workforce plan, investing in training our home-grown healthcare workforce. On the social care side, we have a 10-year vision for social care, which includes ambitious workforce reforms, which are in progress, including the first ever national career structure for care workers and new national qualifications. I am determined that care workers—indeed, care professionals —be recognised for their skills and supported in their work and career.

I would say to the SNP spokesperson, the hon. Member for East Dunbartonshire (Amy Callaghan), that she should read up on these care workforce reforms, as should the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), who called a moment ago for a care workforce pathway. I know he is relatively new to this role—we have not done that many debates opposite each other—so I ask him to go take a look online. He will see our care workforce pathway programme, which we have published and which we worked closely with the sector on to develop this national career structure. We did so exactly because it was one of the things we knew was missing from social care, and because when people come into social care, they want to see that they have an opportunity to progress in that career. We are also developing national training that will be recognised across different employers. Those are just two of the headline policies of a truly ambitious reform programme for the social care workforce.

[Amy Callaghan]

I do not particularly appreciate being given homework by a Minister who is doing so much damage to the health and social care sector in Scotland. I have certainly done my homework already—I do not need to be given some by her.

[Helen Whately]

I think it is probably helpful if I move on, rather than our having some sort of back and forth.

I turn to the question in hand, which is specifically to do with international recruitment and the reasonable concerns raised by my right hon. Friend the Member for Spelthorne about the exploitation of some workers who come to support us in this country in health and social care. One of the things he spoke about was the code of practice. He is absolutely right that we have a code of practice for the international recruitment of health and social care personnel, which sets out ethical recruitment and employment standards that employers must adhere to. The code is kept under regular review. In fact, my right hon. Friend referred to the update of the code last year. I can assure him that my Department works closely with the Royal College of Nursing and other trade unions and stakeholders to strengthen that code and make sure it addresses the current issues and ethical concerns. For instance, we have set out stricter principles on the use of repayment clauses in employment contracts, and the code is now explicit that charging recruitment fees is illegal under UK employment law. I absolutely agree with my right hon. Friend that we should continue to make sure the code of practice truly captures all that it needs to, and is as effective as it can possibly be.

Alongside the code of practice, we have the ethical recruiters list. This contains a cohort of recruitment agencies that have agreed to operate in accordance with the rules of the code. The list is run by NHS Employers, and it makes it easy for employers in the NHS and the social care sector to check that recruitment agencies are signed up to meet the high ethical recruitment standards we expect. Any organisation suspected of breaching the code will be investigated, and can be removed from the list.

Most overseas staff have a positive experience working in the UK, but I acknowledge that, regrettably, this is not the case for all. We know there are some rogue agencies and employers that take advantage of people who want to come to the UK to work. We have published guidance for prospective overseas candidates to help them make informed decisions and prepare for life in the UK. The guidance sets out what candidates should check in their employment contracts before signing them, what working rights and standards they can expect in the UK, and how to recognise and deal with exploitation, should that unfortunately be something they experience.

My Department is working with colleagues in the Foreign, Commonwealth and Development Office to disseminate that guidance effectively, so that it reaches prospective candidates at an early stage and helps make informed decisions and avoid scams and unethical practices. We want them to be able to do that in their home countries, before they even apply to work here in the UK.

My right hon. Friend the Member for Spelthorne mentioned punitive repayment clauses in employment contracts. We are clear that those are unacceptable, and in certain cases illegal. There are some instances where repayment clauses may be used legitimately to cover some up-front costs incurred, should an employee decide to leave their job after a short time. But in all cases, employers must make it clear in contracts what is to be reclaimed, and how and when that will take place. Instances where repayment clauses are excessive, or extended over a lengthy period, have the effect of trapping international workers into jobs, and that is unacceptable. Repayment clauses cannot be used by employers to cover the cost of agency fees, certificates of sponsorship or the immigration skills charge.

As I mentioned, the code was updated to address that issue. The NHS has gone further, producing additional bespoke guidance for NHS employers to explain how to implement the code’s principles when using repayment clauses. That will ensure transparency and fairness in employment contracts for all international recruits working in the NHS.

