Sunday, January 15, 2017

The Brexit Train begins to move this week.

Important few days coming up for Brexit. We are expecting the Prime Minister to make a substantive speech on Tuesday outlining early thoughts on the challenge that lies ahead. Personally, I don't expect her to give too away much. I certainly hope not. I expect her to re-iterate her commitment to invoking Article 50 in March, and tell us that the Govt will bring forward a bill to take through the necessary statutory processes if the Supreme Court finds against the Government later this month. She may also give us some idea what her 'red lines ' are.

Don't know when the Supreme Court will inform us of its decision but I would expect it to be this week or next. There seems to be a general expectation that the Government will lose its case. However what may be more interesting will be whether it will be a unanimous vote, and if not what the balance of opinion will be. I sense that if three or four judges support the Govt position, it may be seen as a sort of success.  If a Bill is then brought before Parliament, there will be interesting debate. The people voted in favour of the UK leaving the European Union and I would expect only the Liberal Democrats, Plaid Cymru and the SNP to refuse to accept the people's vote. I notice Plaid Cymru spokesman still banging the 'Project Fear' drum today. Is anyone listening?

Perhaps it's too much at this stage for the Prime Minister to say emphatically that if the UK cannot secure acceptable terms to leave, we should simply fall back on WTO rules. I do think that at some stage, the UK will have to take that position. There can be no compromise on leaving the jurisdiction of the European Court of Justice. There can be no going back on securing control of who is allowed into the UK. If it's possible to retain access to the Single Market or remain within the Customs Union at the same time, that would be excellent.  At present can't see how we can.

Been also good to note that New Zealand is keen to agree a trade deal with the UK. NZ always been a good friend to UK. And Canada and Australia. But the big fish is the US. It's a massive market. And the new President seems well disposed towards the UK. Wonder how many people feel as I do - keen to start working on these trade deals across the 50 countries that Liam Fox is targeting. Pessimism and navel gazing creates negativity.

Inevitably there is a degree of nervousness amongst the sheep farmers in my constituency. I share it. We do not want to see any significant tariff on lamb exports. I don't expect that to happen under any circumstances. And I hope not. I would immediately have to stop consuming any imports from the EU, whether it be cars, wine or anything else. I see some media coverage today to comments by the Chancellor who is reported as having said that the UK will reset its economic strategy if the EU imposed conditions which would hurt the UK economy - that we would not take it lying down. Well that's how I feel, and I expect it will be how many others feel as well. It's very early days yet, but there will be significant developments over next few days.

Friday, January 13, 2017

How best to deliver health and social care.

On Wed two things happened at the same time in my life. I read an email from a constituent pleading with me to pressurise the Chanceller to allocate more money to the NHS. At the same time, I was participating in a debate in the House of Commons about 'The Future of A&E services in Shropshire and Mid Wales'. The instigation for this debate was a decision by the two Clinical Commissioning Groups in Shropshire to ignore the recommendations of the Future Fit Programme Board which had been set up by the very same two CCGs to research and recommend a way forward to improve A&E provision. This research had taken three years, and had cost several million pounds. What sort of a waste of money was that - millions of pounds that could (should) have been invested in our NHS. These points may not be earth shattering in themselves, but are typical of what happens on a daily basis.

It's about money. Now I'm not an economist but I can spot a trend that's going off the graph. It's why I snort, almost derisively when opposition politicians shout about 'austerity'. We are already spending like there's no tomorrow. The UK deficit remains unsustainable over the long term. And it's not so much that our  National Debt is reaching heights that would daunt Sergio Bubka, but it's going up and up. And when I talk to those who understand local government pensions, I'm horrified by the level and growth of these extra liabilities. And it seems that consumer and personal debt is reaching record levels as well. It's against this background we need to consider NHS funding.

