Irish Diaspora in Britain
Steven Bonnar Excerpts(2 years, 9 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
Go raibh maith agat, Madam Deputy Speaker —thank you very much. I, too, wish all right hon. and hon. Members and also all my constituents across Coatbridge, Chryston and Bellshill a very happy St Patrick’s day.
We all know that Ireland is Scotland’s closest neighbour and relation, and our often shared heritage and our historical bond run as deep today as the Rivers Clyde and Liffey combined. We in Scotland value immensely the relationship between us and our Irish brothers and sisters, and our bond remains ever strong.
The histories of the peoples of Ireland and Scotland are closely intertwined, with our stories of migration taking many forms at different times over the centuries. Whether Scottish or Irish, chances are we are all immigrants. Place names and family names and our traditions across both our lands are an ever-present reminder of our interlocked Gaelic past and, more importantly, our shared futures together.
My own family surname comes from an Irish heritage, and my roots can be traced back to County Donegal, itself an Irish county with its own unique story, being geographically in the north of Ireland but part of the 26 counties that make up the rest of the island. Today, my ties to Ireland allow me to visit frequently; just last week I was fortunate enough to be in the town of Drogheda, County Louth. The reason for that trip was to partake in one of those old Scottish and Irish traditions we share, wetting the baby’s head, as we welcomed Finn Martin Murphy into this world—born of a Scottish mother and an Irish father, so it is safe to say the connections between our families and countries are safe for at least another generation.
While there, I took the opportunity to visit the site of the Battle of the Boyne in Drogheda—a truly historic place that can be appreciated regardless of faith, creed or political persuasion. The profound consequences of the battle reverberate to this day in the to-ing and fro-ing over the withdrawal agreement and the Northern Ireland protocol, but it is always worth remembering there is far more that unites us than separates us. I was also able to indulge in Ireland’s greatest export, Guinness. I extend my gratitude to those kind persons of the St Laurence’s Club at McHughs for their warm hospitality. As they say in Ireland, the craic was 90.
Both Scotland and Ireland are nations who have stood strong through both glory and tragedy, from the creation of Saint Columba’s monastery on the Isle of Iona—the Irish saint also lends his name to my local parish in my constituency—to the tragedies of the Scottish highland clearances and an Gorta Mór, the great famine in Ireland, which saw so many perish and thousands of Scots and Irish move between these lands. Millions of people worldwide today can trace their descendants back to these tough, resilient Irish and Scottish survivors.
The 2011 Scottish census revealed that almost 11,000 Irish citizens were living in Scotland, and Coatbridge in my constituency is long renowned in both Scotland and Ireland for its Irish diaspora. By the same token, many of my countrypeople live across the Irish sea—15,000 in the north of Ireland alone, based on the same 2011 census. A further 57,600 people were recorded as speaking an Gaeilge, so it is no surprise that our relationship across the sea remains vibrant and is vital to Scots and Irish alike.
With the current census in Scotland ongoing, and the ramifications of Brexit never far from the minds of the Scots or the Irish, I am entirely confident that the number of Irish passport holders in Scotland will have increased sharply over the past couple of years. Such drastic impacts on our identities and outlooks as Brexit will have a profound effect on the eventual make-up of these shared islands. Despite our no longer sharing membership of the European Union, the strong and enduring foundation of the common travel area and the structures created by the Good Friday agreement provide a stable foundation for the continued development of good relations between our peoples.
Ireland has a long tradition of diaspora engagement around the world, which was reinforced by the Department of Foreign Affairs appointing its first Minister for diaspora affairs in 2014. Scotland engages her global diaspora through GlobalScot, a worldwide network of almost 800 entrepreneurial and inspirational business leaders and experts. The Scottish Government will continue that good work with Irish colleagues on common issues and shared goals, particularly on diaspora affairs, to assess where lessons can be drawn from Ireland’s experience.
There is also scope for increased exchange and partnerships between different diaspora organisations. That is something I am eager to encourage, in the hope that it will allow us to provide greater support to Irish community organisations across Scotland—a community that, it cannot go unsaid, has not always been fully accepted into Scots society by all.
However, today is about celebration—the celebration of the feast of St Patrick—and we are all a wee bit Irish today, are we not? Together across this House we celebrate our shared heritage, our music, our traditions and our culture.
Covid-19: NHS Support for Prostate Cancer Patients
Steven Bonnar Excerpts(2 years, 9 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
It is a pleasure to see you in the Chair today, Ms McDonagh. I am grateful to the hon. Member for Carshalton and Wallington (Elliot Colburn) for securing this vital debate on a subject that unfortunately does not receive the attention that it deserves.
For a long time, prostate cancer has been wrongly labelled an old man’s disease. In fact, all men are at risk of developing prostate cancer at any age, with one in six of us facing a diagnosis in our lifetimes, and we have also heard that it has a disproportionate effect on black African and Caribbean men. Yet there is still a lack of awareness of this disease—awareness that is needed to support affected men. That was particularly true during the pandemic, which has seen our healthcare provision being put under great and unprecedented pressure.
The earlier prostate cancer is found, the better the chance of a good outcome. Analysis by Prostate Cancer UK suggests that between April 2020 and September 2021, 600 fewer prostate cancer diagnoses were confirmed in Scotland. Prostate Cancer UK estimates that, because of the pandemic, 14,000 men across Scotland and the rest of the UK have not yet started treatment for prostate cancer.
Just a couple of weeks ago, Prostate Cancer UK launched a UK-wide campaign alongside the NHS to find those 14,000 missing men, and we in the Scottish National party welcome this initiative. Throughout the covid-19 pandemic, cancer has remained a Scottish Government priority, and the Scottish Government are focused on ensuring that patients are diagnosed and treated as quickly as possible. Scotland has 76 general practitioners per 100,000 citizens, compared with a UK average of 60 GPs per 100,000 citizens. That has undoubtedly helped to improve early detection of cancer in Scotland, and I am sure that right hon. and hon. Members will agree that GP provision—or a lack of it, in many respects—is hugely impactful in the wider healthcare arena.
