Oral Answers to Questions

Marion Fellows Excerpts

Tuesday 5th December 2023 Commons Chamber

[Maria Caulfield]

It remains our intention to bring forward a mental health Bill when parliamentary time allows. We have the draft Mental Health Bill, which we have put through pre-legislative scrutiny. We are looking at the report from the Joint Committee and will be responding to that shortly.

[Marion Fellows (Motherwell and Wishaw) (SNP)]

12. What recent assessment she has made of the potential impact of increases in the cost of living on mental health.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

We are acutely aware of the impact that the cost of living has on mental health, which is why this Conservative Government spent over £350 billion during the pandemic on protecting people’s jobs and over £60 billion during the recent cost of living pressures to pay for their energy bills.

[Marion Fellows]

The Centre for Mental Health, the British Psychological Society and others have raised serious concerns about the UK Government’s new back to work plan, warning that the increased threat of applying benefit sanctions or coercing people into jobseeking will be detrimental to claimants struggling with their mental health. Does the Minister share my concern about this, and has she made any representations to her Cabinet colleagues about the mental health impact of these measures?

[Maria Caulfield]

That is the difference between the SNP and the Conservatives: we have aspiration for people, and we absolutely want to support people with mental health problems and illness to get into work. They should have the same opportunities to get into work, and not just to get a job, but to get a good job and get a career. If we look at its website, Mind supports people getting into work, saying that it is not just a source of income, but provides a “sense of identity” and “structure” as well as support, confidence and ambition.

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

We now move to topical questions. We are running late because questions have been too long, as have answers. I often make this plea. In any case, Members should not be reading their questions—questions are not meant to be read; they are meant to be questions. Can everybody please cut out those bits that say their constituency is beautiful, for example, and just ask a question? We all believe that our constituencies are beautiful, and none more so than mine.

[Marion Fellows (Motherwell and Wishaw) (SNP)]

T1. If she will make a statement on her departmental responsibilities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

My priority as Secretary of State is to reform our NHS and social care system to make it faster, simpler and fairer. Since my appointment, we are making progress. To make our system faster, we have hit our manifesto target to recruit and retain 50,000 more nurses for our NHS, and to deliver 50 million more GP appointments, achieving both commitments months ahead of time. We have made an offer to health unions that I hope will end the consultants’ strike, which has disrupted care for the public and put a strain on staff. To make our system simpler, we have announced Pharmacy First, which will make it quicker and easier for millions of people to access healthcare on the high street. To make our system fairer, we have agreed a deal with pharmaceutical companies that will save the NHS £14 billion in medicine costs and give patients access to more life-saving treatment. The NHS is one of the reasons I came into politics—[Interruption.] I know Labour Members do not like to hear that, but I look forward to working with patients and staff across the country—[Interruption.]

[Madam Deputy Speaker]

Order. I do not need any help, thank you. The Secretary of State has answered the first question at length. I am sure that means she will answer the other questions much more briefly.

[Marion Fellows]

People with disabilities and serious health conditions already have higher living costs, and the proposals in the work capability assessment activities and descriptors consultation will mean that if they are reassessed they will lose £390 a month. I appreciate that the Secretary of State is new to her role, but will she commit as a priority to taking this up and consulting Cabinet colleagues, to ensure that people who are disabled and have serious health conditions are not pushed even further into dire poverty?

[Victoria Atkins]

As I said earlier, careful thought has gone into the announcements that were made in the autumn statement, and of course I will work with the Secretary of State and the Chancellor to ensure that the commitments we already have to people living with disabilities are maintained, and that we have their wellbeing at the heart of all our policy making.

World Stroke Day

Marion Fellows Excerpts

Thursday 23rd November 2023 Westminster Hall

[Marion Fellows (Motherwell and Wishaw) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I congratulate the hon. Member for Bromley and Chislehurst (Sir Robert Neill) on securing this debate. It is always better in any debate if there is a degree of experience and I think we all benefited from his. It is very good of him to share it.

The Scottish Government recently published their Stroke Improvement Plan 2023. In many cases Scotland is more fortunate because we have our own NHS and a smaller area to cover; there are only seven health boards, so there is less difference across the country. I am not saying there is not any difference, but it is much easier for the Government to work with individual health boards and organisations and produce a plan that everyone has bought into.

Unfortunately, strokes remain a leading cause of death in Scotland. The Scottish Government’s new stroke improvement plan seeks to minimise strokes. It is difficult to imagine that anyone in this room will not have had contact with someone who has had a stroke or who knows of someone still suffering. It is still the leading cause of death and disability in Scotland.

I hate to say this, but age is the most important factor. A stroke is most likely to occur after the age of 55 —I will say no more on that at the moment—but younger people can be affected as well. It is the fourth single leading cause of death in the UK.

Some good news is that the number of deaths from stroke is going down, partly due to a reduction in the incidence of strokes, but also thanks to the greater awareness of symptoms. As the hon. Member for Bromley and Chislehurst told us, the FAST programme was the first advertising campaign. It was really useful: most people can now recognise what a stroke is, what the factors are and can try their very best to get people into hospital much more quickly.