I do think NHS funding (incorporating social care) will have to receive more funding though. But it will have to be balanced by budget reductions elsewhere. We are living longer, many of us with multiple health problems. There are new expensive health treatments coming along which keep alive patients who would have died until recently. New pressures are piling on clinicians, many of whom are retiring early. No matter how hard they work, it becomes ever more difficult to keep up. There will be more money, but it won't ever be enough. This is why it makes my blood boil to see millions wasted by failure to face up to reality and tough decisions - as we've seen recently in Shropshire.

I know this blog post could run to a hundred pages, so I'll just add one point I'm interested in floating with the Chancellor. We need to help/encourage family care of those who need it, rather than expect the state always to take the full burden. Many families do of course. But too many don't. We need to use the taxation system in an imaginative way. Tax allowances for approved capital spending to help families adapt homes. Better targeted care allowances for domicillary care. The extra money we must invest in our health and social care system should be directed towards ensuring more care is delivered at home and not in hospitals, the purpose of which should be to treat people not who need clinical care rather than social care. And we need to move fast.

Green light for Green 'Lagoon' Power?

The Energy and Climate Change Committee is gone, deceased, defunct, but I'm still interested in energy generation projects. For many years, I've thought it must be possible to source energy from the power of the tides that surround the British coastline. Had high hopes for the Severn Barrage, but it wasn't to be. And then a few years ago, the Swansea Bay Tidal Lagoon floated into view. I would love to see it fly, but never been totally convinced it will, despite really wanting it to. Well maybe today is the start of the reassurance I've been looking for and an early sign of a brand new Tidal Lagoon technology.

Media running very positive headlines on the likelihood of £1.3 billion Swansea Bay Tidal Lagoon winning the go-ahead from Govt on the back of the Hendry Report. My instinctive response is to be really pleased. I reckon most people will feel the same. I feel sure that one day we'll find a way of harnessing the power of the tide and maybe this is it. But I'm not sure that there has been any great move forward today that warrants all the positive headlines. I just cannot see what is that new today.

When Charles Hendry was asked to prepare a report, I expected it to be positive. Charles, who was a very good energy minister, has long been hugely enthusiastic about renewables. And nothing wrong with that. But what we have had today is a report which talks about spreading the capital costs of the project over the 120 yrs that a Lagoon in Swansea Bay is predicted to deliver power. That's what makes the power competitive. I reckon that will make the Chancellor choke over his corn flakes. But perhaps not. I was a bit disappointed that Charles considers contemplating further tidal lagoons around the coast of Britain as too ambitious a goal before even one is built. It's always been the case that Swansea Bay Tidal Lagoon on its own has never seemed to me viable. It's a 'pathfinder' but I'd like him to have been a bit more positive about the bigger cheaper lagoons that seem more likely to be viable.

I've not had chance to read the report yet, only media reports of it. Next week perhaps. And surely the 'Marine Licence' will be a challenge too. My experience of Natural Resources Wales is that there will have to be cast iron protections for marine life before it's granted. But thats me - always cautious. I need to be sure it's a financially viable project, and environmentally acceptable. I suppose my informal position is similar to what I'd expect Govts formal position to be. Well done And thanks to Charles Hendry for a report which deserves to be read carefully.

Tuesday, January 10, 2017

A&E Services in Shropshire and Mid Wales.

MP for Shrewsbury, Daniel Kawczynski has secured tomorrow's adjournment debate. It's decided by ballot and will take place after the 7.00pm votes. It's on the subject of 'A&E services in Shropshire and Mid Wales'. Normally adjournment debates are confined to the MP whose debate it is and the responding Minister. Because Health Minister, Philip Dunne, MP for Ludlow has a constituency interest, it will probably be Health Minister, David Mowatt who responds. However, I have asked Daniel and the Speaker's office if I can also speak. 2/3 minutes will do. I very much hope so, and this blog post is roughly what I will say if I 'catch the Speaker's Eye', as we say in Westminster-speak.

