Building an NHS Fit for the Future

Steven Bonnar Excerpts

Monday 13th November 2023 Commons Chamber

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

Thank you very much, Mr Deputy Speaker. It is always a pleasure to follow the hon. Member for Weaver Vale (Mike Amesbury).

Since its inception, the NHS in Scotland has stood as a testament to our way of life and our society’s outlook and as a beacon of our compassion, all thanks to the unwavering dedication and commitment of our NHS staff and social care workforce. Even in the face of an unprecedented pandemic, coming as quickly as it did after the damage already caused by Brexit, our NHS staff have remained steadfast, their commitment undeterred. We clapped them—remember?—and then this place let every single one of them down, time and time again. They held the hands of our dying relatives while those who were setting the rules our NHS staff had to endure were breaking those rules.

In Scotland, we cherish each individual and the contributions they make to all our lives, day in and day out, across the Scottish NHS and social care sector. They are working under immense pressure for myriad reasons, but none is more apparent than the wilful damage inflicted on Scotland by this place over the past four years alone, let alone the 13 years of Tory rule. Let us stop to consider the pressures placed on our NHS staff: consider the pandemic, and the attack that it unleashed on our frontline service provision; consider the third of our NHS workforce sent home overnight when our freedom of movement was removed; consider the Truss-Kwarteng psychodrama that played out before us, and the tanking of the economy hitting every single household across the UK. When we consider all of that, is it not the workers of our NHS who should be honoured and decorated by this place? However, instead of crowns, they wear paper hats and scrubs, and they struggle on day by day. Speaking of crowns, when we look past the pomp and the grandeur of Westminster, we find nothing in the King’s Speech that resonates in any way with the hard-working people of Scotland. The Tory Government fail to address the core issues affecting people’s lives today—the soaring cost of food, mortgage costs, energy costs and interest rates, not to mention the lack of support for those on the lowest of incomes or those in the middle who are being squeezed from every conceivable angle.



Scotland’s NHS has been independent since its inception, and despite all the issues I have mentioned as being faced by service users and staff alike, we in the SNP can say with confidence that it fares much better than its counterparts across any of the constituent parts of the United Kingdom. The operational separation it enjoys has undoubtedly enabled and maintained that better performance over many years. Earlier, we heard the Opposition Health spokesperson, the hon. Member for Ilford North (Wes Streeting), lay out the state of play in England’s NHS—and, let us be honest, it was not pretty —but as of today Scotland’s NHS has higher staffing per head of population than the NHS in England. In Scotland we have 8.3 qualified nurses and midwives per 1,000 of our population, compared with just 6.3 here in England. This means that nursing and midwifery levels are 32% higher per head of population in Scotland than they are here in England. Overall, nursing and midwifery staffing is up by 13% under the SNP Scottish Government, and medical and dental consultants are up by 65% under the SNP Scottish Government. A band 2 porter in Scotland earns more than £2,980 extra when compared with a porter in England, a band 5 nurse in Scotland is earning £3,080 more when compared with a nurse in England and a band 6 paramedic is more than £3,480 better off when compared with their counterparts in England. All of this is while avoiding any strikes within NHS Scotland.

The one area where our NHS does not enjoy full independence is funding, and this has proven critical for a few reasons. For the past three years, we on the SNP Benches have been calling on the UK Government to deliver the funding necessary to not only deal with the pandemic, but make sure our NHS comes back better and healthier than before. If the Government in this place were to lift up wages in NHS England to match those in Scotland, they would not only secure NHS staff in England, encourage greater staff retention and possibly avoid the strikes we have seen so many of, but unlock billions in additional funding to make its way up the road to Scotland. However, this Government, with the reserved borrowing powers of Westminster, have refused to act. Despite all our efforts, a Westminster Government ultimately hold the key to delivering the funding necessary to catapult our NHS not just back on to its feet, but forward into a future the public so much deserve.

The pressure in our NHS demands urgent action, so what my constituents in Coatbridge, Chryston and Bellshill are asking themselves is: what change will come under a Labour Government? Will employment law be devolved, and will immigration law be devolved? What exactly are the changes that the Labour party is proposing, because its foreign policy is practically the same, its economic policy is largely the same, its welfare policy is largely the same and its constitutional policy is largely the same? Both the Tories and Labour offer Scotland the status quo. They both offer a life under a Westminster Government who do not care for it, will never put it first and will never put it before the interests of little Britain. Only the SNP is offering the people of Scotland any real change and any real hope, and it will only come with independence. Only then can the great reset begin.