Throughout the ongoing health crisis, the First Minister of Scotland has persistently stressed that the NHS remains available for those who need it. Advice has been sent to all cancer services in Scotland, including the key message that boards are expected to maintain full urgent cancer services. Indeed, most cancer treatment continued throughout lockdown; even at the height of the pandemic, patients in Scotland waited on average just two days before starting treatment. Regrettably, I understand that that was not the case in England or Wales.
The impact of this decision in Scotland undoubtedly saved the life of one of my constituents in Coatbridge, Chryston and Bellshill. After feeling unwell and explaining their symptoms to the NHS 24 helpline, they were quickly admitted to hospital, with specialist cancer treatment and support to hand. However, the only available treatment option that could be offered was invasive surgery, bringing with it, of course, a longer recovery time and more risk compared with a keyhole surgery procedure. None the less, that early diagnosis proved to be critical.
In order to ensure that this does not spiral into a secondary health crisis, a large amount of investment will be needed to clear the backlog of screening and treatments, to get cancer services back operating at the level that they were before the pandemic. We should actually be aiming to make them even better. The Scottish Government continue to engage with the cancer community to ensure that all key partners involved in the delivery of the national cancer recovery plan, which will support cancer patients to have equitable access to care regardless of where they live, improve patients’ experience of care and roll out innovative treatments to improve cancer services.
To improve cancer performance over the next five years, the Scottish Government are taking a range of actions, including ensuring that everyone across Scotland who meets referral criteria has access to an early cancer diagnostic centre, and investing £40 million to support cancer services and improve cancer waiting times, with a focus on the most challenged cancer pathways, including neurology, colorectal and breast cancer. Of that, £20 million will support the Detect Cancer Early programme, providing greater public awareness of signs and symptoms of cancer and supporting the development of optimal cancer pathways to improve earlier diagnosis routes. We are also supporting a rehabilitation programme for cancer patients, to ensure the best possible preparation for treatment and improve both the experience of treatment and its clinical outcomes. That is what a Government with their priorities in the right place look like.
The UK Government must begin to invest properly in the NHS in England. That, of course, will ensure that adequate consequentials are delivered to Scotland to enable us to recover from the pandemic. Those improvements should be funded through efficient decision-making, strategy and budgeting, not by raising national insurance, which threatens to hit those on the lowest incomes in the midst of the cost of living crisis. They are the very people who are most likely to rely on the services of our NHS, so they are facing quite the double-edged sword. I urge the Minister and the Government to take a leaf out of our book in Scotland and take the necessary steps to safeguard the prospects of prostate cancer patients in the light of the pandemic, and for generations to come.
I reiterate the comments of the hon. Member for Carshalton and Wallington, and I urge all men to go and get that check. That moment of discomfort and embarrassment may just be the moment that saves your life.
Covid-19: Deteriorating Long-Term Health Conditions
Steven Bonnar Excerpts(2 years, 9 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
It is a pleasure to see you in the Chair, Mrs Cummins. I, too, am grateful to the hon. Member for Bromley and Chislehurst (Sir Robert Neill) for leading this important debate for us today.
I will start with a quote from a doctor in my constituency of Coatbridge, Chryston and Bellshill, who was working throughout the pandemic in University Hospital Monklands’ accident and emergency department. He told me:
“People are presenting with conditions that are unfortunately too severe for us to treat. Covid has caused appointments to be missed and regular health checks to be postponed. The simple loss in social contact with healthcare professionals has created a lasting impact that we are only just beginning to realise.”
Sadly, due to the pressures on our hard-working healthcare professionals and the measures required to prioritise resources towards those contracting covid-19, many of our regular NHS services have been paused or delayed. That disruption and continued backlog will indeed take time to be addressed fully—we know that—but our foremost thoughts must be on how we support our constituents whose long-term conditions continue to deteriorate.
Undoubtedly, the reality is that the greatest support package that any Government can give the sector is direct investment. I am proud to say that, once again, Scotland is showing the way, with the Scottish Government in Holyrood making the Scottish NHS the best-funded health service in the United Kingdom.
In February 2021, the former Health Secretary in Scotland, Jeane Freeman, announced a new community living change fund of £20 million to deliver and redesign a service for people living with long-term illness and complex needs, including intellectual disabilities and autism, and those enduring mental health problems. We know that there are many conditions that we could highlight, as the hon. Member for Bromley and Chislehurst (Sir Robert Neill) did in his opening remarks, and that there will be a legacy of mental health implications for us all to tackle in the wake of the pandemic.
That £20 million funding is the beginning of the Scottish Government’s implementation of the Feeley review—the independent review into social care in Scotland, which delivered many recommendations for the reform of social care in Scotland. The Scottish Government understands that we need not only to make up for what has been lost over the pandemic but to make healthcare provision even better than it ever has been before. We must ensure that nobody who is ill or suffering feels it best that they do not ever go to a hospital; we can never have a repeat of that.
The new Scottish Budget 2022-23 delivers record funding of £18 billion for the health and social care portfolio, which will be used to support the remobilisation of services, as well as delivery on the priorities relating to prevention and early intervention. This is a 20% increase in NHS frontline spending, which equates to £183 per person in Scotland and is 12% higher than the £163 of investment per person planned for England in the coming year. On top of that, the Scottish Government will of course abolish all dentistry charges, eye examination costs and non-residential social care charges for those in need of our support.
My question to the Minister is this: these are simple changes being made through targeted investment decisions, so where is the difficulty in applying such a scheme in England and Wales? The only answer that I can determine is that there is no such difficulty, and that there is simply a complete lack in prioritisation of the NHS and a lack of political will to safeguard the most precious resource that these four nations have to offer.
