(3 weeks, 6 days ago)
Commons ChamberI thank my hon. Friend for that contribution, not least because it allows me to place on record this Government’s thanks to Javed Khan for the work he did in his review of smoking. My hon. Friend has hit the nail on the head, because in the parts of Greater Manchester that he and I represent, health inequalities are stark and visible. We are going to turn them around. Our health mission pledged to tackle the social inequalities that influence health, and to ensure that children have the very best start possible, in which they are given the building blocks for a healthy life. That will be an immense challenge, but every member of this Government is up for the battle.
Colleagues have made a number of points, and I will try to answer as many as I can in the time we have left. First, I pay tribute to the hon. Member for Harrow East for the work he has done on this issue over a number of years. I assure him that all tobacco products are covered by this Bill, including the chewing tobacco product that he referred to. My hon. Friend the Member for City of Durham, who has also been a passionate spokesperson for tackling smoking harm, is absolutely right to raise the issue of article 5.3. The new Labour Government take very seriously their obligations as a party to the World Health Organisation’s framework convention on tobacco control, and we remain fully committed to that convention, including the important commitment, under article 5.3, to protecting public health policies on tobacco control from
“commercial and other vested interests of the tobacco industry”.
The shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), referred to the powers to bring in smokefree places. We will consult on extending smokefree places to include areas outside schools, children’s playgrounds and hospitals in England. We believe that strikes the right balance between protecting the most vulnerable and recognising the pressures facing the hospitality sector. I want to make the shadow Secretary of State aware, though, that the Bill was designed in full consultation with, and to meet the needs of, the devolved Governments across the whole of the United Kingdom. It is a UK Bill, with powers that meet the requirements of each of the component parts of our country, and I reiterate that as far as England is concerned, this Government will seek to consult on schools, children’s playgrounds and hospitals only.
A number of Members, including the hon. Member for Harrow East, raised the topic of stop smoking services. We are putting an extra £70 million into local stop smoking services, which could help with up to 200,000 successful quits a year. We are still rolling out a smokefree pregnancy incentive scheme, which will support pregnant women in quitting and ensure that more babies do not suffer a hit to their life chances before they are even born.
I am very sorry that I was not in the Chamber for the beginning of the debate. I have very strong views on this matter, because my father died of cancer—I quit 20 years ago, thank God. It occurs to me that we have heard from other people who have quit, and that we who have quit could be mobilised to help others quit. Why do the Government not use us? We could do a lot of good and provide a lot of help.
I think the hon. Gentleman has just talked himself into a job. He is absolutely right that the best people to advocate for stopping smoking are former smokers.
We will still encourage adult smokers to switch to vaping through Swap to Stop in England, and I am delighted that localities have asked for over half a million starter kits so far. On advertising regulations, of course the consultation will take place after Royal Assent, but I hope that I can assure the hon. Member for Harrow East that we will take away his point about ensuring that the NHS can still advertise Swap to Stop under those regulations. On a tobacco industry levy, fiscal matters are for the Treasury, but I am sure that his views and those of others have been communicated to Treasury Ministers.
The hon. Member for Lewes mentioned the rise of the black market. This is a line that has been parroted by the tobacco industry for years, so we need to spell out the facts. Whenever Governments of any guise have introduced targeted tobacco control measures, the black market actually has not prospered. Consumption of illegal tobacco has gone from 15 billion cigarettes nearly 25 years ago to just one 10th of that amount last year, and when the last Labour Government raised the age of sale from 16 to 18, the number of illicit cigarettes fell by a quarter. However, this requires better enforcement, and we will use every second of the generously long buffer period to support businesses in preparing for and implementing the changes, including through information campaigns. We are providing £10 million to trading standards to increase their capacity and capabilities next year, and there is £100 million for Border Force and His Majesty’s Revenue and Customs over the next five years to tackle illicit and under-age sales. The Bill also allows trading standards to issue on-the-spot fines of £200, and to reinvest the proceeds of those fines, and indeed the licensing regime, back into further enforcement.
