Health

Lisa Cameron Excerpts

Tuesday 14th May 2019 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is an absolute pleasure to speak on behalf of the Scottish National party and to see you in your place, Madam Deputy Speaker.

As we know, public health campaigns can be extremely successful. They make health improvements in a widespread manner; individual interventions do not have the same effect. However, the work of public health campaigns and departments is not always visible. It tends to take place behind the scenes. Constituents do not often speak to their MPs about these issues. Very infrequently has anyone come to my door to ask about a cervical screening appointment, or about our campaigns and work on obesity. Public health is not the most visible area of our NHS, unlike the frontline issues of access to treatments, accident and emergency waiting lists and access to GP appointments. It does not have the profile that it ought to have, and it certainly does not feature the sensationalism on which the media often want to report. However, it is important to say that public health is fundamental to the health of the nation. Therefore, public health should not be underestimated and should certainly never be underfunded.

Since 2006-07, the annual health resource budget has increased in Scotland by £4.8 billion, and the Scottish Government have passed all consequentials on to health and care. Funding for NHS boards will increase again by £430 million—an increase of 4.2%—and the package of investments in health and social care in Scotland for integration programmes will be £700 million to the better. Health spending per head in Scotland is almost 9% higher than in England, according to Treasury analysis in 2018.

Investment in primary care is essential; our GPs are at the frontline and it is important that we increase funding for that. The Scottish Government have invested over £930 million in primary care, and £30 million will be invested to extend the free personal care individuals have in Scotland to the under-65s. Some £11.1 million will be provided to increase nursing and midwifery bursaries from £8,100 to £10,000 the following year. Again, midwives and nursing staff are on the frontline of our public health achievements.

Young families across Scotland receive the opportunity to have a baby box as soon as their baby is delivered, which is fundamentally to the good; it is about saying, “We know your baby is born; it is the most valuable thing in your life and we want every baby in Scotland to have the same start and to reduce the inequality we know impacts on people’s lives and families.”

We also need to increase our sportscotland funding, and there has been a pledge of 3%. We have discussed obesity today. I was a member of the Health and Social Care Committee when it was looking at the issue, and again this underlines the importance we must place on public health investment. Advertising and marketing campaigns overshadow the work we are able to do because of the huge investment the industry puts into encouraging people to eat and to feed their children the wrong types of food and to give ourselves treats many more times than we should. I have fallen foul of that, particularly since arriving in the House of Commons; our Tea Room has far too many little treats at the counter. These are all things we grapple with as families and individuals, and that is why it is so important that public health and public health campaigns are supported.

I am pleased to learn more about the Government’s nudge unit. The UK Government has put some investment into psychological approaches to public health and to health, and I was pleased to meet a member of the nudge unit a few months ago at the all-party group on psychology, which I chair, because we must try to help people shape their behaviours and make it as easy as possible to make the right decisions moving forward. Making the right decisions is difficult anyway, but things such as having the opportunity to have a piece of chocolate at the till when we are making purchases makes it that little bit more difficult for people to make the choices we know they need to make. Public health and taking responsibility for our health is all about shaping behaviour: making those choices ourselves through our motivation, but also the Government helping to shape the society we live in and make sure that the easy choices are the healthy choices.

It is important that we raise as much awareness as possible of mental health, particularly in this week, Mental Health Awareness Week. This has often been about communities plugging gaps, however. Progress has been made across the UK, but community mental health service waiting times are still far too long, particularly for young people and adolescents awaiting access to child and adolescent mental health services. That is why there has to be a partnership between public health, health services, voluntary agencies and others in the community.

An example is the Trust Jack Foundation in my constituency, which was formed following the tragic suicide of a young person in my constituency, Jack. His mother came through that terrible trauma and created the foundation, which enables young people in Stonehouse and elsewhere in Lanarkshire to have access to mental health services while they are on the waiting list for CAMHS, and it is really making a difference by giving them the support they need and the earliest possible intervention.

