Monday, February 13, 2017

Best way to help Syrian refugees.

I've blogged before about the best way to help Syrian refugees, challenging the idea that the proposal put forward by Lord Alf Dubs to take refugee 'children' in from France was neither the most effective nor the most humanitarian. I have much respect for Lord Dubs' opinion, bearing in mind his personal back story, but thought he was mistaken. It was too important an issue just to 'go with the flow' for an easy life. Because of Lord Dubs background, I felt there was not a proper evaluation of the options open to the UK to help. I also disagreed with Govt when it legislated to accept the amendment. I made my views known to my whips office.  The Minister telephoned me at home on a Sunday morning, hoping I would not rebel on the issue. I didn't because the Dubs amendment would clearly bring humanitarian relief to refugees, even if not the most effective and most humanitarian way to do it. The Dubs amendment has worked in practice very much as I expected. The Home Secretary has now published a 'statement' outlining the Govt position - as follows....

"Britain has a proud record of helping the most vulnerable children who are fleeing conflict and danger, and this Government is committed to upholding this fine tradition.

Our response to the migrant crisis has been to establish resettlement schemes from the region, where we can best target our support to help the most vulnerable. That is why we will resettle 20,000 Syrians over the course of this parliament and we will also resettle 3,000 children and their families from the wider region. In the last year we have granted asylum or another form of leave to over 8,000 children and of the over 4,400 individuals resettled through the Syrian Vulnerable Persons Resettlement scheme so far, around half are children.

This week the Government announced that in accordance with section 67 of the Immigration Act (the so-called Dubs amendment) we will transfer 350 children.  to meet the intention and spirit behind the amendment.  This number includes over 200 children already transferred under section 67 from France, and will include a further 150 over the coming months.

The scheme has not closed, as reported by some. We were obliged by the Immigration Act to put a specific number on how many children we would take based on a consultation with local authorities about their capacity. This is the number that we have published and we will now be working in Greece, Italy and France to transfer further children under the amendment. We’re clear that behind these numbers are children and it’s vital that we get the balance right between enabling eligible children to come to the UK as quickly as possible and ensuring local authorities have capacity to host them and provide them with the support and care they will need.

We consulted extensively with local authorities over several months to reach this number, but if your local authority is contacting you suggesting they have extra capacity to take children then please encourage them to participate in the National Transfer Scheme. Each year we have around 3,000 unaccompanied asylum seeking children arrive in Britain and currently a small number of councils are taking a disproportionate share of the burden in caring for these children.

The Government has also always been clear that we do not want to incentivise perilous journeys to Europe, particularly by the most vulnerable children.  That is why children must have arrived in Europe before 20 March 2016 to be eligible under section 67 of the Immigration Act.

I’m proud of the action this Government has taken, and will continue to take, to support and care for the most vulnerable children caught up in the crisis in Syria."

Sunday, February 12, 2017

Speaker error - not that important.

Speaker Bercow was (in my opinion) 'out of order' to effectively ban the President of the United States of America from speaking in Westminster Hall and the Royal Gallery when he visits Britain later this year. But I think "So what". Everyone does and says things I disagree with. What matters is the overall judgement and effectiveness of Speaker Bercow. And I've always thought and said that he has done an excellent job, reforming how the House of Commons works, and holding the Govt to account. But this post is about why I think he was wrong to lay into Donald Trump as he did. And I am not going to speculate on why he did it - but I do think he will be entirely happy that I should. It helps his standing with other political parties.

All I'm going to do is repeat parts of an article by Vernon Bogdanor, Professor of Govt at King's College. Brilliant authority on constitutional issues. The best, and I share his opinion.

"The Speaker of the House of Commons is expected, like the Queen, to preserve strict political neutrality. Yet, John Bercow...has declared that President Trump should not be invited to make an address to Parliament."
"The Speaker, however is a servant of the House of Commons. He is not empowered to express his own views in public, but only the views of the Commons. But the Commons has not yet come to a view. The Speaker's intervention, therefore, constitutionally improper."
"It is also politically unhelpful. For it is by no means clear whether an invitation to address Parliament is one that the US President actually seeks. In that case, the Speaker will have initiated an unnecessary diplomatic spat by pronouncing on an issue that may not arise and in any case did not need to be addressed in public."

"Theresa May has been treading on eggshells. She believes, probably rightly, that there is more to be gained from private remonstrance than from publicly snubbing the notoriously thin skinned President. She is engaged in a delicate diplomatic balancing act, avoiding confrontation while making it clear she does not share some of the President's views and in particular his policy on immigration."

"The Prime Minister will likely be not grateful to the Speaker who, in parading his virtue, may have undermined her diplomacy."