I had the privilege recently of witnessing another of the Scottish Government’s new schemes and strategies to achieve early diagnosis when I visited Mackie Pharmacy in my constituency. They are one of many pharmacies across Scotland that are taking part in a campaign to promote local pharmacies as the heart of first-contact healthcare services and provision. The development of this “pharmacy first” scheme will relieve the pressures on GP practices and on our accident and emergency departments, by allowing for the diagnosis and treatment of common ailments on a more localised basis.
In addition, the constant contact that our pharmacies have with our communities allows them to identify issues even before people themselves are aware of them. During my visit to Mackie Pharmacy, one assistant told me how she noticed that an elderly lady who regularly comes into the store was not her usual self. After a few exploratory questions about how the woman was feeling and then noticing some changes in her over the course of a few days, the pharmacist recommended an admission to hospital and it was found that she had a serious heart condition. That visit to the pharmacy that day saved that lady’s life. That is how prevention post-pandemic can and should happen. Schemes such as “pharmacy first” will play a vital role in helping us to better support those with long-term conditions.
The Scottish Government are caring for our elderly population in other ways as well, by delivering a new deal for our care sector. The independent Feeley review into social care in Scotland delivered many recommendations for reform. The review estimated that implementing its recommendations, including a national care service, would cost £660 million. The Scottish Government are going further, increasing social care investment by over 25% during this Parliament, which is equivalent to over £840 million.
Among the recommendations of the Feeley review are the creation of a national care service and the scrapping of non-residential social care charges, and we are going to deliver those things. While the UK Government delay, the SNP are taking action right now in Scotland to deliver a modern social care service that is fit for the 21st century. Why not match our ambition or our approach?
I believe that the crux of the matter is that the Government here in Westminster cannot be trusted with the protection of the NHS. How do we protect those who are deteriorating with long-term health conditions after the severest pandemic that this country has witnessed in recent history, when the Tories are geared towards creeping privatisation in England while forcing hard-working families to pay more in national insurance and income tax to access what healthcare remains public?
It must also be noted that even when England’s healthcare provision is so reliant on immigrant workers, the Tories create a “hostile environment” in attempting to drive away the workers they rely on so much. Some workers in England have even left the NHS to work for multinational companies such as Amazon that pay their staff better than the NHS does and have better conditions. These facts speak for themselves.
While Scotland pushes forward with new ideas to deliver a health and social care service fit for the 21st century, the UK Government continue merely to paper over the cracks of their own mismanagement and continue to pursue policies in other areas that actively harm healthcare provision in these countries.
The pandemic is an opportunity for Governments all over the world to look again at the way that things have always been done. I sincerely hope that this UK Government will regard the pandemic as an opportunity finally to look after our NHS and all those in desperate need of its support.
Draft Human Medicines (Coronavirus and Influenza) (Amendment) Regulations 2022
Draft Human Medicines (Amendments Relating to the Early Access to Medicines Scheme) Regulations 2022
Steven Bonnar Excerpts(2 years, 9 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
It is a pleasure to see you in the Chair, Ms Rees. I thank the Minister for laying out his reasons for introducing the legislation, and why it is required. I echo the comments made by the Opposition spokesperson on our gratitude to our frontline health workers in the fight against coronavirus. They are the real heroes of these nations.
The Scottish National party welcomes moves to ensure that an expanded category of authorised vaccinators who can deliver the coronavirus vaccine is maintained, and to extend the expansion of locations at which vaccines can be prepared and administered. With full authorisation of the coronavirus vaccine still pending, those moves are necessary. The fact that the conditions need to be extended, as laid out by the Minister, is a reminder to us all that the pandemic is still ongoing, and therefore a reminder to Governments that they should be taking a cautious and sensible route out of it. This is one way in which we will be able to achieve that.
Moving on to the draft Human Medicines (Amendment Relating to the Early Access to Medicines Scheme) Regulations, the SNP again welcomes moves to support more patients for whom medicines exist that are not yet authorised for full sale and marketing in the UK medical market. Approval of medicines under EAMS must be followed by the adequate provision of medicines to those who need them. As the legislation around medical marijuana shows, approval does not always translate to availability to those in need. The UK Government should take the opportunity, while reviewing medicine provision, to consider the removal of prescription fees. While people throughout the UK face the consequences of a real cost of living crisis, forcing them to pay for their medicine too is, in our opinion, wrong. I would like to hear the Minister’s opinions on that.
Dementia Research in the UK
Steven Bonnar Excerpts(2 years, 10 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
I too commend the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this debate and for her excellent contributions to it.
We have heard that dementia affects around 850,000 people in the United Kingdom—one in every 14 people over the age of 65, and one in every six over the age of 80. Dementia is one of the leading causes of death across the United Kingdom and currently, as we know, there is no cure. The most well-known impact of dementia on an individual is progressive memory loss, which affects both mental and physical abilities and makes it difficult to execute even the most basic of daily activities effectively and efficiently. When someone is diagnosed with dementia, it can be overwhelming, as they face several difficult challenges on the long road ahead.
We all know and have heard just how much dementia has affected many of our constituents and their loved ones during this awful pandemic. The House heard so lovingly from my hon. Friend the Member for Ochil and South Perthshire (John Nicolson) about his plight and the plight of his wonderful mother Marion. I have spoken to those who care for family members across my constituency of Coatbridge, Chryston and Bellshill, and they have expressed how much more difficult covid and the pandemic have made the experience, as the pandemic has presented its own new and unique challenges.
Not only does dementia cause harm and heartbreak to millions of families throughout the countries of the UK but it is completely unsustainable for our health and social care systems. The economic cost to the UK of caring for people with dementia is estimated to grow from the £24 billion it was in 2014 to £47 billion by 2050. Age is, of course, by far the biggest risk factor for a dementia diagnosis, and as our population ages the number of people diagnosed with dementia will increase. The number of people living with dementia in the UK is expected to exceed 1 million by 2025.
