Health

Theresa Villiers Excerpts

Tuesday 14th May 2019 Commons Chamber

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is an absolute pleasure to speak on behalf of the Scottish National party and to see you in your place, Madam Deputy Speaker.

As we know, public health campaigns can be extremely successful. They make health improvements in a widespread manner; individual interventions do not have the same effect. However, the work of public health campaigns and departments is not always visible. It tends to take place behind the scenes. Constituents do not often speak to their MPs about these issues. Very infrequently has anyone come to my door to ask about a cervical screening appointment, or about our campaigns and work on obesity. Public health is not the most visible area of our NHS, unlike the frontline issues of access to treatments, accident and emergency waiting lists and access to GP appointments. It does not have the profile that it ought to have, and it certainly does not feature the sensationalism on which the media often want to report. However, it is important to say that public health is fundamental to the health of the nation. Therefore, public health should not be underestimated and should certainly never be underfunded.

Since 2006-07, the annual health resource budget has increased in Scotland by £4.8 billion, and the Scottish Government have passed all consequentials on to health and care. Funding for NHS boards will increase again by £430 million—an increase of 4.2%—and the package of investments in health and social care in Scotland for integration programmes will be £700 million to the better. Health spending per head in Scotland is almost 9% higher than in England, according to Treasury analysis in 2018.

Investment in primary care is essential; our GPs are at the frontline and it is important that we increase funding for that. The Scottish Government have invested over £930 million in primary care, and £30 million will be invested to extend the free personal care individuals have in Scotland to the under-65s. Some £11.1 million will be provided to increase nursing and midwifery bursaries from £8,100 to £10,000 the following year. Again, midwives and nursing staff are on the frontline of our public health achievements.

Young families across Scotland receive the opportunity to have a baby box as soon as their baby is delivered, which is fundamentally to the good; it is about saying, “We know your baby is born; it is the most valuable thing in your life and we want every baby in Scotland to have the same start and to reduce the inequality we know impacts on people’s lives and families.”

We also need to increase our sportscotland funding, and there has been a pledge of 3%. We have discussed obesity today. I was a member of the Health and Social Care Committee when it was looking at the issue, and again this underlines the importance we must place on public health investment. Advertising and marketing campaigns overshadow the work we are able to do because of the huge investment the industry puts into encouraging people to eat and to feed their children the wrong types of food and to give ourselves treats many more times than we should. I have fallen foul of that, particularly since arriving in the House of Commons; our Tea Room has far too many little treats at the counter. These are all things we grapple with as families and individuals, and that is why it is so important that public health and public health campaigns are supported.

I am pleased to learn more about the Government’s nudge unit. The UK Government has put some investment into psychological approaches to public health and to health, and I was pleased to meet a member of the nudge unit a few months ago at the all-party group on psychology, which I chair, because we must try to help people shape their behaviours and make it as easy as possible to make the right decisions moving forward. Making the right decisions is difficult anyway, but things such as having the opportunity to have a piece of chocolate at the till when we are making purchases makes it that little bit more difficult for people to make the choices we know they need to make. Public health and taking responsibility for our health is all about shaping behaviour: making those choices ourselves through our motivation, but also the Government helping to shape the society we live in and make sure that the easy choices are the healthy choices.

It is important that we raise as much awareness as possible of mental health, particularly in this week, Mental Health Awareness Week. This has often been about communities plugging gaps, however. Progress has been made across the UK, but community mental health service waiting times are still far too long, particularly for young people and adolescents awaiting access to child and adolescent mental health services. That is why there has to be a partnership between public health, health services, voluntary agencies and others in the community.

An example is the Trust Jack Foundation in my constituency, which was formed following the tragic suicide of a young person in my constituency, Jack. His mother came through that terrible trauma and created the foundation, which enables young people in Stonehouse and elsewhere in Lanarkshire to have access to mental health services while they are on the waiting list for CAMHS, and it is really making a difference by giving them the support they need and the earliest possible intervention.

On disability, we must pay cognisance to the fact that those who are disabled are much more likely to be living in poverty than those who do not have disabilities. It is important to take account of that, because people who have disability have less access to the workplace, to transport, to adapted housing and even to shops, because in some cases, Changing Places toilets are not available in our shops. They also have less access to getting about, because Changing Places toilets and facilities and accessible transport are often not available. All those factors contribute to the impact of poverty on people with disability, and we need a joined-up approach across Departments if we are to make a difference.

I want to speak briefly about homelessness. I cannot help but notice that every time I arrive here in Westminster each day, there are people sleeping at the underground station just outside the entrance to Westminster. I have also noticed that, a number of times, there have been flowers left for those who have died there. It is incumbent on us all, as MPs and as a Government, to notice what is right in front of our eyes and to act to ensure that those homeless people have opportunities and that their health and wellbeing are cared for.

I want to touch briefly on the subject of older adults. Public health campaigns will have to focus on and target older adults in the years to come. We are living longer by virtue of the good health we enjoy as a result of the interventions, treatments and technologies that are now available, but chronic illnesses will be with people for longer and affect many more people.

