Health and Care Bill

Debate between Catherine West and Philippa Whitford

Report stage
Monday 22nd November 2021 Commons Chamber

[Dr Whitford]

I would say that really no one who has a health problem should be stigmatised. Having dealt over 33 years in the NHS with many people who were problem drinkers, I know that the public image of someone who abuses alcohol is quite a caricature. There will be many people across this House who drink more than is healthy for them and I have met many people as patients from the middle and upper classes who had serious alcohol problems, so we should get away from the stigma and the caricature. We will not spot everyone who needs to deal with alcohol just by looking at them.

[Catherine West]

I commend the work of my hon. Friend the Member for Liverpool, Walton (Dan Carden) in this regard. Does the hon. Lady agree with me that the whys and wherefores are all very well in this debate, but in the end the cuts to local government, which would primarily be providing services in relation to alcohol abuse, have been most disgraceful, and that is why we are seeing the huge increase in the number of people who have passed away from alcohol disease in the last couple of years following covid?

[Dr Whitford]

There is no question but that, after public health moved into local government—we can absolutely defend that because, as I have said, health is often delivered by things that are nothing to do with the NHS—the problem was that the budget was then cut, so the potential benefit of putting public health into local government was lost due to the cuts to services.

On alcohol not being classed as a less healthy food, with this Government I find it hard not to ask: why not, and what or who may have influenced that decision? I certainly support amendments 11 to 13 from the hon. Member for Liverpool, Walton (Dan Carden), which would include alcohol, particularly the medium and high-strength alcohols, under less healthy foods, so that alcohol is covered by advertising regulations. I also support his new clause 15, which would mandate much clearer labelling of alcohol units, or whatever measure, on labels. It is no good just saying “Drink aware” or “Drink Responsibly” when the consumer has not actually been given the tools on the product to make a proper choice, such as by asking, “How much is in this?” Why not agree to use a simple, straightforward approach? A lot of public health advice is in units, so why not actually use them? People would then learn to be aware and ask, “How many units have I already drunk today?” or “How many units have I already drunk this week?”

New clause 17 calls on the UK Government to follow Scotland, and now Wales, by introducing a minimum unit price for alcohol. The UK Government have the advantage in that they can do that by setting alcohol duty based on unit, instead of on classes of drink. In every Budget we hear about a penny on a pint of beer, or so much on spirits, but why not do it by unit? It is much more accurate, and it would still allow the raising of taxation to help fund alcohol services, as well as those public services most hit by alcohol abuse, such as healthcare and policing. Under devolution the Scottish Government, and now the Welsh Government, did not have that power.

Over the past year and a half of the pandemic we have, unfortunately, seen a big increase in both smoking and alcohol consumption, as people struggled to cope with the loneliness and boredom associated with lockdowns and pandemic restrictions. However, the initial valuation of minimum unit pricing in Scotland showed that alcohol sales fell, for the first time in many years, by more than 7% in Scotland, compared with a continued rise in England and Wales. It was not possible to demonstrate a reduction in overall alcohol-associated admissions to hospital, which may include car accidents, violence and so on, but there was a drop in admissions due to alcoholic liver disease, suggesting that the policy was working. More evaluation after the pandemic will be required, but an immediate impact was an almost three-quarters drop in the sales of cheap white cider. That product is cheaper than soft drinks, and predominantly used by young—indeed, often under-age—drinkers, who purchase it, or get someone else to purchase it, so that they can drink it at home. However, that sector is literally disappearing overnight.

It will be important to review and maintain the pressure of the unit price on a regular basis, because young drinkers also drink many other products—this is the same issue as young smokers; more people are being recruited, often into problem drinking and problem products. Minimum unit pricing does not affect good wine, high-end spirits, or what is sold in a pub, but it does affect what someone can buy in a small shop to then hang out with their mates in their bedroom. Some of those products are not affected by the 50p unit price, and that must be kept under review.

