Martyn Day debates involving the Department of Health and Social Care during the 2019 Parliament

Coronavirus Response

Martyn Day Excerpts
Monday 20th July 2020

(3 years, 9 months ago)

Commons Chamber
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Matt Hancock Portrait Matt Hancock
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I stand with my hon. Friend and the people of Wolverhampton in saying that, if they need more testing, they will get more testing, but right now I know for sure that anybody in Wolverhampton who needs a test can get one if they have symptoms. If in doubt, get a test because that is the most important thing people can do to help control the virus across the country.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP) [V]
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Independent SAGE has estimated another 27,000 deaths in the UK by spring without a second wave of the virus, if the UK Government continue with their current approach, so will the Secretary of State agree to follow the example of Scotland, Wales and Northern Ireland and pursue a strategy of eliminating the virus, rather than accepting the terrible projected death toll that living with the virus will cause?

Matt Hancock Portrait Matt Hancock
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Those projections did not take into account the actions that the UK Government are undertaking.

Coronavirus Update

Martyn Day Excerpts
Tuesday 14th July 2020

(3 years, 9 months ago)

Commons Chamber
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Matt Hancock Portrait Matt Hancock
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I take very seriously the royal colleges report. We are engaged in a massive ramp-up of testing and of the contact tracing that my right hon. Friend has long championed. The scale of the ramp-up of testing will be big enough to cope with the sorts of figures that are described in the royal colleges report—that is even on the current testing technology. If there is a breakthrough so that we can get testing technology that is even easier to roll out, where it can be done at the bedside in the community rather than having to be sent to a lab, we will be able to have an even bigger roll-out.

On my right hon. Friend’s final point, as he and I have discussed in this Chamber, we have put in place a programme of regular testing of NHS staff that is advised by clinicians. That insists on regular testing that is, again, risk-based, and as we further ramp-up testing above and beyond the current 300,000-a-day capacity that we have now achieved, which is one of the highest in the whole world, we will of course continue to expand that effort.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP) [V]
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I thank the Secretary of State for his statement; it represents a welcome step towards preparing for any potential new second wave of coronavirus infections this winter. The virus has not been eliminated, so as we lift lockdown and people increasingly interact with one another, we need to use every tool we have to reduce the risk of a second wave.

A report commissioned by the UK chief scientific adviser, Sir Patrick Vallance, has concluded that July and August must be a period of intense preparation for a potential winter resurgence of the virus, with R potentially rising to 1.7 by September. The report’s worst-case scenario forewarns of an estimated 119,000 associated hospital deaths between September and June—more than double the deaths we saw during the spring wave. This outcome, of course, does not take any account of likely actions that the Government may take. I sincerely hope that an elimination strategy is adopted as part of that.

The move to compulsory face coverings is a welcome and helpful intervention, but I am in no doubt that effective uptake will require consistent and effective public messaging. So far, we had the Chancellor of the Duchy of Lancaster saying on Sunday that face coverings should not be mandatory, the Justice Secretary saying that they perhaps should be, the Prime Minister saying that he is looking at the evidence and, thankfully, the Health Secretary today saying they will be mandatory. Will he confirm the implementation date? Press speculation has suggested 24 July. When the head of the World Health Organisation said yesterday that mixed messaging from leaders is one of the worst challenges in tackling covid-19, who do we think he had in mind?

The chair of the British Medical Association said that

“each day that goes by adds to the risk of spread and endangers lives.”

While I welcome the UK Government’s falling into line with Scotland and 120 other countries worldwide on mandatory face coverings, they need to be one component of a wider elimination strategy, not just about keeping the virus down. I hope the Secretary of State will take this opportunity to commit to an elimination strategy.

Matt Hancock Portrait Matt Hancock
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I certainly agree that the UK has throughout the virus moved largely in lockstep but for a few days in some cases, owing to the implementation and timings of these sort of decisions. That is a good thing, because we are far stronger when we work together as one single United Kingdom. I welcome the Scottish Government’s support for the decision we have taken.

I add only that suppressing the virus is absolutely critical. As all countries around the world have discovered, elimination is extremely difficult. Those countries that thought elimination was achievable are finding that cases pop up again. The correct approach, which we are following right across the United Kingdom, is local action whenever we see cases, clamping down on them as much as possible in order to suppress the virus, while lifting those national measures.

Coronavirus

Martyn Day Excerpts
Tuesday 7th July 2020

(3 years, 9 months ago)

Commons Chamber
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.