As things stand, we in the SNP come to this place daily to stand up for Scotland and to address the challenges in our healthcare system, our economy and our interactions with the world through UK foreign policy. In my opinion, it is becoming more difficult to come here, and to sit and listen to the rhetoric of this place and of this Government. Listening to some of it has been hard to stomach, so let me be very clear: both the Government and the Opposition, in refusing to call for an end to innocent lives being lost and the collective punishment of Palestinians via a humanitarian ceasefire on all sides, are once again out of lockstep with the people of Scotland. The SNP amendment to the Loyal Address, to which I have put my name, calls for an immediate ceasefire to take place. I very much look forward to voting for that in the name of peace and humanity, and I hope many hon. and right hon. Friends will join me in the Lobby.

Scotland’s reputation among our partners in the international community is being damaged and we are being dragged down by our attachment to this place. The harm that has been caused to our economy, our public services, our population and our reputation are unparalleled. Is it not a little bit ironic that the man who caused so much of it, with his Brexit vote and his failed Remain campaign, is back? Former Prime Minister Cameron is now in the Government as Foreign Secretary—unelected, of course, but simply handed an ermine robe and told, “You’re a Lord now, Dave. Get on wi’ it!” He is allowing himself to be used as some kind of stooge to distract from a weak Prime Minister, who had no option but to sack his dog-whistling Home Secretary. The Leader of the Opposition is no stranger himself to anti-immigration rhetoric, specifically targeting the NHS and recruitment from overseas. This is at a time when the recruitment and retention of senior medical staff is one of the biggest challenges we are facing, with over 40% of GP trainees being international graduates. The challenges felt in the health and social care sector resonate across other sectors too—agriculture, fishing, food production and distribution have all been victims of Brexit—and the last thing Scotland needs is any more right-wing rhetoric on immigration from this place.

The best future for the NHS is an independent future in Scotland. An independent Scotland, free from the constraints of this place, can chart its own course, ensuring the wellbeing of its citizens without being tethered to the whims of political agendas thought up by right-wing ideologues who do not prioritise our nation, its health or our people. The people of Scotland deserve so much better, and we in the SNP will work to deliver a healthcare system that puts people first, values our healthcare professionals and recognises the true worth of our national health service—and to achieve this, our fight continues.

Oral Answers to Questions

Steven Bonnar Excerpts

Tuesday 11th July 2023 Commons Chamber

[The Minister for Health and Secondary Care (Will Quince)]

That is hugely frustrating, because I know how hard my hon. Friend campaigned for the Stockton community diagnostic centre and that he recognises the urgency of increasing diagnostic capacity locally. Delivery plans have to be agreed at a local level, so I urge Stockton council to work with him to meet the ambitious timeline and get Stockton CDC open as soon as possible.

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

A recent report by the Trussell Trust warns that people facing hunger are more likely to be affected by spiralling debt and a decline in their physical and mental health. The same report shows that one in seven people in the UK faced hunger in the last year due to a lack of money. Will the Minister make representations to his colleagues at the Department for Work and Pensions about increasing support for low-income households, thereby improving public health outcomes for all?

[Neil O’Brien]

It is to protect public health that we have provided cost of living support worth £3,300 on average per household, and that is why we have been paying about half of people’s average electricity and other energy bills. However, we always look at further things we can do to drive improvements in public health.

Aortic Dissection: Patient Pathways and Research Funding

Steven Bonnar Excerpts

Tuesday 13th December 2022 Westminster Hall

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

It is a pleasure to see you in the Chair today, Mr Pritchard.

I begin by paying tribute to the hon. Member for Mid Derbyshire (Mrs Latham), not only for securing this debate, but for the strength and courage she has shown in leading it. My thoughts and those of all in my party are with her and her family after the tragic loss of her son, Ben. May he rest in eternal peace.

No parent should witness the loss of their child, and I welcome the positive and heartfelt contributions from across the House today about taking more effective action in preventing this disease. As we have heard, 2,000 people a year in the United Kingdom lose their lives from aortic dissection. It is a treatable condition; indeed, it has a better than 80% survival rate when it is diagnosed and treated in time. Yet today, in the year 2022, 50% of people who are struck by this condition ultimately lose their life.

The British Heart Foundation has done a tremendous amount of work in this particular area, and I thank it for its dedication. In Scotland, the BHF has worked alongside the Scottish Government, Members of the Scottish Parliament and local NHS boards to champion all those who are working to beat heart and circulatory disease. Through their record-high health funding, the Scottish Government have supported and will continue to support health research and innovation, as a vital part of pandemic recovery and their wider aims to improve the health of our populations.