I will not go down the path of describing the treatments available because that was done in an exceptional manner—in a way that even I can understand—by the hon. Member for York Central (Rachael Maskell). But it is really important that we are all aware of what we and Governments can do to help people have better health in general. If someone has high blood pressure, high cholesterol, an irregular heartbeat or diabetes, that makes them more likely to have a stroke.

One of the things the Scottish Government are trying to do is reduce health inequalities across Scotland. It is really important that the Scottish Government use a human rights approach on this basis. Poverty is also one of the leading factors for bad health. As Lorraine Tulloch, the programme lead of Obesity Action Scotland said, those facing the choice of heating or eating amid the ongoing cost of living crisis are likely to be more focused on ensuring that there is enough food to go around than noting the nutritional value of food. In Scotland, we are having to deal with the consequences of poor diet and higher weight—we also need to look at poverty, which is the leading cause of those two things.

In Glasgow, the Scottish Government are investing £500 million through the city region deal, and regional partners have secured £300,000 of Health Foundation funding as part of their work to align economic development and improved health conditions. This will include the development of a capital investment health inequalities impact assessment tool, which will ensure that the health inequality impacts on the people who live and work in the Glasgow region—which includes my own constituency of Motherwell and Wishaw—are considered throughout the life of the project. Again, the Scottish Government are doing all they can to minimise the impact of poverty, but it is really difficult.

It is also important that the plan looks at the psychological issues referred to by the hon. Member for Bromley and Chislehurst—and it does. Often, someone who has a stroke needs not only physical recovery, but the right recovery from depression and the psychological impact. I have had some personal experience of that with people I know who have had strokes. Often, they may be accepting of the fact that they will not recover all their mobility, but they find it quite difficult to lose the life they had. That is something we must all take into account. The range of disabilities stroke can give is greater than for any other condition: limb weakness; visual problems; language and communication problems; extreme fatigue; and depression, as I have already mentioned. They are all common. The really difficult thing is that two thirds of working-age survivors are unable to return to work. That leads again to further depression and anxiety.

In order for those who experience stroke to be best placed to navigate their journey, stroke care should be provided in line with the principles of realistic medicine, which include listening to and understanding the patient’s problems and care preferences; ensuring that patients are allowed to take part in the decision making; and ensuring that patients have access to the clear and understandable information required to make an informed choice about their care.

I am not quite finished. I would like to talk about something that I find really interesting and that is a wee bit more uplifting than what we have been hearing. The hon. Member for Bromley and Chislehurst referred to self-led post-stroke care groups. He and I have to declare an interest: my son’s father-in-law leads one of those in Wishaw. I know from him and some of the people in his group how beneficial they find that kind of thing. But it would be much better for everyone if they did not have the problem of finding premises and all the other things. Across the UK, that should be something that Governments can take on and fund, because it helps with the psychological distress, anxiety and depression.

I recently heard about a tech-enriched rehab programme that recently opened at University Hospital Wishaw—or “Wishy General”, as most of my constituents would refer to it. It is to help meet the overwhelming demand for rehabilitation. I talked to a patient who was treated there, and she says how wonderful it is and how good it is to get something like that locally. This incredibly exciting pilot between the University of Strathclyde and NHS Lanarkshire is aimed at reducing disability and bettering outcomes after strokes. Recent research conducted at the University of Strathclyde has shown this type of model to be safe and feasible when used by people in the chronic phase of stroke recovery and has led to improved outcomes. It is really exciting to hear of these kinds of trials; it is something the Minister might consider looking into in order to benefit folk across the United Kingdom.

I make no apologies for being a Scottish nationalist and for praising my Government for what they do, but I do not think anyone could ever accuse me of not caring about people across the UK. It is important that we share knowledge and understanding to benefit all the people in what the hon. Member for Strangford (Jim Shannon) refers to as this United Kingdom of Great Britain and Northern Ireland. I know that the Minister will have listened carefully. I hope he will take on board what has been said and look to Scotland for answers in some of the things that we do that might help to improve lives here in England and in Northern Ireland and Wales.

National Carers Week

Marion Fellows Excerpts

Thursday 8th June 2023 Commons Chamber

[Marion Fellows (Motherwell and Wishaw) (SNP)]

I hugely congratulate the hon. Member for Gosport (Dame Caroline Dinenage) on securing this really important debate and on the work she does with the APPG.

Here we are again in National Carers Week, and things have not improved tremendously since the last time we had this debate in Westminster. Carers UK wants this week to be about communities across the UK coming together to recognise the huge contribution that unpaid carers make to society. Politicians—that’s us—employers, that’s us as well; health and social care services; businesses; education providers and members of the public all have a role to play in raising awareness of caring and making sure carers are able to access the information and support they need.