"Until the Commons comes to a definite view on the state visit and the possibility of anaddress to Parliament, the Speaker should stay silent, even if he believes his view is backed by many. It is not his job to counterpose his own opinion against that of the elected Government. In any case, megaphone diplomacy rarely succeeds."

Friday, February 03, 2017

Colostomy Irrigation Speech.

When I secured this debate, I had not realised that it would be so close to World Cancer Day - on Saturday. Given the close connection between my subject and cancer, I could not have chosen a more appropriate date.
I begin by paying tribute to the colostomy nurses at the Royal Shrewsbury Hospital, particularly Tracy Lunt, my personal stoma nurse, who helped me through a difficult time in my life and who encouraged me, and introduced me to colostomy irrigation 14 years ago. I also thank colostomy nurse, Julie Powell, who telephoned me late one evening this week to help me to prepare, after hearing that I had secured the debate. Colostomy nurses are special people, drawn to an unglamorous job that involves helping and encouraging people at the most difficult time in their lives.
 I imagine the subject of this debate is not often the subject of debate in Parliament. Madam Deputy Speaker, you have been an MP for longer than I have and may remember another occasion, but I do not. As far as I know, this may be the first time that this subject has appeared on the Order Paper.
I had best begin with some explanation of why the subject is of such importance to me and to many other people—we do not know how many people because the subject is not talked about much. It is difficult to know how many people are irrigators, how many could be irrigators or how many would be if encouraged and helped by a sympathetic introduction process. At this point, I should introduce the background to my interest, which derives from bowel cancer. Colostomy irrigation has given me the freedom to live a full and active life. I will mention bowel cancer quite a lot because of its close connection with colostomy irrigation.
I am an ostomate—a person with a colostomy. I have owned my colostomy for almost 15 years, since undergoing an abdominoperineal resection to remove a cancerous tumour in 2002. I did not want a colostomy, but the alternative at the time was a far less attractive prospect. It was perhaps the most traumatic event in my life. I was uncertain about the future or, indeed, whether I even had a future at all. It certainly gave me a good understanding of how others feel in the same situation. I consider myself to have been extraordinarily lucky in that I made a full recovery.
One of the key reasons for my good luck and full recovery was that my cancerous colorectal tumour was diagnosed early in its development, before the disease had spread to my liver and elsewhere, when full recovery would be much less certain. Unsurprisingly, I have been a champion of early diagnosis ever since, and played a role in promoting bowel cancer screening programmes in Wales, when they were introduced a few years ago. The campaigning charity, Beating Bowel Cancer, is currently leading a campaign to reduce the age at which screening is offered from 60 to 50, as it is in Scotland. Instinctively, I support early screening, but I realise that it serves no real purpose unless accompanied by the availability of sufficient endoscopy capacity.​
Colorectal cancer, or bowel cancer, as it is commonly known, is one of the most common forms of cancer, with 110 new cases diagnosed every day. It is a traumatic shock for many when the tumour is first diagnosed, but the cancer is completely curable if caught early enough. It is possible to recover and do some fairly crazy things. For example, after recovery, I initiated the establishment of the Welsh parliamentary rugby team. In passing, I should say that, rather shamefully, our first game versus the Lords and Commons parliamentary team degenerated into a full-scale brawl, which received much coverage in the national media, and that is when I first met the hon. Member for Newcastle-under-Lyme (Paul Farrelly), a Labour MP. I went training with the late, great All Black Jonah Lomu, who had also suffered life-threatening illnesses, in preparation for that game. My friends, of course, think it was even crazier to seek election as a Member of Parliament.
The final introductory point I want to make concerns the title I have chosen for this debate. Until recently, I used the term “colonic irrigation”, like most people, but it is too often associated in the public mind with a lifestyle choice available in health and massage centres—a practice I have never really taken much interest in—so I now use the term “colostomy irrigation”, which has no such associations, and which accurately describes the process.
My speech has three main purposes. First, I want to explain what colostomy irrigation actually involves—what it is. Secondly, I want to explain why I decided to become an irrigator. Thirdly, I want to explain why I am seeking to raise the profile and awareness of colostomy irrigation, which is something I have been doing for 14 years. This Adjournment debate is the best platform to raise awareness that I have ever secured.
First, on the actual process, I am constantly surprised by how little is known about it. Even people suffering illnesses such as colitis or bowel cancer, who face the prospect of a permanent colostomy, seem to know little about the procedure. A colleague MP with a background in the clinical profession approached me today and said that not even all colostomy nurses know about it or encourage it. It seems not to be thought suitable for polite conversation; the human mind seems to go into “block” mode if the subject crops up.
However, the process is very simple. All it involves is hanging what is in effect a polythene bag, containing 1,000 to 1,500 ml of warm water, on some convenient hook—I usually use the bathroom curtain rail. One of the problems with smart modern hotels is that there are often no convenient hooks. Luckily, I am a farmer by background, so I am quite practical and naturally given to improvisation, and a coat hanger can be quite a handy hook. The water is then allowed to run by gravity, via a polythene tube, into that part of the lower bowel that my brilliant consultant surgeon left me with after surgery in 2002. Then, the water is allowed to just run out naturally; there really is not much more to it than that. The biggest downside is that the irrigator has to remain in the same location for about 45 minutes, but with complete freedom to read, write, telephone, prepare speeches for Adjournment debates, do sudoku, watch TV and a whole host of other things.
I want to emphasise that the process is not suitable for all ostomates. There can be insurmountable physical and, indeed, mental barriers that mean irrigation is just not possible. There are additional bits of equipment, such as commercially available water pumps, that replace simple gravity, but my experience is that they are not usually needed.
There is another point of interest here—certainly to me and, I think, to the Minister. I am told that while a very small percentage of ostomates in the UK irrigate—less than 5%—a very high percentage do so in the US. That is thought to be because all the equipment associated with wearing a colostomy bag is free in the UK but has to be paid for in the US—1,000 ml of water comes free.
Secondly, why do I irrigate myself? When I am asked, I give the same answer as when I am asked why I voted to leave in the EU referendum on 23 June—it could one day become a pub quiz question: what is the connection between the EU referendum and colostomy irrigation?—and that answer is to take back control. I wanted to take back control of my own body and not allow my colostomy to rule my life, which it could well have done. I did not want to have to wear a colostomy bag. I wanted to continue my public life without being concerned about an “active” colostomy at inconvenient times. I can irrigate when and where it is convenient for me to do so. I take the decisions, not my colostomy. I have—as, indeed, have all the other ostomates who irrigate—genuinely taken back control.
Thirdly, I turn to the main reason why I am raising the issue in this debate. Having experienced the extra freedom, self-confidence and control that colostomy irrigation gives me, I want to encourage other ostomates to think about doing the same. I must emphasise that it does not work for every ostomate, and, in any case, it is a matter of choice. It is not a question of what one should do; it depends on what one can do and what one wants to do. All I want to do is to suggest to ostomates who have never thought about irrigation to consider it. There will be a few uncertain days to begin with while the body familiarises itself with the process, but, with the guidance and encouragement of their stoma nurses, they too may find the freedom and control that colostomy irrigation brings.