In 2020, the Scottish Government announced a one-off £75 million increase in funding for Scottish universities to ensure that they can protect their world-leading research programmes against the financial impact of covid-19 and the other crises that we are having to live through, whether it be the food crisis, the energy crisis or everything else. That significant intervention helped to secure the jobs and training needed to support ongoing and future research work.

Dr Alex Fletcher is leading a study on behalf of the University of Edinburgh that is monitoring around 60 patients at risk of dissection, which aims to develop a more effective screening tool. That study could not have been conducted without the SNP Scottish Government recognising the important work and impact of medical research charities, and I urge the UK Government to uplift support for medical research to ensure that vital studies can continue and more positive breakthroughs can be made.

However, research is not enough. The strategic direction of the UK Government must change if they are truly committed to supporting those with aortic dissection. This is particularly the case when the covid-19 pandemic has brought an even greater need for action into sharp focus. The pandemic had a significant impact on people with heart disease and on the services that support them.

In recognising that material societal change, the Scottish Government have published their heart disease action plan, supported with an investment of £2.2 million. The four priorities of that plan are prevention, timely diagnosis, treatment and care, and workforce.

The Scottish Government have outlined the importance of providing appropriate support to enable people with heart disease to live well with their condition. That means identifying ways to support people experiencing the emotional and psychological impacts of heart disease, and giving as many of them as possible access to specialist support, including vital rehabilitation services and, wherever necessary, supporting access to palliative care.

These measures may seem simple, but they are fundamental to helping minimise the presence of heart disease within our communities. I encourage the Minister to follow the Scottish Government’s footsteps, and to learn and share best practice methods to ensure that aortic dissection cannot continue to blight people’s lives, and have a difficult and lasting impact on their families.

NHS Industrial Action: Government Preparations

Steven Bonnar Excerpts

Monday 12th December 2022 Commons Chamber

[Mr Speaker]

I call the SNP spokesperson.

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

Scotland’s First Minister has managed in one day to do what the Tory Government could not—agree with the nursing unions to call off strikes planned for this month. NHS workers are the backbone of these countries. If they do not work, the country does not work, and if the country is not working, it is broken. Britain is broken, is it not? And Brexit has broken Britain, has it not? The Tories will not negotiate and the Labour Opposition spokesperson has branded the British Medical Association as “hostile”, while in Scotland the strikes are off, and they are off permanently. An offer of 7.5% has been negotiated and agreed, with an 11.24% pay rise for the lowest paid across the board in NHS Scotland. Why are the UK Government refusing to give public servants a decent pay increase when they have all the financial power to do so?

[Will Quince]

I thank the hon. Gentleman for his question. My understanding is that the industrial action in Scotland has been suspended, not cancelled, as the hon. Gentleman suggested. The Scottish Government have made a considerably higher offer, partly because a politician has got involved in pay negotiations, directly in contrast to the independent pay review body, and it will be interesting to see whether the First Minister of Scotland is going to do this every single year and go against the recommendations of their pay review body.

Would the hon. Gentleman like to confirm—I appreciate he cannot do it now—whether the Scottish Government have also looked at things such as leave and working times? I think it is important to stress that every 1% increase for the “Agenda for Change” workforce equates to about £750 million. That is £750 million that will come out of the NHS budget and that we will not be able to spend on things such as tackling the elective backlog, which is so important to people up and down the country.

Oral Answers to Questions

Steven Bonnar Excerpts

Tuesday 6th December 2022 Commons Chamber

[Mr Speaker]

We come to the SNP spokesperson.

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

There are concerns that officials and high-ranking associates have reaped the financial benefits of a deadly disease, shamelessly profiteering on public funds. The SNP has long sought to highlight the Government’s rampant cronyism and corruption, and this PPE plundering is the most egregious case that we have seen so far. In Scotland, the Scottish Government have robust procedures in place to ensure protection of procurement in healthcare. How will the Secretary of State better regulate the cronyism of his colleagues? Will he commit now to scrapping the UK Government’s VIP lane for healthcare contracts?

--- Later in debate ---

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

Intellectual property protections are an important way of protecting healthcare companies’ innovations, as we know. However, developments on intellectual property can also impact the rights of individuals, limiting access to affordable, life-saving and essential medical products. What recent representations has the Secretary of State made to colleagues in the Department for International Trade to seek assurances that nothing in the proposed free trade agreement with India will impact or jeopardise access to affordable medicines for NHS patients in Scotland?

[Steve Barclay]

I can reassure the hon. Gentleman on that. I would have thought that he would also welcome the commitment to a £15 billion to £20 billion increase in R&D investment, the championing of life sciences that the Minister for Health, my hon. Friend the Member for Colchester (Will Quince), has been leading on, and the opportunity we have to address greater variation within the NHS by bringing forward the innovations from our life industry and applying them much more quickly.