Like many others here in the Chamber, I went to the parliamentary reception yesterday, where I met Karen, among others. Karen told me her story and how she gave up a high-flying job with a really good salary, right at the start of the pandemic, to take care of her mother. She did so willingly, but it was a full-on job—in fact, so full-on that she did not have time to apply for any kind of carer’s allowance. Three years on, she finds herself almost bankrupt and in danger of losing her home. I think that shames us all. I pay tribute to Karen and folk like her, who are taken for granted. They save the economy billions of pounds and they do not always come out of it well enough, even though they have done the very best they can.

I also pay tribute to two organisations in my constituency, Lanarkshire Carers, which works in Motherwell and Wishaw—it has just been recognised as an exemplary Carer Positive employer in Scotland, which is fantastic news—and North Lanarkshire Carers Together, which attends the regular meetings of the poverty action network that I have set up locally. Both organisations do such immense and positive work to signpost carers, helping them to get money and respite, ensuring that they are included, providing short breaks—afternoon caring time—and even just allowing paid and unpaid carers to talk to others, which is a huge help.

[Wendy Chamberlain]

I, too, visited Lanarkshire Carers over the recess, in neighbouring Hamilton, and I heard about the exemplary award and the innovative ways in which they have approached things since the pandemic to ensure that they reach out to carers. They are a best-in-class organisation, and the hon. Lady is very lucky to have them.

[Marion Fellows]

Oh, I know. I thank the hon. Member for her intervention and for the Carer’s Leave Act 2023, which she piloted through Parliament—it will make a difference. I ask the Minister to please listen and give carers some money for the five days off to which they will now be entitled.

Last month, the chief executive officer of Carers Trust told the Work and Pensions Committee that, as Members have noted:

“Carer’s allowance is devolved in Scotland, so there has been a big focus on increasing the adequacy of the benefits. Part of that has been around focusing support on 16, 17 and 18 year olds who are unpaid carers. There have been financial payments, payments of £300”—

quite a lot of money for a young person—

“to allow them to access broader life opportunities, given so much is not open to them.”

They also get a Young Scot card, which gives them free transport, discounts and other things. It also looks as if the Scottish Government will remove the 21-hour rule for study, and I hope that the UK Government do not intervene against that, because it is important. A young carer needs the opportunity to enhance their education and better equip themselves for further work.

In Scotland, we really try to support and help carers. We know how much they contribute to our economy. It has been estimated that there are about 800,000 carers saving the economy £3.1 billion a year—that is an enormous amount of money. We also have to face the fact that most carers are women, and that leads to lower pensions. The gender pay gap already means that women do not get as good a pension as men, but the fact that more women than men take up caring responsibilities mean that they are being hammered twice.

The Scottish Government are very keen on stakeholder engagement. As with the national care strategy that they recently announced, nothing is done without talking to stakeholders. I am very proud that one of my former employees, Sophie Lawson, is working on a Scottish Government initiative on this topic—good luck to her. Sophie works for the Glasgow Disability Alliance, which has done a lot of good work with carers.

I have been the SNP’s Westminster disability spokes- person since 2020, but appallingly, it was only last year that it really dawned on me that there is a huge link between people with disabilities and carers, and how much we all owe to carers, who help the most undervalued groups in our society. Unpaid carers cover all parts of society, but they can often be marginalised. That is where local organisations are useful. I know that is happening all over the country.

One thing that I hope the Minister will recognise is that 29% of carers in the most deprived areas across the UK care for 35 hours a week. There is a real link between ill-health, poverty and the fact that so many people have to give up work to care for their loved ones. There is also real stigma, as has been mentioned. Many people who are cared for do not recognise that they are being cared for, and that can prevent their carers from accessing organisations and help from other people.

I am aware of the time that I have taken, so I will finish. I hope the Minister has listened very carefully to everyone in the Chamber, and will consider what is happening in Scotland. This is an important issue, and it needs to be addressed, especially now, during this cost of living crisis.

Prescription Charges: People Aged 60 or Over

Marion Fellows Excerpts

Monday 6th March 2023 Westminster Hall

[Marion Fellows (Motherwell and Wishaw) (SNP)]

It is a pleasure to serve under your chairmanship, Sir Edward. I thank all the previous speakers; some of what I say will be a repetition, but in this case I do not think repetition is unwelcome.

Under the SNP Scottish Government, prescription charges were abolished in Scotland in 2011. Scotland gets free prescriptions because the Scottish Government believe that mitigating the costs of illness is in the best interests of the population of Scotland. The SNP has led the way in delivering progressive and forward-thinking public health measures, which people across Scotland continue to benefit from. I speak from experience, as I was honoured to be part of the call for the new generation of cystic fibrosis medications to be released in Scotland, which was first place to get them. I declare an interest, because my granddaughter Saoirse will continue to benefit from those new drugs for the rest of her life, and they will extend her life expectancy quite considerably.