As we have heard, 90,000 people are currently living with dementia in homes all across Scotland. That is why the SNP Scottish Government published a dementia and covid-19 action plan in December 2020, to build on, continue and expand the national action taken since March 2020 to support people with dementia and their carers. The Scottish Government are working with partners such as Age Scotland to help dementia patients to get better support and have a bigger say in what works for them and in their individual care package.
The Scottish Government have pledged a further £1 million to help to tackle dementia in Scotland. Brian Sloan, the chief exec of Age Scotland, said:
“This funding will help address some of these challenges by shaping communities that work for those who have lived experience of dementia.”
That is a clear indication of the effectiveness of Scotland’s response. The Scottish Government have seen how the coronavirus pandemic has had a disproportionate impact on people with dementia. Through partnerships, they will help to grow the community support that has been considered critical to people and their families. I am of the belief that Scotland is also seeing positive results through our policy of integrated health and social care among health boards and local authorities. The Westminster Government should follow that lead.
Of course, Scotland is currently the only country in the United Kingdom with free personal care, which is extremely important support for people under the financial strains that dementia and living with dementia can place on families. People who are not in Scotland may wonder what that looks like: a dementia sufferer can receive up to four visits per day in their own home, where care is administered and the carer spends some time with them because, as the right hon. and gallant Member for Beckenham (Bob Stewart) pointed out, loneliness can be one of the biggest indicators that mean people simply give up. We must do everything we can to make sure that people live a fulfilling and wonderful life.
Steven Bonnar
Thank you.
In 2017, the UK Government declared that the UK would be the most dementia- friendly country in the world by 2020. [Interruption.] The Minister nods his head, but unfortunately we know that that is not true: just look at the hundreds of dementia care homes in England that were discovered to be providing substandard care to their dementia patients.
A Care Quality Commission report found that one in every five homes specialising in dementia were rated as “inadequate” or “requiring improvement”. Some posed such a serious risk to people with dementia—because of filthy living conditions, poor infection control and poorly trained staff—that inspectors had to order them to be put into special measures. In total, 1,636 care homes are failing patients, according to findings described as “appalling” by charities and campaigners. They stated that immediate action was required to address the “unacceptable” state of dementia care across the country.
If we are to position the UK as the world leader in dementia—something we all want to see—we should not start by cutting the much-needed funding that was promised by the Government for dementia research. As we have heard, the 2019 Conservative party manifesto committed to address dementia by pledging to double funding for dementia research to more than £160 million per year. However, two years later and another broken promise later, we find ourselves in the same situation, with no plans from the Government to deliver on their manifesto pledge. The funding for dementia research for 2020 was £75.7 million—a decrease from £82.5 million in 2019 and from the high of £98.1 million in 2016.
What else do we need to say to persuade the Government to recognise the importance of funding dementia research in trials? Currently we have over 150 clinical trials worldwide examining potential dementia treatments. It is more pressing than ever that we can transform dementia diagnosis. We need early diagnosis of the diseases that cause dementia and we need to diagnose them more accurately; otherwise it will be too late for patients to benefit from potential new treatments. The Government should invest now in infrastructure, resources and the clinical workforce to build diagnostic capacity and support innovative ways of organising NHS services such as brain health clinics to offer new diagnostic pathways. I look forward to the Minister outlining how the Government intend to achieve that.
The Scottish Government have proven our commitment to dementia research with a one-off £75 million increase in funding for our universities to ensure that they can protect world-leading research programmes against the financial impacts of covid-19. That is exactly how we protect those we care about and those who care for us. The current prevalence rate of dementia among older people in the UK is about 7.1%, and of the four countries Scotland has the lowest prevalence rate, with England having the highest overall prevalence rate. With the growing trend and threat of dementia to our citizens, it is now time for this Government to act and to outline a proper plan to help combat the threat of dementia across these nations, with the goal of preventing people from developing the onset of dementia.
The UK Government can follow in the footsteps of Scotland and become the world leader in dementia research they told us they would be, but to do so they must deliver on their manifesto commitments to double the funding for dementia research, speed up progress in clinical trials, and ultimately—maybe only by the grace of God—help us to find the cure. We cannot allow any more time or opportunities to pass by as we seek to support those living with and at risk of dementia.
Covid-19: Purchasing Effort
Steven Bonnar Excerpts(2 years, 10 months ago)
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Edward Argar
My hon. Friend puts it even better than I could have done. He is absolutely right to emphasise that this is a reflection of our straining every sinew to buy what we needed at the height of the pandemic, with inflated global prices, to give our NHS workers the protection that they needed. The global market has now returned to normal levels, and that, coupled with the fact that we have helped to stimulate and build a UK manufacturing base for PPE in this country, is a simple fact of economics. The shadow Secretary of State, who I think was formerly a shadow Exchequer Secretary, should know that. Sadly, the fact that that is not reflected in his comments, for whatever reason, causes me to question how much the Labour party has really learned about how to manage our nation’s finances and economy.
Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
I thank the Minister for advance sight of his statement. Yet again, this Government are set rigid on making the working poor pay for their ineptitude and mismanagement. We know that £4.3 billion has been wasted, written off as covid loan fraud. We know that the Government spent £12 billion on PPE in England up to March 2021, of which £9 billion has been declared by the Government themselves as “wasted”—[Interruption.] We have some chuntering from those in a sedentary position, but I will continue.
Does the Minister believe that wasting all that money spent on PPE is a sign of good governance, when £2 of every £3 spent on VIP lane contracts was wasted due to so-called errors in supply? Now hard-working people will be taxed £12 billion by this Government to pay for their mismanagement, when the Bank of England has just told us that UK households must be warned to “brace themselves” for the biggest annual fall in living standards in 30 years, since records began, and inflation is set to soar to 7%. Why is his Government not vigorously pursuing companies that provided £9 billion-worth of useless PPE equipment to ensure that they pay it back? Will he assure the House that his Government will pursue that with complete vigour?
