Sunday, October 15, 2017

Follow up on Brexit radio chat this morning.

It’s difficult to know what to expect when entering into the Lion’s Den that is the Sunday Supplement studio with Vaughan Roderick. Especially when the subject under debate is Brexit. I realised The inevitability of being asked which way I’d vote if the EU Referendum was held again. But there are so many other strands blowing in the winds of uncertainty.

The two strands that Nia Griffiths, Labour Shadow Defence Minister and I talked with Vaughan about   this morning were the transition/implementation period after March 2019 and our approach during it to the leaving of the Single Market and the Customs Union. We will be formally leaving all of them in March 19. There are some who refer to this as “The hardest of Brexits”, which I do think is utter nonsense. My hope is that the UK will agree that our relationship with the EU during the transition/implementation period will match as closely as possible current arrangements - where this benefits both sides. Must admit I’m not personally that bothered about the two year limit, as long as it’s not just a tactical delaying tactic.

Vaughan quite rightly brought up impact on Welsh sheep farming. We knew before Referendum day that the tariff on lamb could theoretically be a massive 40% if we have no agreed deal and have to fall back on WTO rules. That is a ‘worst case scenario’ and of course it inevitably means some uncertainty. It would also require some highly stupid and perverse decision (or non decision) making. I’m a lot more optimistic. But I do accept the possibility of perverse stupidity, so am keen to promote diversification. A good long term strategy whatever happens. It’s already happening.

Which brings us to what is a sensible approach to the ‘No Deal’ question. And here I do think the opposition position is bizarre. I watched Labour’s main spokesman on this issue, Kier Starmer on the Sunday Politics today. Sounded like a man who has never done any sort of deal in his life. Only a fool enters a negotiation, informing everyone that whatever deal is reached, it will be/must be accepted. Like me in a former life, walking into the John Deere sale room, waving my chequebook around and informing the salesman I’m buying no matter what the price. It’s an attitude quarenteed to deliver a very bad deal. We all want a good deal for the UK and a good deal for the EU. Thank goodness Mr Starmer isn’t sitting at the negotiating table.

Anyway, that was about it. I was expecting this morning to be about how we manage powers reserved to the EU in devolved subject areas, and the wide use of Henry VIII powers. Now that would have been much more difficult for me to cope with!!

Friday, October 13, 2017

More chat about Brexit.

It may not be a wise decision but I’ve agreed to appear on Sunday Supplement this week to discuss Brexit. In current climate, my ambition will be not to commit a ‘gaffe’. And that will not be easy because even the slightest grammatical error is treated as a ‘gaffe’ when the subject of Brexit is under discussion. And Vaughan Roderick is a crafty interviewer.
First question is bound to be ‘Which way would you vote if the referendum were to be re-run today.? The obvious answer should be the one the Prime Minister gave. It’s not going to be re-run and we are leaving the EU in March 2019, so don’t ask such a pointless hypothetical question. But when I’ve been asked over recent days, I’ve replied “I’d vote same as June 2016”. I’d vote Leave, with the same degree of uncertainty as I did last time. I find the question no easier to answer today, even though the blood curdling nonsense churned out by the Treasury before the EU referendum has been shown up as the ludicrous scare stories without foundation that we thought it was. But reality is we still face uncertainty, and will continue to do so for a good while yet.
I might be asked if I support a ‘Hard Brexit’ or a ‘Soft Brexit’. I really do not know what these terms mean. They are bandied about by people as if they are clearly defined terms. They are not. They are just some sort of code, which I don’t fully grasp.  I am in favour of the UK leaving the EU, including the Single Market and the Customs Union. Anything else is not Brexit. Call that response what you will. I see leaving the EU simply as ‘Brexit’.
And then we have the issue of whether the UK Government should prepare for ‘no deal’. Of course we should. I’ve never gone into any negotiation without retaining the option of ‘no deal’. And I fully expect the EU to be preparing for ‘no deal’ as well.  Not having that option on or near the negotiating table almost guarantees a bad deal. Most people want a good deal for the UK, and a good deal for the EU. But it’s seemed to me all along that the conditions imposed on the negotiations by the EU at the start almost guarantee ‘no deal’. That is a dreadful pity - both damaging and unwise. But if that’s the way it is, so be it. And I’m not sure we should waste much more time dancing to an unacceptable Juncker/Barnier tune on this. The one individual whose behaviour promotes ‘no deal’ above all others is Juncker. I hope there are no gaffes in that!