World AIDS Day

Steven Bonnar Excerpts

Thursday 1st December 2022 Commons Chamber

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

. I join all Members in commending the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) for leading this debate and for informing us so well on a subject on which he is such a powerful crusader and advocate. I thank him and commend him for his contribution today.

Today, 1 December, is the annual World AIDS Day. From the inaugural World AIDS Day in 1988, the first ever global health day, until today, it has given an opportunity for people worldwide to unite in the fight against HIV, to show support for people living with HIV and to commemorate those who have, sadly, lost their lives as a result of AIDS-related illnesses. More than 105,000 people are living with HIV in the UK, and globally an estimated 38 million people have the virus. Despite the fact that the virus was only identified in 1984, more than 35 million people have died of HIV or AIDS-related illnesses, making it one of the most destructive pandemics ever known.

Each year in the UK more than 4,000 people are diagnosed with HIV. Many people do not know the facts about how to protect themselves and others, and stigma and discrimination remain a reality for so many people who are currently living with this condition. About 6,000 people in Scotland are living with AIDS, according to Health Protection Scotland data, and 98% of those attending HIV specialist treatment and care were receiving antiretroviral therapy—ART. In 95%, the virus cannot be detected in their blood, meaning they have an undetectable viral load and cannot transmit HIV. We know that many within our society are still largely unaware of the disease and the risks of it. A recent survey from the National AIDS Trust found that only 16% of people surveyed knew that if someone with HIV is on effective treatment, they cannot pass on HIV and can expect to live a long, happy, healthy and fulfilling life.

HIV continues to be a major public health crisis both in the UK and across the world, as we have heard today. Although we know that HIV disproportionately impacts segments of the LGBTQ+ community, the two issues should not be conflated; HIV is by no means confined to LGBTQ+ communities or certain black or ethnic minority communities. The fact is that anyone, regardless of sexual orientation, gender, age or any other factor, can acquire HIV or AIDS.

We in Scotland are extremely proud to be the first country in the UK to make PrEP available free of charge to those at a high risk of acquiring HIV. We have made huge progress in detecting and treating HIV, and people with the virus are able to live those long, happy and fulfilling lives. PrEP is free of charge from NHS Scotland for anyone who is more at risk of getting HIV. As we have heard from the hon. Member for Brighton, Kemptown, it is simply an oral medicine, in pill form, comprising two HIV antiretroviral drugs. It is prescribed to HIV-negative people at risk of becoming infected as part of a comprehensive approach to HIV prevention. We know that the drug is highly effective at stopping HIV from being passed on. In clinical trials, PrEP has been shown to reduce the risk of sexually transmitted HIV by between 75% and 86%, so it is hugely successful. Research lead by Glasgow Caledonian University’s Professor Claudia Estcourt shows there has been significant reduction in HIV infections since the implementation of the first PrEP programme in Scotland in July 2017, and that new diagnoses in Scotland have fallen by 20%.

The SNP Scottish Government will continue work to reduce the stigma of HIV, raise awareness of the condition and reduce its transmission. Support is being provided for new research on reducing transmission of the virus, and a separate working group will also look at the clinical utility of PrEP in Scotland.

The SNP Scottish Government have also provided £337,000 to develop a national online service for sexually transmitted infections and blood-borne viruses, which will allow people to request a test online and conduct that home self-sampling that we have heard about today from across the House. Every tool possible will be required in our fight against HIV/AIDS. These are all excellent tools and the Scottish Government remain committed to being on course to reach their target of eliminating HIV transmission in Scotland, and across the rest of the UK, by 2030.

As a fierce defender of minorities in this place, I must also mention the plain fact that many of those living across these nations with HIV are vulnerable. Some experience language, faith and cultural barriers associated with long-standing stigma, while others have complexities, such as mental health and societal issues, that impact their access to health and social care services, leading to poorer health outcomes. As we are all too aware, socio-economic inequalities drive health inequalities. Will the Minister outline the steps being taken by his Government to mitigate the impact of austerity and reduce inequality for all our minority communities?

The Government need to take an intersectional approach to healthcare—an approach that recognises that many people in the United Kingdom will face multiple and often overlapping disadvantages and barriers to accessing good healthcare, and sometimes, as we have heard, a postcode lottery.

