Health Committee

Philip Boswell Excerpts

Thursday 16th March 2017 Commons Chamber

[Dr Wollaston]

I commend the work my right hon. Friend has done over her whole career on autism and to highlight what more can be done to help those individuals and their families. She will know that one of the key barriers is having an assessment in the first place for people who suffer from autism. Too often, they fall between the gaps in mental health services. My key message would be that we must ensure that they receive the services and support that they need and that that is delivered in the right way.

[Philip Boswell (Coatbridge, Chryston and Bellshill) (SNP)]

I congratulate the hon. Lady on bringing this critical issue to the House and I fully support the report. I declare an interest as the patron of Chris’s House, a centre for help, response and, critically, intervention on suicide, and the first 24-hour interventionist suicide support service in Scotland. We set up the centre to offer a safe environment in which people in crisis may have respite from their current unwellness. They can find refuge in Chris’s House and receive an individually tailored programme to offer support and respite throughout their journey to wellbeing. I urge others throughout the UK to look at this more interventionist model and replicate it to the benefit of all UK citizens. I further urge as many people as possible to join us in our Walk of Hope on 6 May 2017 in Glasgow, as we walk from darkness to light to raise awareness about suicide prevention.

[Dr Wollaston]

I thank the hon. Gentleman for his contribution and join him in paying tribute to voluntary groups throughout the country that are doing extraordinary work to reach out to people in crisis. As he will know, the level of variation in support is a key issue, along with the financial challenge faced by people around the UK who are trying to provide proper support.

National Arthritis Week

Philip Boswell Excerpts

Thursday 20th October 2016 Westminster Hall

[Philip Boswell (Coatbridge, Chryston and Bellshill) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Betts. I thank everyone who has contributed to this important debate. Arthritis is a disease that affects many; most people know personally someone who suffers from it. I particularly thank the hon. Member for Strangford (Jim Shannon) for bringing this important issue and debate to the House.

The hon. Gentleman mentioned some of the good work carried out in Scotland. One initiative that is worth mentioning is self-referral for physiotherapy. A multi-centre national trial involving 26 general practices and 3,000 patients in Scotland identified that an average episode of care was more cost-effective when it followed self-referral for physiotherapy than when it followed GP referral. That equated to a saving of 25%. If the initiative was rolled out across Scotland, it would provide an average cost-benefit of £2 million a year. I hope that the Minister is listening.

A common misconception about arthritis is that it is a disease that primarily affects older people—something touched on by hon. Members in the debate. Arthritis affects people of all ages and takes many forms, a number of which, such as rheumatoid arthritis, can begin at a very young age—again, that was highlighted by the hon. Member for Strangford. Many individuals in the working-age population face the prospect of managing this long-term degenerative illness while in employment. Arthritis is not always a visible condition, and the prevalence of the disease among the working population can easily be underestimated.

In fact, according to Arthritis Research UK, musculoskeletal disorders are the most prevalent diseases in the UK working population. Worryingly, the statistics indicate that not enough is being done by employers to support employees affected by these conditions. It may be surprising to many people, but musculoskeletal problems cause the greatest number of working days lost; 30.6 million working days are lost each year. Back pain alone costs the economy about £10 billion a year.

Unfortunately, due to a lack of support, only just under 60% of people of working age with arthritis are in work. However, the responsibility to support those with arthritis lies not only with employers, but with the Department for Work and Pensions and the wider UK Government. The role that this Government must play in assisting those with arthritis and other musculoskeletal disorders in the workplace has become even more important with the growth of the gig economy and the prevalence of those who are self-employed, a large portion of whom are not self-employed by choice.

I have one constituent, whom I will not name, whose story is incredibly pertinent to the debate. My constituent was diagnosed with rheumatoid arthritis at the age of 14. For those who do not know, three quarters of people with rheumatoid arthritis are of working age when diagnosed. Two years after onset, one third of those diagnosed will have stopped working. Within 10 years, half are unable to work. The Disability Discrimination Act 1995 requires employers to make provision for employees with disabilities and long-term conditions. However, my constituent does not have an employer because he is self-employed. As I said before, this is not through choice, but from necessity, given the increased flexibility seen in the workplace over the past few years—by flexibility, I mean the mechanisms implemented for the erosion of workers’ rights that is so prevalent in our society today.