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Matt Hancock Portrait Matt Hancock
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I take my hon. Friend’s point very seriously. We are planning significant investment in the health service in Hampshire. That has to be done in a way that enhances services locally, in Winchester and across the county. We have learned a huge amount during covid about how the health system works best, with system working, much more community activity, and much more treatment at home by telemedicine, which is one of the things that have gone incredibly well in this crisis.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP) [V]
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Polling from YouGov shows that so-called anti-vaccination sentiment is on the increase in the UK, with 16% of UK adults saying they would probably or definitely avoid a covid-19 vaccine. What does the Secretary of State feel that means for the hopes of achieving immunity?

Matt Hancock Portrait Matt Hancock
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The Government of the United Kingdom will recommend a vaccine as soon as one is available that is safe, but only when it is safe. It is so important, and it is incumbent on every single Member of this House, that we make the case for why vaccines are both safe and effective. The hon. Gentleman is absolutely right to raise this issue, and I am grateful to him for doing so. It is an issue, I think, on which all parties agree. Should a vaccine come off, it will be such good news for humanity, frankly, and we will need to make sure that people are given the support and the confidence, and of course the logistical convenience, to be able to get the vaccine should that be clinically appropriate.

Covid-19 Update

Martyn Day Excerpts
Monday 29th June 2020

(3 years, 10 months ago)

Commons Chamber
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Matt Hancock Portrait Matt Hancock
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I am working with my right hon. Friends the Communities Secretary and the Chancellor of the Exchequer on exactly those measures.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP) [V]
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Sir Jeremy Farrar, who sits on the Scientific Advisory Group for Emergencies, has said that in winter we anticipate rebounds and second waves. He said that it was crucial to get to the position that Scotland is in, with low numbers of cases giving a low base from which to tackle local outbreaks. With 901 new cases reported over the past 24 hours, how confident is the Secretary of State of reaching that low base by winter?

Matt Hancock Portrait Matt Hancock
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Clearly, the measures that we have in place are there to bring the number of cases right down. We have been able to do that over the past few weeks, since the middle of April, when we saw the peak. That has been happening across the country. Where we see local outbreaks and that trend going into reverse, we can take action, whether that is at a highly localised level around a single cluster or, as demonstrated tonight, with an outbreak such as the one in Leicester.

Covid-19 Update

Martyn Day Excerpts
Tuesday 5th May 2020

(3 years, 12 months ago)

Commons Chamber
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Urgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.

Each Urgent Question requires a Government Minister to give a response on the debate topic.

This information is provided by Parallel Parliament and does not comprise part of the offical record

Matt Hancock Portrait Matt Hancock
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Getting new Government guidance to the visually impaired is of course a challenge. It is something we have been working hard on. In the first instance, the first port of call should be primary care—somebody’s GP or 111—if there are any queries. That is where I would point people in the first instance. It has been a challenge, because we have been making policy at speed, and writing and updating guidance at speed, but I would point those who are visually impaired to 111 and their GP if they have any questions.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP) [V]
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The Trace Together app in Singapore has been down- loaded by 17% of its population since it was introduced in March. What estimate has the Secretary of State made of the numbers that will be required to download NHS app, and have there been discussions about making it compulsory if not enough people do so?

Matt Hancock Portrait Matt Hancock
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The more people who download the app the better it will be and the more effective it will be in keeping people safe. However, even small numbers downloading it will help us to spot hotspots and so will bring some value. I was really delighted yesterday afternoon to hear from Isle of Wight Radio, which stated that 80% of people on the Isle of Wight in an early survey said that they wanted to download the app. That would be a terrific result. I pay tribute to the work of Isle of Wight Radio and the local press on the Isle of Wight, who have taken to Isle of Wight’s important role in piloting this roll-out with enthusiasm. There is no numerical answer to the hon. Gentleman’s question. The answer is that as many as possible will make us as safe as possible.

Oral Answers to Questions

Martyn Day Excerpts
Tuesday 10th March 2020

(4 years, 1 month ago)

Commons Chamber
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Jo Churchill Portrait Jo Churchill
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As we have laid out from the beginning, our approach will be science-led and about the safety of everybody. That is why at some point in future doctors will make decisions and clinical judgments, and those with existing co-morbidities or at the more serious end of an illness will be triaged up into an appointment first. That may mean that some people have to wait a little longer during this period, but it will always be done on clinical advice and with the safety of the patient at the heart of things.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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Last year, 85% of doctors surveyed by British Medical Association Scotland said that the pension taxation crisis would have a significant effect on NHS services, such as through waiting times. The Government’s proposal to raise the taper threshold to £150,000 does not fully solve the problem and would cost the Treasury more than it would to reverse the policy, so what is the Minister doing to address the issue?

