A Plan for the NHS and Social Care

Philippa Whitford Excerpts

Wednesday 19th May 2021 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

I rise to speak to amendment (i), which stands in my name and those of my colleagues. At the start of my speech, I wish to pay tribute to all health and social care staff, right across the UK, for everything they have done this past difficult year. Although there are real concerns about the rise of the Indian variant in multiple areas, we are all hoping that we can continue, slowly, to open up our society. Our attention is therefore now turning to patients who have been waiting many months for treatment or who have not yet even come forward with their health concerns. All four health services are working on recovery from the covid pandemic, and the Scottish Government have put in place their 100-day plan, to utilise some of the innovations used in the past year to increase the diagnosis and treatment of both elective and cancer patients.

However, the wellbeing and recovery of NHS staff must also be put front and centre, otherwise we will simply lose staff who are worn out. Especially after Brexit, the UK already faces workforce challenges. All NHS staff have worked above and beyond over the past 15 months, and the public have shown how much they value them, by clapping on their doorsteps and sticking rainbows in their windows. It has to be said that the derisory 1% pay rise for NHS staff in England is not exactly making them feel valued; you can’t spend claps in the supermarket. For NHS staff, this feels like a kick in the teeth. Many feel disrespected and are considering whether they will stay in their profession.

By contrast, in Scotland, where our NHS staff were already higher paid, they will get a 4% pay rise, the largest since devolution. Our nurses still get a bursary of £10,000 a year and do not pay tuition fees. That means that the Scottish Government invest £20,000 a year in every student nurse, so that they do not start their careers £50,000 to £60,000 in debt. NHS staff in Scotland have faced the same horrendous pandemic year, but we are trying to say thank you with a simple bonus of £500 and by focusing on their wellbeing and support services during recovery. The four national health services across the UK are not about hospitals or machines; rather, this is about the NHS staff who diagnose us, treat us and care for us, and now it is vital that we look after them so that they can recover.

There can be no NHS recovery without allowing staff to recover. It is only by supporting staff that they in turn will be able to look after patients and contribute to the huge task of treating those who have had to wait because of the pandemic and those who come forward now. Clearing the backlog of cases will take many months, but it will also require significant investment, yet the additional covid funding in England has already started to be removed since April. Although English trust debts were wiped last year and the NHS was told it could have whatever funding it needed, analysis by the King’s Fund shows that the core health and social care budget actually fell by £1.7 billion.

The main piece of health-related legislation in the Queen’s Speech is the health and care Bill, which, less than 10 years on, will repeal some aspects of the Tory-Lib Dem Health and Social Care Act 2012. It was that policy that brought me into politics. I had been following the proposals since 2011, in sheer disbelief that anyone could think that breaking up the NHS in England would somehow make it work better. Although I and others will be glad to see the back of section 75, which forced GPs to put services out to tender, this Government’s management of the covid response does not suggest that they are any less keen on outsourcing.

Exactly how commissioning will work is not at all clear, and that is causing concern for key community services such as dentistry and community pharmacies. Although the Secretary of State rightly highlights that prevention is better than cure, public health in England was decimated by funding cuts and reorganisation before covid hit and even went through further upheaval at the height of the pandemic. With regard to the White Paper and the Bill, the devil will be in the detail. Personally, I am concerned about how the United Kingdom Internal Market Act 2020 is reversing devolution, and particularly about how the procurement Bill might be used to undermine our integrated public NHS in Scotland.

Overall, it is easier to talk about what is not in the Queen’s Speech than what is. The most glaring omission is the long awaited social care Bill. That is in keeping with its complete absence from the Budget in March, but it is unforgivable. Not only has the pandemic highlighted the vulnerability of the social care sector, particularly those living in care homes; it also brought home to all of us the important role played by care staff, whether in care homes or looking after people in their own homes.