As my constituent is self-employed, he does not have the same protections as those who work for traditional employers. He cannot take time off work, as that would directly affect his income. He is not entitled to sick pay, and often finds himself having to work despite flare-ups. As he is a joiner—a job that is much more physical than others—he is particularly affected during a flare-up; even something as simple as driving to a job can be a struggle. However, he enjoys his work, has invested his career and a number of years in building up his skill set and, in addition, has a family to provide for and simply cannot afford to retrain for a different role. In many ways, he is stuck between a rock and a hard place, and he has both my sympathy and my full support.

The UK Government are not just failing to support those who are self-employed; there are also substantial failings in support for those employed in a traditional sense. As I am sure many of us here can attest, numerous constituents come to us for help because they have their personal independence payments unfairly stopped or reduced after assessments. This is of particular concern for those who struggle with arthritis, which is very much an invisible disability—a point touched on by the hon. Member for Neath (Christina Rees). In addition, symptoms can fluctuate in severity, which can make an accurate assessment of the impact of the disease difficult in a time-restricted interview setting. In a recent survey, almost three quarters of people with musculoskeletal conditions who had a face-to-face work capability assessment said that they did not feel that they had received sufficient support to help them get back to work. Clearly, more action needs to be taken.

In summary, no one should have to take redundancy because of a lack of support for a manageable long-term illness. I look to the Minister and his Government to do more to support arthritis sufferers. Let us see whether there is indeed such a thing as a caring Conservative. The test will be in the action of the Government, rather than the words of their spokesperson.

--- Later in debate ---

[David Mowat]

I thank the right hon. Gentleman for his intervention. The fourth division of the Liverpool Shipping league is probably a higher division than I played in during my very short football career.

Due to the time, I will not refer to every speech. The Scottish National party spokesman, the hon. Member for Linlithgow and East Falkirk (Martyn Day), talked about what Scotland is doing on managing obesity and chronic pain. I would like to see England learning more lessons from Scotland’s health system; and, I humbly suggest, vice versa—I also include Wales in that. Health is devolved and we are beginning to do things in different ways. Sometimes things will work well, and sometimes things will work less well. One of the highlights of these debates is to hear what happens in other nations, and those remarks are interesting.

The shadow Minister also gave a good speech. She talked about budgets and health spending, particularly public health spending—she has now been able to tell two Health Ministers about that issue—and it is true that the public health budget was cut. The UK spends above the OECD average on health and adult social care, which has not always been the case. We are not the highest spender—we spend 9.9%, but France and Germany probably spend about one percentage point more—but we are above the OECD average. It matters very much how effectively we spend that money. There are always decisions to be made, and those decisions are sometimes difficult.

What are we doing? I will not be able to answer all the points in great detail other than to say that MSK is a priority because it is so important. MSK is one of the national programmes within NHS England, and in 2013 we appointed a clinical director, a gentleman called Peter Kay, who is running a £5 billion programme covering a number of areas and seven strands of work, which I will briefly run through.

First, we need to ensure good awareness of the signs and symptoms of MSK. That is about public health and things such World Arthritis Day and the UK “Share your Everyday” campaign. It is also about the important Public Health England activities that we have heard about. We ran a successful public health campaign on arthritis last year, and we need to maintain that pressure.

Secondly, we need high-quality clinical guidance to diagnose and manage the disease. Thirdly, we need to provide holistic care, support, and planning in partnership with patients. Fourthly, and this is important, we must spread best practice across the NHS—I would go further and talk about spreading best practice across the health systems of all the Administrations within the UK. Fifthly, we have heard a lot today about the benefits of physical activity for MSK patients, notwithstanding some of the issues experienced by the hon. Member for Neath and the right hon. Member for Knowsley. Fitness and exercise are of course a preventive measure for nearly everything, particularly for MSK diseases.

Penultimately, we need to do more to enable people to remain in work and to return to work. Finally, we need to invest in research. Those are the seven streams of activity, and I will talk a little about the one that has been spoken about most this afternoon, which is what we are doing to keep people in work. As I said, the points about DWP and PIP were well made, and I will see that that is reflected to DWP Ministers.

