Health and Social Care

Patrick Grady Excerpts

Monday 27th February 2017 Commons Chamber

[Patrick Grady (Glasgow North) (SNP)]

I do not intend to detain the House for desperately long. The debate has been filled with trepidation and anticipation as Members, and perhaps the wider public, wait to see whether the House will actually debate any of the estimates before us. To pay tribute to hon. Members, we have not done too badly. The estimates document, HC 946—all 748 pages of it, at three and a half inches thick—and the Order Paper give us an estimate of £8,716,216,000 for the NHS. That takes up pages 137 to 151 of the document, but the only line that actually includes expenditure for health and social care is for the

“Health and Social Care Information Centre (known as NHS Digital)”

on page 151, which has £151 million of resources. That might have made for a considerably shorter debate, if hon. Members had not used their ingenuity to quite the extent they have.

We have debated the 10 detailed reports from the Health Committee and the Public Accounts Committee. I congratulate the Chairs of those Committees on securing time from the Liaison Committee, but even that raises the question of why 10 reports are squeezed into a three-hour debate that is supposed to be about supplying the Government with the resources needed. I congratulate the Committees on securing that time, but perhaps those reports ought to have had more time to themselves.

The NHS is one of the biggest areas of Government spending, second only to pensions. Adequate funding of aspects of the NHS is a constant major feature of political discourse, as it has been today, but there are no means to seek to amend any of this in any meaningful way through the estimates process. All we can do is table amendments that might lower the amount, but the theme of the entire debate seems to have been that the NHS in England needs more money, not less. Of course, any change to the NHS budget in England has some sort of Barnett consequentials in Scotland. I wonder whether, at any point today or anywhere in the Supply estimates book, we can find out what those are. I suspect we cannot.

Nevertheless, a number of important points have been made. The Chairs of the Public Accounts Committee and the Health Committees spoke in detail about the different budget lines and departmental spending lines and about the important long-term consequences of the transfers from the capital budget to the revenue budget. The hon. Member for Newton Abbot (Anne Marie Morris) spoke about the need to ring-fence certain lines. The hon. Member for Colne Valley (Jason McCartney), who is no longer in his place, made important points about the disaster that PFI has been in the health service, and that is true north and south of the border.

The hon. Member for Bishop Auckland (Helen Goodman) rightly asked where the £350 million a week for the NHS was. It certainly is not in the Supply documents brought to the House by the Government today. There is, in fact, a systematic underfunding of the NHS in England under this Tory Government, and that has serious implications for the NHS across the UK as a whole. As we have heard from Members on both sides of the House, that environment will only become more challenging as the population ages and demographics continue to change.

The Scottish Government, as I am sure we will hear from my hon. Friend the Member for Central Ayrshire (Dr Whitford) on the Front Bench shortly, are focused on these challenges and on building a health service that meets the demands of the 21st century. They are not just investing in the NHS but reforming it—integrating health and social care, and engaging with communities and the medical workforce, to bring about sustainable and positive NHS reform, as opposed to pressing ahead with the hasty cost-cutting exercises that seem to be the priority of the Tory Government.

However, perhaps it suits the Tory Government to have an NHS that is in the crisis described by Labour Members, because that gives Ministers an excuse to bring in private capital and private management and to outsource services to private providers. That, in turn, would have major consequences for the NHS budget in England and consequentials for the devolved budget, which brings us back to the inadequacies of the estimates and Supply process in this House.

The former Leader of the House promised us that these Supply days and estimates days were our chance to scrutinise the Government on things that we were otherwise excluded from during the English votes for English laws processes.

[Mr Speaker]

Order. May I just very gently say to the hon. Gentleman that he is a distinguished ornament of the Procedure Committee, which has deliberated upon this matter? The question of the character of debates on the estimates has been, at this point, decided by the House, and the hon. Gentleman should not use his opportunity to speak in this debate, which he should guard jealously, to dilate on his disapproval of the process. What he ought to do is to focus on the subject which has been chosen. [Interruption.] It is no good him grinning at me like a Cheshire cat—I trust that that means that he is acquiescing in the judgment that has been reached. We always look forward to the mellifluous tones of the hon. Gentleman, but they should focus on the subject that we have chosen and not on that which he would prefer to have been chosen.

[Patrick Grady]

Indeed, Mr Speaker. I do not intend to detain the House very much further. What I have been trying to demonstrate is how the health and social care budget in England and Wales affects the health and social care budget north of the border and the overall Scottish Parliament budget. We have precisely proved the point that we do not have the appropriate opportunities to scrutinise those things in this debate, so the Government have to live up to their promises, and then we will see whether they are prepared to allow Members of this House a proper say over spending on the NHS and social care or on any of the other budget lines or Departments included in the estimates.

--- Later in debate ---

[David Mowat]

I have given way to the hon. Lady once already, and I need to make some progress.

[Patrick Grady]

Some Conservative Back Benchers have suggested—not in today’s debate but at other times—that some of the 0.7% gross national income aid budget could be used to fund health and social care. Can the Minister confirm that the Government remain committed to that target? By reading out the proportions of GNI spent on health and social care, he has shown how small that budget is in comparison.

[David Mowat]

The 0.7% budget for overseas aid is not being discussed here today and it is not my ministerial or my Department’s responsibility. I am proud that we are one of the few countries in the world that meets that commitment, and many of the other countries among our EU partners that have been mentioned do not make that commitment. However, I shall not be diverted any further down that road today.

We have of course had a difficult winter in the NHS. We know that A&E targets are on about 86% rather than the 95% we expect; and ambulance targets are at 60% rather than the 75% we expect. As we have heard, delayed transfers of care—not “bed blocking”—have probably doubled over the past three years. In response, I make one point that I am always keen to raise in these discussions: we do not talk enough about cancer. There are cancer metrics, and we should be proud of the fact that NHS England, is meeting seven of our eight cancer metrics. The trend is towards meeting them more easily than in the past. We have heard quite a lot this evening about how well they are doing in Scotland. In fairness, to redress the balance that we have heard about in respect of A&E, I make the point that Scotland is doing somewhat worse than we are on those cancer metrics.