Thursday, October 12, 2017

Paying for Domiciliary Care

On Monday morning this week, I ‘launched’ a social care conference, arranged by TLC, a local service delivery company, at Llanidloes.  I think it was rather grandly described as a ‘Keynote Speech’. I refer to this only because my main message was much the same as that heading up today’s front page in the Telegraph. My contention was that Domiciliary Care ‘service users’, (those who can afford to that is) must pay more for their care. It’s what the Social Care Minister, Jackie Doyle-Price is reported to have said at a fringe meeting at the recent Conservative Party Conference. Hope I’m supporting the Minister’s and the Government’s emerging policy on this issue. I’ll summarise the thrust of my speech.

I began by acknowledging that paying for social care is both a complex and controversial issue. It’s arguable that a Conservative attempt to tackle the issue in June’s manifesto contributed to a more disappointing election result than I hoped for. The description of the policy as a ‘Dementia Tax’ was an utter disgrace - repeated in today’s Telegraph. The Telegraph, and every other media outlet that does the same should be ashamed of themselves. It’s a policy area that is in desperate need of reform. It is deeply unfair is several ways. The people who pay for this failure to tackle a very thorny issue are the frail elderly, whose voice is not heard as much as it should be in today’s society.

Firstly, let’s consider the difference between how residential care and domicilliary care are treated. Those who need care pay for residential care, until the value of their assets fall to a certain level. Those who are deemed to qualify for domiciliary care don’t. Not only is this unfair, but it distorts decision making amongst families. And we know that assets are sometimes transferred in cases where the need for care can by anticipated.

Secondly, in the absence of magic money trees, domiciliary care is paid for by taxpayers, often much less wealthy. It simply seems wrong to me that young families, struggling financially to bring up children have to support people far wealthier receive care.
I agreed with the Conservative manifesto proposal (after it was amended to include a ‘cap’ on the total paid. It was payable by ‘service users’ who were worth more than £100,000. In my view the ‘cap’ on total payments should be less than £100,000. And payment should be deferred until after the used dies.
I know this is not likely to be a popular viewpoint. But as I’ve grown older, I think it’s more important to be right, responsible and fair that it is to be ‘popular’. The second key message of my speech on Monday was that as new policy is developed (which it will have to be) it should developed in partnership with representatives of those who use the services and those who deliver the care. This is not an issue that can be left, simply because it’s difficult. And there are commentators who will do their utmost to make it an impossible to tackle it.

Sunday, October 08, 2017

Public Consultation on Shropshire NHS Reform.