All credit to the Scottish Government: inhalers, antibiotics, life-saving medicines such as insulin for diabetes and many other treatments are provided at no cost at all to the patient at any stage. Scotland receives no extra funding for this decision and does not take money from other areas of the United Kingdom to pay for it. England is out of step with the rest of the UK. For more than a decade, NHS prescriptions have been free in Scotland, Wales and Northern Ireland. Yet the Tories, who have been in power in England for 13 years, have not replicated this approach, instead penalising those wishing to collect medicines; and, as we have already heard, the cost of living crisis has increased the non-collection of prescriptions.

When the NHS was founded in 1948, there were no prescription charges, but fees were introduced in the early ’50s to help with funding. Labour’s position in 2019 was to roll back charges for England—that appears to have been dropped under the present leadership. Unequivocally, the SNP has used the powers we have to ensure that people in Scotland benefit from the most generous social contract in the UK. The cost of NHS prescriptions can be mitigated in England if people use a prescription season ticket—a prepayment card. However, many people in England are still unaware of the system. Is the Minister prepared to advertise it more than is currently the case?

I used the example of cystic fibrosis medication, but the hon. Member for Gower has done really good work in the area of hormone replacement therapy over the years. After the arguments she has forcefully put in this place, it is incredible that women going through the menopause still have to pay for their HRT. The most recent announcement committed the Government to reduce the cost from April this year so that women can receive a year’s supply of HRT for the cost of two single NHS prescriptions in England, but in the rest of the UK they get it free. Although cost reductions are welcome, charging menopausal women less seems inadequate—they should get it free because the amount of work they can then do will increase, and that is a benefit to the whole economy.

People who have asthma are sometimes afraid to collect their prescriptions, as we heard from the hon. Member for Gower (Tonia Antoniazzi). A small survey of pharmacists published by the Royal Pharmaceutical Society last month found that a rising number of patients in England are failing to collect their medicines, because they cannot afford them. Some 51% of the pharmacists surveyed reported an increase in patients not collecting their medication, and 67% saw a rise in patients asking whether there was a cheaper over-the-counter substitute for the medicine they had been prescribed. That is appalling in this day and age, and it leads to more hospital admissions and more expensive care being required in the longer term. It defies common sense to allow that to continue.

The three devolved Governments have taken a preventive approach to mitigate poorer health outcomes by providing free access to medicines for those who need them. In England, the tax on sickness reduces access to medicines and leads to poorer health, time off work and potential hospital admissions, offsetting any costs gained from prescription charges. The UK Government should scrap prescription charges. To introduce them for people who are working until 67 is absurd. As the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) said, we are more likely to need medication as we get older.

The Government’s public consultation document ominously states:

“Anyone aged 60 and older can get free prescriptions for medicine. We are thinking about changing this.”

The change would mean that prescriptions would be free only when people get to pension age. Today’s pensioners have no need to worry, but they will worry—people worry even more during a cost of living crisis.

Is the Minister prepared to heed what is happening in the devolved nations and to equalise access to medicine across the United Kingdom?

Eye Health

Marion Fellows Excerpts

Thursday 15th December 2022 Westminster Hall

[Marion Fellows (Motherwell and Wishaw) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank the hon. Member for Strangford (Jim Shannon) for the nice things he said about me and congratulate him on securing this important debate. He is right: people would have been present if it had been possible, but weather, transport and other emergencies intervened.

Eye problems can affect anyone at any age. It is important that people get their eyes tested regularly. In Scotland, we feel that that should be by having a free NHS-funded eye examination. It is easy for us to neglect our eyes, because often they do not hurt when there is a problem. Having our eyes examined regularly can help to detect early signs of sight-threating conditions and other serious health conditions such as diabetes, cardiovascular disease and high blood pressure, in addition to the conditions that the hon. Member for Strangford told us about a moment ago.

In Scotland, community optometrists are the first contact point for any eye problems. They can diagnose and treat a number of conditions without the patient requiring an appointment with their GP or an ophthalmologist. An increasing number of community optometrists are registered independent prescribers and can issue patients with an NHS prescription to treat their eye problem.

The Scottish Government intend to expand further the range of eye care services delivered in the community by investing in a shared electronic patient record and in accredited practitioner training. That will include the management of stable glaucoma and treated ocular hypertension patients, and a national low vision service for visually impaired people. The Minister should probably have a look at that.

The Scottish Government also have a national ophthalmology workstream on hospital eye services, which sets out how they manage the delivery of hospital eye care services to provide timely care for patients. Patients with ophthalmic conditions are often vulnerable and must be supported by a responsive health service. Their care should primarily be safe and timely.

In Scotland, the Government are committed to improving services for sensory impaired people through their See Hear strategy. Adults and children with a sensory impairment should expect seamless provision of assessment, care and support, and the same access to employment, education, leisure, healthcare and social care as anyone else. In 2017, NHS Education for Scotland carried out an independent review of low vision service provision across Scotland.