Kleptocracy is defined as a situation where politicians enrich themselves or their associates through the funnelling of public money and assets to their connections outside the rule of law—a statement we know all too well in this House. Given that the UK Government’s VIP, Tory crony fast lanes for Tory party associates have been declared unlawful in the Court of Session and seen billions of pounds wastefully funnelled to politically connected friends of this Tory Government, does the Minister agree that his Government are fast becoming a kleptocracy?
Edward Argar
In general, and certainly after that contribution, I will take no lessons in financial illiteracy from the SNP. The hon. Gentleman regularly, in that contribution, referred to £8.7 billion or £9 billion—rounding, if he wishes to—as wasted. He will know that, as I have set out, it is not wasted. It is a write-down on the value of stock, but it is not wasted. That stock is available. That is the point I make to him. The vast majority of that stock is available and in warehouses. This is an accounting point about the value of what was paid at the time compared with its value in a recovered market.
I will pick up one point I missed with the shadow Secretary of State, who I hope will forgive me. He mentioned ventilators, and I apologise for not answering that point. In the case of ventilators, we followed the scientific advice at the time, which was that ventilators were the most effective way of treating those who were severely ill. Thankfully, due to amazing advances by our clinicians and scientists and to the action taken by this Government, we did not need them and the treatments available improved significantly. Again, I make no apologies for our being prepared for all eventualities.
To conclude on the contribution of the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar), I reiterate the same thing: we make no apologies for having strained every sinew—in a global pandemic, at the height of the market, when some countries were imposing export bans—to purchase the PPE to protect our frontline workers. I also pay tribute to the officials who worked flat out, often through the night, sourcing the PPE. They were the ones assessing it, and they were rigorous in their assessments. I put on record my tribute and my gratitude—
Edward Argar
I think the hon. Gentleman nodded assent, so we may be in agreement on that point. I put on record my tribute and my gratitude to them for all their hard work to protect the frontline.
Future of the NHS
Steven Bonnar Excerpts(2 years, 10 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
It is a pleasure to serve under your chairmanship, Mr Gray. I thank all those who signed this petition. The position of the SNP on this matter is clear: the NHS was created to be free at the point of use and to treat all citizens equally from cradle to grave. That is the NHS we want to see back—an NHS for the people, by the people and firmly in the hands of the people. Despite the fact that the Government lack a democratic mandate to privatise the NHS, vast sums of public money are being wasted on business managers, private providers, PFI debts, multinational accounting firms, and corporate consultants. By enshrining privatisation in NHS England, the Tory Government continue to jeopardise access to care and universal standards.
Let us look at social care, for example. Scotland has successfully integrated health and social care services since 2014 and has put in record investment to allow continued quality improvements in services year on year, and that is without any privatisation. It has been achieved even with the culture of cuts to public services that has been forced on Scotland by Westminster’s austerity agendas. If Scotland can create a social care system that works with one hand tied behind our back, what is England’s excuse?
We have heard hon. Members refer to dental health and the lack of dental care in England. Of course, in Scotland we made provision for free NHS dental care for 18 to 25-year-olds in our last manifesto, and that is coming through the Scottish Parliament just now. That is on top of free annual and biennial eye tests for everybody, because those are the things that matter and they can have a better effect on the management of our NHS and address the clogging up of appointments.
For the UK Government, it seems that healthcare is a hassle; for the Scottish Government, it has been our priority. The covid crisis has demonstrated why the NHS is our most important public service, and Scotland has recognised that. We gave our NHS workers a bonus as we came out of the pandemic. The Scottish Government have also put record funding into our health and social care services of up to £18 billion, with resource funding up 90% under the Scottish Government. Frontline health spending is £111 higher per head in Scotland than it is in England. These figures speak for themselves.
The SNP Government in Holyrood have a history of making different parts of the health and social care system work together. They have used legislation to get these efforts under way. We also contributed to the betterment of the UK system by voting against the Health and Care Bill going through this House. That Bill gives the UK Health Secretary enormous powers over NHS England—over its structure, functions and budget—giving him more leeway during trade negotiations, with particular risks from American healthcare interests. Such ministerial control over NHS England is concerning, as there will be long-term consequences for the national health services in Scotland and the other devolved nations, particularly in terms of funding and what is included in any free trade agreements. The Bill eliminates the requirement for competitive bidding and allows NHS bodies to award some contracts directly. Can you imagine if the future care of your family and friends, your children and relatives, was all dependent on how much money was left in somebody’s locker, as opposed to whose expertise and resources were best to deliver it? The SNP has been clear that those in charge of services should have only the best interests of patients at heart, not the vested interests of private healthcare.
We appreciate our healthcare system and in particular its staff, who have been invaluable to every member of our society before and throughout the covid pandemic and will be after the pandemic has, thankfully, gone.
We heard what was said by Dr Pelle Gustafson, the chief medical officer of the Swedish patient insurer. When asked which country he would
“hold at the very top of the pillar”
with regard to patient safety, he replied:
“If you take all preventive work as regards patient safety, I would say that I am personally very impressed by Scotland. In Scotland, you have a long-standing tradition of working. You have development in the right direction. You have a system that is fairly equal all over the place and you also have improvement activities going on. I am very impressed by Scotland.”
If the Minister is listening to that, this is the NHS that the UK Government could and should be using as a basis to drive improvements for the health and social care sector across these nations, because if they do not, we are at a very real risk of doing citizens the greatest injustice that this country has ever seen.
Skin Conditions and Mental Health
Steven Bonnar Excerpts(2 years, 10 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate the right hon. Member for Gainsborough (Sir Edward Leigh) on securing this debate on such an important matter, and for informing us all so much through his excellent contribution. Millions of people across Scotland and the UK suffer from skin conditions, which can have a devastating impact on a person’s mental health. The skin is the most noticeable part of our body that could be impacted by psychological factors, yet very few psychologists are researching it. It is classic health psychology, just in a different area. It may seem purely aesthetic to the unaffected, yet the impact goes much deeper, as we have heard.
