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?