Health Care in Scotland

On Wednesday 18th January I spoke at the Health debate in the Scottish Parliament.

My full speech is below.

I declare an interest as a councillor in Dumfries and Galloway.

When Labour created the NHS in 1948, life expectancy in Scotland was 64 years for men and 69 for women. Today, it is about 77 for men and 81 for women. That shows the success of Britain’s greatest achievement: our NHS. However, if we are to ensure that life expectancy continues to increase, new challenges will be posed for Government and for us all as individuals, parents and families.

If our bodies are to be on the road for longer, our children need the healthiest start in life and the earliest intervention when needs arise and, as we grow older, we all need to take better care of ourselves if we are to get the most out of life in our later years.

It is still not widely understood the extent to which lifestyle has an impact not only on the chances of developing cancer and heart disease, but on the chances of developing diseases like dementia.

The truth is that individuals and communities need to be helped to take more responsibility for their health—that includes no-one’s health being disadvantaged by where they live or what they earn. If we do not make changes, the NHS will not be sustainable at a time when funding is simply not keeping up with demand.

The nature of the public health challenge that we face has changed. If the 20th century challenge was about adding years to life, the 21st century challenge is about adding life to years. The problem is that the very nature of 21st century living works against that. Our complex and fast-moving modern world exposes children to ever-more sophisticated commercial pressures and we are all absorbing higher levels of stress and insecurity, which can erode our mental health and wellbeing and lead to poor diet and addiction.

We all risk taking on more sugar, fat and salt than is good for us—and then we fail to move enough to burn it off. The consequence is probably the most pressing public health issue that Scotland faces today: obesity, or rather, an obesity crisis.

Two thirds of Scotland’s adults are now classed as being overweight and, shamefully, almost a third of children are at risk of becoming overweight. Not only does that have an impact on our nation’s health by contributing to a whole host of health issues, it impacts on our public finances, with an annual cost to the NHS in Scotland of £600 million.

It has now been six years since the Scottish Government and the Convention of Scottish Local Authorities published the obesity route map. Although it provides a positive policy framework, it is clear that the route map’s action plan has not reached its milestones. Therefore, Labour welcomes the commitment by the Scottish Government to consult on a new strategy on diet and obesity. That plan needs to include ensuring that the proceeds of any sugar tax are invested in after-school sports. Serious consideration needs to be given to better regulation, for example, of the advertising of unhealthy foods and of multibuy discount promotions.

However, what we really need to see is a comprehensive, cross-government strategy to tackle the root causes of obesity. That means tackling inequality. We know that there is a clear link between deprivation and obesity. A quarter of children aged 4 to 5 from the most deprived areas are at risk of being overweight, compared with around 18 per cent of children from the least deprived areas.

That gets to crux of the issue. Deprivation and inequality are all too often the drivers of a person’s health. To tackle health inequality, we need to tackle wealth inequality.

The first paragraph of the Health and Sport Committee’s “Report on Health Inequalities” from 2015 is chilling. It said:

“A boy born today in Lenzie, East Dunbartonshire, can expect to live until he is 82. Yet for a boy born only eight miles away in Carlton, in the east end of Glasgow, life expectancy may be as low as 54 years, a difference of 28 years or almost half as long again as his whole life”.

It is clear that the solutions to health inequalities cannot be tucked away in the national health service or written off as a problem of individual behaviour. That is why in a 2014 report, the Scottish Public Health Observatory concluded:

“Interventions that redistribute income, such as increasing the standard rate of income tax or implementation of a Living Wage are among the most effective interventions for reducing inequalities and improving health”.

Yet the Scottish Government’s recently published “Health and Social Care Delivery Plan” does not say enough about tackling health inequalities. The Government has taken its eye off the ball when it comes to what is happening with inequality in Scotland, because it is too distracted by what is happening between Scotland and England.

Worse than that, the recent Scottish Government budget shows contempt for the fight to tackle health inequalities, by making a £327 million cut in local council core budgets. Cutting local council budgets will not cut health inequalities. It is our local councils that deliver the early years framework to give our children the best start in life. It is often our local councils that provide the sport and leisure centres to keep people active. It is our local councils that are often there when our most vulnerable need a home to keep them safe and warm. Yet, as a result of this Government’s budget, councillors right here in Scotland, right now, are wondering what services they will need to axe next.

We know that it does not need...

This Parliament has the power to make sure that we do not have to make those choices. We have the power to be progressive, and to say that, if we want decent public services, we need to fund them properly.

Later today Labour will support the Conservative motion and the SNP amendment. The challenge to those parties is to show that they are serious about tackling inequality, to support Labour’s amendment and to put a stop to the cuts.

I move amendment S5M-03440.1, to insert at end:

“; further believes that tackling health inequalities requires well-resourced local services; considers that the Scottish Government’s £327 million of cuts to local council budgets will only further increase health inequalities rather than tackle them, and believes that it should use its tax powers to stop these damaging cuts in the Scottish budget.”

 

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ColinSmythMSP

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