Leaving the EU: Health and Social Care

Debate between Lisa Cameron and Alison Thewliss

Tuesday 19th March 2019 Westminster Hall

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

It is an absolute pleasure and a privilege to serve under your chairmanship, Mr Bone. I thank my hon. Friend the Member for Argyll and Bute (Brendan O’Hara) for his thorough and passionate account of why a clear focus on the health and social care system is so important. That will be true beyond Brexit, but Brexit is our immediate concern, which is why we must give it serious attention.

The NHS does fantastic work. I had the privilege of working for four years in Argyll and Bute, covering the hospital there as a forensic psychologist. Rural hospitals in Argyll and Bute are excellent and innovative in their practice. Even 10 to 15 years ago, when I was working there, we were grappling with the internet and how to engage in therapy on timescales that would best suit patients. The use of technology in those rural areas was innovative, and I commend the NHS staff I worked with, many of whom still work there, for their work to provide fantastic patient care.

Two weeks ago there was an extraordinary meeting when seven all-party parliamentary groups came together to look at health and social care. I am fortunate enough to have been the chair of the all-party parliamentary group on disability since the 2015 general election. The chairs of the all-party groups were there and we brought in carers and service users to speak about their concerns. There is growing concern in Parliament about the NHS, and about the implications of a no-deal Brexit, particularly on medicines regulation and our ability to staff hospitals and provide excellent care, as we always have. It was an important and informative meeting and I suggest to the Government that a further meeting might come out of it, with the all-party group chairs, to hear the views of the service users and carers who attended, and to take forward some of their recommendations. They are on the frontline and know what happens day to day in our services. I am sure that they will be extremely informative and constructive if they have an opportunity to meet the Minister.

When I was a member of the Health and Social Care Committee, we conducted an inquiry into Brexit, medicines, medical devices and substances of human origin. A particular concern was raised about our ability to lead on research trials, and about patients’ ability to participate in trials, particularly on diseases that are perhaps less common but where there is a need to pull in subjects or participants from a huge area such as the EU. Currently, patients here can participate in such trials, and we can also lead on some of them. That has brought some of the best scientists and researchers to the United Kingdom. I would be interested to hear from the Minister how we will ensure that continues. Also, how will our constituents continue to have access to such important trials, rather than having to wait until some way down the line to get new and innovative medications?

During that inquiry, the Select Committee urged the Government particularly to look at regulatory alignment and the implications of no deal. We raised concerns about the lack of references to Brexit in the Department’s single departmental plan. It would be useful to have an update from the Minister on that work, which I am sure is ongoing. There was also some concern about protecting the UK’s position globally in relation to pharmaceuticals. On the matter of full membership of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use, reassurance was sought that that matter would be taken up at the earliest opportunity. It would be extremely helpful if the Minister gave an update on that.

The Select Committee recommended negotiating a close relationship with the EU, including associate membership of the European Medicines Agency, and supported the Government’s intention in that respect. Our report stated:

“Failure to achieve an ongoing collaboration would signal the triumph of political ideology over patient care.”

I say firmly to everyone involved, from all parties in Parliament, that patient care must be placed firmly before political ideology. The NHS is one of our most prized institutions—for everyone across the United Kingdom—and must remain so. Our overriding message was that almost all the evidence received suggested that

“the UK should continue to align with the EU regulatory regimes”

for medicines and devices. An update from the Minister would be helpful.

The hon. Member for Coventry South (Mr Cunningham), who is not currently in his place, made an interesting intervention about predatory procurement. I understand that we do not want to be alarmist in Parliament, but patients bring such concerns to us, so reassurance from the Minister would be helpful. The hon. Member for Henley (John Howell) spoke eloquently about his constituency and talked about diabetes and cystic fibrosis. Many constituents go to their Member of Parliament seeking reassurance about the implications of Brexit for their medicinal needs. The hon. Gentleman also spoke about mental health, which we cannot speak about enough in Parliament, because for many years it was never broached. I am the Scottish National party’s spokesperson on mental health, so I thank him for raising it, because I consider it important for it to be mentioned in as many debates as possible. It has an impact in every part of our lives, and if we are to provide holistic care it must have parity with physical health in all we do.

My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) spoke about medicinal isotopes. There is a huge pharmaceutical industry presence in my constituency, and I have been in touch with those businesses in the past month. There continue to be grave concerns about alignment and regulation for the industry. I think it is the continuing uncertainty that puts such a burden on businesses.