Jo Churchill Portrait Jo Churchill
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I am sure the hon. Gentleman will understand that my right hon. Friend the Chancellor might be a little upset if I started to make announcements from the Dispatch Box today. It is a work in progress. It has been a little trickier with general practice than it is in the health service, because GPs do not do specific shifts, making it a little trickier to organise.

Martyn Day Portrait Martyn Day
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Scotland’s Cabinet Secretary for Health, Jeane Freeman, wrote to the Chancellor last month to call for a sustainable resolution on this matter in the Budget. Ahead of tomorrow’s Budget, what assurance can the Minister offer that the joint Department of Health and Social Care and Treasury review of the impact of pension taxation on the NHS will produce a long-term solution that will work for all doctors?

Jo Churchill Portrait Jo Churchill
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I gently refer the hon. Gentleman to the answer that I gave a few moments ago.

Lesbian, Bisexual and Trans Women’s Health Inequalities

Martyn Day Excerpts
Tuesday 10th March 2020

(4 years, 1 month ago)

Commons Chamber
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Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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It is a pleasure to take part in today’s important and informative debate on health inequalities faced by lesbian, bisexual and trans women. I am grateful to my hon. Friend the Member for Livingston (Hannah Bardell) and the hon. Member for Reigate (Crispin Blunt) for securing today’s debate.

The aim of LBT Women’s Health Week is to raise awareness of lesbian, gay, bisexual, trans and queer women’s health inequalities, to make it easier for service providers to empower service users and for communities to support LGBTQ women. It is important for a range of reasons that we eliminate LBT health inequality and improve LBT health, to ensure that all individuals can lead long and healthy lives. It is worth considering Public Health England’s review of health inequalities for lesbian and bisexual women, which reported:

“There is consistent evidence from the UK and internationally that there has been a paucity of attention, concern and research on lesbian and bisexual women’s health inequalities.”

That emphasises the importance of today’s debate.

As we have heard today, the LBT community experience significant health inequalities and specific barriers to services and support. The many benefits of addressing these health concerns and reducing inequality include reducing disease transmission and progression, increased mental and physical wellbeing, reduced healthcare costs and, of course, increased longevity for the people involved.

We have heard from a range of speakers today, with some powerful testimony. My hon. Friend the Member for Livingston made many good points, talking about her own life experience and the value of her supportive network, which not everyone in the community benefits from. She said that coming out can be more traumatic for trans people than gay and bi people. I had not given that much consideration, and we should all remember that point. She highlighted a whole range of issues around safe sex and gave us details of dental dams. I go away informed—every day is a school day!

The hon. Member for Reigate talked about his personal experience of coming out in 2010. I am grateful for his work on the APPG on global LGBT rights. He informed us that this Parliament has more LGBT MPs than any other. As I say, every day is a school day, and it is a pleasure to take part in debates where we go away having learned more than we came in knowing. He also said that we have delivered equality in law, and we now need to deliver in outcomes, and I wholeheartedly agree with that profound point.

The hon. Member for Sheffield, Hallam (Olivia Blake) gave us some interesting statistics, including that 34% of advice workers said they were not confident dealing with trans people. That is a really important figure. In my research for today’s debate, I had been looking at it from the other side, and that backs up what trans people are saying—Stonewall Scotland says that one in four LGBT people have experienced healthcare staff having a lack of understanding of their specific needs.

Kate Osborne Portrait Kate Osborne
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Does the hon. Member agree with me that it is essential to ensure that all NHS mental health services train all staff on the mental health needs of LGBT people, including the specific experiences and inequalities faced by LBT women?

Martyn Day Portrait Martyn Day
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I thank the hon. Lady, and she has read my mind because that is exactly the point I was coming to. We are hearing it from both sides—from the healthcare workers and from the community—and both feel that there is a gap, so there is clearly a training requirement that we need to address as a society.