I was disappointed that new clause 30, which is listed for discussion tomorrow, was not included in this group. It calls on the Government to reform the out-of-date Misuse of Drugs Act 1971, and to devolve it so to allow the devolved nations to take a public health approach to tackling drug addiction, in the same way as we take a public health approach to dealing with alcohol. Such an approach has already been demonstrated in many countries across the world, yet the Government keep sticking their head in the sand.

Santander Closures and Local Communities

Debate between Catherine West and Philippa Whitford

Thursday 14th February 2019 Westminster Hall

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I, too, thank my hon. Friend the Member for Glasgow East (David Linden) and the other Members who supported his bid for this debate. It is great to see this Chamber so busy, as it often is not. That shows the strength of feeling and how much the closures will affect our communities.

The letter that I received was sent to me as a customer. That was the first that I heard that our Santander branch in Troon was closing. I was previously a customer of RBS, and, like some other hon. Members, I moved my custom to Santander. I am not really sure where I am heading next. That is one of 140 closures—one fifth of the Santander network—15 of which are in Scotland. Some 1,300 jobs are now under threat, and only one third are likely to be redeployed. In the meeting, we were told that a third of those staff are looking to retire, get a package and get out. Have those discussions taken place, or is that a presumption?

[Catherine West]

Does the hon. Lady agree that it is inappropriate for an organisation to put staff on to less secure contracts in the knowledge that it will make 1,200 staff redundant, and might need those jobs later? It is not just a slap in the face to customers but to the staff who work hard in those branches.

[Dr Whitford]

I absolutely agree. I pay tribute to the staff in my branch, who were very helpful when we opened our account and are always cheerful. They are not about to retire. They are young working people who are not looking to take a package, but will need a job. They are being made unemployed, and they are deeply shocked by that.

There have been 3,000 branch closures since 2015, 230 of which are in Scotland. Two thirds of branches have been cut since the end of the ’80s. By the end of this year, we will have fallen from 21,000 to less than 7,500 across the UK. That is an incredible change. I totally accept that banking is changing, but, like many others, I use mixed banking. I will use an ATM, go into my branch and do online banking, but it is important that I have that choice. We are talking about choice being taken away.

This change is 20 years too early; we are not yet cashless or online. My mum, who is 84, and most people over 70 are not happy to do banking or any sensitive financial transactions online. My mum has her iPad and can do emails. It is not stupidity. She simply does not trust it. In making this change, we are leaving two decades’ worth of older citizens feeling uncomfortable and like they have had things taken away from them.

When banks move out, they do not leave their ATMs behind, which means that there is less access to cash in community after community, and the ATMs that remain are running out. Troon has already lost three banks. This is our fourth. I went through all this with RBS, which tried to use a unique customer identifier. It told me that only 97 customers a week went into the branch. I found that really strange, because every time I went in, I was in a queue. It only counted people who only went into that branch and went into the branch every single week. As was said, no other business would count custom in that fashion. When I finally got the correct figures out of RBS, that number was 10 times as high. Yet the bank would not reconsider its decision.

Although my hon. Friend the Member for Glasgow East has highlighted the issue of vulnerable people who have poor internet access, in Troon, a place to which many people retire, the issue is the elderly. In the impact assessment, it says that 58% of people have, on at least one occasion, used online, mobile or telephone banking, meaning that 42% have never used those methods. There is no quantification, so we do not know—as the hon. Member for Glasgow North East (Mr Sweeney) said—whether someone simply phoned the branch to ask what its opening hours are or when they could go in to get a statement. The idea that that means someone is suddenly ready to manage all their finances by phone or online is just a fairy tale.

The problem we have is that our elderly population is suddenly being told, as I was assured, that the closest branches are within a 10-mile radius—it is seven miles in one direction and 11 miles in the other—and for most of the elderly who live in Troon, however, that means taking two buses and more than an hour’s journey on a bus that is not frequent, so a visit to the branch could mean a three-hour round-trip. As was highlighted earlier in the debate, that also takes footfall out of Troon’s town centre, because if someone takes the trouble to go to Ayr, the chances are that they will shop in Ayr. They will not come back, go in to the middle of Troon, shop, and then get a bus home. That is gradually killing our high streets.