The background to every colostomy is some form of clinical need, involving fear, trauma, great uncertainty, great need for relief from pain or even simply a desire to stay alive. World Cancer Day is on Saturday, and I am really grateful that I have had the chance to play a small part in making life better for at least some of those who are suffering from the implications of bowel cancer.

Sunday, January 29, 2017

The Special Relationship.

President Trump is not the easiest of men to deal with. Luckily for us in the UK we have a Prime Minister who seems to understand the President and get along with him. Hopefully this will enable her to influence him. This is important for several reasons, the most important of which is national security. It was very reassuring to hear the President giving enthusiastic backing to NATO, which has underpinned our security for decades. He has been making the entirely fair point that he wants NATO members to contribute the agreed 2% of GDP to defence, but it has created nervousness throughout the world that the US might not continue to support NATO. This would of course be the end of it as a truly effective deterrent. But it emerged in discussions between the Prime Minister and Mr Trump that the US remains firmly committed to NATO.

The second reason the British PM needs to develop a good relationship with the President is trade - not so much the development of a bilateral trade deal, but to challenge his enthusiasm for a 'protectionist' approach to world trade. The world, and the West in particular needs the US to be buying and selling around the world. Through promoting trade agreements with the US, we challenge the idea that 'protectionism' is a wealth creating approach for any country, including the US. I read so much 'guff' about how crucial a 'trade deal' with the US is, and where in the non-existent queue the UK stands. What the UK and the world needs is as close to tariff-free trade as possible. Prime Minister May did some excellent 'groundwork'. 

And then there is the hoohah that the new President creates through controversy. I'm never sure whether it's deliberate or accidental. But our media love it. NATO - boring. Protectionism and trade in a capitalist world - boring. Let's do some headlines about 'holding hands'. Even I thought the interpretations were quite funny, if ludicrous. The reality is it was a hugely successful visit.

But it is President Trump - who cares not a fig what the media thinks. No sooner had the UK Prime Minister left his country, he signed an executive order banning citizens from seven countries from entering the US. OK, following his election campaign, its no surprise that he wants to tighten up immigration control, but this ban won't work in the US interest, and in due course will probably be dropped. It's discriminatory and very UN-British.  Bit of fuss that the Prime Minister did not immediately condemn President Trump at a media event. She did what she usually does. Thought it through carefully, understanding what it means and then tells us it's not a policy she or Britain would ever follow, and that her Govt will act to support any UK citizens caught up in it. Careful, cautious and thought through. All in all, our Prime Minister has had a very good week. 