Another issue raised by my right hon. Friend is that of recruitment agencies charging international candidates high fees to find them work in the UK. For UK-based agencies the law is clear: charging a candidate any recruitment fee to find them a job in the UK is illegal. The Employment Agency Standards Inspectorate is the organisation responsible for regulating employment agencies, and it will investigate such misconduct and prosecute where appropriate.

However, we do face the challenge of agencies based overseas that fall outside the UK’s jurisdiction. Regrettably, we have limited direct levers to stop the unethical treatment of workers overseas, but we have taken steps to try and mitigate the risk as far as possible. First, our international candidate guidance, which I mentioned a moment ago, warns potential candidates that they should not be paying any kind of fee to find work in the UK, and that they should not work with any agency that requests such a fee. Secondly, our embassies and high commissions are actively working with higher-risk countries to tackle exploitative practices by recruitment agencies overseas. NHS Employers, as holders of the ethical recruiters list, undertakes regular spot checks of agencies on that list to ensure they are complying with the code of practice.

As a Department, we are working collaboratively with the labour enforcement agencies that take action against those breaking the law in the UK. Those include the Gangmasters and Labour Abuse Authority, UK Visas and Immigration, and the Employment Agency Standards Inspectorate. We therefore have a multi-agency approach across Government which uses our collective intelligence, capabilities and resources to respond to concerns about exploitation. That includes providing insight, advice and guidance to businesses and supply chains in relation to possible labour market offences.

My right hon. Friend mentioned language skills and the potential challenge for somebody whose English might not be fluent, to navigate the landscape and know their employment rights, for example. It is clearly important that the language skills of anyone providing care in England are good enough to communicate with their employer, the people they provide with care, and other care and healthcare professionals.

Care providers must ensure that their chosen candidates have the skills needed to work in care and should assess a candidate’s English proficiency at the interview stage of recruitment. For somebody to work in social care, employers should ensure a good standard of English. For staff from overseas, the Home Office sets English language proficiency requirements. Individuals are required to prove they can speak, read, write and understand English to at least level B1 on the common European framework of reference for language scale.

My right hon. Friend also asked about cross-Government work in general on tackling exploitation. I can assure him that we are working across Government. My Department is working particularly with the Home Office and UKVI, both at official and ministerial level. I have had several conversations with Home Office Ministers about our care worker visa scheme and what we are doing to tackle the risk of exploitation and abuse.

I worked closely with Home Office colleagues on the recent changes to the care visa. We agree about striking the right balance with overseas care workers, who are supporting us in some of the challenges of meeting the social care and healthcare need in the UK. We also need a balance between international workers and our home-grown workforce, ensuring that there are safeguards for international recruits.

Following those conversations, we have announced changes to the care visa scheme, as referred to during this debate. One is that, as of March, we will no longer allow care workers to bring dependants with them. Another safeguard is that we are restricting sponsors to CQC-registered care providers. At the moment, as long as someone is providing social care, CQC-registered or not, it depends on the sort of care provided.

The Government do not have all the answers at the centre, and I feel strongly about that. That is one reason why, as we have introduced the care worker visa, we put £15 million funding into regional partnerships of local authorities, to have established leads around the country for international recruitment, to support employers and recruits. I meet our regional leads, to hear what it is like in their areas, and to discuss what they are doing on the ground to support employers and social care staff. For instance, they are supporting providers with legal and HR advice on recruiting and employing international staff.

There is a specific example relevant to this debate. East of England has commissioned Unseen to run seminars and provide one-to-one support for care providers on safeguarding and spotting signs of exploitation. I continue to work with those leads to get the best possible insight on the ground on the extent to which internationally recruited workers may face difficulties. That could happen if someone has been brought here for a job with a particular sponsor who loses the licence to employ them, and the leads are working hard, trying to support recruits in that situation. I am also setting up a meeting directly between our regional leads and the Home Office and UKVI, to ensure that they share their intelligence directly, making the most of the leads’ work and insights.