Finally, on the matter of funding, the SNP is once again calling on the UK Government to reverse, in effect, the 83% cut to UNAIDS funding, which is a consequence of their decision to cut the aid budget from 0.7% to 0.5% of our GDP. On 31 Oct 2022, the UK Government missed the deadline to donate to the Global Fund to Fight AIDS, Tuberculosis and Malaria. At the time, Mike Podmore, UK Director at STOPAIDS, said:

“The UK is acting as an unreliable partner and preventing the Global Fund from communicating clearly to its grantees about what funding is now available for them to work with, creating uncertainty.”

The consequences of that action could be immeasurable when it comes to the number of lives affected. Although the UK did provide some funding, it was £400 million less than in 2019. Again, we in the SNP call on the UK Government to do the right thing. The aid budget must be restored to its 0.7% level, especially if the UK does not want to be known as an unreliable partner among its counterparts.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the shadow Minister.

Draft Food and Feed (Miscellaneous Amendments) Regulations 2022

Steven Bonnar Excerpts

Monday 28th November 2022 General Committees

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

It is a pleasure to see you in the Chair, Mr Sharma. The SI is required for the reasons that the Minister outlined, and I thank him for doing so. The Scottish Government have given their consent to it, so I will make only a short contribution.

Six years since the Brexit vote, and two years into its implementation, we are still implementing SIs to patch up Brexit legislation gaps. The Retained EU Law (Revocation and Reform) Bill is set to repeal thousands more laws, and ensure that even more time is taken up by patch-up jobs such as today’s. Far too much legislative time has already been taken up with post-Brexit fixes because this Tory Government refuse to realise the futility of it all.

NHS Staffing Levels

Steven Bonnar Excerpts

Tuesday 22nd November 2022 Westminster Hall

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

It is nice to see you in the chair this afternoon, Mr Hollobone. I congratulate the hon. Member for Wirral West (Margaret Greenwood) on securing and leading this vital debate on NHS staffing levels. I also thank all Members who have made valuable contributions. I place on the record my thanks and admiration, and that of my party, for all those who work in our NHS in Scotland and in all social care settings.

We live in unprecedented times. We have endured the worst pandemic in living memory; we have witnessed the worst Prime Minister and Chancellor in living memory; we have an energy and cost of living crisis thanks to the invasion of Ukraine by the egomaniac Vladimir Putin and persistent public spending cuts that have crippled our economy; and we have the small matter, which very few dare to mention in this place, of the most horrific act of self-harm in living memory—Brexit. We in this place can dance around any fact we like, but the real reason for the staff shortages and real pressures in our NHS is Brexit. Because of all those combined factors, our greatest asset, the national health service, is under the greatest strain in its 74-year history across all the nations of the United Kingdom.

Consistently poor and, frankly, dumb economic choices undertaken by the Government have led to unprecedented inflation, limiting the Scottish Government’s ability to act in the areas in which they are required to do so due to the significant cuts to the Scottish budget. The previous Prime Minister’s catastrophic mini-Budget wiped £1.7 billion from the Scottish Government’s forthcoming budget in a matter of just a few days, dwarfing any increase announced recently by the newest Chancellor’s autumn statement. Scotland has been left with an additional £200 million shortfall and Scottish health spending power has been reduced by £650 million. Is that what we have to be thankful for? It is most certainly not our Union dividend or our Brexit bonus.

Together with the Welsh Health Minister, the Scottish Health Secretary Humza Yousaf recently wrote to the UK Government calling for the Chancellor to announce additional funding for this year in the NHS budget so that health boards and the devolved Governments can afford to pay the wages that our NHS staff so rightly deserve. Covid costs continue to eat into funding, despite the UK Government stopping covid funding altogether. The UK Government are pulling their usual stunt of giving with one hand while taking away with the other. Unless the Government take urgent action to immediately increase their budgetary spend, the NHS as we know will be in extreme peril.

A hard Tory Brexit—and one backed and endorsed by the Labour party, as the people of Scotland are fully aware—means that Scotland has endured the greatest depopulation of any of these island nations. As a result, we have a shortage in available workforce, as reported on page 3 of today’s Financial Times so illuminatingly. Scotland needs people to come in and bring their skills with them. We need a migration system that works for all of us and is fit for purpose. There is no other option if we are to fill the national labour shortages in our NHS and social care settings, as well as in other sectors that are in dire need of an eligible workforce—hospitality, transport, agriculture, fishing and many more. Again, Brexit is causing problems throughout every sector. The SNP’s position is that immigration powers must be devolved to Scotland and the Scottish Parliament. If the UK Government do not want to solve the problems effectively, if indeed at all, it is time to get out of the way and allow us to do so.