In contrast to England and Wales, the Scottish Government provide free, universal, NHS-funded eye examinations, which is really important, especially given the cost of living. Universal access to healthcare is one of the Scottish Government’s key priorities, which is why free eye examinations for all were introduced in Scotland in 2006. Anyone, from any background, is able to access free eye care to help reduce the risk of sight loss. That includes all people in Scotland who are UK resident, refugees, asylum seekers and some eligible overseas visitors. Appointments are available every two years, and people are able to attend an optometrist for an NHS-funded examination of any eye problem that arises between times, including emergencies.

I was a beneficiary of that system. My eye started to fail and I found it very difficult to carry on my work, especially here in Westminster Hall, when I could not read the screens properly unless I was sitting very close to them. I went to my local optometrist. She checked my eyes and discovered cataracts, and immediately put me on a path for treatment, which really helped. When the same thing happened in my other eye, I was able to go back between appointments and say, “Look, I think there’s a problem. Can you help?” Again, I was put on a treatment path. I now have two artificial lenses—one in each eye, as my late father would have said. I have really benefited from that system, as have many people in Scotland.

If someone is unable to travel unaccompanied because of a physical or mental illness or disability, they can arrange to have a home visit quite easily. In fact, I walk from my house to my son’s house every week, and there are posters on railings across the roundabout that I have to go by, telling people that they can have that service. That is hugely important because, often, it is as people get older and more vulnerable—I put myself in that category some days—that they benefit from free eye care.

Those on benefits such as employment and support allowance, jobseeker’s allowance, pension credit, universal credit, working tax credit or child tax credit, and children under 16 years old, are entitled to help with the cost of glasses or contact lenses, and the repair or replacement of glasses or contact lenses, in the form of an NHS optical voucher.

In Scotland, before a child starts primary school, they will be offered a vision screening appointment as part of the See4School programme. That helps children begin school with the best possible vision and helps provide for any long-term visual problems. My daughter only discovered she had eye issues when she was learning to play a musical instrument and could not read the music from where she had to stand. If she had been screened earlier, it is possible that she would not have needed glasses for her whole life, as she does now.

In Scotland, we believe that socioeconomic inequalities drive health inequalities. That is why the Scottish Government are acting to mitigate the impact of austerity and reduce inequality. Where we have public health issues, Scottish Government public health efforts are complemented by wide-ranging cross-Government action. That is where Scotland benefits from being a small country. It is much easier to work in partnership and get cross-governmental things done.

We know that the worst health outcomes are driven to a significant extent by deprivation. That is why the Scottish Government are committed to addressing the underlying causes of health inequalities and to ending poverty; increasing access to fair employment, education and training; and improving our physical and social environments. That whole-systems approach and cross-Government action is needed to improve equity for Scotland’s people and communities. I believe that is true right across the four nations of the United Kingdom. That will be achieved by focusing efforts on the determinants of health inequalities and working more effectively in partnership. Reducing poverty and inequality sits at the heart of the SNP Scottish Government’s investment across all portfolios, and is a key driver of their development of a wellbeing economy that will have the needs of each individual at its core. The wellbeing economy is now becoming a recognised way of improving not just health, but everything around health and the lives of a nation’s people.

We believe that prescription charges are a tax on ill health and a barrier to better health for many. Charging for prescriptions would mean that many people with chronic conditions, or even those receiving treatment for cancer, could be liable. The Scottish Government continue to demonstrate their commitment to the provision of free healthcare advice and treatment when needed, with the introduction of the NHS Pharmacy First service, which is available in all community pharmacies to everyone registered with a GP or ordinarily resident in Scotland.

The Scottish Government are keen to support people to make healthier lifestyle choices that help take care of their eyes. I do not think many people realise that giving up smoking helps, because smokers are much more likely to develop age-related macular degeneration— the most common cause of sight loss in the UK—and cataracts than non-smokers. Given that smoking is more prevalent in the most deprived communities, the Scottish Government have set specific targets for cessation services focused on those communities. They provide £9.1 million a year to health boards to fund smoking cessation services targeted at achieving successful 12-week quits for 1.5% of the adult population in the most deprived areas. Through all of that, the Scottish Government will ensure a “done by communities, for communities” approach, making sure that lived experience is central to their work.

The Scottish Government are also keen that people drink within the recommended limits, because heavy alcohol consumption may increase the risk of developing early age-related macular degeneration. The alcohol framework sets out the priorities for preventing alcohol-related harm. We consulted on potential restrictions on alcohol advertising and promotion in 2022 to protect children and young people. The Scottish Government have twice run their “count 14” campaign work to raise awareness of the UK chief medical officer’s lower-risk drinking guidelines of 14 units per week. It was run for four weeks in March 2019 and over six weeks in January to March 2020. They are exploring the evidence around managed alcohol programmes and are delighted to be able to contribute to the running of the model being piloted in Glasgow by Simon Community Scotland and its evaluation. Of course, making alcohol more expensive in Scotland, especially the kinds of drinks that young people in particular used to drink, has also helped. In the end, it will help their eye health as well.

Will the Minister look at what we are doing in Scotland? I am sure he has a very good idea. It is really important. Will he tell us what he hopes will happen in England?

