The National Health Service

Debate between Bill Grant and Philippa Whitford

Wednesday 23rd October 2019 Commons Chamber

[Dr Whitford]

Well, I am afraid that it was the Labour party that set up independent treatment centres. I am a surgeon, and one of the issues was that such centres were sucking away the routine elective work that contributes to training future surgeons, and leaving the NHS to deal with the complex, chronic, expensive cases. Before the Health and Social Care Act, the NHS usually managed to find enough money down the back of the sofa that, at the end of each year, it would have about £500 million left. After the changes, it was £100 million in debt, £800 million in debt, and then £2.5 billion in debt. That is because money is sucked out in all these different ways, leaving a lack of funding that leads to rationing, which is pushing people to have to pay for more of their own care. We are hearing about that with co-payments—paying for a second cataract operation or for a second hearing aid. My Choice, which the Health and Social Care Act also brought in, raised the cap from 2% to 49% of income that an NHS hospital could earn through private patients. The highest amount at the moment is over 27%.

The idea that that does not impact on NHS patients is nonsense, because surgeons have limited capacity in terms of who they can operate on during the day, so if someone is able to jump the queue within the NHS, they are taking someone else’s place. As we saw with Warrington and Halton Hospitals NHS Foundation Trust, price lists have been pinned up in clinics suggesting to people that they might want to pay £7,000 or £8,000 for a hip or knee replacement, and there were also a lot of cosmetic and minor operations. I would gently suggest, as a surgeon, that surgery is not a sport. Either the patient needs an operation clinically, in which case it should be provided by the NHS, or they do not, in which case they should not be able to buy it from the NHS. Under the principle of My Choice, hugely high thresholds are being set. In the case of some CCGs, a person has to have had two falls before they can have a cataract operation, or they have to be in pain, even in bed, to get their hip done. That is driving families to club together to address that. That is not right. If someone needs it, the NHS is meant to provide it free at the point of need, and if they do not, every single operation is a risk and should never be done to attract income for an NHS trust.

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

I value the hon. Lady’s comments about how money is being sucked out of the NHS. In Scotland, we have a particular issue with a large showpiece hospital in Edinburgh that should have been opened in 2012, seven years ago, that is sucking money from the NHS—millions of pounds annually over the past six or seven years. She may wish to comment on that.

[Dr Whitford]

Well, it has not been sucking money for the past six or seven years because it was only declared open in February. I totally agree that it is a huge setback that, due to a failure within the health board’s tendering process for the build, it did not recognise the need for the level of ventilation in an intensive care unit. I would gently suggest to the hon. Gentleman that I do not think he would have wanted our Cabinet Secretary to simply go ahead putting babies and children in an intensive care unit where the ventilation was not considered safe.

In Scotland, so far our funding for the NHS has doubled in the past 10 years and will actually increase further next year. But it is not just about funding; it is about structure. What is happening in NHS England is fragmentation. It is not just that NHS hospitals are competing with private companies; they are competing with each other, and that undermines collaboration. We need to have collaboration, with the patient at the centre. Anything that fragments or undermines that collaboration is weakening the quality and safety of care.

World Cancer Day

Debate between Bill Grant and Philippa Whitford

Wednesday 30th January 2019 Westminster Hall

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this important debate.

It is staggering that about 4,600 women and more than 20 men in Scotland are diagnosed with breast cancer each year. Sadly, few people, particularly males, realise that men can also be affected. My researcher was diagnosed with breast cancer nearly 16 years ago and remains eternally grateful for the care and support she received from the national health service. Her paternal grandmother and great-aunt were of a different, less fortunate generation and lost their lives to breast cancer shortly after diagnosis, although a delay in seeking assistance was undoubtedly a factor in their demise.

Regrettably, previous generations were often reticent to seek assistance, perhaps due to a lack of knowledge or embarrassment. Encouraging openness and interaction, as World Cancer Day does, and media campaigns from the national health service and various cancer charities are vital if we are to empower people through education and advocacy, including peer support, to improve their quality of life and life expectancy following a cancer diagnosis.

[Dr Whitford]

I welcome the mention of embarrassment. Does the hon. Gentleman not think that we have a particular job to do with men to get beyond the embarrassment of talking about bowels, bowel motions and other bodily functions? If people cannot talk about it with their families, they will struggle to talk about it with a GP.

[Bill Grant]

I totally agree; I am of the embarrassed generation. It is challenging for males—I concede that it is men in particular—to go to the general practitioner, but we need to educate them about making that first contact and being conscious of the risk. It is particularly my generation; the generation following are a bit less self-conscious and more eager to go to the GP, where they will find that help.

As a member of the Select Committee on Science and Technology, I have become acutely aware of the importance and benefits of research. In 2014, the city of Glasgow, not far from my constituency, hosted the European breast cancer conference. Such conferences bring together experts in their respective fields to share knowledge and experience for the benefit of patients and to consider preventive measures for the future, such as developments in immunotherapy that harness the body’s immune system to target cancer cells. As I understand it, such developments may be able to complement, if not replace, radiotherapy and chemotherapy, the side effects of which many breast cancer patients find more challenging than the cancer itself.

Treatment has very much improved, recognising the importance of body image in an era when the media often seek to portray the perfect person. The charity Breast Cancer Care stages regular fashion shows in which those who take to the catwalk have themselves been cancer patients. The male and female models, resplendent in their latest outfits, send a very clear message that they have beaten or are robustly fighting cancer.

Tamoxifen, a common medication for breast cancer treatment, is now just one of a range of drugs available to patients. It was heartening to learn of the Scottish Medicines Consortium’s decision to approve the life-extending drug Perjeta for routine use in treating secondary breast cancer on Scotland’s national health service. Compared with existing treatments, the drug apparently has the potential to offer valuable time to those with incurable HER2-positive secondary breast cancer.

Nowadays, cancer is treated by multi-disciplinary teams that include GPs, surgeons, oncologists, radiographers, radiologists and clinical nurse specialists. It is crucial that we have appropriate succession planning so that we can replace those vital experts as they reach retirement age or change career for whatever reason. It is quite concerning that 20% of breast radiologists in Scotland are predicted to retire before 2025, according to the charity Breast Cancer Now. We need to get the wheels in motion to replace those very important individuals.

Cancer is a challenge to our society. It changes people’s lives in different ways, and sadly some go on to develop lymphoedema. However, collectively we can meet that challenge. Some countries have a lesser incidence, so it may be prudent, as an aspect of self-help, to reflect on diet and lifestyle choices in the UK that may have a bearing on development or outcomes. The potential effects of obesity, cigarettes and alcohol need to be seriously addressed. That apart, we need to focus on the future needs of the researchers and medical professionals to protect the population who are at risk of cancer.

Finally, my constituents and I thank the national health service professionals, the volunteer drivers, the penguins of Dundee, the marathon runners from the borders and the charities. They all make the challenge of living and dealing with cancer that wee bit easier.