On disability, we must pay cognisance to the fact that those who are disabled are much more likely to be living in poverty than those who do not have disabilities. It is important to take account of that, because people who have disability have less access to the workplace, to transport, to adapted housing and even to shops, because in some cases, Changing Places toilets are not available in our shops. They also have less access to getting about, because Changing Places toilets and facilities and accessible transport are often not available. All those factors contribute to the impact of poverty on people with disability, and we need a joined-up approach across Departments if we are to make a difference.

I want to speak briefly about homelessness. I cannot help but notice that every time I arrive here in Westminster each day, there are people sleeping at the underground station just outside the entrance to Westminster. I have also noticed that, a number of times, there have been flowers left for those who have died there. It is incumbent on us all, as MPs and as a Government, to notice what is right in front of our eyes and to act to ensure that those homeless people have opportunities and that their health and wellbeing are cared for.

I want to touch briefly on the subject of older adults. Public health campaigns will have to focus on and target older adults in the years to come. We are living longer by virtue of the good health we enjoy as a result of the interventions, treatments and technologies that are now available, but chronic illnesses will be with people for longer and affect many more people.

[Theresa Villiers (Chipping Barnet) (Con)]

Does the hon. Lady agree with a point made to me by a number of my older constituents at an event last week, which is that we need to ensure that sports facilities are providing the right encouragement and opportunities to keep older people active for longer, given that that is crucial for public health goals?

[Dr Cameron]

Yes, that is an absolutely fantastic point. I was going to mention the fact that our local sports and leisure facility has an agreement with the NHS that GPs can prescribe sports facilities to people so that they can have an exercise regime designed specifically for them. If they can benefit from such a regime, that can maximise their health. All these things actually save money in the long term, and that is why public health is so crucial. We really are investing for the good of the nation.

From my own experience of working in addiction services many years ago, I know that we have to take on board the fact that there are huge levels of comorbidity with mental health. Often, people in addiction services have a history of trauma. They are self-medicating with alcohol or drugs, and they are not coping with life due to their underlying mental health issues. However, those very same people are often refused access to mental health services treatment until they have dealt with their addiction. That is a circular argument, and those who are struggling with mental health and addiction problems never really get the support that they need or deserve. That is why integrated services in relation to addiction are so important.

[Diana Johnson]

I am interested to hear about what is happening with drug and alcohol services in Scotland, particularly the 9% budget increase that the hon. Lady mentioned. Has she had the same experience that I have had in Hull, where more and more people on the streets seem to be taking Spice, which turns them in an obvious way into someone who is taking drugs and which is causing real problems on the streets? Is that happening in Scotland as well? We have seen an 18% cut in drug and alcohol services since 2013.

[Dr Cameron]

This is always a difficult situation, because when people self-medicate, they tend to take the drugs that are available. They may take something that has an impact on their behaviour and personality, which may then have an impact on their life if they become involved in crime and so on. The types of drugs that are coming on to the market seem to lower people’s inhibitions, so they can get into terrible difficulties with the criminal justice system, but their difficulties—their underlying trauma and addiction—are not dealt with. That money is welcome, but we have a long way to go to ensure that we also deal with other issues.

Finally, it is important not to forget about our veterans when it comes to public health. These individuals who have served us may be invisible, silent or hidden in the background, but they need interventions and they need us to reach out. I wanted to mention the excellent Veterans First Point service in Lanarkshire for providing counselling without a waiting list to our local veterans to ensure that their needs are met.

I thank everybody who will take part in this extremely important and timely debate. The more that we can do in terms of public health, the better success we will have in years to come in dealing with inequality and the underlying issues that mean those in our society who did not get the best start do not get the chances that they deserve. We can achieve that only by working together on a cross-Government basis, with local councils and within communities, and I look forward to working with everybody in the Chamber who has an interest in moving this issue forward to ensure that progress is made.

[Several hon. Members rose—]