In conclusion, it is really important that there is a blueprint, as the hon. Member for Strangford said. In Scotland we do things differently, but we want everyone to benefit from our experiences and to have the same chance of good eye health. Will the Minister support a national eye health strategy? As has previously been mentioned, the hon. Member for Battersea (Marsha De Cordova) cannot be here today, but she recently introduced the National Eye Health Strategy Bill. Will the Minister support the Bill on Second Reading on Friday 3 March? Everyone here wants the best for people in their communities. The best way forward—and I would say this—is to look at the Scottish example and put aside the barriers that prevent people from having their eyes tested regularly.

World Menopause Day

Marion Fellows Excerpts

Thursday 27th October 2022 Westminster Hall

[Marion Fellows (Motherwell and Wishaw) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Hollobone, especially in this debate. I will probably not take four minutes—that will sound strange to many folk who hear me here regularly—but I am just here as a cheerleader. I went through the menopause—I was trying to work it out, but my arithmetic is absolutely rubbish—about 30 years ago. I know it is hard to believe, but it is true. It was an early-ish menopause, and no one spoke about it. It was the Cissie and Ada time—Les Dawson and his colleague, who just mouthed “the change”.

I find it refreshing, glorious and essential that we talk about menopause. The hon. Member for Swansea East (Carolyn Harris) knows that she is my heroine, even though I got to meet Richard Gere and she did not—that has always been a bone of contention between us. I pay tribute to her and her work. I also pay tribute to the right hon. Member for Romsey and Southampton North (Caroline Nokes), with whom I served on the Education Committee. They are great role models, including for people like me.

Another of my role models is my First Minister in Scotland, Nicola Sturgeon. She recently went to a centre in Coatbridge—I may have got the location wrong—to talk to other women about the menopause. That would not have happened even five or six years ago, but it is vital for all the reasons that everyone has talked about. We have heard the statistics about working women who are going through the menopause, and about the lack of understanding from employers.

I was fortunate, because I worked in an FE college and I commanded the room. If I felt hot, the students had wide open windows. If I did not feel too great, they kind of tiptoed around me, but I did not tell them that I was suffering from the menopause. They did not really know what was going on. It is important that younger women, younger men and older men know what the menopause involves. We must not make life even more difficult for 50% of the population, who are experienced—usually highly experienced—working colleagues.

I say to colleagues here: more power to your elbow. I think you are all doing a wonderful job, and I am just sailing along on your coattails. Mr Hollobone, I think you are having an education this afternoon.

Heart and Circulatory Diseases (Covid-19)

Marion Fellows Excerpts

Thursday 23rd June 2022 Commons Chamber

[Marion Fellows (Motherwell and Wishaw) (SNP)]

I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate and for his passion in delivering his speech today. We all know and value the work he does to raise issues for his constituents here and in Westminster Hall. I also thank Chest Heart & Stroke Scotland and the British Heart Foundation for the valuable work that they do.

I start by pointing out that NHS Scotland is and always has been independent; NHS England or the NHS in Northern Ireland do not cover Scotland. We have always done things slightly differently, but work well in conjunction with the other health services.

Heart disease remains a major cause of death and disability in Scotland, accounting for more than 9,000 deaths each year. Ischaemic heart disease, which can lead to heart attack, is still Scotland’s single biggest killer, responsible for 11.2% of all deaths in 2019 and 25,000 hospital admissions every year. In March 2021, my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) spoke in a Westminster Hall debate on patients with heart failure, emphasising that the most important factor in such diseases and premature deaths is poverty. Within their limited powers, the Scottish Government are doing everything they can to help those in poverty in Scotland by such measures as mitigating the bedroom tax, introducing a baby box to give a good start to every baby born in Scotland, and introducing other benefits to those qualifying, including a best start grant, pregnancy and baby payment, and the Scottish child payment. These are all designed to improve life chances for people, and especially children, living in Scotland. If we keep the weans well, they will continue with good outcomes further on in their lives.

The covid-19 pandemic has been a worrying time for many folk, especially if they already had a pre-existing condition such as heart or circulatory disease. There is no doubt that covid-19 has impacted some groups more than others. It is an unwelcome reality that communities experience health, quality of life and life expectancy differently. Having a heart or circulatory condition probably does not make someone more likely to catch coronavirus, but if they have a heart condition, it can mean that they could get more ill if they catch it, so anyone with a heart condition is considered at an increased risk of more severe complications, and someone who is over 60 years old has a particularly high risk. The covid vaccine—we have to emphasise this—is safe for people with heart and circulatory conditions. Getting the vaccine is one of the main things that people can do to reduce the risk of becoming seriously ill from covid-19, as well as getting a booster shot when offered. During the first lockdown period of the pandemic, there was a deferral and reduction of services, including diagnostics, access to specialist support in the community, and cardiac rehabilitation. This needs addressing across the United Kingdom.