[Theresa Villiers (Chipping Barnet) (Con)]

Does the hon. Lady agree with a point made to me by a number of my older constituents at an event last week, which is that we need to ensure that sports facilities are providing the right encouragement and opportunities to keep older people active for longer, given that that is crucial for public health goals?

[Dr Cameron]

Yes, that is an absolutely fantastic point. I was going to mention the fact that our local sports and leisure facility has an agreement with the NHS that GPs can prescribe sports facilities to people so that they can have an exercise regime designed specifically for them. If they can benefit from such a regime, that can maximise their health. All these things actually save money in the long term, and that is why public health is so crucial. We really are investing for the good of the nation.

From my own experience of working in addiction services many years ago, I know that we have to take on board the fact that there are huge levels of comorbidity with mental health. Often, people in addiction services have a history of trauma. They are self-medicating with alcohol or drugs, and they are not coping with life due to their underlying mental health issues. However, those very same people are often refused access to mental health services treatment until they have dealt with their addiction. That is a circular argument, and those who are struggling with mental health and addiction problems never really get the support that they need or deserve. That is why integrated services in relation to addiction are so important.

--- Later in debate ---

[Theresa Villiers (Chipping Barnet) (Con)]

Thank you, Mr Deputy Speaker. Supporting the NHS and its values, and securing the best healthcare for my constituents, has always been one of my highest priorities as a Member of this place, so I warmly welcomed the news that the NHS would get the biggest increase in funding in its history, with a £20 billion cash boost. As we have heard today, the demands on our health service are increasing as we grow older as a society, and I would like to pay a warm tribute to all NHS staff, especially those working in and around my constituency at the Barnet and Chase Farm Hospitals and in primary care. They do incredible work and we all owe them a great debt of gratitude. We need only to consider some of the statistics that the Secretary of State shared with us, such as the fact that the NHS currently sees 3.3 million more people attending at A&E than in 2010. The number of operations carried out is up dramatically, as are the number of diagnostic tests and out-patient appointments. The NHS is delivering more care than at any time in its 71-year history.

There is much that we should praise about the service but, as we have heard today, we should also acknowledge the challenges and the concern felt about waiting times, about access to new and innovative treatments, about caring for our frail elderly, about dealing with health inequalities and about action to improve outcomes for the most serious conditions, such as cancer. That is why the new funding and the new NHS plan are both so crucial. The goals set out in the NHS long-term plan will greatly improve patient care, and they should also boost productivity in the NHS to ensure that taxpayers’ money is used as effectively as possible and gets to the frontline care about which we all care so much. The key challenge now is to ensure that those goals are delivered in practice.

[Liz Twist (Blaydon) (Lab)]

Does the right hon. Lady agree that we also need to tackle the preventive measures covered by public health programmes? It is really important that we maintain public health spending and run smoking cessation programmes and others that prevent ill health from developing in future.

[Theresa Villiers]

I think there is cross-party support in the Chamber for effectively funding our NHS and public health. Both those spending areas will continue to be a priority for the Government.

I particularly welcome the Government’s commitment that primary care and GP services are at the heart of the NHS long-term plan. GPs are very much in the frontline of increasing healthcare needs, and they are feeling the pressure. I want to see the Government’s £4.5 billion commitment to primary care deliver expanded GP capacity in my Chipping Barnet constituency. The proposals for GPs to be able to call on support from teams of other professionals, such as district nurses and pharmacists, may play a helpful role in relieving the pressure on GP services.

If we are to ensure that patients can get appointments when they need them, we need to train and recruit more GPs. This need is even more intense in areas such as Whetstone in my constituency, where new homes are being built and patient rolls are getting longer. I would like to have the Minister’s assurance that the Government’s target to increase medical school places from 6,000 to 7,500 per year will be met. It is also vital to ensure that whatever reforms are introduced to our immigration system when we leave the EU, we ensure that the new system meets the needs of the NHS and ensures it can continue to bring in skilled professionals from the EU and beyond. It is also important to enable doctors to expand their buildings to improve facilities for patients, and I commend the plans to do so that GPs in High Barnet, Whetstone and elsewhere in my constituency are taking forward.

A third aspect of the NHS plan that I would warmly welcome is the improvement of digital capability, in which respect I wish to highlight an important success in my local area. In autumn last year, Chase Farm Hospital reopened in a brand new £200 million state-of-the-art building. It uses the most up-to-date digital facilities, and the new building is significantly improving patient care. It is situated just outside my constituency but used by many of my constituents and is part of the same trust as Barnet Hospital. I campaigned for many years to secure Chase Farm Hospital’s future, and I welcome the great new facilities for my constituents.

I will always be the strongest supporter of the NHS and its values. This debate is an opportunity to celebrate the incredible achievements of our national health service and its staff, but also to recognise that there is a huge amount of work to be done to ensure that the NHS can continue to meet the needs of future populations. We should never ever forget that delivering a strong economy and strong public finances is imperative if we are to continue to have a strong NHS. It is the only way to deliver the funding that the NHS needs to provide the care on which we all depend. A strong economy is vital to ensure that our constituents get the best possible healthcare in the years ahead, and I urge the Government to ensure that they continue to deliver the economic stability and prosperity on which we all depend and on which the NHS depends for a successful future.