My hon. Friend the Member for North Ayrshire and Arran also said that one in five GPs are EU nationals and talked about our heavy reliance on workers from the EU, who do a fantastic job in the NHS. A number of witnesses to the Health and Social Care Committee told us just the same. We of course do not want to lose their valuable skills and expertise. They have built bonds with patients—or, if they work in the social care sector, with the people they care for—over a long period of time, and that cannot be overestimated. We must never undervalue their contribution. They need their place to be secure. Many of those workers do not earn over the £30,000 threshold, so we need a specialist case to ensure that the expertise stays in the country to support those vulnerable constituents of ours who need it.

Something that was repeatedly raised with the Select Committee—the hon. Member for Strangford (Jim Shannon) also mentioned this—is the fact that we have come to rely on high levels of staffing from the EU and elsewhere. It has been mooted that if we cannot attract staff from the EU, we could attract them from India or perhaps Africa. Those places in particular need their trained staff, and something must be done about training for young people in this country who want to go into health and social care settings.

[Alison Thewliss (Glasgow Central) (SNP)]

My hon. Friend makes a good point, but she will be aware that many people who have qualifications are currently not allowed to work by the Home Office. Two of my constituents worked in a care home and it would have loved to have them back, but the Home Office says no. Does she share my frustration that the Government say one thing on the one hand, and then something else on the other?

[Dr Cameron]

My hon. Friend makes an excellent point. Things have to be joined up exactly so that we can provide the continuity of care that patients need so much. There are thousands of excellent, high-achieving students who particularly want to study medicine, as well as psychology, occupational therapy and other occupations that are badly needed to support our NHS and our community health services. We must invest in these young people as we go forward. That point was made strongly by the hon. Member for Strangford, who is always an extremely good advocate for his constituency.

I look forward to the Minister’s response on social care, on medicines regulation and on the other issues we have spoken about. My hon. Friend the Member for Glasgow East (David Linden) also expressed concern about social care and those working in care homes. We must make that a more attractive occupation for people coming from school. I did it for a few years before going into clinical psychology; it is a rewarding occupation where carers build a real bond with those they care for. I ask the Minister to meet the APPGs, and I say to him very sincerely that we want to collaborate in a constructive way.

Yemen: Political and Humanitarian Situation

Debate between Lisa Cameron and Alison Thewliss

Wednesday 5th July 2017 Westminster Hall

[Alison Thewliss]

I absolutely agree with the right hon. Gentleman. I pay tribute to him for going to Yemen with Oxfam, as well as to Oxfam for its work on the ground.

After first mentioning that more than 2 million children under the age of 5 are acutely malnourished, including half a million who are at the most extreme level of that critical danger, I was going to come on to the situation with the cranes and the ports. The World Food Programme has, I understand, been refused access for the four new mobile cranes that it had provided to aid the situation. Could the Minister provide any further updates on the situation with the cranes? If food and medical supplies cannot get in, we are unlikely to see any alleviation of the problem.

It is not just about access to Hodeidah port. There is no access to Sana’a Airport, and the route through Aden is at capacity; people cannot get anything more through there. The aid that is getting through Aden is then subject to an overland journey, which is, as hon. Members can imagine, very difficult and extremely dangerous in a conflict situation for the aid agencies involved. They are having to take aid overland. Had access been possible, that aid could quite easily have gone through Hodeidah port.

On 2 July, the World Health Organisation managed to get a shipment in through Hodeidah, which included 20 ambulances, 100 cholera kits, hospital equipment and 128,000 bags of intravenous fluids. It sounds like big numbers, and it was a 403 tonne shipment that they managed to get in—but there are 200,000 cases of cholera. That is not even enough bags of intravenous fluids for every person that has cholera. It is a drop in the ocean in terms of the need in that region; there is a need to get aid in quickly and to prevent any further delays. We must make all the efforts we can to make sure that aid gets to the people that need it and gets there now. The people in Yemen cannot wait any longer.

I am glad that the hon. Member for Cardiff South and Penarth (Stephen Doughty) mentioned the issue of arms sales. It is absolutely clear that aid agencies that are working so hard on the ground are being impeded in their work by the bombs falling from the sky above them and the danger that they face every single day. They cannot provide the services that they would like to, because they are constantly under attack.

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

My hon. Friend is making a poignant speech. Would she agree that UK Government policy appears to be undermining itself, selling arms on the one hand and trying to provide aid through the Department for International Development on the other?

[Alison Thewliss]

I agree that it is a huge waste of money to be providing aid and to also be endorsing the bombs that are being sold in such huge volumes and at such huge financial value. That has to stop. We cannot continue to ask aid agencies to put their staff at risk every single day. It is not just international aid agencies such as Oxfam, Save the Children, the Norwegian Refugee Council or Islamic Relief, but the locally based aid agencies as well. They are at significantly greater risk, because they are right there on the ground facing severe dangers every single day. I implore the Minister to act to try to provide the support and ceasefire that we need to allow aid agencies to do their work and to prevent any more children dying from preventable causes. It is a situation that we can fix.