The Royal College of General Practitioners has found that more than 40% of GP trainees are international graduates. Forty-nine per cent. of that number have reported issues with the visa process and 17% are considering leaving the United Kingdom altogether and, as a result, taking their much-required skills elsewhere. That is talent that we should be nurturing and harnessing, but we are instead pushing it away and rejecting it. The UK Government have consistently hamstrung the NHS with their privatisation and red tape agendas, and now an immigration mess is adding to the chaos. Now we have different NHSs across the nations of the UK competing internally with one another to attract and retain staff in our healthcare settings. It is one sorry mess, and the architects of Brexit must shoulder the responsibility.

GP numbers were touched upon earlier, and there have been concerns about GP numbers in Scotland, as well as elsewhere across the United Kingdom. It is worth noting that Scotland has a record number of general practitioners working across our nation, with more GPs per head of population in Scotland than across the rest of the UK’s nations. The Scottish Government are committed to further increasing the number of GPs practising in Scotland by 800 by the end of 2027, investing £170 million each year for that purpose. We are making good progress on that commitment, with Scotland’s GP headcount increasing by 277 to 5,195 between 2017 and 2021.

The Scottish Government continue to look for ways to encourage staff into working for our world-renowned NHS service and will continue to work co-operatively with the UK Government wherever possible to encourage sufficient inbound migration to plug the labour shortages and support the full staffing of our national health service. Last week, the Chancellor announced that more than 600,000 people on universal credit will be asked to have a meeting with a work coach so that they can get the support they need to increase their hours or their earnings. Instead of sanctioning the poorest people in our communities and attacking workers’ rights by restricting trade unions, the UK Government must get real and focus on creating a fair and tailored immigration system that works for the people of Scotland and, indeed, the rest of the United Kingdom. However, it cannot be any clearer—other than to those who choose not to see—that the ramifications of Brexit are now beginning to bite in the very areas we knew they would, and we see nothing at all from this Government to suggest anything other than that the best future for Scotland’s NHS and for Scotland as a whole is one in which the representatives of the Scottish people directly decide on how best to safeguard all that we hold dear. That only comes with our country’s independence.

As I have a few wee minutes left, I will say to any hon. Members who represent English constituencies that the groundbreaking Pharmacy First service is excellent. It is working so well in Scotland, and I am glad that it will be rolled out across the rest of the UK. In Scotland, anybody under the age of 26 is now eligible for free NHS dental treatment. We have free annual eye tests for everybody in Scotland, and biannual tests for those over 65, free prescriptions for all, and free hormone replacement therapy and sanitary products. We are not getting it all right, but there is an ambition to get better, and we need the support of the UK Government to do so.

Huntington’s Disease

Steven Bonnar Excerpts

Wednesday 9th November 2022 Westminster Hall

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

It is a pleasure to see you in the Chair today, Mr Robertson. I thank the right hon. Member for Leeds Central (Hilary Benn) for securing this debate on what is an increasingly prevalent feature across our communities. He made a powerful and heartfelt contribution, and I thank him for it. I also place on record my full support for his early-day motion 72, whose aims echo those of a motion already passed in Holyrood by 98% of Members of the Scottish Parliament—we would like that sort of unity in this place—which aims to expand the range of specialist services available to all those with Huntington’s disease.

This has been an excellent debate, with powerful and thoughtful contributions. The hon. Member for Strangford (Jim Shannon) spoke of the long-term impact on the life of a young person with the gene and how it can affect their whole life, marriage, opportunities, finances and all that goes with them as they go on their journey through this world.

My hon. Friend the Member for Paisley and Renfrewshire North (Gavin Newlands) spoke of Scotland’s national care framework for Huntington’s, and its five principles. For obvious reasons, we are keen to champion that excellent body of work, and I hope that the Minister will take note of it. I thank all Members who have contributed to this morning’s excellent debate.

Huntington’s disease is an inherited condition. It is a progressive disease that slowly leads to the loss of the ability to walk, talk, eat, drink and make decisions of care for oneself, as well as the many other issues outlined by the right hon. Member for Leeds Central. It causes the progressive breakdown of nerve cells in the brain. That gets gradually worse over time and is ultimately fatal after between 10 and 25 years.

We have heard that each child of a person with the Huntington’s gene has a 50% chance of inheriting this awful condition. Affected children can likewise pass the gene to their own offspring.

According to the Scottish Huntington’s Association:

“Around 1 in 5000 people in Scotland has Huntington’s disease”,

which means that about 1,100 people are living in Scotland with Huntington’s disease,

“and an estimated 4,000-6,000 others…are at risk of inheriting it from their parents.”