I want to come briefly to some of the points made by the hon. Member for Westmorland and Lonsdale (Tim Farron). He mentioned the connection between social care supply and delayed discharge in his local area, which is something that I have done a huge amount of work on over the past year. I want to be clear, particularly on this topic, that social care does not exist just to discharge and support the discharge of patients from hospital. Social care is absolutely an end in itself, supporting both older people and those of working age with care needs.

We know that there is a connection between discharge delays from hospital and social care, because some people who are delayed in hospital, when they are medically optimised for discharge, are in need of social care packages. That is why we put in an extra £600 million in funding to support discharge over the past year, and there is another £1 billion coming this year. We have also put in an extra £570 million of funding to support social care. Just this morning, I was talking to a number of directors of adult social services from local authorities who assured me that that funding has made a meaningful difference to social care funding and supply.

I know that there are still significant financial pressures, and the national living wage increase puts an additional pressure on care providers and local authorities for the coming financial year. While that increase is a good thing for those at the bottom of the pay scale, it also places financial pressure on employers and those funding social care. I assure the hon. Member for Westmorland and Lonsdale that that increase in supply, thanks in part to the extra funding, has helped to speed up discharges over the past year and reduced some of the delays, and we have seen an increase in the number of people being discharged both overall and particularly with social care support. We have made progress on that point.

I come back to this point in closing. I want to be categorically clear, in the light of this debate, that no member of staff in health or social care should face abuse of any kind, and illegal and unethical international recruitment and employment practices will absolutely not be tolerated. Internationally recruited staff play a really important part in caring for people across health and social care. They have helped us to build and increase our health and social care workforce. On the NHS side, we have achieved our manifesto commitment of 50,000 more nurses. On the social care side, we have over 20,000 more care workers in the care workforce. We have seen vacancies come down and retention improve, so we have been making progress on both the social care and the NHS workforces. While international recruitment plays an important part, it goes hand in hand with our work as a Government to build up our home-grown workforce both on the NHS side, with our NHS long-term plan, and the social care side, with our ambitious social care workforce reforms.

Oral Answers to Questions

Amy Callaghan Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Mr Speaker]

Order. I am a little bothered, because we have a long way to go on the Order Paper. I call the SNP spokesperson.

[Amy Callaghan (East Dunbartonshire) (SNP)]

We cannot discuss winter pressures in the NHS without acknowledging workforce shortages. The Secretary of State is having to contend with new immigration policies from her Cabinet colleagues that prevent dependants from coming to the UK, meaning that we are asking people to come and care for our loved ones while they leave behind theirs. I imagine that she is frustrated that that is now another barrier to recruiting staff to our health and care sectors. Has she expressed those frustrations to her Cabinet colleagues?

[Victoria Atkins]

I genuinely want to work with the Scottish Government, because I am troubled, to put it bluntly, that Scotland has some of the worst health outcomes in western Europe. It has the worst level of drug death rates in Europe, the highest alcohol death rates in 14 years, and there was a fall in life expectancy for three years in a row. We offered to allow Scottish patients to receive lifesaving operations in England, but sadly, that offer has been declined. I remain genuinely willing to work with the Scottish Government to help them with their health service.

--- Later in debate ---

[Mr Speaker]

I call the Scottish National party spokesperson.

[Amy Callaghan (East Dunbartonshire) (SNP)]

Cancer Research UK has found that too much UV radiation is the third biggest cause of cancer across these isles. Does the Secretary of State recognise that cost is a barrier for people wishing to protect their skin from the sun, and will she commit to having conversations with Cabinet colleagues to remove VAT on sun protection products, which will help protect NHS budgets and ultimately save lives?

[Victoria Atkins]

We see that as part of a much wider campaign to ensure that we treat the sun safely, by reducing the amount of time we spend in the sun, particularly during peak hours of the day in summertime. I keep all these discussions in play with my Treasury colleagues.

NHS Winter Update

Amy Callaghan Excerpts

Monday 8th January 2024 Commons Chamber

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Scottish National party spokesperson.