The hon. Member for Runnymede and Weybridge (Dr Spencer) spoke about stigma, and he used a phrase, “minorities within the minority”, which probably sums things up and really gets to the crux of it for the people we are discussing. Latterly, we heard from the hon. Member for North Down (Stephen Farry), who gave us the Northern Ireland perspective. I think we can echo the issues of bias being ingrained in society and concerns about homophobic bullying throughout the rest of the United Kingdom, and I will touch on some of the Scottish perspectives.

Of course, no debate on health goes by without my mentioning that health is devolved and that in Scotland we do some things a little bit differently. Scotland has a really high record of health funding—up by over 60% under the SNP—and frontline health spending in Scotland is £136 per person higher than in England. In our recent budget, which has been termed the equality budget, we will continue to maintain Scotland’s position as one of the most LGBTI-progressive countries in Europe. The budget’s investment in mental health will have a positive impact on LGBTI people, who have higher rates of attempted suicide, self-harm, depression and anxiety.

Tackling hate crime also continues to be a top priority for the Scottish Government, and they will work with LGBTI stakeholders to challenge discrimination and to encourage understanding. An important point that we should take home is that every individual is some mother’s son or daughter, and we need to be far more accepting of one another in our own society.

The definition of gender identity and transgender used in the Offences (Aggravation by Prejudice) (Scotland) Act 2009 is considered to be one of the most inclusive definitions in use. The Scottish Government will continue to work to reduce the stigma of HIV, raise awareness of the condition and reduce its transmission. Scotland is the first country in the UK to make PrEP available free of charge to those at the very highest risk of acquiring HIV.

It is clear that this is one area where our nations face many of the same challenges. In Scotland, LGBT people are at a higher risk of experiencing common mental health problems than the general population. Stonewall Scotland’s survey of LGBT people in Scotland found, as we have heard, that almost half of LGBT people—49% on its figures—have experienced depression over the last year. My hon. Friend the Member for Livingston went through the whole range of figures, so I will not repeat them, but they bring home the very powerful point that there are real questions about inequality.

Scotland is an open and welcoming country. Prejudice, hate and discrimination will never be tolerated, and I believe that diversity makes Scotland richer and stronger, as well as happier and, I hope, healthier. The SNP Government are clear about the central equality of human rights to Scotland’s future and the importance of inclusive growth, fair work and social justice to our economic success and our social wellbeing. Scotland is considered one of the most progressive countries in Europe in terms of lesbian, gay, bisexual, transgender and intersex equality, and we aim to preserve and advance Scotland’s reputation as one of the most progressive countries in Europe for LGBTI equality.

In its 2015 rainbow map, the European Region of the International Lesbian, Gay, Bisexual, Trans and Intersex Association ranked Scotland as the most inclusive for LGBTI equality and human rights legislation: it met 92% of the ILGA’s 48-point criteria. Changes by the SNP mean that Scotland has been named the best country in Europe for LGBTI legal equality by Pink News. Those are all achievements of which we can be proud. However, there remains much that needs doing, and we must continue tackling homophobia, biphobia, transphobia and all forms of discrimination, stigma and inequality.

This debate goes some way to highlighting these issues, and I would just end as I began by once again thanking the hon. Members responsible for bringing it here today.

Coronavirus

Martyn Day Excerpts
Monday 9th March 2020

(4 years, 1 month ago)

Commons Chamber
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Matt Hancock Portrait Matt Hancock
- Hansard - - - Excerpts

I pay tribute to the Chair of the Select Committee for the way in which he has handled this—for instance, in demonstrating the need for transparency in the questioning of the chief medical officer last week. I will take away his point on the need for a central estimate. The figures out there relating to the proportion of people who will get the virus are a reasonable worst-case scenario. On the central estimate, there are still things that we do not know about the spread of the virus through China—in particular, whether the degree to which the slowing of the increase in cases in China is because the virus has reached a large proportion of the population and there is a large proportion who are not symptomatic, which would mean that the mortality rate was lower than otherwise thought; or whether the significant measures that the Chinese have taken are having a significant effect, and that therefore, as and when they are lifted, the virus will continue to spread. Either of those options is possible, and we do not know which one it is, but whichever it is, the approach that we are taking in the UK is the right response to both of those scenarios.

Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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There seems to have been some media confusion in reports that the move from the contain phase to the delay phase will involve an instant flick-of-the-switch moment. Will the Secretary of State assist us by confirming that that is not the case and that any move will involve a phased transition? Another area of particular vulnerability is the UK prison system, which is extremely short-staffed and stretched. What measures will he be taking following reports of riots and deaths among inmates in Italy’s prisons to ensure that our prisons remain under control during what will be a period of heightened tensions and frustrations as restrictive measures are introduced? Will he also confirm that he is aware of the latest workplace advice from Health Protection Scotland, which was published today and which urges routine cleaning of phones and keypads and says that food should not be left open for people to share? Will his Department be making a similar recommendation for England?

Matt Hancock Portrait Matt Hancock
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The hon. Member is absolutely right to suggest that the transition to the delay phase is indeed that: it is a transition. We will not give up hope of containing this disease while we can still take containment actions, and many of the actions that are needed to contain it are also effective for delaying. Of course, the primary action is that everyone should wash their hands, but there is much more than that. He asked about the advice from Health Protection Scotland. We are working very closely with HPS, and Public Health England will shortly be bringing forward further updated guidance that we have been working on over the weekend, not just on social care, as I mentioned earlier, but more broadly, including for businesses, employees and others.

Nursing Workforce Shortage: England

Martyn Day Excerpts
Tuesday 3rd March 2020

(4 years, 2 months ago)

Westminster Hall
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Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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It is a pleasure to serve under your chairmanship, Ms McDonagh. I am grateful to the hon. Member for Bedford (Mohammad Yasin) for securing this debate today, and also grateful for his summary of the issue. He is correct to say that the growth in nursing numbers is nowhere near enough. I agree with him on the importance of investing in the NHS and the nursing workforce.

I am also grateful for the work of the Royal College of Nursing in highlighting the issue, including the recent petition with more than 200,000 signatures that was presented to the Prime Minister in February and called for action to remedy the staffing shortages as a priority. We know that there are some 40,000 nursing vacancies in England, and one in three nurses are due to retire within the next 10 years. In Scotland, of course, this issue is devolved, and in normal circumstances I would not interfere in a debate focused on the issue in England. However, devolved Administrations do not operate in a policy vacuum. UK policies, such as those on Brexit and immigration, affect all parts of the UK, so I will contribute to the debate today. Nor do I feel alone in this matter as several of my Celtic cousins have already spoken in the debate, and the issue benefits from hearing about what happens in Northern Ireland, Wales and Scotland.

NHS Improvement reported in September last year that the latest nursing vacancy rate in England stood at 12.1%. Information Services Division statistics show that NHS Scotland’s nursing and midwifery staff vacancy rate was 6% in the same month. Qualified NHS nursing levels per head are already 46% higher in Scotland than in England. For nursing levels in England to match Scotland’s, they would need to increase nursing numbers by more than 130,000. That puts the 50,000 nurses that were promised for England into a certain context. Consequently, there may be lessons we can learn from how each of the four national health services operate, and I hope my observations on the differences between the two countries’ nursing numbers are seen as constructive and helpful.

NHS staffing per head is 26 staff per 1,000 people in Scotland, whereas England’s is 19.7. Those figures are from September and August last year—I could not get the months to match, but it sets the pattern. There are more qualified nurses and midwives per 1,000 of the population, with 8.1 whole time equivalents in Scotland versus 5.5 in England. Why is that? The number of people in Scotland choosing a career in nursing is increasing, and bursaries are undoubtedly one reason for that. Bursaries for student nurses in England were scrapped as part of the Tories’ austerity measures, a policy that led to a drop of more than 30% in nursing applications. In stark contrast, those bursaries were protected and increased in Scotland by the SNP Scottish Government, and nursing student numbers in Scotland have increased for seven years in a row. One of the big differences is that in Scotland, nurses will receive a bursary of £10,000 a year from next September, and already benefit from free tuition. The UK Government pledged a £5,000 annual grant for student nurses from this year—only half of what we are offering in Scotland—and still expect nursing students who train on the job to pay thousands in tuition fees. I believe that figure in England is around £27,750, a stark contrast to the figure in Scotland, which is zero.

Nurses in Scotland across all bands are better paid than elsewhere in the UK, which also helps to make nursing a career choice and benefits retention. Training more nurses is key to addressing this issue. The latest UCAS figures show a 2% increase in people from Scotland choosing nursing as a career, but a decrease of 4% in the English figures. Meanwhile, a report last year by the Nuffield Trust, the Health Foundation and The King’s Fund concluded that the NHS in England has no chance of training enough GPs and nurses to solve the shortages it faces. This suggests that in order to address the current and future shortages, we need to look elsewhere.