I have three points to make. Point 1 - to emphasise that the major Shropshire hospitals serve Mid Wales as well as Shropshire. The Welsh Parliament (as I like to call it)  is a devolved parliament. It is not the  parliament of an Independent state/country. I usually refer to Wales as a nation. There is no hard border twixt England and Wales. There are financing arrangements which allow for NHS services to be accessed where best for the patients. Those calling for anything else have no proper understanding of what devolution means. Emergency care, secondary care, elective care, specialist care (whatever you call it) for most of Montgomeryshire  is accessed in Shropshire. This is not even debatable.

Point 2 - the current Emergency care model is not sustainable. The A&E services at the Royal Shrewsbury and the Princess Royal, Telford are not 'emergency services'. Only about 20%of those who present there are real emergencies. The only viable sustainable option is to build a new 'Emergency Unit' for the 20% and two 'Urgent Care Centres' for the 80%, one in Telford and one in Shrewsbury. We've known this for years. But over the last 3years, at a cost of £2million, a body charged to research and recommend, the Future Fit Programme Board,  confirmed what we already knew and made its recommendation to the joint Clinical Commissioning Boards which had set it up. Just before Christmas, the CCGs refused to accept the recommendation - a total shambles which cannot be allowed to stand. It would simply mean that A&E consultants would not be attracted to Shropshire, and services would migrate to other hospitals further away.

Point 3 - Where should the Emergency Unit be located. The clear view of the Future Fit Board was Shrewsbury. Unsurprisingly, the view of everyone I've talked to in Mid Wales is Shrewsbury. My guess is that rural parts of Shropshire (around Oswestry, Ludlow etc) would share that view. But Telford says No. Lots of Mid Wales patients have to travel anything up to an hour to reach Shrewsbury now. Telford would be another 15 minutes on top, even travelling under blue light. While Telford itself is only around 20 minutes from Wolverhampton. I must concede I do not know how this is going to end up. But I do want my parliamentary colleagues in England to know anything less than a reformed Shropshire NHS, with an Emergency Centre based at Shrewsbury would make no logical sense.

Sunday, January 08, 2017

Colostomy Irrigation.

I ocassionally speak and write (sometimes irreverently) about my experiences of bowel cancer - particularly colostomy irrigation of which I am an enthusiastic champion. Because it has changed my life, I try to persuade fellow-ostomates to give it a go as well. It's always surprised me that so few British ostomates do 'give it a go' as opposed to the US, where I'm told most do. Perhaps it because all the equipment in the UK is free, while in the US, it has to be paid for. Colostomy irrigation has very little cost. I'll write a paragraph on how I acquired my colostomy, and another paragraph on what irrigation involves. It seems strange to me that so few people know what's involved - probably lot of people think bowels cant be mentioned in polite society. That's an attitude that leads to a lot of people dying before they should.

In 2002, in consultation with my surgeon, Mr Hunt, we decided on an Abdomininal Perineal Resection to remove a cancerous tumour. It was a big op, around 5/6 hours. Only a 5% chance of dying though. It involved removal of the lower part of the bowel, the rectum, and anus, bringing the cut end of the remaining bowel out though a small incision in the abdomen to form a colostomy. Looks like a cute little opening rosebud, about an inch across. It's quite radical surgery, so unsurprisingly it takes a while to settle down. That part of our bodies we sit is not 'flat' so just pulling the skin across and stitching it up needs time to recover. And I found infections developing in the space where bits of me had been removed. Had no bother with either of these issues for years now. Most people attach a colostomy bag to collect the excreted waste. I did not like that, and when my colostomy nurse suggested trying irrigation, I decided to give it a go. Soon became used to it. Changed my life and I'd never go back.

