Seamus Logan: Winter Fuel Payment cut will devastate NHS

Last week, when given the chance to register opposition to this in the House of Commons, not a single Scottish Labour MP chose to do so.

Labour MPs as compliant lobby fodder? Perhaps not a surprise to most independence supporters, but hopefully an early wake-up call for voters more generally that for so long as Scotland isn’t independent and is sending MPs to Westminster, it really does matter what values those MPs represent and how they are willing to speak up for them.

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What remains a shock – if not necessarily a surprise – is the admission which came in a BBC Breakfast interview with English Health Secretary Wes Streeting last week that Labour had failed to undertake any assessment at all of the impact that cuts to the Winter Fuel Allowance could have on the health of pensioners.

Previously, the Labour Party’s own research had suggested that just such a cut could result in the deaths of 4000 pensioners. I think it’s safe to assume that no official government assessment was carried out because Labour ministers already knew pretty much what it would say.

Evidently, they didn’t fancy having that verdict confirmed by civil servants and later quoted back to them, either by opponents in Parliament or in the broadcasting studios.

Quite apart from the individual financial impact this will have, it will also clearly affect the health of tens of thousands of pensioners this winter – something which will in turn bring an immediate and direct impact on all of us this winter because of the increased and entirely unnecessary pressures this will place upon the NHS.

A report published last week by surgeon and former Labour peer Lord Darzi described the NHS in England as having been left chronically weakened by a decade-and-a-half of UK government austerity and starved of capital investment in consequence.

Despite the best efforts of Scotland’s Government, we know to our cost how the impact of cuts to spending for England directly reduces the funding available for devolved services in Scotland.

Scotland’s government has tried to do things differently, with higher rates of pay for NHS staff than elsewhere in the UK and generally better outcomes for patients – not that you’d know this if you relied on most of Scotland’s media for your information.

Pressures on services don’t only come as a consequence of tighter budgets, however. Increased demand for those services also plays its role in terms of making it harder to ensure that targets and needs can be met.

By way of an example, our GP surgeries are the entry point for many to access NHS treatment. It used to be that people visited their GP an average of three times in any given year. Now, that average figure is six visits per year.

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So how can that particular demand pressure be reduced? Already, there are initiatives like the Pharmacy First scheme, which allows community pharmacies to give people expert help for treating several common conditions and to offer referral to other healthcare teams if required.

Also, we need to recognise that many matters can be dealt with appropriately in surgeries by healthcare professionals other than GPs, freeing up those precious GP appointments for those patients who need them the most.

Although Scotland already has more GPs per head than the rest of the UK, the Scottish Government has a commitment to further increase that number by 800 by 2028. To achieve that, we will need not only to attract more people into General Practice, we will also need to find ways to help retain GPs at all ages and stages once they are in practice.

That could involve looking at how we can support GPs in the first five years of their careers as they transition from their training programmes to the reality of fully-fledged general practice.

Also, as a way of encouraging more medical graduates to stay in Scotland, perhaps we could look at ways of helping to reduce their student debt for each year that they spend in NHS practice in Scotland.

Retention for some may come down to helping address the increasingly challenging finances of trying to run a practice, while for GPs further along their career path, it may come down to ensuring that there is increased support to allow for continuing professional development in the role.

Meanwhile, for those approaching retirement, we also need to make sure there are no financial impediments which make it not worthwhile to continue in work for so long as they both wish and are able to.

Of course, there are many pressures in our acute settings too. While greatest media and political attention is focused on A&E waiting times, this is itself often a symptom of pressures caused elsewhere within the system, such as the difficulty of putting together care packages to allow people to be discharged from hospital to more suitable care settings.

And in this, let’s not forget the enormous adverse impact that Brexit and restrictions on freedom of movement has had on those increased pressures in our NHS and social care settings.

The NHS provides us with an example of the limits of devolution and what happens when you have a government which is rightly held responsible for policy, but which lacks control over key aspects of the resources needed to deliver as it would like.

As damaging as a decade-and-a-half of Westminster austerity has been, the continued Labour and Tory opposition to freedom of movement or visa schemes to attract the widest pool of talent shows that those constraints aren’t only financial.