Dr Zubir Ahmed

It is a pleasure to serve under your chairship, Dr Huq. I welcome the Minister, my hon. Friend the Member for Bury North (Mr Frith), to his place—he knows that I was in his place not too long ago, and I will be kind to him in my asks. I also welcome the Opposition spokesperson, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), who is a former orthopaedic surgeon, so he knows a thing or two about the blood vessels that run around the bones of the body. It feels like a unique privilege for me to stand here today as the Member of Parliament for Glasgow South West—where we have one of the largest hospitals in the country—a trained vascular surgeon, and a former Minister who was partly involved in bringing forward the cardiovascular modern service framework when I was in post. Vascular surgery was my bread and butter when I was a surgeon. There is no greater feeling for a surgeon and their team than returning blood flow to the limb—usually a lower limb—of a patient with critical limb ischemia, preventing them from undergoing a near-certain amputation, and watching them walk out of hospital. That is usually the culmination of many years of surgical training. I shall take this opportunity,  because I may never get it again as a parliamentarian, to thank those who trained me and many like me in the west of Scotland and enabled us to acquire and practise those skills: people like George Welch, Wesley Stuart, Keith Hussey, David Kingsmore, David Wallace and Steven Boom, and colleagues in the Public Gallery such as my good friend Tamim Siddiqui, a consultant vascular surgeon in the west of Scotland. I am biased, but I believe that the west of Scotland vascular surgery is a cut above the rest, although other vascular surgeons are available in the Public Gallery. One of the reasons I think the west of Scotland vascular surgeons are a cut above the rest is that, unfortunately, our area suffers from some of the highest burdens of vascular disease in the country. That is reflected in the statistics more widely. In Scotland, life expectancy and healthy life expectancy are going down, having steadily increased from 1980 until about 2012. We now have some of the lowest life expectancy rates anywhere in western Europe. We have to reflect on why that is. Scotland spends more on its NHS and has more staff and resource relative to the rest of the country, yet productivity is lower. Scottish hospitals are treating fewer patients now than before the pandemic, unlike English hospitals, which have surpassed pre-pandemic activity levels under the Labour Government. We have to reflect on where the political failure lies. On behalf of my constituents in Glasgow South West, it is only responsible to reference the fact that the SNP Government have proposed a massive restructuring of Scotland’s NHS, seemingly without any detailed consultation with anyone. It is not clear who that structural change serves, how much it will cost, or how we can judge its success or failure. I urge the Minister, who also has responsibility for four-nation engagement, to ask the Scottish Government how we can help to reverse the trend by imparting our wisdom and what we have learned over the last couple of years about turning around waiting lists and optimising clinical pathways. We have become habituated to the idea that there is a physical border between Scotland and England that cannot be transcended, whereas I believe that we can co-operate and problem solve instead of point scoring. I urge the Minister to lend the weight of his office so that patients near the border can benefit from services each way and do not have to travel 80 or 100 miles to receive services simply for lack of political will. I shall be grateful if he does that and writes to me about the outcome. Will the Minister consider the asks from the Circulation Foundation and the APPG, with which I have done some work in the recent past? As we all know, diabetes is unfortunately on the rise. Synonymous with diabetes is diabetic foot, which is now the primary cause of limb loss in this country. A concerted effort is required because early intervention on a diabetic foot can prevent major limb amputation. I ask the Minister that we think about the national foot attack pathway, with a same-day or next-day triage service for urgent cases that enables much quicker treatment of diabetic feet and diabetic foot sepsis. The model of stroke care that we have established, particularly in England with thrombectomy services, which I understand will become near-universal in only a few months—it is far from universal in Scotland—is a good model to follow for diabetic foot care and the national foot attack pathway. We need community foot protection services in every single integrated care board, with multidisciplinary hubs linked to specialist centres, so that we can offer more care not in hospital, but in the community, which is a linchpin of our 10- year health plan in England; and the implementation of national waiting time standards of five days for in-patients and two weeks for out-patients with transparent reporting. If we do that, we will save not only money, but limbs and lives. On commissioning, we have all become too habituated to paying for activity and inputs. It is time to shift the dial and pay for an outcome. In many ways, vascular disease and diabetic foot disease offer an early win—an early exemplar—of how we can shift the dial on commissioning services from input to output. Alongside that, it is important to think about how we support innovation, which is in the Minister’s title. I know at first hand that there are so many innovative vascular scientists and specialist surgeons doing things very differently from what we were doing only five years ago. They need the Government’s support. The Government will be pushing at an open door if they come forward with new ideas for how to innovate so that patients benefit directly from effective technologies and digital technologies. We can even optimise the NHS app to produce end-to-end digital pathways for these patients. I know that the Minister takes these matters very seriously and will consider them in his response. I end where I began, by thanking everyone who has attended today, particularly the colleagues from the vascular community in the Public Gallery. I reiterate that it has been an honour and a privilege to be part of this debate, as a parliamentarian serving a constituency with a diverse community that suffers from diabetes and vascular disease, but also as a proud member of the vascular surgical community.