I’ve known for about 40 years that the populations of Shropshire and Mid Wales cannot sustain two large District General Hospitals in the long term. 40 yrs ago, an old ld squash friend of mine, Dr Paul Brown (who was also a top consultant in Shropshire) explained why very clearly. He was far seeing and absolutely right. Tragically Paul died young. Today there is a Paul Brown Department at the Princess Royal in Telford.
I’ve been closely involved in the discussion about structural reform of the major hospitals serving Shropshire and Mid Wales for about 20 years. While it would have been best to build a new hospital on a green field site to replace the two hospitals currently located at Telford and Shrewsbury, it has proved to be too costly - about £600 million. So the only way practical forward is to merge the Royal Shrewsbury and the Princess Royal, running them as one hospital, but on two sites. The two Clinical Commissioning Groups (CCGs) serving Shropshire, who decide on future structure agreed this a few years ago and set up a body known as the ‘Future Fit Programme Board’ to consider the matter in detail and make a recommendation on the way forward. After investing more than 3yrs and £2million it finally agreed (after much angst) to recommend that ‘emergency care services’ should be located at Shrewsbury and ‘Planned Care’ should be located at Telford. In the end, following much argument, it was a unanimous recommendation by both CCGs. The public meeting where it was decided was noisy and angry. This ‘preferred option’ includes the transfer of the most serious cases of maternity trauma from Telford to Shrewsbury as well.
In order for this ‘preferred option’ to proceed, the UK Government (NHS England) has to agree the budget needed for the capital works - about £200 million. I expect this to be agreed. There also has to be a public consultation, the details of which we do not yet know. What I expect is that it will be of 14 weeks duration, beginning sometime in November. The statutory requirement is that it be of 12 weeks. Also, we don’t know how many options will be put before the public. It will probably be 2, but could be 3. But the key factor is that there will be a ‘preferred option’ - which is that Emergency Care should be located at the Royal Shrewsbury Hospital. This is very important to Mid Wales. It’s been a long and tough battle.
It would be easy to think that since there is now a ‘preferred option’ that the debate is all over. Such an attitude would be a serious mistake. It’s vital that the people of Mid Wales respond to the public consultation by making their opinions known. When we know the precise date when the consultation period begins, and the precise options before us also I hope thousands of Montgomeryshire residents will respond. It will be vital that we all write individual letters.
Reform of the secondary care system which serves Shropshire and much of Mid Wales, including most of Montgomeryshire, is perhaps the most dominating issue throughout my years as an Assembly Member and Member of Parliament. It has certainly been the most important issue for my constituents. Over the 12 or 14 weeks of the public consultation, I will be holding one or two meetings every week throughout the constituency, where there will 2/3 of us present to help with letter writing etc. The County Times has assured me that it will help publicise this campaign. We need to make sure that there is no complacency or distraction from our objective, which is to have our new ‘Emergency Care Centre’ built at the Royal Shrewsbury Hospital.

Saturday, October 07, 2017

Presumed Consent. Triumph of Idealogy over Evidence.

As long as I can remember, I have been enthusiastic about organ donation. Carried a donor card, but much more importantly have told next of kin of my wishes. Been involved in campaigns, and met up with Specialist Nurses (SNODS) to discuss how we can increase donation levels. But I have always been an implacable opponent of presumed consent. I simply do not consider it right that the state should take the organs of the dead, without the expressed approval of the dead or a family member taking the decision on behalf of the dead. And it doesn’t deliver more organs for donation.

Unfortunately, whenever this issue is under discussion, I have to repeat that I support Organ Donation. I also have to repeat that my opposition is not based of faith or religion, but on efficacy. It does not work. I now refuse to do media interviews. What happens is that someone needing a transplant informs the listener that an organ is needed to save his or her life - and then I’m asked why I disagree. I politely make clear that I don’t disagree. The follow up question (totally ignoring what I’ve just said) is usually asking how I can support religion blocking the saving of a life. I politely point out that my views have nothing to do with religion, but are based on there being no evidence that presumed consent will improve donation levels, and may well lead to the opposite. My experience confirms that there are none so deaf as those who will not listen.

There are three ways in which we can increase organ donation. Firstly promote ‘opting in’. Donor cards are useful but most effective way by a country mile is to tell next of kin. Secondly, increase number of Specialist Nurses (SNODS) who are trained to talk with next of kin when they are coping with the pain of a loved one’s death. Evidence tells us the rate of donation increases dramatically when SNODS are involved. And thirdly, increase number of Intensive Care beds, which are needed to allow a transplant to take place.

Of course, we will all be able to ‘opt out’. But we know that most people will not ever think of this issue. The state will be taking organs from people who would have opted out if they had thought about it. This is anathema to those of us who remember the horror of Alder Hey. My view is that ‘opting out’ will in effect be reserved to the more educated, informed part of society.

But the main reason I’m opposed to presumed consent is that it transforms the principle of donated ‘gift’ into a statutory ‘duty’. The State decides and then ‘the state’ acts. We as individuals no longer need to. ‘The State’ will have no interest in asking us. Over recent years we’ve see huge increases in live donors, often donating altruistically. This will fall, (they already are) in the same way care of elderly family members has fallen over time as the state took over the responsibility.

I was very disappointed to learn that my government intends to proceed with presumed consent. There is no evidence to support such a policy. I will not oppose it if it’s a whipped vote, but it should be a ‘free vote’. I will continue to publically oppose it, as I’m doing now, and challenge it on the floor of the House of Commons. It’s putting ideology before evidence. And worst of all, It will not increase number of donors - may even decrease them.