[Philip Boswell]

I am delighted to hear about the open door to Arthritis Research UK, which has been excellent in championing the rights of arthritis sufferers, preventing the onset of arthritis, developing a cure for arthritis and transforming lives. Arthritis Research UK’s work is considerable, and it is worthy of our support. I thank the Minister for his words and his initial actions.

[David Mowat]

I thank the hon. Gentleman for those words. It occurs to me that I have to give the hon. Member for Strangford time to say a few words at the end. I will write to Members about the various specifics that have been raised. I will now sit down and allow him half a minute or so. I apologise for there being so little time.

NHS Spending

Philip Boswell Excerpts

Wednesday 6th July 2016 Commons Chamber

[Joan Ryan]

The lack of primary care—particularly in London but also elsewhere—is a key factor behind the huge pressures on our accident and emergency departments and urgent care. No wonder people go there when they cannot get an appointment.

[Philip Boswell (Coatbridge, Chryston and Bellshill) (SNP)]

It takes four years to train a nurse and five years to train a doctor, but the divorce proceedings triggered by article 50 will be done in two years. It clearly presents a critical problem for NHS funding if staff leave when the UK leaves the EU.

[Joan Ryan]

As we have heard, Brexit will present us with many problems, particularly with health care provision. Not only are we not getting large sums of money, but we will actually be worse off. We will face many challenges because of that decision, and if the promise of £350 million led people to vote in a particular way that will undermine the funding we receive, that is a desperate state of affairs.

People feel badly let down by the leave campaign’s empty pledges on the NHS over the past few months, and residents in Enfield are deeply disenchanted by the Government’s failure to fulfil their recent promises to our local health service. Before the 2010 general election, the then Leader of the Opposition—actually, he was then Prime Minister of the coalition Government—stood outside Chase Farm hospital in my constituency and vowed to protect its A&E and maternity units. By 2013, his Government had shut both departments. Many of us warned at the time that closing Chase Farm’s A&E department would put huge strain on other local health services, including North Middlesex University Hospital NHS Trust, which is the subject of the CQC report that I referred to earlier. We were right, and almost three years since the decision to close Chase Farm’s emergency department, the NHS in Enfield has reached breaking point.

Earlier today the Care Quality Commission published its report into the standard of care at North Middlesex hospital, following a spot check by its inspection team in early April. It found that the closure of Chase Farm’s A&E has led to significant increases in patient numbers attending the emergency department at North Mid. Despite being one of the busiest A&E departments in the country, North Mid’s urgent and emergency services have been graded as “inadequate”, and patient safety has been compromised. Patients who arrive at the emergency department are not seen quickly enough by clinical staff, and they are waiting too long to be seen by a doctor. Some blue-light patients are being brought in, and hard-pressed nurses are dealing with them because no doctor is free to treat them.

Green Investment Bank

Philip Boswell Excerpts

Thursday 29th October 2015 Westminster Hall

[Mr Wright]

I thank the hon. Lady for her remarks. I wonder whether she agrees that, in future, state-backed development banks will be part of a modern, innovative, dynamic economy. The UK is unusual in that we are the only one of the G7 countries without such a financial institution. Ensuring that the state, through a development bank, can drive forward the innovations and technologies of the future is the hallmark of a modern, successful and prosperous economy. It is madness that we are moving away from that model; we need to accelerate towards it and concentrate our efforts.

The bank has achieved so much in such a short period of time and it has the potential to achieve much more if its scale is expanded. The move the Government propose, given the bind they find themselves in, means that the privatisation is fraught with risk. It will compromise Britain’s environmental credentials and any ambition we should rightly have to lead global commercial and industrial opportunities in the new, low-carbon economy.

[Philip Boswell (Coatbridge, Chryston and Bellshill) (SNP)]

rose—

--- Later in debate ---

[Philip Boswell (Coatbridge, Chryston and Bellshill) (SNP)]

Thank you, Mr Crausby. I also thank the previous speakers for their contributions to the important debate, which highlights the importance of providing capital in renewables. I share many of the concerns expressed by the hon. Member for Hartlepool (Mr Wright), but I will focus on more local issues pertaining to the Green Investment Bank.