Recent research has highlighted alarming figures, showing that the prevalence of Huntington’s disease in Scotland is almost three times greater than reported elsewhere in Europe, North America and Australia, and, as has been mentioned, is more than five times greater than the worldwide average. Those are not mere figures or statistics, worrying and sobering as they are. They are people’s lives—our citizens—and it is the duty of all of us to do our utmost to protect our people wherever possible.

With that principle in mind, the Scottish Government have released funding to allow University of Aberdeen academics and NHS Grampian Huntington’s disease clinic staff to lead pioneering research into tackling the disease. They have done so by leading on international drug trials, attempting to find ways to slow the progression of the disease and to increase our understanding of potential generational cures. The researchers have also gone one step further by engaging in close partnership with families affected by Huntington’s and working with the Scottish Huntington’s Association—we have heard much about its work already, and I place on record my thanks for it.

We must always remember that the disease is not about one individual, as we have heard. It is a cruel disease that has the power to destroy entire families. My heart goes out to all those who have lost loved ones through this horrible illness.

Children and young people have informed that body of work by agreeing to be interviewed about their experience of Huntington’s. That has allowed tools to be developed to support parents who face dilemmas about how, when and what to tell their children about the genetic condition. The use of such interviews is groundbreaking, taking a fully holistic approach to medical research within this field, and guided by one of the principles of Scotland’s national care framework—a family systems approach. I hope that that approach will be considered by other academics and Governments across the other nations of the UK.

Dr Karen Keenan, who conducted those interviews, explains:

“Living with a parent who has a serious hereditary degenerative condition like Huntington’s disease (HD) can be extremely difficult for children and young people. Many witness the loss of a parent as the illness progresses, whilst also discovering they are at 50% risk of developing the disease themselves in adult life.”

Families with Huntington’s disease can also face or feel considerable stigma, as my hon. Friend the Member for Paisley and Renfrewshire North outlined. There are higher rates of family breakdown and often there is secrecy about the existence of the disease within a family. The readiness to deal with a diagnosis is so important.

The Scottish Huntington’s Association is the only charity in Scotland exclusively dedicated to supporting families impacted by HD. It does this through a team of Huntington’s specialists, specialist youth advisers and a finance wellbeing service. The lifeline service provided by the association can and does make the difference between families coping and not coping. We can all find out more about its work by visiting hdscotland.org. I encourage all to do so.

Scottish-led research has been instrumental in identifying a need for age-appropriate information and support for children and young people impacted by the disease, and a need for parental guidance about disclosure to children and young adults. Over the last two decades, studies conducted by Scottish researchers have built an evidence base that has been used to inform support services for young people across Scotland, Europe and the rest of the world. It has influenced health and training, and social care professionals in the work that they do each and every day. I am sure we would all like to place on record our thanks and gratitude to them for that work.

I look forward to hearing what the Minister has to say on the Government’s approach as we all go forward together. Cross-party support in both the Scottish and the UK Parliament is quite apparent. The togetherness in this room during debates such as this, where we are all in total agreement, is another step forward in the right direction of raising awareness of this genetic illness.

Pancreatic Cancer Awareness Month

Steven Bonnar Excerpts

Tuesday 8th November 2022 Westminster Hall

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

It is a pleasure to see you in the Chair, Mr Hollobone. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate on Pancreatic Cancer Awareness Month and setting out matters in such great detail for us. We have heard from hon. Members about a wide range of issues faced by constituents across the nations of the UK in dealing with this type of cancer. The hon. Member for Stroud (Siobhan Baillie) spoke of how well informed her constituents are and the asks they have of the Government in this area. My hon. Friend the Member for East Dunbartonshire (Amy Callaghan) spoke of her constituent Barbara and her experience of NHS services failing to identify and diagnose her cancer in time. We also heard from the hon. Members for East Londonderry (Mr Campbell), for Upper Bann (Carla Lockhart) and for Carshalton and Wallington (Elliot Colburn), and I thank all Members for their contributions.

November is Pancreatic Cancer Awareness Month and 17 November is World Pancreatic Cancer Day 2022. It is so important to raise awareness through these days and through our debates to improve early diagnosis by ensuring that more people know the early symptoms of pancreatic cancer. It has the lowest survival rate of all common cancers and is the deadliest common cancer in Scotland and across the United Kingdom. There are around 10,500 new cases in the UK each year. That equates to 29 cases every single day. It is the 10th most common cancer in the United Kingdom, accounting for 3% of all new cases, and the fifth biggest cancer killer with 9,000 deaths each year. In Scotland, there are around 900 new cases per year, with an incidence rate of 15.5 per 100,000 people.