[Amy Callaghan (East Dunbartonshire) (SNP)]

A very happy new year to you, Mr Deputy Speaker. Our NHS faces an unprecedented winter of pressure, with inflationary costs, increasing viral infections and staff shortages. While the SNP Scottish Government have acted with £300 million to cut waiting lists and negotiated with NHS staff, preventing even a day of strike action, NHS England is undergoing a junior doctors strike—the longest in the history of any NHS in the UK. No one wants strike action, but it works, which is exactly why the Tories want to ban it. In fact, this Tory Government appear to be working to make this winter harder by cutting NHS capital funding, undercutting attempts to recruit new staff and not getting round the table with trade unions, instead blaming the BMA and junior doctors. Is the decision to underpay NHS staff and stoke strikes the policy of this Health Secretary, or is she being forced down that path by a Chancellor who is continuing his decade-long war on junior doctors?

[Victoria Atkins]

I imagine that the hon. Lady has seen that we accepted in full the pay review body’s recommendations last year and, as of September, junior doctors and doctors in training have received on average an 8.8% increase on their basic salaries—they also earn money on top for antisocial hours, working overtime and so on. In addition, they have pension contributions of some 20%, which is a rare employment benefit across both the public and private sectors. In the future, I want to find a fair and reasonable settlement with the junior doctors, as we have been able to reach with consultants and specialty doctors, but we cannot do that if junior doctors are on strike. That is why it is so very disappointing that they walked away from the discussions.

Oral Answers to Questions

Amy Callaghan Excerpts

Tuesday 5th December 2023 Commons Chamber

[Maria Caulfield]

We want a more cross-Government approach to mental health provision, and that is why in our suicide prevention strategy we are working with multiple Departments. My hon. Friend asks about support for nutrition in schools, and I will certainly raise that with colleagues in the Department for Education to see what more can be done.

[Amy Callaghan (East Dunbartonshire) (SNP)]

I welcome the Secretary of State to her new role. Research by the Mental Health Foundation found that the cost of living crisis has left a third of UK adults feeling anxious, more than a quarter feeling stressed, and almost one in 10 feeling hopeless. What representations has the Minister made to Cabinet colleagues regarding the impact of the cost of living crisis on health outcomes since she took up her post?

[Maria Caulfield]

I have outlined some of the financial support that the Government have given during covid and the cost of living pressures. I also point to schemes that the Treasury has rolled out, such as the Breathing Space programme, which sees enforcement action from creditors halted, and interest frozen for people with problem debt who are experiencing mental health issues, and covers a 60-day period. That is the sort of practical help that this Government are giving to people.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

My hon. Friend has already raised this issue with me several times in the almost two weeks I have been in this post, so he is doing a great job, and he is right to raise it. Tendering exercises for NHS dentistry are bound by current procurement law, but I am happy to meet him to discuss how much faster we can go to get this sorted out.

[Amy Callaghan (East Dunbartonshire) (SNP)]

Brexit broke Britain and it is continuing to wreak havoc on supply chains. The shortage of ADHD medication is now set to drag on into next spring. The shortage has seen 70% of patients forced to ration their supply of ADHD drugs, with 62% reporting an increase in suicidal thoughts. What steps is the Minister taking to ensure that supplies of these vital medications are reaching pharmacies across the UK?

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

The shortage of ADHD medication is a global issue; it is not Brexit-related. We are hoping to have some positive news over the coming weeks.

Building an NHS Fit for the Future

Amy Callaghan Excerpts

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.

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. I remind the hon. Lady that she has to face forward.

[Amy Callaghan]

The First Minister’s pledge of £300 million to cut NHS wait times is an example of the fantastic work that the SNP Scottish Government are doing. There will be 100,000 fewer patients on our NHS wait lists come 2026, because of that incredible investment.

Despite the year-on-year reduction in Barnett consequentials for health, NHS Scotland staff remain the best paid across these isles. What does that look like in practice? A band 2 porter in Scotland earns £2,980 more a year than their counterpart in England, and a band 5 nurse in Scotland earns £3,080 more a year than their counterpart in England. This is all despite the increased privatisation in NHS England. Under the SNP, the Scottish NHS fares much better than its counterparts across these isles, but under the current funding structures only the UK Government can deliver the funding necessary to get the NHS back on its feet. Down here, the Treasury gives money to private companies to provide a service for NHS England. That means less capital investment into NHS England, which means less money for the Scottish Government to spend on NHS Scotland.