That leads me on to the topic of immigration. EU nationals make up 10% of the medical workforce, and we should be concerned about the insight into their mindset provided by the 2018 British Medical Association survey of 1,527 EEA-trained doctors across the UK, which found that 35% were considering moving abroad. Of course, only time will tell what actually comes to pass. However, immigration to the UK has fallen to its lowest level in six years according to the Office for National Statistics, and Cambridge Econometrics’ analysis states that leaving the single market will see the working-age population fall by nearly 2% by 2030, which is equivalent to 790,000 people.

The challenges with recruitment are not going to get any easier. On 15 November, the King’s Fund, the Health Foundation and the Nuffield Trust predicted that NHS England staff shortages will rise to over one in six health service posts by 2030. Clearly, we must attract skilled workers from abroad, but the UK Government’s regressive immigration plans look set to make the situation worse. At this time, details of a UK NHS fast-track visa scheme remain unclear, and I look forward to hearing those details; perhaps the Minister will enlighten us. With regard to the proposed points-based immigration system, I assume that nursing will be classed as a shortage occupation, which would require a £20,480 minimum salary. I believe it must be on the shortage occupation list, but also that it should be exempt from any salary threshold. The Library briefing for today’s debate gives us the RCN’s opinion of the points-based system:

“We are concerned that these proposals from the Government will not meet the health and care needs of the population. They close the door to lower-paid healthcare support workers and care assistants from overseas, who currently fill significant numbers of posts in the health and care workforce.”

I also echo their calls for the introduction of an immigration system that supports nursing, and to exempt nursing staff from the immigration health surcharge, which seems an unnecessary burden to put on people coming here to relieve our own health crisis.

I will finish with a quote from the RCN’s general secretary, Dame Donna Kinnair, who has said that there are

“43,000 vacancies in the NHS in England alone. Yet failure to increase nurse numbers isn’t inevitable, but a political choice. We need proper financial help for nursing students in every nation of the UK in order to ensure the supply of nurses in the future, and clear legal duties for governments and NHS leaders across the UK to ensure there are enough nurses to provide safe care to patients.”

It is indeed a choice, and I hope that my Scottish comparisons and views on immigration help to inform the choices facing NHS England.

Social Care

Martyn Day Excerpts
Tuesday 25th February 2020

(4 years, 2 months ago)

Commons Chamber
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Martyn Day Portrait Martyn Day (Linlithgow and East Falkirk) (SNP)
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It is a pleasure to take part in today’s debate on social care. As we know, social care covers all forms of personal and practical help for children, young people and adults who need extra support. It covers services such as care homes and other types of help, including supporting unpaid carers.

The Conservative manifesto contains one expensive pledge on the future financing of social care, saying that

“nobody needing care should be forced to sell their home to pay for it.”

It seems to me that the Conservatives have a large hole in their manifesto costing, which would imply additional tax increases, more borrowing or public spending cuts elsewhere. It remains to be seen what comes to pass.

Social care is a wide-ranging topic and in Scotland it is of course devolved. We are proud of what we have achieved in Scotland and what we continue to achieve using our devolved powers. All four UK national health services face many of the same challenges of increasing demand, workforce shortages and tight finances, but the NHS in England has of course faced almost a decade of unprecedented austerity. In Scotland we do some things differently from the rest of the UK. For example, the Scottish Government spend 43% more per head on social care. We are the only country in the UK with free personal care, which we recently extended to all under-65s who need it, and that now benefits nearly 80,000 people, including more than 10,000 self-funders in care homes. It gives people peace of mind and security. That is not without cost and challenges, but it helps to reduce delayed discharges and it reduces emergency admissions, and on balance it is estimated to be cost-effective. The Scottish experience would certainly support the call for the UK Government to bring forward plans for free personal care elsewhere in the UK.

Despite UK Government cuts to the Scottish budget, in Scotland we are continuing to invest in social care and integration, and the integration is one of the most significant reforms since the creation of the NHS. Of course the devolved Administrations do not operate in isolation and policy decisions from Westminster continue to have an impact on social care. Brexit, for example, is going to be potentially catastrophic for the Scottish social care sector, and while we remain within the Union it will impact upon us.

The Expert Advisory Group on Migration and Population report warns of the damage that ending free movement will inflict on social care in Scotland, saying

“the overall reduction in EU immigration would be especially challenging for those sectors most reliant on lower-paid, non UK workers, including occupations such as”—

you’ve guessed it—

“social care”.