I am pleased that the Scottish Government are taking action on tackling heart disease in Scotland and have published an updated heart disease action plan. The covid-19 pandemic has brought the need to address heart disease in Scotland into even sharper focus, having had a significant impact on people with heart disease and on the services that support them. The heart disease action plan sets out the Scottish Government’s vision of minimising preventable heart disease and of ensuring timely and equitable access to diagnosis, treatment and care. The vision of the plan is to minimise preventable heart disease and ensure that everyone with suspected heart disease in Scotland gets what they need. We need to identify ways to support people with the emotional and psychological impacts of heart disease, giving as many people as possible access to specialist support, including vital rehabilitation services, and, where necessary, supporting access to palliative care. Addressing inequality will be monitored and considered carefully throughout the implementation of the plan. In Scotland, one of the things we are really good at is listening to a wide range of voices in efforts to create pathways and reshape models of care. The use of technology and care closer to home has also been vital to maintain care throughout the pandemic and has important lessons for delivering person-centred care in future.

Cardiovascular disease is one of the main causes of death and disability in the UK, but it can often be largely prevented by leading a healthy lifestyle, and the Scottish Government are supporting people to make healthier choices. It is not always good to talk about what has happened but good rather to think about how we can prevent it happening in future. Many people in Scotland live with cardiovascular risk factors such as high blood pressure or high cholesterol that place them at increased risk of heart disease or stroke. Health-harming products—alcohol, tobacco and unhealthy food and drinks—contribute to widening of health inequalities. Improving diet and levels of healthy weight is a public health priority. The Scottish Government are taking wide-ranging action to support healthier choices, as they have set out in “A healthier future: Scotland’s diet and healthy weight delivery plan”. The Scottish Government are shifting the emphasis from dealing with the consequences of obesity to tackling the underlying causes, which includes: ending poverty; supporting fair wages and families; and improving physical and social environments. The Scottish Government are committed to introducing during this Parliament a Bill that includes powers to restrict the promotion of food and drink that are high in fat, sugar and salt. They have long advocated that TV and online advertising of foods high in fat, sugar or salt should be restricted to give children the best start in life. The SNP welcomes the fact that the UK Government have now moved in line with the Scottish Government’s position, although it is disappointed at the delayed implementation.

The Scottish Government’s tobacco control action plan sets out the priorities for reducing smoking rates to 5% or less by 2034. Their alcohol framework sets out priorities for preventing alcohol-related harm, and it contains 20 actions, building on existing action to change Scotland’s relationship with alcohol, including Scotland’s world-leading minimum unit pricing policy.

The Scottish Government are investing in health and are committed to significantly reducing health inequalities. There is no doubt that covid-19 has had a disproportionate impact on people living in areas of socio-economic deprivation. The Scottish Government’s programme for Government includes commitments to improve life expectancy and to tackle health inequalities.

The Scottish Government are committed to ensuring appropriate staff resources and training to deliver timely and equitable services across Scotland for people with heart disease. Under the SNP, Scotland has record health funding: a total health portfolio funding of £18 billion, with resource funding up over 90% in cash terms under the SNP since 2006-07. Frontline health spending is £111 higher per head in Scotland than in England. That is important because the Scottish Government recognise that we start from a lower base of good health, and they are committed to improving health. As I have said, disease prevention is a big factor.

We now have higher staffing per head than NHS England. We have a record number of GPs working in Scotland, with more per head in Scotland than the rest of the UK. The Scottish Government’s NHS recovery plan, which is backed by more than £1 billion, sets out plans for health and care over the next five years. They are creating a network of national treatment centres, increasing capacity for more than 40,000 additional planned elective procedures and diagnostic care across 12 different specialities. They are also targeting improvements designed to maintain the 31-day standard and achieve the 62-day standard on a sustainable basis. They are also scaling up the use of NHS Near Me, which is a really good initiative and supported by £3.4 million a year. They are providing general practices and their patients with support from a wide range of healthcare professionals in the community. My own GP practice uses such healthcare professionals and it is really effective.

The Scottish Government also recognise the negative impact that long covid can have on the health and wellbeing of those affected, so they are spending more money to improve the care and support available for people with long covid across Scotland. The Scottish Government’s chief scientific officer is funding nine Scottish-led research projects on the longer-term effects of covid-19, which will also impact on those with heart conditions and circulatory diseases. Does the Minister agree that what the Scottish Government are doing will help people with heart and circulatory diseases, and will she consider emulating their actions?

Covid-19 Vaccinations

Marion Fellows Excerpts

Thursday 4th November 2021 Commons Chamber

[Maggie Throup]

I thank my right hon. Friend for his questions. I reiterate on the antivirals that we are working across government and the NHS to urgently get this treatment to patients. As he rightly says, it is important that we act very quickly. It was only earlier today that the Medicines and Healthcare products Regulatory Agency gave its approval, so we are already taking rapid steps in letting people know about this issue. He talked about the JCVI, for which I have huge respect. I do not think it is my position to intervene in its processes. We need robust processes to make sure that what we have available and the programmes we have are very safe, as the UK population would expect. He also talked about booking the booster. We always need to look at ways of improving accessibility, but we did open up the opportunity for people to go to walk-in centres for their booster, so that they do not need to book online or call 119. We are looking at ways of making this easier all the time. On the mandating of jabs, the Secretary of State will make an announcement in due course.