The bank in its initial form represented not only a vote in confidence in Scotland, but an investment in the future of our country and its people. Scotland was chosen as the location for the Green Investment Bank for a variety of reasons, the first being that as it was to be located in Edinburgh, which has 11 universities within an hour’s drive, an abundance of academic knowledge and research would be available to it.

It is worth highlighting that Scotland potentially has a wealth of green energy. The Vivid Economics report for the Department for Business, Innovation and Skills in October 2011 emphasised the need to ensure that green economic policies were implemented in practice to unlock financial capital.

The whole point of locating the Green Investment Bank in Edinburgh, and vitally in Scotland, was the need to assist a necessary change in approach to develop low-carbon energy projects. The requirement for a green investment bank is more relevant now than when it was created. The development of green energy will make the economy capable of resisting the volatility associated with commodities, which can create price instability in the energy markets. Promotion of growth for the sake of growth can lead to boom and bust, so what is clearly needed is growth that is sustainable in nature, thereby ensuring longer term economic growth. The investment made by the Green Investment Bank in Edinburgh as a financial centre, with its expertise in asset management together with the factors associated with a highly skilled workforce, is now at risk due to the privatisation agenda.

It could be argued that one of the first acts of the new UK Conservative Government was to privatise the bank. That in and of itself not only creates a degree of market flux and instability, but shows that ideology overrules all other considerations. The Green Investment Bank has been marginalised. Its privatisation runs contrary to the principles of Vince Cable’s period in office at the Department for Business, Innovation and Skills.

[John Mc Nally]

I apologise to the House because earlier on I should have declared an interest in that a relative is associated with a company that represents the Green Investment Bank. Does my hon. Friend acknowledge that Edinburgh in particular was recognised by Vince Cable as a centre of excellence for the development of green energy? That was confirmed yesterday when the bank’s chief executive said that it wishes to keep its headquarters in Edinburgh because of the quality of its staff and their commitment to the green energy programme.

--- Later in debate ---

[Philip Boswell]

I thank my hon. Friend for his intervention. I agree that it is vital not to view the bank in the abstract. Exactly as he said, its set-up was a vote of confidence in Edinburgh as a financial centre of note. In addition, it employs people from Edinburgh.

In respect of future green energy investment, the privatisation as currently outlined is a backward step that fails to recognise why the bank was set up in the first place, namely that mainstream financial institutions have not delivered green energy projects. The privatisation of the Green Investment Bank is cloaked in commercial confidentiality, as is the nature of such financial transactions. Having said that, it was confirmed to me in a ministerial answer that UBS has been advising the Green Investment Bank about the transaction. Though UBS is a highly regarded investment bank, it would be remiss not to state that it has had issues when it comes to adhering to strict financial regulations. This month alone it was fined $17.5 million for failing to comply with Securities and Exchange Commission regulations.

As stated previously, there were particular reasons why Edinburgh was chosen as the location for the Green Investment Bank. An excellent campaign was run by the Edinburgh chamber of commerce, and the bank was established there to build on the already good work undertaken in terms of asset management and the development of a key financial hub. The UK Government must recognise that other financial centres need to grow, not just the City of London. Edinburgh is that second hub.

The future is bright for green investment. One only has to look at the trends in other European countries. Denmark has a history of investing in offshore wind farms, with two pension funds taking a 50% financial stake in them worth $1.1 billion. This year, there has been a €2 billion investment in a Danish renewable energy fund and there is a €16 billion investment by a Dutch healthcare investment fund that aims to increase its green investments by 2019.

UK pension funds need to get active in clean energy, not just for the sake of the environment, but because investment in green energy is expected by many to provide greater returns on investment than fossil fuels. That is highlighted by the fact that there has been divestment from fossil fuels in pension funds throughout Europe. Swedish pension fund Fjärde AP-fonden—the fourth Swedish national fund—worth $40 billion, recently completely divested from fossil fuels. Mats Andersson, its chief executive officer, recently stated:

“We did it because we want to get better returns. There’s a misconception that there’s a conflict between sustainability and long-term investing. We believe it’s a return enhancer.”