The access to banking standard and the need for an impact assessment were mentioned. We have all been sent little infographic-laden impact assessments, but it strikes me that they are largely about the impact on the bank. They are not really about the impact on customers, staff or our high street. The hon. Member for Ynys Môn (Albert Owen) mentioned the idea of having a hub. The obvious way to do that would be to bring back Crown post offices, but why do we expect post offices to co-locate with other businesses, but not banks to co-locate with each other or with post offices? It is absolutely vital that communities have some form of safe and secure access to financial services and advice.

Post offices are proposed as the answer to everything, but we cannot use them to open new accounts, carry out bank transfers or, if trying to manage our money, get full bank statements—only a balance. We certainly cannot arrange loans. Many of us used to go into a bank to speak to our bank manager, who was very strict about the income that we needed to obtain a mortgage. Part of what led to the 2008 crash was random decisions to lend people three, four, five, six or seven times their income so that they could get a mortgage, instead of giving them the chance to sit down and talk with someone who could see their financial performance. That applies to business customers who, at the early stages of development, need really personal input from someone who manages their service.

Quite apart from being the answer to all those problems, post offices are struggling financially. Previously, postmasters would get a fee, but funding for that is being cut from £210 million to just £70 million. As this is the fourth bank to close in Troon, all of that work is going to the post office. It has the same number of counters that it has always had, and it had a two-year gap of struggling to find a new postmaster when our previous one was ill and found it frankly all too stressful. In the Which? survey, 42% of those not happy about the move to the post office were concerned about queues. If the post office has the same number of counters but is suddenly doing the work of four banks, queues are inevitable.

Our closest town, Prestwick, has also lost three banks. When I met our postmaster after the most recent closure, he was initially quite positive, because he saw it as a business opportunity. I met him recently, however, and the bank transactions actually take money out of his business. Cash deposits are time consuming and he has had to take on an extra part-time member of staff. He does over 500 extra banking transactions a month and takes in £1 million a month. While Santander charges £7 per £1,000 deposited, the postmaster is paid 37p per £1,000 deposited. The Government subsidy for the 3,000 community post offices that are protected as the last shops in the village will end in 2021. We will literally have dead and empty communities with no access to anything and nothing to maintain footfall in a town centre.

We need to reward and support the post office. Santander is one of the biggest users of post office services, because it makes its business customers deposit cash in the post office. The fee paid to post offices for those transactions is currently being renegotiated. It is critical that that fee be fair, because otherwise we will see the last remaining Crown post offices not redeveloped as banking hubs, but shut down. Frankly, post offices wedged in corners of shops are not always accessible, are often cluttered and do not offer privacy to carry out financial decisions and management.

Contaminated Blood

Debate between Catherine West and Philippa Whitford

Tuesday 11th July 2017 Commons Chamber

[Dr Whitford]

The Scottish Government set up the Penrose inquiry, but I would assume that any inquiry will look at the whole UK, and the Minister has committed to that. It must be remembered that the decisions that led to the scandal were taken here and in Whitehall. This was before devolution. Governments such as the Scottish Government have tried to step up to support citizens who have been affected, but getting the answers to what caused the situation is a matter for this place.

[Catherine West]

Does the hon. Lady agree that the lack of trust has been enhanced by documents such as “Self-Sufficiency in Blood Products in England and Wales”? That was a Department of Health document, but many people felt it was inaccurate and contained outright lies?

[Dr Whitford]

The inquiry will have to look at all those things. Documents, patients’ records, things that were altered and hidden, and things that are hiding behind public interest barriers now all need to be opened up so that light can be shed on the matter, as with Hillsborough.

Penrose was a Scotland-only inquiry. The Department of Health was invited to take part and turn it into a UK-wide inquiry, but it declined. One of the key weaknesses of the inquiry was that Penrose did not have the right to summon documents or people.