Skin conditions can be extremely distressing. They can affect all aspects of people’s lives, from schooling, relationships, self-esteem and career prospects to social and leisure activities. Unlike hypertension, diabetes or other health problems, skin problems are usually obvious to any onlookers. That can lead to feelings of isolation, embarrassment, depression or anxiety. People may have psychological reactions that seem out of proportion to their actual skin complaint. Around a quarter of the UK population consult a GP every year for a skin complaint, the most common being for stress caused by the complaint. Despair and other psychological issues can exacerbate the skin problem, creating a vicious spiral.
Acne, psoriasis, eczema and hives are just a few of the dermatological conditions that have been scientifically proven to be exacerbated by stress. Psychodermatology treatment is becoming more accepted among dermatologists, and psychologists are becoming more involved in assisting dermatology patients. Dermatologists and other skin experts are still researching the role of stress and other psychological factors on skin conditions. They are also working on therapies to help dermatology patients deal with the mental health difficulties associated with their conditions.
We heard the hon. Member for York Central (Rachael Maskell) speak about her constituent’s issue, as well as about women’s health more broadly. My hon. Friend the Member for Bracknell (James Sunderland) spoke about the number of people impacted by mental health issues compounded by their skin condition, such as eczema or psoriasis. Despite all that, there is still a gap in services available for people experiencing distress. A report released in September 2020 by the all-party parliamentary group on skin, undertook some fantastic research and found that many primary healthcare professionals lacked access to dermatological training—even fewer are trained to support patients with the psychological effects of these conditions. We may miss critical signs of distress if primary healthcare providers lack the expertise to conduct a psychological evaluation.
According to the British Skin Foundation, 70% of people across the UK have noticeable skin disorders or scarring that will lower their self-esteem. For example, psoriasis is an illness that primarily affects the skin, and occasionally the joints through psoriatic arthritis. It presently affects between 2% and 3% of the UK population, which is over 2 million people. Psoriasis can have a significant and sometimes catastrophic psychological impact, causing anxiety and depression. Despite that, there is a lack of resources to help persons with inflammatory skin feel less stigmatised. I am myself a psoriasis sufferer, and fully understand the implications of the condition and the effect it can have on a person’s self-confidence. I developed psoriasis in my teens: it is a genetic, hereditary disease, passed on to me from my mother. In fact, my granddad, my mum, my auntie Anne, and now myself have all been long-term sufferers.
The damage that this condition can cause does not simply arise from the impacts on a person’s skin, many though they can be. I am maybe fortunate that my psoriasis manifests mainly on my scalp and head: I often jest that as long as I keep hold of my hair, I should be okay. However, I have also seen first hand the impacts of severe and extreme breakouts resulting in hospitalisation, and have touched on the stress and anxiety of sufferers, none more so—in my opinion—than that of the parent watching their child growing, hoping against hope that they will not have unwillingly passed their condition on to their children. My 13-year-old has so far been unaffected, but that seems to be by the grace of God.
I put on record my thanks to NHS Scotland for its continued work in this field, which has been made possible by the Scottish Government boosting mental health spending by over 65% in the past year alone. I am sure that Members will agree that the mental health consequences of skin diseases are vast, and that as a morally responsible society, we must do more to combat those effects.
Vaccination Strategy
Steven Bonnar Excerpts(2 years, 11 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
Once again Scotland has set an example for the UK, and I want to take this opportunity to thank all those NHS and frontline key workers involved in the excellent vaccination roll-out programme. We lead the way on first and second doses administered, and we rank second worldwide for the most successful booster roll-out programme, with over 80% of our adult population given their third vaccine. The rest of the UK also has one of the highest vaccination records in the world, along with most of Europe. Is it not well past time to begin a serious campaign of vaccine sharing and the vaccination of those who have so far been left behind in our global community?
Secondly, when the booster roll-out does wind down, will the UK Government commit to shifting the momentum from domestic vaccination to vaccination sharing with the poorest countries? While we welcome the 30 million doses that have been donated, they are a mere drop in the ocean in terms of what is actually required. Lastly, will this Tory Government finally show a shred of compassion for the plight of those around the world?
Maggie Throup
The hon. Gentleman makes a good point about ensuring that rural communities have access to vaccines, and that is exactly what we have done through our programme. We have made sure that walk-in centres have been stood up, as well as other ways for people to access vaccines such as vaccine buses, so that community pharmacists can deliver in rural settings and among hard-to-reach groups. Whether in rural or urban areas, it is important that we use every possible route—for example, working through community groups, local leadership and faith groups—to put everything in place to ensure that everyone has access to the life-saving vaccines.
I reiterate what I said to the hon. Member for Denton and Reddish (Andrew Gwynne), that to date we have donated 30 million doses to COVAX and bilaterally. We will continue to fulfil our commitment to donate 100 million jabs globally by the end of June this year.
Eye Health and Macular Disease
Steven Bonnar Excerpts(2 years, 11 months ago)
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Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
I commend the hon. Member for Strangford (Jim Shannon) for bringing forward this debate on a hugely important subject. Macular disease is the biggest cause of sight loss in the UK, with up to 40,000 people developing wet age-related neovascular macular degeneration every year, with wet macular degeneration being the worst of all known eye diseases.
Age-related macular degeneration is a common condition that affects the middle part of a person’s vision. It usually affects people in their 60s and 70s, rising to a rate of around one in 10 people aged 75 and above. However, it can strike at any age. It can happen in one eye or both and, as we have heard from the hon. Member for Great Grimsby (Lia Nici), it affects the middle part of a person’s eye. AMD can make things such reading, watching television, driving or even facial recognition difficult. Other symptoms can include seeing straight lines as wavy or crooked—which was how the hon. Lady established that she had a problem—objects looking smaller than normal, colours seeming less bright, or seeing things that are not even there.