[Marion Fellows (Motherwell and Wishaw) (SNP)]

I thank the Minister for previous sight of her statement. Scotland leads the UK in both first and second vaccination rates: 90% of those aged over 12 have been vaccinated with at least one dose, whereas in England the figure is 85; for second doses, the figures are 81% as against 79%, with booster roll-outs taking place across these lands as we speak. How do the UK Government plan to match Scotland and encourage greater uptake of vaccines among those who are so far unvaccinated?

The Government said in their Budget that they planned to invest responsibly. Does the Minister believe it was responsible to cancel a multi-million-pound contract—threatening hundreds of jobs in Livingston for no good reason— to supply a covid-19 vaccine that phase 3 trials show may be more effective than the Oxford vaccine? Will she rethink that outrageous decision?

World Menopause Month

Marion Fellows Excerpts

Thursday 21st October 2021 Commons Chamber

[Marion Fellows (Motherwell and Wishaw) (SNP)]

How do you follow that? I thank the hon. Member for Strangford (Jim Shannon). I was looking around the Chamber before I started thinking about what I would say, and I think I am probably the oldest woman here who has gone through the menopause. It must have been 15, 20 years ago. You can ask my children or, if you could, my late husband, and they would tell you. It is absolutely wonderful that we can have this debate today. I am someone who started to squirm when they showed sanitary products in adverts on telly a few years ago. In my lifetime, growing up and becoming a woman and having children, none of this was ever discussed. I am of the Cissie and Ada generation, with Les Dawson— I cannot do the impression—but that is how everyone did not speak about the menopause. This debate is refreshing, important and, beyond everything, it lets people outside this Chamber see that there are issues we can come together on—men and women, and different parties.

I will rush through my speech now. This debate has been great. I will not list everyone who has spoken, but many important issues have been raised. I want to give some hope to people. The Scottish Government have a women’s health plan, which we are pressing forward with. There might be ideas there that the Minister can take forward, and I urge her to do that. I am not saying this as anything other than help. We have all these different things such as, through NHS Education for Scotland, the training of GPs, frontline providers and everyone else to do the kinds of things that make doctors think about menopause when women turn up to their surgeries and other places. It is important. We have a menopause specialists network, and that helps move things forward. The SNP Scottish Government want all women to have access to proper, high-quality and appropriate information and support, and they will shortly be starting on a campaign to make people more aware of menopause and menopausal symptoms.

As most Members will know, we do not pay prescription charges in Scotland, and that helps a lot of women. It makes it easier for people to go to their doctor, knowing that they can get treatment that is paid for by way of prescription. That encourages people to do things.

The menopause, as we have heard this afternoon, has a serious physical and psychological impact on women, from memory loss to pain, and it has to be taken seriously by health professionals and society more widely. More support in the workplace is particularly needed. We have had examples of good companies this afternoon, but that is not the point; it has to be across the board. We have to get all organisations and companies to understand what is needed.

In Scotland, the Scottish Government use their fair work policy to promote fairer work practices. They work with women’s organisations and trade unions to improve workplace equality and push for the full devolution of employment powers. However, I make an appeal to the UK Government. They must stop delaying and move forward with their long-awaited Employment Bill, including a day one right to request flexible working, as has been mentioned. That would begin to address the pressing issue of workplace inequality, which has only been worsened by the pandemic.

It is essential that women have access to the right support and are met with understanding in the workplace when managing menopausal symptoms. I was lucky. I had a room full of students, and if I said, “Is it hot in here?”, and they all went, “No, Marion”, I said, “I don’t care. I’m opening every window”, and they sat and froze through the rest of their lecture. I am not saying that everyone should do that, but I do say that dealing with this issue is important, because we could lose the best of the workforce with so many women who are going or will go through it.

There is an obvious and huge need to improve healthcare for women and to tackle the stigma around women’s health that still exists. World Menopause Month is a welcome opportunity to break down that stigma and to push for greater action to tackle health inequalities that have an impact on women’s day-to-day lives. I will write to the Minister with more detail about what we are doing in Scotland if she would be willing to receive that.

Covid-19 Update

Marion Fellows Excerpts

Monday 28th June 2021 Commons Chamber

[Marion Fellows (Motherwell and Wishaw) (SNP)]

Now that the Health and Social Care Secretary is in post, will he break with his predecessor’s outright refusal to deliver the pay rise to NHS staff in England that they deserve? Will he, at a minimum, commit to matching NHS pay rates in Scotland, delivering a pay rise for staff in England, and to providing more money in consequentials to help devolved Governments support NHS staff in devolved nations?

[Sajid Javid]

The whole House would agree that the Government must absolutely make sure that there is a fair pay settlement for all NHS workers, and that is certainly what there will be.