During the 2019 election, the Prime Minister claimed to have his fully prepared social care plan, but maybe he was mixing it up with the oven-ready Brexit deal that he was boasting about at the same time. Far from being ready to go, it has yet to see the light of day. Various Ministers have recently tried to blame delays on Opposition parties taking too long to sign up to a cross-party approach. Well, I have certainly never seen it, and I note that the shadow Care Minister, the hon. Member for Leicester West (Liz Kendall), has said the same. I do not know why the Government are finding it so difficult to make contact with us; our email addresses are all in the parliamentary directory.

We have not just been waiting since December 2019 or even last July; a Green Paper on social care has been promised since 2017—four years ago. During that time, social care in England has been allowed to wither on the vine, with the gap between what is funded and what is needed growing to between £8 billion and £10 billion. The Scottish Government spend 43% more per head on social care, which allows us to provide free personal care, letting people stay in their own homes for longer, which is something that all of us would prefer.

After the experience of the covid pandemic last year, the Scottish Government commissioned the independent Feeley review, which has proposed a human rights approach to social care—valuing and enabling participation in society, rather than always looking on care support as a burden. The report outlines the route to establishing a national care service, with Scotland-wide service standards, staff training, and national terms and conditions.

Another key element missing from this Queen’s Speech is any real detail about rebuilding a better society and economy than the one that was driving poverty and inequality before the pandemic brought life to a shuddering halt. We all know that we need a different economic model ahead of 2030 if we are not to burn or consume the planet. With the added economic damage of Brexit, it will take the investment of time, energy and money to recover from covid. We therefore have a choice about what kind of society we want to rebuild: one that exacerbates inequality or one that focuses on the wellbeing of everyone who lives here.

Wellbeing is not about healthcare or the NHS. It is much more than an absence of physical or mental illness. It comes from having a decent start in life, a warm and safe home, enough to eat, and fair opportunities at school and beyond. Scotland already has a broad range of wellbeing policies for all ages, from the baby box to welcome newborns, through to free personal care to support our older or vulnerable citizens. The Scottish Government are founders of the Wellbeing Economy Governments group with Iceland and New Zealand. They have already committed to a wellbeing and sustainability Act to ensure that every level of Government and every public body in Scotland puts the health and wellbeing of local people at the heart of all policy decisions.

We have seen the impact of covid on those in low-paid and insecure jobs, who, without decent sick pay, simply could not afford to isolate when they tested positive. Failing to properly support people to isolate has been one of the biggest mistakes in the UK Government’s covid response, yet we see no evidence that any lessons have been learned and no proposals for change. Where is the employment Bill that we heard about? Where is the plan to tackle child poverty, which has been driven up right across the UK since the first welfare cuts in 2012 and exacerbated by the benefit freeze and heartless policies such as the two-child limit and the rape clause?

There is nothing in this Queen’s Speech about genuine levelling up for the most vulnerable. That is just a slogan for blatant pork barrel politics. In Scotland, the Government pay the bedroom tax and are providing the Scottish child payment to help fight to child poverty, but more people are beginning to recognise the effort and money that is spent just trying to mitigate the policies of Tory-led Governments that repeatedly put the heaviest burden on the weakest shoulders.

Poverty is the biggest driver of ill health, and a decade of Tory austerity has been the biggest driver of poverty, but the Chancellor has already stated that the uplift to universal credit will be cut in September, signalling the start of yet another decade of Tory austerity. The people of Scotland certainly aspire to something better—a fairer society that looks out for those who need support. As we rebuild from the pandemic, we need to move away from an economy based on relentless growth in consumption to a more sustainable one that values people rather than just GDP.

That demonstrates the clear blue water between the UK Government’s plan for yet more austerity, poverty and inequality, and our vision for a fairer, healthier and more sustainable independent Scotland. The people of Scotland have the right to choose between those two visions. In Scotland, more people are beginning to recognise that we need the full powers of a normal independent country to be able to direct our recovery from covid and build the better country we want to live in and pass on to our children and grandchildren.