Pancreatic cancer is caused by the abnormal and uncontrolled growth of cells in the pancreas—a large gland that is part of our digestive system. In the early stages, a tumour in the pancreas does not cause any symptoms, which can make it difficult to diagnose, as we have heard. Symptoms can vary from person to person and may include jaundice, indigestion, stomach or gut pain, back pain, diarrhoea, constipation or weight loss. Pancreatic cancer is particularly difficult to diagnose early, as we have heard so many times, and Pancreatic Cancer UK reports that 80% of cancer patients are not diagnosed until the cancer is at an advanced stage. While the causes are not clear, it is most common among those aged 75 years and over, with almost half of all new cases diagnosed falling in that age demographic.

Early diagnosis is crucial to improving survival outcomes, with one year survival rates for those diagnosed at an early stage being six times higher than those diagnosed at stage 4. However, most people with pancreatic cancer are unfortunately diagnosed at that late stage. At present, surgery is the only treatment with curative intent for pancreatic cancer, while chemotherapy and radiotherapy have been shown to improve survival in those with late- stage pancreatic cancer. If it is diagnosed at a late stage, surgery to remove the cancer is usually not possible.

The Scottish Government are committed to diagnosing cancer as early as possible, which is why they continue to invest in their detect cancer early programme, or DCE, and are rolling out rapid cancer diagnostic services across Scotland. We know the earlier that cancer is diagnosed, the easier it is to treat. That is why the Scottish Government continue to invest in that programme, which adopts a whole-system approach to diagnose and treat cancer as early as possible. They are developing a new plan for early diagnosis as part of their new cancer strategy to be put in place in spring.

The new 10-year strategy will take a comprehensive approach to improving patient pathways from prevention and diagnosis through to treatment and post-treatment care. That follows on from the establishment of three rapid diagnostic services centres, developed within the NHS infrastructure. The centres are in Ayrshire and Arran, Dumfries and Galloway, and Fife. They will play a key role in delivering early diagnosis and improved care, with fast-track diagnostic testing at the first appointment wherever possible.

The First Minister announced as recently as 10 October that the next two rapid cancer diagnostic services centres in NHS Scotland will go live in my own NHS board of NHS Lanarkshire and in NHS Borders. Through the NHS recovery plan, the Government in Holyrood have invested £29 million to provide an increase of 70,000 diagnostic procedures next year and 90,000 by the end of the plan in 2026. A new DCE awareness campaign is also under development to empower people with possible cancer symptoms to act early. That is due to be published in spring 2023.

In Scotland, it has been recognised that the impact of the covid-19 pandemic may have exacerbated inequalities within cancer screening, and the Scottish Government have committed up to £2.45 million to the screening inequalities fund over the past two years. Public awareness campaigns and messages have run throughout the pandemic to encourage those with possible cancer symptoms to seek help. To support scope-based diagnostics, the Scottish Government have published a £70 million endoscopy and urology diagnostic recovery and renewal plan, focusing on key areas such as balancing demand and capacity, optimising clinical pathways, improving quality and efficiency, workforce training and development, and infrastructure and innovation redesign. A further £9 million has been allocated this financial year to support diagnostic imaging capacity, with six mobile MRI scanners and five CT scanners in place across Scotland’s NHS.

Despite all that work and all the amazing work of charities and activist organisations, and their dedicated supporters, which has been placed on the record today, there is still so much more for us to do. Investment in facilities, improved treatment options and early detection are all necessary, but it is also vital that research into alternative cancer treatments continues and expands. The Scottish Government provided an average of £2 million each year to cancer research causes in the five years before the pandemic, and that remains our priority.

According to Pancreatic Cancer UK, research into the disease has been underfunded for decades. The charity estimates that pancreatic cancer receives 1.4% of cancer research funding and yet is the fifth biggest cancer killer. Just recently, to mark World Cancer Day, Cancer Research UK delivered a cash injection of £12 million to the Cancer Research UK Scotland centre, supporting the work of cancer researchers from the University of Edinburgh and the University of Glasgow. Professor Ian Tomlinson, who is co-director of the centre, welcomed the finance but highlighted how challenging the previous year had been and the fact that covid-19 has slowed down research.

Finally, we in the SNP commend all the charities and activist organisations and their dedicated supporters for their tireless efforts to raise awareness of pancreatic cancer. We have called on the UK Government to support Cancer Research UK and other research charities throughout the pandemic, while their funding activities have been curtailed by restrictions, and now in the face of people being more cautious with their money. With the Tory cost of living crisis continuing to undermine people’s financial security and their ability to support charitable efforts, it is more important than ever for the Government to step in and support charities in their work and to directly fund cancer research.