Wednesday, October 04, 2017

Prime Minister’s Conference Speech.

Listened to the Prime Minister’s speech on the radio this morning. In the past, my voice has embarrassed me by ‘cracking up’, but never as spectacularly as Theresa May’s voice cracked up today. It was a big achievement on her part to fight her way through to the end. Luckily, I was not concerned about style, presentation or any such things. BBC Wales had invited me on at 5.00pm to discuss the speech on Good Morning Wales. I wanted to know what she actually said!  

I thought it a very good speech. In my opinion, it was an unusually radical, progressive speech. It was very much a Theresa May speech, quite prepared to lead a Government intervening where she sees market failure. And it was good that she apologised to party members for the disappointing General Election results. She had, properly, refused to respond to the self important media demands that she apologise before today. She did it in the right and proper place.

The commitment to more housing was very welcome. In particular she made special mention of Councils being given a role in delivering housing. Personally I would like to have heard more about ensuring planning authorities start helping the private sector deliver new housing instead of making it more difficult. But I do sense today’s speech is going to give a green light where previously it’s been red for No.

We also had an announcement of a review of the Mental Health Act. Probably about 20 yrs overdue. And very significantly, the Prime Minister made it clear she’s had enough of energy companies ‘ripping off’ customers. For long enough, they have had warnings that Govt would act if they didn’t set their house in order. They refused, driven by greed, and Theresa May has acted. We will see the Government Bill next week.

It wasn’t all about state intervention though. The Prime Minister spoke at length of a commitment to the role of the private sector, and to the capitalism which has risen living standards of many millions of people across the world. Mrs Theresa May is a true Conservative, one that knows the value of an economy based on capitalist principles, but willing to step in to correct market failures.

One last word of congratulation to Good Evening Wales. My interview did not include anything about the obnoxious publicity seeker which others (like Radio 5 which I listened) seemed more interested in helping gain the publicity he wanted. It was a proper interview about serious subjects.

Sunday, October 01, 2017

Reaching out to the younger generation.

Its very fashionable amongst Conservative commentators to speak of reaching out to younger voters. About time too. If I chip in my tuppenyworth before any of the speeches, I can't be accused of being divisive! Much of today's pre conference discussion focuses on tuition fees and housing. The Prime Minister has been setting the scene. It's still a few weeks before the budget, but seems to me today's discussion has committed to Chancellor to spend/invest quite a few billions under these budget heads.

Let's take tuition fees first. Much of the coverage has been about cancelling proposed increases in fees. I agree with this, but it will deliver a reduction in university's  income. They will not be happy about this, not happy at all, but its not earth shattering. And won't be much public sympathy for universities either, after the publicity a few days ago about what uni bosses are paying themselves. But it seems to me that increasing the income level that a graduate must reach before having to repay any loan from £21K to £25K is rather more significant. It's going to cost the Chancellor many billions. So much that in the long run, I think this could be so expensive that it could lead to fewer places at university.  I hope it's not too controversial a comment for me to make that this would not be an unwelcome development.

And so on to housing, thought to be a 'touchstone' issue for young people. This really is a key issue. We need young people to have a personal stake in capitalism - through ownership. No better way than through home ownership. I've been saying for a while that we need a dramatic commitment that takes the headlines. "A million new houses by 2022" or something similar. Today's discussion has been about Gov't commitment to 'Help to Buy'. Asking myself if this will work, or will it just feed into higher prices. And it's a lot of public money.  Only real way to tackle the housing issue is through allowing more freedom to build. Increase supply. Seems obvious to me. And we need to end hoysebuilders stockpiling land. We need more permissive planning systems. Let the people build, not just let housing associations and councils build. It's the planning system that killing development through limiting supply.

Difficult for me as a past president of CPRW to advocate greater freedom to build - and limiting the ability of planning systems to frustrate development. I recall my astonishment when I was asked to take on presidency of CPRW. I had been Chair of a planning authority for many years, and was in favour of more development. Yes I thought it should be of quality, and sensitively located, but new houses, new factories and new transport infrastructure there has to be. Not sure there's a need for Govt to throw billions at this - just set the private sector free to deliver. Hope these are the messages coming out of Manchester this week.