I have always found the monarch’s speech quite baffling, but particularly so over the past few years, with so many broken promises and so many shallow, unfulfilled commitments. I think of promises to ban conversion therapy, commitments to reach net zero and pledges for a mental health Bill. The Government think my party does not respect this place, yet it is them who make a mockery of it by not fulfilling the policy agenda that they set for themselves. Perhaps this threadbare King’s Speech is perfect for them: less to fail on.

[Jim Shannon]

I thank the hon. Lady for her empowered speech. One issue with Barnett consequentials is that although Scotland perhaps is not getting its full complement, Wales does, and I am grateful that it does, but Northern Ireland does not. We have asked for the Barnett consequentials for Northern Ireland to be looked at and reviewed to enable us to be at the same level as Wales; perhaps the hon. Lady would like to see that for Scotland.

[Amy Callaghan]

I absolutely would like to see the same for Scotland. The Barnett consequential system in itself is quite frustrating, because we do not see the full complement we should get because of how the British Government exercise spending decisions. I would absolutely like to see a different funding structure exercised down here. The way it is spoken about is complicated in itself, and a bit of truth around that would be useful.

I have been struggling with the image of the King delivering his speech from his gilded throne while innocent people in Palestine are dying. It feels a ridiculous thing for this Parliament to have been focusing on. We are witnessing the biggest humanitarian crisis that many, if not most of us, have ever seen. It bears witness to how soulless this British Government truly are. Children are dying, refugee camps are being bombed and hospitals are being destroyed. For each second that Members throughout this House fail to call for a ceasefire, more innocent people are dying in Gaza.

Not just a humanitarian pause but a ceasefire is necessary. Riham Jafari of ActionAid Palestine so aptly described the difference between a humanitarian pause and a ceasefire:

“What use is a four-hour pause each day to hand communities bread in the morning before they are bombed in the afternoon?”

Innocent men, women and children in Palestine continue to die. I make a plea to colleagues on both sides of the House: walk through the Lobby with us on Wednesday night to vote for a ceasefire. They need you to show leadership. We need to show leadership and vote for the SNP’s common-sense humanitarian amendment to the humble address.

In preparation for this debate, I found myself reflecting on the words inscribed on the mace of the Scottish Parliament: “Wisdom, Justice, Compassion and Integrity”. The mace is not just about tradition, and it is not a bit of a pantomime like in this Parliament. In Holyrood, the mace is there to signify the relationship between the people, the Parliament and the land.

No institution better represents the link between the people and the state than our precious NHS, but being tied to this financial Union means that our NHS is suffering terribly. We have workforce shortages, medication shortages and equipment shortages—shortages, shortages, shortages. I got into politics because of the rampant health inequalities I saw in my part of the world when I took unwell as a teenager. We all know health outcomes are impacted, whether directly or indirectly, by the quality of our support network. I saw first-hand the effect of poverty on outcomes. That is why I am so proud that our SNP Scottish Government implemented the young patients family fund, which helps to prevent income from being a barrier for families being able to support a young person through ill health. Scotland is leading the way in transforming lives and outcomes with that fund.

It would have been nice to see some flickers of hope and progress woven through the King’s Speech, but given the British Government’s lack of willingness to learn from good practice elsewhere on these isles, it is relatively unsurprising not to see it. The pomp and pageantry of this place, its traditions and its reactionary main parties seem to me to be a distraction from the real work and hard conversations that neither of the two main parties want to have. Instead, we have a celebration of the dance we call debate in this place.