I do not necessarily advocate that approach completely, but where financial trend analysis is going is clear. We must protect the future viability of our pension investments and our children’s future.

The hon. Member for Beverley and Holderness (Graham Stuart) spoke about the Green Investment Bank delivering affordable bills. That gives me an in on fuel poverty, which is critical, because one of the bank’s goals is to reduce it. The Scottish Government have designated ending fuel poverty as a clear policy objective—recent statistics have shown that 40% of households in Scotland are considered to be living in fuel poverty—but more must be done at the UK-wide level.

The effects of fuel poverty reach far beyond being unable to keep the heating on. According to a report by Friends of the Earth, children living in cold homes are more than twice as likely to have respiratory problems, and adolescents living in cold homes are five times more likely to have multiple mental health problems, as those living in warm homes. Fuel poverty means that household income that could otherwise be used to purchase healthy, nutritious food is used to pay energy bills. It has far-reaching consequences right down to the ground. This is not just about banking and investment or Government decisions. It affects real people on a day-to-day basis. If we do not get this right, it will have a negative impact on children’s emotional wellbeing and educational attainment.

The combination of mental and physical health problems, poor diet, emotional turmoil and diminished educational attainment caused by fuel poverty is a recipe for condemning people to the cycle of poverty—in essence, they are poor and paying for it. Forty per cent. of households in Scotland face the consequence of fuel poverty every winter. Tackling fuel poverty must therefore be a key factor in any consideration of the growth potential of the Scottish energy industry. Ending fuel poverty goes hand in hand with using fossil fuels more efficiently and moving towards enhanced use of renewable energy.

Scotland has one tenth of Europe’s wave potential and a quarter of its offshore wind and tidal potential. In 2010 the eventual income of direct sales from the North sea’s electricity potential was valued at £14 billion, but if that potential is to be reached, there must be investment. The Green Investment Bank was a leap forward for investing in the future prospects not only of the renewables sector but of the people of this country, as that necessary investment was not being made by the private sector.

[Caroline Lucas]

The hon. Gentleman is making a strong case. Does he agree that there is a real irony that at the same time as we are talking about privatising the Green Investment Bank, many other countries are looking at it as a wonderful model to go forward with? China is particularly interested in following exactly our model. If the UK wants to remain a centre of green finance, it absolutely has to keep this kind of model.

[Philip Boswell]

The hon. Lady is absolutely right. If it’s not broke, why are we fixing it?

Moreover, privatising the Green Investment Bank will put future investment in the vital emerging renewables market in jeopardy. The privatisation is one in a long and growing line of actions taken by the Government which hinder renewable growth and investment. That is not the future that most people in these islands want for themselves and for their children.

--- Later in debate ---

[George Freeman]

No, I do not accept that. The hon. Lady’s party is committed to promoting green technologies and investment, but I do not think her insistence that the sector is in decline will be encouraging for investor sentiment. We all have a duty, whatever our policy differences, to contribute to confidence in the sector.

[Philip Boswell]

The Minister talked about the Government promoting green energy; but there are wind and solar energy subsidy cuts. I was Shell’s contracts lead on the carbon capture project, moving it from Longannet to Peterhead, and with the way things are going I am waiting for a backtracking announcement on that. The Green Investment Bank is a unique British success story, still in its infancy and much admired around the world. Does the Minister agree that privatising it is an exercise in blind ideology, and that it ignores common sense?

[George Freeman]

The hon. Gentleman has made his point eloquently. Not surprisingly, I do not agree, and I will explain why. Perhaps I can just say something about the rationale for the move.

Several hon. Members have asked why the Government want to move the Green Investment Bank into private ownership if it is already so successful. One or two said, “If it ain’t broke, don’t fix it.” I want to explain why it ain’t broke, and why we want to allow it to go on and succeed. Moving the bank into private ownership is the natural next step for the company, now it has proved itself to be a successful commercial enterprise making a strong rate of return on its investments. We want it to be able to grow and develop its balance sheet, get access to private capital markets and borrow, none of which it can do at the moment, as a public sector entity. It is because we want it to flourish that we want to give it those freedoms.