(1 month, 2 weeks ago)
Commons ChamberThis Budget delivers the largest Scottish block grant in the history of devolution, delivering a total of £47.7 billion for Scotland’s budget in 2025-26, including the £3.4 billion boost to spending through the Barnett formula next year, which comes on top of the £1.5 billion this year. Our Chancellor has provided £2.8 billion extra for day-to-day spending and £610 million for capital investment, including £20 million for my home town through the Clydebank town fund and tens of millions for Dumbarton’s regeneration. This Budget marks the end of the era of austerity, raising much-needed funds for our public services in Scotland. It keeps our promises to Scotland and to my constituents in West Dunbartonshire, and demonstrates the value of Scotland’s having voted Labour in July.
The historic funding must be used by the Scottish Government to fix the NHS and support our public services. The SNP Government are now out of excuses. They must show the same level of ambition for our NHS in Scotland as this Government. They must not squander this opportunity with their usual financial mismanagement. No more excuses; no more blame game. The SNP Government are facing a make-or-break chance to revive Scotland’s failing NHS, where one in six Scots is stuck on a hospital waiting list.
The hon. Gentleman is making a very good speech outlining the Scottish context. Should the SNP Government not repair the damage done to maternity services in the north of Scotland, where mothers have to make a more than 200-mile round trip to give birth? They should put things right in the north and all parts of Scotland.
Yes, I agree. The SNP is not here this afternoon, but this Budget means that the Scottish Government are receiving more per person than equivalent spending in the rest of the UK. The SNP just needs to get better at spending it. Scots can see that the SNP has lost its way and is out of ideas, and that its Ministers are incompetent and as bad with their money as they are for taxing us more and giving us less.
Figures released today for the past month reveal the scale of the crisis: the Scottish NHS is flagging on multiple fronts. The number of operations cancelled due to hospital capacity rose to the highest level since August 2022. Delays to patient discharge rose to an average of 29 days, while thousands of Scots attending A&E waited more than eight hours to be seen. There were 50,000 fewer planned operations in the past 12 months than at the same point before the pandemic.
The new money that the Government announced in the Budget should not be diverted by the Scottish Government. They must spend every penny of the extra NHS cash on Scotland’s ailing health service, and use the boost of billions of pounds to cut waiting lists. The message should be clear: they have the power and they now have the money, so no more excuses and no more hiding places. They must get the money to the frontline and get the one in six Scots off the hospital waiting lists.
This is a very good Budget for Scotland, but only if, finally, the Scottish Government are able to display a semblance of economic competence. But not for too long—just until 2026, when the people of Scotland get to complete the job of getting rid of both the failing Tories and the SNP.
(5 months ago)
Commons ChamberLet me get my specs on properly, Madam Deputy Speaker. They have a wonky leg that sticks out sideways.
I must say at the outset that I have heard some excellent maiden speeches today. It is a bit worrying to hear such good maiden speeches, because it makes one feel somewhat mundane in comparison. Let me also welcome the Minister to her place: it is a pleasure to see her sitting opposite me.
This Adjournment debate is the first of the new Parliament, and I am grateful to the Speaker for granting it. It concerns a topic that is important not only to my constituents in the highlands, but to constituents in every rural area in the country. I thank the Minister for her attendance, and look forward to hearing what she has to say. I hope that the debate sets the tone for how a Government and an Opposition can work together to meet the needs of every citizen of the United Kingdom, no matter where they live.
I recently had the great honour of being re-elected to represent Caithness, Sutherland and Easter Ross, which is now the largest constituency in the United Kingdom. It measures a staggering 11,798 sq km, more than half the size of Wales. We are here tonight to discuss the adequacy of healthcare services in rural areas, and for fear of being predictable I am afraid to say that the health services in the highlands are not even faintly adequate. I recognise, of course, that health is devolved, but 17 years of centralisation have wreaked havoc on my part of the world. Health services have been stripped back and gutted, leaving my constituents with access to far too few local services.