I remember when the scandal started to unfold in the ’80s. As a surgeon who was, of course, using blood on her patients, I remember how shocked I was at the mere thought that an action I might have taken could have harmed a patient I was looking after. In my elective surgery, I set about chasing every single blood cell to avoid spilling blood. I used electrocautery and all sorts of modern techniques. If I were to wheel out the staff from my theatre now, they would moan about how long I used to spend doing that. If a clinician is dealing with someone who has been hit by a bus, however, they have no choice.

I remember a critic of Penrose in 2015 saying that they were surprised that clinicians showed so much trust in the quality of blood, but a clinician who is using hundreds of drugs, implants, machines and blood products must be able to trust them. We have no mechanism personally to check them. That is the role of the Government and all their agencies. It is why we have licensing and inspections, and it is why action must be taken when there is a suspicion of harm. Failing to act, hiding and not dealing with the situation at the time all happened pre-devolution, and this inquiry must take account of that.

At a conference in Glasgow in 1980, clinicians were already raising concerns about changes in the liver function of patients who were receiving blood concentrate for haemophilia. A 1981 meeting of the UK’s Blood Transfusion Research Committee, which we have all read about recently, recognised that about 50 patients a year developed some form of liver damage. Yet the decision at that meeting appeared to be to let that continue and simply to study the situation, using those patients as a way of developing a test for what was known at the time as non-A, non-B hepatitis. It is important that we ensure that this inquiry looks at all this. The official from the Department of Health and Social Security who was at that meeting would not attend Penrose. Such people need to be called by this inquiry.

Going forward, the inquiry must include the families and the victims so that we are sensitive to what they want to know. This is also about not just the Government but producers—and not just producers in America. We try to make ourselves feel better by blaming this on the States, where people bought blood, and where people with addictions, people living in poverty and prisoners were used. In the mid-70s, prisoners in this country were also used, and it is claimed that that was encouraged by the Home Office as part of prisoner rehabilitation. We need the documents on that; we need to understand if that decision was made. UK producers have often been found wanting in the quality of product they came up with, so we must not pat ourselves on the back and imagine that the UK product was somehow safe and that this was all due to the US. We need to follow this right down and get the answers.

These people have been failed so many times, over and over, and it is crucial that that does not happen again. We need to keep the Government on their toes. We need to have reports back from this inquiry as it is set up, so that we know what it is actually going to look into. If we fail to get answers this time, and particularly if we fail to deliver compensation for the lives lost, the suffering, the failure to get a mortgage or insurance, and the costs of care, we will have failed these people all over again.

Junior Doctors’ Contracts

Debate between Catherine West and Philippa Whitford

Wednesday 28th October 2015 Commons Chamber

[Dr Whitford]

I totally agree with that.

As mentioned on both sides of the House, people do not work in an NHS hospital to make a lot of money. It is not high up the list of ways for the smartest people in our country to make money; it is a vocation, which means we have a responsibility not to exploit them. The Secretary of State says that no one will lose money, but what will happen to the people who start next August? After the first hours change, when I started my surgical career in Belfast, the “two in three” rota—every third evening off and no weekends off for a year—was no longer legal, and the hospital henceforth considered extra hours to be voluntary service. The NHS is a hierarchical organisation, bullying exists within it, and the junior doctor is in a weak position. These safeguards have worked well for a long time, and I would be reluctant to see them go.

[Catherine West (Hornsey and Wood Green) (Lab)]

Does the hon. Lady agree that across the piece—nurses, doctors, everybody—there is a huge loss of morale in the NHS? It is down to us to stand up for the workforce and put them at the heart of our thoughts, rather than concerns about how it might look politically.

[Dr Whitford]

I totally agree. I also agree with the Secretary of State about patient safety. There is no one in the profession who does not want a seven-day emergency service that is strong and responsive to the needs of unwell patients, but we keep moving from people who are ill to routine services. He has said we must not call them avoidable, yet he just referred to 200 avoidable deaths a week, which is exactly what Bruce Keogh described as “rash and misleading”, and people object to that. There are no excess deaths at the weekend; the issue is with people admitted at the weekend, usually for radiology or investigation. Scotland has been moving on this for the last decade, by working with the profession, not pulling out the pin and throwing a grenade.