So what's involved. It's so simple and straightforward. A flexible polythene bag, which will hold near 2 litres is hung on a peg in the bathroom. I use the end of the curtain rail. In hotel rooms, it's usually the top of the nearest door!! I pour about 1600 ml of warm water into the polythene bag, allowing it to run down a tube and into the bowel through the colostomy. For me gravity is sufficient, though pumps are available for those who prefer it. And then you just let it all run out into the loo. I usually sit on an adjacent comfortable chair, with my mobile and IPad to work on - or read the paper. Have to remember not to use face-time. Takes around 40-60 minutes. To start with I was disciplined and did it every day at exactly the same time. But now I irrigate when it's convenient. Lots of grandchildren etc. making demands on the bathrooms in our house. Usually it's every two days but if I've not been eating much, it can be three days. So I live with more control that most people have, and never have an active stoma when I'm working, or speaking in public. For me, it's as easy as it reads.

I know it doesn't work out so well for all ostomates, but I cannot understand why those it would work for don't give it a go. Changed my life, and I'd never go back to using colostomy bags. To those who have read this far, I hope you've not found my post too gruesome, and you now understand what colostomy irrigation is about.  It's so much less complex and intrusive than Brexit or the Wales Bill!!

Saturday, January 07, 2017

UK will re-engage with the World.

Back to Westminster tomorrow. Next three months is a key period in British history, equivalent to the early stages of British withdrawal from 'Empire' in middle of last century. Leaving the EU is that big. Daresay the politicians and public didn't realise they were part of such immense historic change then either. Not that there will be anything dramatic. That's not our Prime Minister's style. She is not going to be rushed by the desperate demands to satisfy the insatiable hunger of the 24 hr news cycle. How often does she have to say "No running commentary". One way or another, Article 50 will be invoked by end of March. But won't be much negotiating til after French and German elections. Hopefully the EU will quickly agree to quarentee future residence for those EU migrants legally in the UK, and UK migrants legally in the EU. The EU is not prepared to discuss this issue until Article 50 is invoked. Andrea Leadsom, Sec of State at Defra tried to reassure the farming industry on this point last week. We're told the Prime Minister is due to give us some idea of her thinking next week. Personally I hope she won't be tempted to give much meat to the news hounds. Only make them bark louder.

But Brexit is not the substance on this blog. It's more how we as MPs react to Brexit. Will we be able to do much else over next three years! And what else will we do! Reason I'm thinking about this tonight is that I'm appearing on Radio Wales excellent programme 'Sunday Supplement' around 8.30 tomorrow morning. Expecting to be alongside Kevin Brennan  - a good 'common sense' Labour MP. Not certain what we're discussing but I think it's what we're expecting in the House of Commons in the year ahead. For me, and most Welsh MPs, the next few weeks will be focussed on the Wales Bill. Hoping that will be done and dusted before end of February. If not, it might not make the Statute Book at all!! But what about after that.

We will inevitably be driven by the implications of leaving the EU. We must turn up the volume on strengthening the Welsh economy. A key part of any strategy must be to re-engage with the non-EU world. The Wales Office and Welsh Government must work closely together as 'Team Wales' to promote our nation across the world, and to attract more investment into Wales. We need a focus on business development and job creation. The US must be a key target if the new President cuts red tape and taxation as he has said he will. The US economy will be on fire. And we'll need to target the other big growing economies - China, India, and using the Wylfa link to engage with Japan. And there's Australia, Canada. South Korea, Taiwan etc.. In the early 90s, around 20% of foreign investment into the UK came to Wales. Won't reach those heady targets again, but we do need ambition and investment in selling Wales to the non-EU world, which has not been what it should have been for a very long time. Wonder if Kevin will agree with that.

Friday, January 06, 2017

New Parliamentary Boundaries.

Held a meeting in Welshpool Town Hall last night to which I invited Montgomeryshire's Town and Community Councils plus organisations which had raised with me concerns about the new Parliamentary constituency boundaries that are proposed to be in place by the 2020 General Election. It was a good engaged meeting but only about 20 people came. I held a similar meeting before Christmas, with a similar response. My aim was to explain what the position on this issue is. It's clear to me from the letters I've received about it that very few of my constituents are aware of the background.  So here goes with roughly what I said.

