May I start by expressing my thanks to all health and care staff across the UK? I pay tribute to them for the work
they do year in, year out—especially during the pandemic, when they literally risked their lives to care for us and our loved ones. Sadly, some of them paid the ultimate price. Others who are suffering with long covid face losing their pay or their job, and we should be ashamed of that.
The covid pandemic had a massive impact on all four health services across the UK. The two biggest challenges are the backlog and the workforce we need to deal with it. However, there were underlying problems before covid. We had 10 years of Tory austerity: up to 2010, the annual average uplift in NHS funding was usually between 3.5% and 4%, but for most of the 2010s it was less than half that.
Scotland spends more than 6% more per head on health than England. That money covers things like free prescriptions. The shadow Health Secretary, the hon. Member for Ilford North (Wes Streeting), talked about not charging for GP appointments. Free prescriptions, in the same way, ensure that people take their medication, so that we do not let diseases get out of control and they do not end up costing more in hospital later.
We also spend a massive extra 43% on social care. That allowed us to provide free personal care, valued at £86,000, when we heard about the potential care cap in England. Providing free personal care, which in Scotland includes people younger than 65 if they have a need for it, allows people to live independent, high-quality lives in their own home for as long as possible. I am sure that there is not a person in this Chamber who will not want that when their turn comes.
Scotland has the highest number of nurses, care staff, GPs and consultants per head of population in any of the UK nations, but all the national health services are facing staff shortages in both NHS care and social care. Even where staff numbers appear to have increased, the problem is that demand is growing quicker. That is because we are an ageing population—and, sadly, we are not ageing well. From the age of about 50, we start collecting diseases. The NHS gets us through and helps us to manage, but many people, particularly in deprived communities, can spend 20 years or more in ill health. The NHS is struggling to cope. We need to invest in a wellbeing approach to every person who lives in the UK—every child born—so that they do not end up a bunch of old crocks like many of us in this Chamber.
Safe staffing is vital. It is not hospitals or machines, but people, who deliver treatment and care when we are ill. The staffing issues have multiple causes. The decade of austerity meant many public sector pay freezes and caps, which made jobs seem unattractive. Caps on public pay and benefits take money out of local economies—many of us know of dead high streets. It is a pointless approach, because less tax goes back to the Government and it strangles the economy. Giving people enough to live on, with decent benefits and decent public sector pay, injects money into local economies and stimulates growth, which we keep hearing is the big thing that this Government believe in.
Another cause is Brexit. There was a 90% fall in EU nurses coming to the UK after the vote in 2016—not even the loss of freedom of movement in 2021, but the vote. Since the formal loss of freedom of movement, care providers have suddenly had to deal with the Home Office. Many MPs in this Chamber will know just how difficult that is, with the cost of visas, the administrative
burden and the general shortage of workers because of Brexit. Health and social care is having to compete with almost every other sector in the economy, so paying people badly simply will not wash.
Of course, there was also the pandemic. I was back in the NHS in the first wave in 2020, and I know that staff were incredible. They felt empowered. We were able to sit around a table, whether it was physical or virtual, work out what needed to be done, make a decision and move on in a way that staff on the frontline are rarely empowered to do. The problem is that this has gone on for three years now. Staff are suffering from exhaustion and burnout, but instead of having people clap for them, they get negative media complaining about staff and GPs and suggesting that GP practices are shut or that a phone appointment does not count.
I became quite ill and ended up in the hospital across the road in autumn 2021. When I finally got back to where I live, I had three GP consultations, two specialist consultations and just one day in a hospital, going through tests, before my medication was organised. Frankly, with my lifestyle, that suited me down to the ground. I did not need to hang around in a clinic, risking infection with covid. The job got done. Let us stop denigrating phone appointments. GPs are not stupid. If they speak to a patient on the phone and need to examine them, they will arrange that.
We have to realise that it is not just about the media; as politicians we have a duty, too. I have to gently point out to the shadow Health Secretary—particularly as my own husband was a GP—that GPs are not just gatekeepers for the NHS. They provide long-term continuity of care, they examine the patient, they are advocates and they guide the patient to the right service. Imagine someone with back pain. Were they digging the garden? Do they need to see a physio? Do they have a slipped disc, do they have a kidney stone, do they have a leaking aneurysm—or do they have metastatic cancer? How is a patient meant to disentangle that without a GP?