Lisa Cameron Portrait Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
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My hon. Friend is making an excellent speech. Does he agree that we must realise and champion the great skills that social care workers have? It is not about earnings in this case; it is about our gratitude to them for looking after some of the most vulnerable people in society, and that should be recognised by Government.

Martyn Day Portrait Martyn Day
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I agree wholeheartedly with my hon. Friend: we cannot put a price on the care that people get.

To return to the expert advisory group report, it said that in the social care example, reduced migration could adversely affect female family members who themselves are most likely to exit the labour market to cover gaps in care provision that would have otherwise been delivered by a migrant workforce.

In the last Parliament my hon. Friend the Member for Argyll and Bute (Brendan O'Hara) lobbied the UK Government to evaluate the effects of EU withdrawal on the health and social care sectors through his private Member’s Bill. No fewer than 102 third sector organisations, trade unions and charities have publicly supported the measures in the Bill, and more recently the UK Government have made it clear that they will not commit to aligning with EU standards or accept the jurisdiction of the European Court of Justice. Addressing the Scottish Parliament’s Culture, Tourism, Europe and External Affairs Committee, Cabinet Secretary for the constitution, Michael Russell, said:

“this would result in new barriers to trade and exports, a fall in national income compared to EU membership and damage to social care and the NHS.”

The SNP Scottish Government will be introducing a new continuity Bill to the Scottish Parliament soon, which would make it easier to align with future EU standards in such areas as the environment and human rights.

David Linden Portrait David Linden (Glasgow East) (SNP)
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My hon. Friend is making an excellent point about the fact that things are different in Scotland because we have the ability to make some different decisions, and of course the Scottish Government have had a focus on preventive spending, which is largely why we are in this situation. Does my hon. Friend agree that unless the UK Government seriously acknowledge the need for regional variation in terms of immigration policy, all that work in terms of preventive spending will mean more problems for us down the line in 20 or 30 years’ time, and if the UK Government are to be so pig-headed about it they should devolve the powers to the Scottish Parliament?

Martyn Day Portrait Martyn Day
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I fully agree with my hon. Friend, and he has read my mind as that is exactly the point I was coming to in my speech.

The Home Office proposals for a new points-based immigration system will be hugely damaging to the social care sector in Scotland. The UK Government have reneged on their promise to deliver an immigration system that works for the whole of the UK: it does not work for it at all. Scotland needs people to contribute at all levels of the economy in vital, challenging roles in social care and elsewhere.

The Expert Advisory Group on Migration and Population reports that

“less than 10% of those in caring personal service occupations in Scotland earn above £25,000”.

The Nuffield Trust advises that

“the proposed new migration system will soon bar people from coming to the UK to work in most frontline social care jobs, even if these are defined as a shortage occupation”

where the proposed lower minimum income limit of £20,480 far exceeds the average salary of a full-time private sector care worker, which in the UK is £16,200 per year. I am pleased that the Scottish average is higher than that, but it still falls far short of that income criteria.

The UK Government’s supposition that people working in social care are “low skilled” is, quite frankly, offensive. We value all those who contribute to our economy and society and they are welcome in Scotland, wherever they come from. The UK Government have ignored the evidence presented to them by the Scottish Government, businesses and industry on Scotland’s labour market needs. Donald Macaskill, chief executive of Scottish Care, told BBC Radio Scotland:

“This immigration proposal, far from enhancing the economic wellbeing of our country, will put a lot of the care sector, a lot of hospitality and other sectors in Scotland at considerable risk.”

He went on to add:

“What is low-skilled about a worker being with somebody at the end of their life, or somebody giving comfort to an individual with dementia?”

Those are sentiments I am sure we could all agree with.

I am in no doubt that social care will be damaged by the proposed immigration proposals, not least because a significant proportion of social care workers are from Europe. If we are to fix the problems of social care workforce shortages, we need an immigration system that is fit for the purpose. With existing workforce shortages added to the pressure to recruit, which is going to become harder as a result, combined with the number of Scots over 80 with social care needs set to increase by 68% by 2036, we face a very serious challenge. If the UK policy does not meet our requirements, then at the very least Holyrood must be given the powers to develop a separate Scottish visa to protect our public services and our economy. Of course, what we really need are the normal powers of independence.

None Portrait Several hon. Members rose—
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