Health and Social Care — House of Commons, 2017-02-27
Topic: Health
Patrick John Grady (Scottish National Party, Centre-left): I do not intend to detain the House for desperately long. The debate has been filled with trepidation and anticipation as Members, and perhaps the wider public, wait to see whether the House will actually debate any of the estimates before us. To pay tribute to hon. Members, we have not done too badly. The estimates document, HC 946—all 748 pages of it, at three and a half inches thick—and the Order Paper give us an estimate of £8,716,216,000 for the NHS. That takes up pages 137 to 151 of the document, but the only line that actually includes expenditure for health and social care is for the "Health and Social Care Information Centre (known as NHS Digital)" on page 151, which has £151 million of resources. That might have made for a considerably shorter debate, if hon. Members had not used their ingenuity to quite the extent they have We have debated the 10 detailed reports from the Health Committee and the Public Accounts Committee. I congratulate the Chairs of those Committees on securing time from the Liaison Committee, but even that raises the question of why 10 reports are squeezed into a three-hour debate that is supposed to be about supplying the Government with the resources needed. I congratulate the Committees on securing that time, but perhaps those reports ought to have had more time to themselves The NHS is one of the biggest areas of Government spending, second only to pensions. Adequate funding of aspects of the NHS is a constant major feature of political discourse, as it has been today, but there are no means to seek to amend any of this in any meaningful way through the estimates process. All we can do is table amendments that might lower the amount, but the theme of the entire debate seems to have been that the NHS in England needs more money, not less. Of course, any change to the NHS budget in England has some sort of Barnett consequentials in Scotland. I wonder whether, at any point today or anywhere in the Supply estimates book, we can find out what those are. I suspect we cannot Nevertheless, a number of important points have been made. The Chairs of the Public Accounts Committee and the Health Committees spoke in detail about the different budget lines and departmental spending lines and about the important long-term consequences of the transfers from the capital budget to the revenue budget. The hon. Member for Newton Abbot (Anne Marie Morris) spoke about the need to ring-fence certain lines. The hon. Member for Colne Valley (Jason McCartney), who is no longer in his place, made important points about the disaster that PFI has been in the health service, and that is true north and south of the border The hon. Member for Bishop Auckland (Helen Goodman) rightly asked where the £350 million a week for the NHS was. It certainly is not in the Supply documents brought to the House by the Government today. There is, in fact, a systematic underfunding of the NHS in England under this Tory Government, and that has serious implications for the NHS across the UK as a whole. As we have heard from Members on both sides of the House, that environment will only become more challenging as the population ages and demographics continue to change The Scottish Government, as I am sure we will hear from my hon. Friend the Member for Central Ayrshire (Dr Whitford) on the Front Bench shortly, are focused on these challenges and on building a health service that meets the demands of the 21st century. They are not just investing in the NHS but reforming it—integrating health and social care, and engaging with communities and the medical workforce, to bring about sustainable and positive NHS reform, as opposed to pressing ahead with the hasty cost-cutting exercises that seem to be the priority of the Tory Government However, perhaps it suits the Tory Government to have an NHS that is in the crisis described by Labour Members, because that gives Ministers an excuse to bring in private capital and private management and to outsource services to private providers. That, in turn, would have major consequences for the NHS budget in England and consequentials for the devolved budget, which brings us back to the inadequacies of the estimates and Supply process in this House The former Leader of the House promised us that these Supply days and estimates days were our chance to scrutinise the Government on things that we were otherwise excluded from during the English votes for English laws processes.