AMD is not painful and does not affect the appearance of the eye. It does not cause complete or total blindness, but it can make everyday activities incredibly difficult. Without treatment, vision may worsen gradually over several years, which is known as dry AMD, or quickly over a few weeks or months, known as wet AMD. The exact cause is unknown; it has been linked to high blood pressure, being overweight, smoking or having a family history of AMD.
I am sure Members agree that the figures and statistics prove the seriousness of the disease, and why pre-emptive measures should and must be taken. I am proud that that is exactly why we are leading the way in optometry in Scotland. We are currently the only country in the UK to provide free, universal, NHS-funded eye care examinations. Since 2006, adults in Scotland have been able to attend a free eye health check biannually, with children under the age of 16 and adults over the age of 60 entitled to an annual visit. That proves that the Scottish Parliament is committed to delivering a world-leading eye care service for its people.
An NHS eye examination in Scotland is more than just a sight test. It provides a general eye health check that can detect early signs of sight-threatening conditions and other general medical conditions, including diabetes, high blood pressure, cardiovascular disease, tumours, dementia, or even arthritis. Optometrists in Scotland deliver a system of eye care services in which all areas of the ophthalmic workforce are truly at the top tier of their professional competency and expertise. That enables higher quality, safe, effective and person-centred eye care services to be delivered in the community and closer to people’s homes, freeing up hospital services to focus on the most complex eye conditions and urgent patient cases.
Community optometrists are already the first point of contact for any eye problems and they can diagnose and treat a number of conditions without the patient requiring an appointment with their GP or an ophthalmologist, easing pressures on an already burdened health service. An increasing number of community ophthalmologists are also registered independent prescribers and can issue patients with an NHS prescription to treat their eye problem or condition.
I was fortunate enough to be able to visit one of the opticians in my constituency of Coatbridge, Chryston and Bellshill just yesterday. Tuite Opticians in Coatbridge is a family-owned optician currently run by Eamonn Tuite, which has been at the heart of our town since 1973. Tuite understands the needs of the community it serves and always goes the extra mile to ensure the best healthcare and support are provided to all service users. As a result, it not only provides eye examinations in the practice, but also a bespoke service for the housebound, ensuring minimum fuss is required by the patient for such a vital check. I am pleased to be able to place on record my gratitude to the optometrist Stephen Kirley, who took the time to explain to me in great detail the impact of macular degeneration on individuals and why early intervention is so important in treating the disease.
That all lies within and is covered by the free eye test and the fantastic policy of the Scottish Government. By ensuring there are no barriers to accessing eye care, optometrists such as Stephen have a positive impact on patients’ health needs. In return for every eye test carried out, the Scottish Government provide practices such as Tuite with a fee to cover the cost of its work and ensure the business can continue to support as many in the community as possible.
Tuite Opticians was kind enough to carry out my own eye test yesterday and I sure all Members will be happy to learn that I have a clear bill of health—all the better for keeping a beady eye on this Government.
John McDonnell
I went for my eye test yesterday. I could not get an appointment in Hayes, my constituency, so I went to Uxbridge. Unfortunately, at the same time the Prime Minister did an official visit to the eye test and disturbed it. How inconsiderate could he be?
Steven Bonnar
That is so surprising. This Prime Minister is known for his consideration of others.
I put my thanks to Tuite Opticians on the record, not only for having me, but for its tremendous commitment to the wider community of Coatbridge for over 30 years.
Jim Shannon
I thank the hon. Gentleman for his positive contribution to this debate. The other good thing about going to an optician, is that if he has any concerns, he can refer the patient on—it does not necessarily have to go through the GP. I did that when I went to my optician in the Cathedral Quarter in Belfast to get all the tests necessary and ultimately was given the all-clear. An optician can put someone’s mind at ease.
Steven Bonnar
I thank the hon. Member for his intervention. He is absolutely right. The optician can highlight so many things. We know the burdens across the NHS, particularly on our GPs and this can lighten the load. However, as he correctly outlined, unfortunately, in England, Wales and Northern Ireland, the situation can sometimes be difficult. Optical practices are not so fortunate in that there is no governmental support and provision for free eye tests for the general public.
In England, a typical eye examination costs between £20 and £25 for all, except children, the elderly or people registered as partially sighted or blind. Having a monetary value attached to an eye examination would undoubtedly deter those unable to afford the crucial health test and endanger their long-term health and hamper the early prevention tactics that so evidently work. This in a country where health care should be free at the point of need is unacceptable. I believe it is unacceptable to administer a charge. The rest of the UK should follow suit. We have heard repeated calls for a national strategy—the example set by Edinburgh should be followed. Scottish citizens do not have to pay to have their eyes examined. Seeing is a privilege that so many of us will struggle to appreciate, but ensuring that there is universal access to eye tests means that those who require them do not have to think of any cost ramifications.
Scotland not only leads the way in the universal accessibility of eye tests but is the first country in the UK to enable access to important treatments for macular disease. Treatment depends on the type of AMD. Dry AMD accounts for 80% or 90% of cases. There is no treatment, but vision aids can help reduce the effects on day-to-day life. Wet AMD, which affects 10% to 20% of sufferers, may require regular eye injections and, very occasionally, as we heard from the hon. Member for Great Grimsby, a light treatment called photodynamic therapy, to stop vision getting any worse.
The other nations of the UK are missing a trick not only in determining new treatment methods for macular disease, but when it comes to understanding the importance of addressing such issues in terms of the impact on the wider health and social care system.
Rehman Chishti (Gillingham and Rainham) (Con)
I am very grateful to the hon. Gentleman for all that he is saying with regard to macular degeneration. From speaking to surgeons such as James Neffendorf at King’s College Hospital, I know that treatments are absolutely crucial, but what will help to save people’s eyesight, whether in Scotland, England, Northern Ireland or Wales, is the public awareness of macular degeneration, so that those signs can be picked up earlier across the United Kingdom. Will he agree that the Government should ensure that there is a public campaign across the country to pick up those signs earlier, so that people can know when those symptoms arise and get best treatment early on?