Let me begin with general practices. In Scotland, we have seen changes in vaccination services because, in an effort to reduce GPs’ workload, GP contract Scotland removed their vaccination capabilities. That is of huge concern to crofters in my constituency who might cut themselves on a piece of barbed wire and need a tetanus vaccination as quickly as possible. The same goes for anyone in need of shingles, flu, covid or travel vaccines. They must travel a staggering 70 miles or more to the nearest A&E, where they will face further waits owing to backlogs resulting from heavy workloads.
I want to keep the tradition alive, Madam Deputy Speaker. This is my first intervention during an Adjournment debate in the new Parliament.
I commend the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for raising an issue that is very important to me and to my constituency. I also congratulate him on his excellent victory in the polls: he has done exceptionally well. I hail from a rural constituency where my own doctor has to service a huge number of people, and the inadequacy of help for rural constituents is abundantly clear to me. Does the hon. Member not agree that the current postcode lottery must end, and that access to GPs, physiotherapists, nutritionists and mental health services for farming and other rural communities must be at least on a par with those in cities and large towns? Why should those in rural communities be second-class citizens in their own country?
The hon. Member makes his point with his customary charm. It is no wonder that he is so well liked in this place, because he always speaks for his constituents.
I have talked about the delays in vaccinations, which also applies to the lifesaving vaccinations that babies must have. The Scottish Government take a one-size-fits-all approach that, frankly, does not work in remote rural areas such as mine. The retention and recruitment of GPs and other healthcare workers is crucial, but poor wages and terms and conditions, and a lack of proper travel reimbursement, all lead to a general impression that the game is simply not worth the candle. That is why we are missing key workers and doctors, and why we are paying through the nose for locum and temporary staff. Madam Deputy Speaker, can you believe that NHS Highland has spent £21 million on locum staffing in the past year? That is almost 3% of its entire budget—an eye-watering sum. Could that money not have been spent much better, for example on care homes, hospitals or pain clinics that have been forced to close?
I apologise for coming a bit late to this debate. Primary care is asked to do more in rural areas than in urban settings, piling pressure on GPs, pharmacists and dentists, yet they struggle to recruit staff, as my hon. Friend said. A dental practice in Street, in my constituency, has been without an NHS dentist on its books for 18 months, despite its best efforts. Does my hon. Friend agree that we must explore ways in which we can incentivise healthcare professionals to practise in rural areas?
I absolutely endorse that. I am glad that I said in my opening remarks that my experience in a very remote part of Scotland applies to other parts of the United Kingdom. What we have just heard proves that this is the case.
NHS Scotland has halted all new builds and repairs to health centres across the entire country, which is another problem for healthcare. I have said already how big my constituency is. Just by commuting or doing house visits, healthcare staff will rack up 3,500 miles easily, because the distances are so great. At that point, their reimbursement per mile is more than halved, which does not encourage people to get involved. It is, in fact, discrimination against healthcare professionals who live in rural communities. Training is overwhelmingly based in urban areas, and there is very little incentive to get people to come and work in rural areas. Other factors, such as a lack of housing and job opportunities, feed into this problem.
There is another issue I want to raise: the lack of women’s health provision, which is pretty severe. In my maiden speech in 2017 I spoke about the need to restore maternity services to Caithness. Seven years later, that is more important than ever. Caithness general hospital used to have a consultant-led maternity service, which meant that expectant mothers could have their babies locally in the far north of Scotland. It was downgraded when I was my constituency’s Member of the Scottish Parliament. At that time, I had more influence and I got it restored. Since then, however, the maternity services have been downgraded again, and there appears to be no movement from the Scottish Government to reverse that. I wish that some Members from the party of the Scottish Government were present today.
Let me give an example of what this situation means: pregnant mothers have to make a 200-mile round trip in the car to deliver their babies. Imagine a trip like that in the middle of winter, and on rickety-rackety roads in the highlands. In 2019, a pair of twins were born—one was born in Golspie, and the other was born 50 miles away, in Inverness. It is a miracle that those children survived, and that neither a mother nor a child has perished. I have been calling for a safety audit all along, but there has never been one. We know perfectly well what the result would be: the arrangements would be deemed unsafe, if not a breach of human rights.