I will now reflect again on the words inscribed on the Mace of the Scottish Parliament. Let us take a look at each and see whether they apply to the British Government. I will start with the wisdom that is being shown—or not shown—in this place where Brexit was forced through, despite the broken promises it was built on. What has come with that wise decision endorsed by both the Government and the Labour party? We have severe medicine shortages, meaning that people are unable to access vital treatments such as attention deficit hyperactivity disorder drugs and hormone replacement therapy, as well as a shortage of staff to supply and distribute them. That oven-ready Brexit deal that the public were promised was lacking one key ingredient: wisdom. My constituents in East Dunbartonshire applied wisdom in advance when they overwhelmingly voted to remain within the European Union, but the structure of the Union meant that their voice was ignored.

Moving on to justice, where is the justice in there being so many material changes of circumstances since the 2014 referendum, while the British Government continue to deny the people of Scotland the right to choose our own future? Some might say that that is an injustice.

Moving on to compassion, there are many ways in which I could question the compassion of this place, but there is nothing more timely or truly horrific than the ongoing attacks on civilians in Gaza. We are witnessing the biggest humanitarian crisis many of us have seen in our lifetimes, and this place has rightfully expressed compassion for those killed and suffering in Israel, yet the compassion is lacking for those children in Gaza. Each day that this place fails to unite behind a ceasefire, children die. Where is the compassion for those children?

[Richard Foord (Tiverton and Honiton) (LD)]

Would the hon. Member get behind a unilateral or a bilateral ceasefire?

[Amy Callaghan]

I would get behind a ceasefire. We are talking about a ceasefire.

[Tim Farron (Westmorland and Lonsdale) (LD)]

With both sides stopping.

[Amy Callaghan]

Yes, with both sides stopping. The hostages should be returned to Israel and we should see a ceasefire. I think that is relatively straightforward, is it not?

Finally, moving on to integrity, integrity should be the foundation of politics. Having trust that manifestos will be implemented and that policy agendas, such as the King’s Speech, will be taken through Parliament in the form of legislation is the bare minimum that folk at home expect. Instead, the British Government have thrown integrity out the window. It will be interesting to see, over the next parliamentary year, how much of what was in the King’s Speech is actually delivered.

I received a desperate appeal from the Linda Norgrove Foundation—it is named for a brave British aid worker murdered by the Taliban—for the UK Government to reopen the Afghan citizens relocation and resettlement schemes to allow 20 female Afghan medical students to come to Scotland specifically to complete their studies. It is now clear that the Taliban will never reopen schools and universities to girls. These young women are now prisoners in their own home, unable to show their face in public or to leave the house without a male guardian. Many live with the terrifying threat of forced marriage. The Linda Norgrove Foundation will pay for them to get here, and the Scottish Government have readily agreed to waive their tuition fees so that they can finish their studies. The only thing stopping these women from finding sanctuary in the UK is the British Government’s refusal to open the Afghan citizens relocation and resettlement scheme and create a legal pathway for them to do so.

That simple change would save 20 incredible women from brutal oppression at no cost to the British Government at a time when our NHS is also in desperate need of qualified doctors. I cannot think of a reason, other than performative cruelty, why the Government would withhold that permission.

I will once again say these words that are so sorely lacking down here: wisdom, justice, compassion and integrity. What could not be clearer is that Scotland’s NHS is not safe while we are tied to the financial structures of Westminster. Broken Brexit Britain is damaging our precious NHS through workforce shortages, equipment shortages and medication shortages. I look forward to a day when an independent Scotland rejoins the European Union, leaving broken Brexit Britain behind.

--- 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?

Future of the NHS

Amy Callaghan Excerpts

Tuesday 24th October 2023 Westminster Hall

[Amy Callaghan (East Dunbartonshire) (SNP)]

It is a pleasure to see you in the Chair, Mr Pritchard. I congratulate the hon. Member for Wirral West (Margaret Greenwood) on bringing forward this important debate. She made an insightful opening speech, and I thank her for this opportunity to highlight the incredible work of the Scottish Government despite real-terms cuts to funding. It is a privilege to contribute to the debate as the SNP health spokesperson and as someone who understands the true value of our NHS. I will break down my contribution into two core components—funding and staffing—and explain why British Governments of any colour are causing real and lasting damage to both of them.