It all began with the 'Expenses Scandal' in 2008/09. I'm glad I wasn't an MP at the time, because their reputations and respect amongst the public fell to an all-time low level. Political leaders at the time entered into what can only be described as an MP bashing competition. David Cameron, then Conservative opposition leader made a manifesto promise to cut number of MPs by 10% - from 650 to 585. Lib Dem Leader, Nick Clegg made a manifesto promise to cut from 650 to 500. Then the  2010 General Election produced a Conservative/Lib Dem Govt on the back of these promises. The quickly agreed 'Programme for Govt' of the new Coalition included a promise to cut number of MPs from 650 to 600. And they got on with it.

After much debate, the Parliamentary Voting System and Constituencies Act received Royal Assent on my birthday, Feb 16th 2011, perhaps the least welcome 'present' I've ever received. This Act cut number of MPs to 600, and legislated that the population of every constituency must be within 5% of the average. Because of historic 'over representation' Wales was affected much more than anywhere else, the number of MPs falling from the current 40 to just 29. The only further step needed to bring the Act into force was a review by the four national boundary commissions to establish the precise boundaries. The reality is that the Boundary Commission for Wales has very little discretion to make allowance for history, culture or common sense. The inevitable consequence were draft proposals that consigned the historic constituency of Montgomeryshire to the dustbin of history, and will end Parliamentary democracy in Mid Wales as we've known it. For me, and most citizens of  Montgomeryshire, this is sacrilege and a catastrophe. If these proposals are approved, a dark cloud will descend over mid Wales. Owain Glyndwr's home is in Montgomeryshire. Where is he when we need him! 

But it's not over. She hasn't sung yet. The Act was supposed to be in place for the  2015 General Election. But in 2013 the House of Lords stepped in and behaved in a constitutionally questionable way. The ermine clad legislators are a law unto themselves - literally. In 2013, their beloved Lordships added an amendment to an unrelated act, the Registration and Administration Act to delay the boundary changes for 5 yrs, commuting the 'death sentence' on Montgomeryshire until after Oct 2018. That's where we are now. On death row. But who knows. If their beloved Lordships can behave outrageously once, they may find a way of doing it again. Or the Govt might change its mind about bringing forward a vote in Oct 2018 because of other issues on its mind. When I was asked last night what I thought would happen, I said my guess was 51%-49% that the 2020 election will be fought on existing boundaries. Don't ask me to say why, because I don't know. Just instinct. We will see.

Wednesday, January 04, 2017

Welcome Sir Tim Barrow.

The UK Govt has moved with surprisingly commendable speed today to appoint Sir Tim Barrow KCMC, LVO, MBE as the new UK Ambassador to the EU. Hard to believe it was only yesterday that Sir Ivan Rogers announced that he was standing down 10 months early. My guess is that the pro-remain press and the BBC were hoping to run "UK Govt in disarray" for a few more days. Their fox has been well and truly shot, and much quicker than anyone anticipated.

Sit Tim Barrow seems the ideal appointment. He's been UK Ambassador to Russian Federation for last few years, and had experience in the EU before that. All these quotes we've been reading about from some back bench Conservative MPs about needing a committed pro-Brexit Ambassador are shot down as well. Even saw suggestions that Nigel Farage would be chosen. That was so outrageous as to be 'lol'. The best the BBC seem to be able to do is James Langdale informing us that "it would be hard to say that Sir Tim Barrow is an out and out pro-European". What is that supposed to mean?  I wonder if they'll ask Clegg, Mandelson, to comment, or whether Sir Ivan will send an internal memo to his fellow civil servants (which will be unfortunately leaked!) telling us what he thinks.

What we need is a calm capable Ambassador committed to helping the UK achieve a positive Brexit in the interests of the UK and the EU - with complete discretion. My guess is Sir Tim Barrow will not say anything or want to become the story. I think it's been a rather good news day for the Prime Minister.