Steven Bonnar
That is a fantastic idea. Any attention that we can draw to this, we must.
Macular degeneration, both wet and dry, leads to visual impairment, which can in turn lead to depression in many patients. The loss of one’s sight is so catastrophic that it often leads to clinical depression or other mental health issues—up to a 50% increase compared to non-affected patients. Furthermore, sufferers also have a 25% increased risk of developing dementia. The role of optometrists in administering primary care in the community is therefore critical to identifying these conditions at an early stage and minimising the impact on other areas of healthcare. If the protection of the wider health service is not a reason to address the shortcomings in eye care, I am not sure what is.
Eye care and macular health is vital. It is important that we, as a Parliament of the people, address needs in this area and remove any barriers, financial or otherwise, to affording our constituents the ability to access sufficient care on a regular basis. Universal free eye examinations enable optometrists to detect sight-threatening and other medical conditions without depending on how much money a person has or the ability to pay. Let this Parliament follow the example of the Scottish Parliament; let this Parliament put healthcare at the heart of everything that we can achieve. Only by doing so will we fulfil our duties to protect all citizens and communities within our reach.
Maria Caulfield
Absolutely: we have heard today about the impact that overall health has on eye health. We know that NHS sight test numbers were impacted at the peak of the pandemic, but there has been a strong recovery, with 9.7 million sight tests carried out between April and December last year. Again, I thank the NHS, and particularly primary eye care providers, for their efforts.
It is vital that once a problem is detected, individuals have access to timely diagnosis and any necessary treatment. Age-related macular degeneration is one of the leading causes of sight loss in the UK, and is a devastating disease that can seriously impact a person’s life. The vast majority of people with age-related macular degeneration suffer from “dry” degeneration, for which there is currently no effective treatment, although vision aids can reduce its impact. For those with “wet” degeneration, this condition can be far more serious and sight-threatening. There are a number of available treatments for that form of AMD, and I point colleagues to the National Institute for Health and Care Excellence’s guidelines: a person should be referred within one day if their condition is considered to be wet active AMD, and offered vascular endothelial growth factor drugs within 14 days of a referral. It is important that patients are able to access that treatment, as indicated by NICE.
Although we do have some effective treatments for macular disease, we do not rest on our laurels. Medicine continues to evolve, and we heard from my hon. Friend the Member for Sedgefield (Paul Howell) about the potential of sleep masks—evidence is still being collected about that treatment. We also heard from my hon. Friend the Member for Great Grimsby, who is the expert in this area, about the exciting developments in stem cell research and the possibilities that they could create in future.
During this time, the NHS has continued to prioritise urgent and life-saving treatments, including for sight-threatening eye conditions. I am pleased that the number of ophthalmology patients seen last October was almost back to a pre-pandemic level.
To help the NHS drive up activity, we have provided £2 billion this year through the elective recovery fund, and a further £5.9 billion of capital funding will support elective recovery, diagnosis and technology. That does include—my hon. Friend the Member for Hendon (Dr Offord) asked about this—the ability to expand capacity for new surgical hubs that will drive through high-volume services, such as cataract surgeries, so that they are high on the agenda in tackling the backlog. The NHS has also been running the £160 million accelerator programme, which includes 3D eye scanners and other innovations that are helping to develop a blueprint for elective activity in the NHS.
Ophthalmology is one of the largest out-patient specialties. Change is needed to ensure the NHS can both be sustainable for the future and deal with the growing numbers of people needing eye care services. To address these challenges, NHS England has developed the national eye care recovery and transformation programme to work across all systems and look at everything from workforce to the services provided. It is working with local systems to prevent irreversible sight loss as a result of delayed treatment.
In recognition of this important work, I am delighted that NHS England is recruiting a national clinical director for eye care. That person will oversee services at a national level, which will filter down to tackle the inequalities and disparities we have heard about in certain parts of the country. Much good work is happening, but it is important that the public health outcomes framework is used to identify gaps in services. The framework tracks the rate of sight loss across the population for three of the commonest causes of preventable sight loss—age-related macular degeneration, glaucoma and diabetic retinopathy. The data is openly available and is being used to match areas where services and outcomes need to be improved.
I want to touch on the points raised by the hon. Member for West Ham (Ms Brown) about her constituent, Darren, and those raised by the right hon. Member for Hayes and Harlington (John McDonnell). I am concerned about issues around laser surgery and the impact they are having. I am happy to meet the right hon. Gentleman and the hon. Lady, and other colleagues, to discuss that. The Care Quality Commission regulates that area, but I am concerned by the information shared today and I am happy to look at the issue further. It is important that the situation of people with minor eye ailments is not made worse by having surgery that may, or may not, be suitable for their needs.
We have had a good debate today. I hope I have reassured colleagues that eye health procedures, treatment and diagnoses are part of the post-covid recovery process. I take on board the points made by my hon. Friend the Member for Great Grimsby that this is about more than just diagnosing and treating; it is about improving the lives of those with sight loss, to enable them to live the most productive and fulfilling lives they possibly can. I am pleased to hear that the Royal National Institute of Blind People and ACAS were instrumental in helping her and others who are trying to improve the workplace experience. My hon. Friend the Member for Darlington also pointed out that technological changes can have a positive impact but that things such as electric cars can have a negative impact on people with sight loss, as those vehicles are so quiet.
To conclude, maintaining good vision throughout our lives is very important. Some preventable factors, such as smoking and obesity, can help improve eye health, but there are many unavoidable issues that we need to deal with.
Steven Bonnar
Are there plans in any part of the national strategy to remove the financial impediment, so that English, Welsh or Northern Irish people can get a free eye test?
Maria Caulfield
Many people in England qualify for a free eye test. We are not seeing that issue as a barrier to people coming forward, but I have outlined the many measures we are putting in place to improve the outcomes for people with significant sight loss problems. As we emerge from the pandemic, our priority remains tackling the elective backlog and ensuring that we have high-quality, sustainable eye care services for the future.