Jobcentre Closures: Glasgow

Debate between Lisa Cameron and Alison Thewliss

Tuesday 20th December 2016 Westminster Hall

[Alison Thewliss (Glasgow Central) (SNP)]

I am glad to be able to speak in this debate, Mr Hollobone, and I am grateful to my hon. Friend the Member for Glasgow South (Stewart Malcolm McDonald) for bringing us all together.

The letter that the Minister sent to MPs said that the plans were

“right for the city, its customers and our people”,

but I see scant evidence from the people I know in Glasgow that the decision would be any of those three things. The decision seems to have been made entirely in isolation by DWP officials, without speaking to anybody else in the city. They have certainly not spoken to stakeholders in Glasgow, Glasgow City Council, which has condemned it, or the Scottish Government, who are not keen on it at all either. They have not spoken to the most important local partner in Bridgeton, Clyde Gateway, which has done a huge amount in the area to reduce the overt claimant count from 39% in 2009 to 28% in 2015. They know that that is due to the huge amount of work it has done in the area to improve the life chances of people in that community, but it has not been consulted. Clyde Gateway is a linchpin for the community in terms of economic regeneration, and it needs to be part of the process.

In Bridgeton, around the corner from the jobcentre, there is a citizens advice bureau, which does a huge amount of work to support constituents. The credit union is across the road. The Olympia is right there, with its newly refurbished library, which has computers and classes that help to support local constituents. The Glasgow Women’s Library, which helps vulnerable women with literacy and to improve their self-esteem, is around the corner.

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

Does my hon. Friend agree that another vulnerable group that we must take into account is disabled people? It is absolutely disgraceful that people with disability will have much further to travel to find jobs. Has any impact assessment been conducted in that regard? The Government have pledged to halve the disability employment gap; surely these plans undermine that policy.

[Alison Thewliss]

I absolutely agree: the plans entirely undermine that ambition. Bridgeton CAB has been collecting evidence for the public consultation—my area is one of the few that will be consulted on—and it is very concerned that people accessing disability advisers will have much further to travel and that it will be much harder for them to get there.

To touch on transport, the Minister has stated that it takes 11 minutes by car to get from Bridgeton to Shettleston, but that entirely ignores the fact that nearly two thirds of households in the most deprived communities of Glasgow do not have access to a car, so they will need to get two buses. The Minister reckoned that it would take people 29 minutes to get there, but the two buses do not arrive in a neat 29-minute slot; one arrives much more regularly than the other. People trying to get there who have children to drop off at nursery or to pick up from school will find it more difficult to fit that into their day.

The consultation that Bridgeton CAB has done this morning highlighted that the time, date and frequency of appointments can be changed. The bus that someone got last week that worked out okay may not be the one they get this week, because the appointment time has changed. That adds a great deal of uncertainty and stress to the situation, because people are faced with the prospect of being sanctioned for being late. That is a huge fear for people. My experience in my constituency office—this is also the experience of the citizens advice bureau and other agencies in Glasgow—is that people are afraid to challenge even the first sanction. They do not want to get into conflict with people from the jobcentre, so they are not challenging the sanction. They think that they will be able to ride it out, but then something else happens at another time and they end up losing their benefits for even longer, which has a huge impact on their family income.

The fact that people have very limited means also means that they will be walking from one jobcentre to the other. It could take nearly 50 minutes to go from Bridgeton jobcentre to the Shettleston jobcentre. That has another impact. People are not walking from one jobcentre to another. That brings me on to my next point. We need to see in the consultation the catchment areas for the different jobcentres. People might be walking from Calton to Shettleston, or Dalmarnock to Shettleston. They could be going any distance to get there. We do not know what the distance will be. We do not have a full idea of what the actual impact on our communities will be without that information.

That is in huge contrast to the types of consultations that Glasgow City Council puts out for its schools. If it wants to close a school or move it somewhere else, the council puts out a map showing where each school pupil lives, or where the people travelling to the new school and new catchment area live, which makes the impact of changes on individuals very clear. We have not had that information at all.

The consultation process has a particular weakness. The Minister has told us that posters and leaflets will go out in the jobcentres, but the Department holds all the details of every single claimant. It could do a whole lot more to contact every claimant and ask them what the impact on each individual will be. I urge the Minister to do that and to come to Glasgow when he is in Scotland, so that he can come on the bus with us to see what the journey is actually like.