It is not just about maternity services; women’s health has been removed from the far north. A routine trip to see a gynaecologist and get a diagnosis for a life-threatening ovarian cyst, or for endometriosis, means travelling the same huge distance—if a woman is lucky enough to get an appointment before her condition has progressed too far for her safety. I wonder what we can do to encourage healthcare professionals to relocate to remote areas, because the health and wellbeing of their wives and daughters must surely be a factor when they consider moving.
For children growing up in the far north, it is no better. The waiting list for child and adolescent mental health assessments is three years. For neurodevelopmental screenings—for the diagnosis of dyslexia, autism, attention deficit hyperactivity disorder and so on—it is four years. That is the majority of their time at school. One family I spoke to during the election had waited 13 years for a diagnosis. That is a disaster. Dentistry has already been mentioned, and we know that intervention is crucial for long-term dental health
I am grateful to my hon. Friend for giving way, and I apologise to him for being caught out by the early start of this Adjournment debate. Does he agree that it would be really helpful if the new Government achieved a quick win to raise morale in rural areas where services have been so depleted for so long? This applies in west Cornwall, for example, where we cannot call on services from the north or south or west very easily. In those areas, as in others, we have a dentistry desert and the NHS and care services are experiencing their biggest crisis in their history. What we need, for example, is for the West Cornwall hospital to re-establish the urgent treatment centre overnight. Those kinds of quick wins could achieve the lifting of morale within the service and start moving things forward and upward from where they are at present.
My hon. Friend makes a good point, and I shall touch upon his sentiments in my closing remarks.
As many in the Chamber know—perhaps new Members do not—I myself am a carer: I am a carer for my wife. So I am very happy that my party has put carers at the top of our agenda. My party leader has spoken about being a carer himself. We desperately need reform, and I believe that the carers allowance should be introduced at a higher rate. In a way, I am declaring an interest here, in that I am an unpaid carer, but we have to look at this. I was recently informed of a constituent who was moved from one care home to another one 123 miles away in the highlands. That is a three-and-a-bit-hour journey each way for the loved ones to go and visit that old man. We can see why this is not great for morale.
I am from the highlands. I love my native highlands and I care passionately about where I come from, but I think that we need urgent intervention. This is my ask of the Minister. I recognise the nobility of the intent to address these problems at UK level, and I look forward to working with the Government in these endeavours, but the fact is that there is not the delivery under devolution that there should be. I am sorry that no Scottish National party Members are here. I am a committed devolutionist. I was part of the Scottish Constitutional Convention and my name is on the claim of right for Scotland, yet I find it incredibly disappointing that the outcomes are a lot worse than they were.
When I was in government in the Scottish Parliament, in coalition with the Labour party, we saw progress between 1999 and 2007, when the SNP came in. Now we see that things have gone backwards. This was the main issue on the doorsteps in Scotland, so I hope that the Labour Government can work hard at improving things. I ask them in a cordial way to do everything that can be done to improve the relationship with the Scottish Government, and perhaps encourage the Scottish Government to look at best practice in the rest of the UK and adopt that. I am not talking about hypothecation or about unrolling devolution, but by working together perhaps we can achieve something.
Also, it would be great if we could encourage NHS England to work closely with NHS Scotland, because it is complete and utter nonsense that people who could cross the border and get treatment have been prevented from doing so by bureaucracy, sometimes by politics of the not-so-clever sort, or by the computer systems not matching. That is nonsense. If someone living in the south of Scotland can get their operation done in Newcastle, let us just go for it.
I look forward to a Labour Government giving extra money to the health service, and I am sure they will. We will be looking closely at how that happens. There will, of course, be Barnett consequentials that will put that money into the devolved Welsh Assembly, the Scottish Parliament and the Northern Ireland Assembly. I hope that the UK Government will look closely at where those Barnett consequentials go. Will they go where we would hope they would go—namely, to improve the health service, to shorten waiting lists, to sort out the nonsense, and to give the standard of health service that my constituents and I believe everyone in rural parts of the UK is crying out for?