Friday, January 27, 2017

The human cost of inaction.

Bearing in mind the dispute there has been (and remains) between Shrewsbury and Telford about the location of  'emergency' services in Shropshire, you'll be surprised to read about my deep concerns about the future for the Princess Royal Hospital in Telford. Of course my main interest is in services available to my constituents in Montgomeryshire, But I've had a close association with and interest in all of Shropshire for all of my adult life.

As we know, the Shropshire, and Telford and Wrekin Clinical Commissioning Groups met before Christmas to consider a new A&E/emergency structure for whole of Shropshire. It proposed an Emergency Centre at Shrewsbury and two Urgent Care Centres at Shrewsbury and Telford, which would deal with about 80% of those currently attending A&E. The plan had been developed by a group set up by both CCGs known as the Future Fit Programme Board. This Board had been working for almost 3 yrs and had cost at least £2million. But the proposals were rejected, casting many of us into a state of despair.

I immediately realised that this refusal to grasp the solution was very bad news for all of Shropshire and Mid Wales, but particularly bad news for The Princess Royal in Telford. Let me explain why to those who do not think so. We can all agree that the status quo is not sustainable  - unless some miracle tree that grows consultants who want to work in Shropshire is discovered. Unfortunately there is no such tree. Over the last 15 years there have been occasions when the A&E service has been barely clinically safe. It is currently 'on the edge'. I remember a previous Chief Executive telling me he should have closed the PRH overnight, because of insufficient consultant cover. Since then, we have had the Mid Staffs scandal. Today, he would have acted, not hoped for the best. With the increasing throughput we are seeing at A&E units, it cannot be long before a real 'clinically unsafe' crisis happens and the PRH is simply closed overnight. It's going to happen. No amount of political posturing will obscure the shock of this situation.

A lot of the debate is presented as a Shrewsbury and Mid Wales versus Telford and Wrekin. It is not. It's a debate about clinical outcomes, where the best outcome for patients across the region is not being taken forward, because of 'Political' considerations. And now I cannot see a way forward. The more I think about it, the more despairing I become. Many people are anticipating an early decision. We've been led to believe it could be a matter of weeks or months. I'm not so sure. The UK Govt is under huge pressure to agree capital investment across every part of England. In most places there is a case agreed locally. Are we really imagining that Govt will allocate capital spending to an area in local dispute, with no sign of resolution.  I feel we have run into a wall of stone cold realism. There will be a heavy price for inaction. And the main sufferers are going to be those who have stood in the way of progress with the Future Fit Programme Board recommendations.

Thursday, January 26, 2017

European Union (Notification of Withdrawal) Bill (HC Bill 132)

A bill to enable Article 50 of the Lisbon Treaty to be invoked has been published today. Debate will take place over the next few days, and it's hoped that it will be approved by both Houses of Parliament in time for the Prime Minister to invoke Article 50 by end of March as she has said she intends to.

                                                         A BILL to
Confer power on the Prime Minister to notify, under Article 50(2) of the Treaty
on European Union, the United Kingdom’s intention to withdraw from the

Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and
consent of the Lords Spiritual and Temporal, and Commons, in this present
Parliament assembled, and by the authority of the same, as follows:—

1 Power to notify withdrawal from the EU

(1) The Prime Minister may notify, under Article 50(2) of the Treaty on European
Union, the United Kingdom’s intention to withdraw from the EU.
(2) This section has effect despite any provision made by or under the European
5Communities Act 1972 or any other enactment.

2 Short title

This Act may be cited as the European Union (Notification of Withdrawal) Act

Wednesday, January 25, 2017

The Brexit White Paper

The Prime Minister has shot another fox in the great Brexit debate. The latest focus for those not entirely supportive of the UK leaving the EU was a demand for a White Paper setting out the Govt's plans. This particular fox was just generating a bit of pace, when Theresa May despatched it by announcing that she intends to publish the demanded White Paper.

Must admit I personally was not that keen for both security and political reasons. The Prime Minister will have to be careful not to include in a White Paper any information that could prove useful to those sitting opposite her at a future negotiating table. Whatever is included, there will be those who will not be satisfied - in fact would not be satisfied until the Govts opponents were in a position to create an impossible negotiating position. I also think the Prime Minister will be careful not to set unacheivable targets, creating opportunities to accuse a future Govt of 'failures'. A White Paper will set out what the Prime Minister will hope to acheive as entering a negotiation. Inevitably there will be some 'give and take'. I feel sure these dangers will be avoided.

Today's announcement does have real benefit apart from the tactical fox-shooting aspect. It creates goodwill and by agreeing to what those who have opposed Leave, and may be fearful of the outcome have wanted. So even though I was a bit doubtful, I can see a White Paper may have some benefit.