I turn first to funding. With more and more privatisation creeping in through the back door in NHS England, there are dire consequences for our NHS in Scotland through Barnett consequentials. The reality is that how much is 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, our NHS, run by the Scottish Government, is continuing to invest in new and innovative ways to reduce health inequalities and protect our NHS for future generations; the young patients family fund comes to mind. We are leading the way in Scotland, supporting young patients and their families to get through ill health without suffering financial detriment, too. The other nations across these isles should take note and replicate the young patients family fund to improve health outcomes. The First Minister’s pledge of £300 million to cut NHS waiting times is another example. There will be 100,000 fewer patients on NHS waiting lists come 2026 because of that investment.

What happens down here is that the Treasury gives money to private companies to provide a service for NHS England. That means less capital investment in NHS England, which means less money for the Scottish Government to spend on NHS Scotland. Despite the year-on-year reduction in Barnett consequentials for health, NHS Scotland staff remain the best paid across these isles. What does that look like in practice? A band 2 porter in Scotland earns £2,980 more a year than their counterpart in England, and a band 5 nurse in Scotland earns £3,080 more a year than their counterpart in England. That is all despite the increased privatisation in NHS England.

I have two questions for the Minister on funding. What representations has he made to the Treasury ahead of the autumn statement? And will there be a change or, indeed, an increase to the money given to private enterprises to provide services to NHS England?

I will move on to staffing. Our staff are our NHS—past, present and future. The staffing issue we face because of being dragged out of the European Union is the single biggest issue for our NHS in Scotland. The future of our NHS hinges on staff recruitment and retention. As I said, our NHS in Scotland pays comparatively higher wages than the rest of these isles. The hon. Member for Liverpool, Riverside (Kim Johnson) rightly pointed out the urgency of ending the exodus of NHS staff. Despite that, attracting and retaining top talent remains our biggest concern, indicative of broken Brexit Britain.

The British Government’s shift to being increasingly insular has significant consequences for our NHS in Scotland. That is why the SNP has repeatedly called for the devolution of powers over migration, because we in Scotland are committed to expanding our workforce. The toxic, hostile atmosphere created by the British Government is a barrier to that recruitment. What representations has the Minister made to Cabinet colleagues about the devolution of migration powers to the Scottish Government?

The hon. Member for Wirral West rightly pointed out that underfunding the NHS, quite apart from the harm it does to our constituents, is not a viable economic strategy. Poverty is expensive, as are health inequalities. Cuts to NHS funding are totally false economies that have real costs in the form of longer waiting lists, lost productivity and pain. As the hon. Member pointed out, it is not the model of the NHS that is broken, but the chronic underfunding that has led us here.

The hon. Member for Shrewsbury and Atcham (Daniel Kawczynski) made the point that NHS England is receiving higher funding than ever before. However, he failed to mention the capital given to private companies to provide services, instead of that funding going directly into NHS England.

[Daniel Kawczynski]

I will repeat the question that I posed to the hon. Member for Wirral West, who instigated the debate. We are putting record levels of investment into the NHS. Where will the hon. Member for East Dunbartonshire (Amy Callaghan) get the extra money that she wants to put into the NHS?

[Amy Callaghan]

We look at progressive taxation measures in Scotland to generate income and revenue to put into our NHS, but we are experiencing cuts to Barnett consequentials because of how the British Government down here are spending money on the NHS, with investment in private enterprises as opposed to capital going directly into the NHS. We are experiencing real-term cuts to our funding despite our generating money through other means.

It will come as no surprise that the financial and staffing issues facing our NHS in Scotland are a result of being tied to this broken Union. We cannot afford to be in this financial Union. Our NHS cannot afford for us to be in this financial Union. I look forward to the day when Scotland is an independent nation within the European Union, with a fully funded NHS and no recruitment or staff retention issues because we have created an inclusive and welcoming environment for all.

Before I conclude, I will say that it is fitting, with World Stroke Day just around the corner, that I am standing here talking about the future of our NHS. I have a future because of our NHS. We must provide proper funding and staffing to ensure that there is a future for the NHS and the millions who will need it for generations to come.