Tuesday, January 29, 2013

Tories will win even on current boundaries

Thank the good Lord that's over. No more obsessing about boundary reform. In the end, the ship went down by 42 votes - bigger majority than anyone expected. We did waste such an enormous amount of Parliamentary time chasing a prize that turned out to be dud. Now we must get on with governing the country and showing the people of Britain why they should vote Conservative at the next election. All the wasted effort going after those extra 20 seats (which I never believed anyway). What we should do is make sure we govern well, engage with the people and we can win the election anyway. We had a 13% plus swing in Montgomeryshire last time round. Its more than possible.

Despite the vote going the way I wanted it to, I don't feel at all joyous. Its a bad feeling, not to have supported the Gov't (if that's the right description without the Lib Dems). First time I'd done that. Like many a ex-virgin who has recently achieved the status, I do ask myself if I did the right thing. I simply couldn't vote because I was faced with two alternatives both unacceptable to me. Firstly we had a Boundary Commission proposal which would cause so much damage to Parliamentary democracy in mid Wales. And the second alternative on offer was the utterly disgraceful amendment from the House of Lords which killed off the reform. Their Lordships were told their amendment was out of order before they passed it, but they went ahead anyway. I just could not bring myself to vote for such a constitutional abomination.

Perhaps the biggest burden my conscience has to carry is that I know the Gov't proposals would have dealt with the gross unfairness inherent in the current distribution of seats and boundaries.  No doubt that the Conservatives lose out. If only there had been a bit more flexibility in the system, which would have enabled the Boundary Commission to deal with the biggest anomalies. But its too late now. Time to move on, and focus on the 2015 winning post. Contrary to current odds, I think we'll win.

Monday, January 28, 2013

Tomorrow's RSPCA Debate.

Debate tomorrow morning led by Simon Hart MP about the way the RSPCA goes about its business. Simon's main point is likely to be that the RSPCA should not be principally a 'prosecution' body rather than principally as a 'welfare' body - and that it behaves more like an animal rights organisation rather than one concerned with animal welfare. I suspect that I'm going to agree with Simon's speech. I have put my name down to speak, and hope to catch the speaker's eye, as we MPs say. Not sure what I'm going to say, until I hear how the debate is going - but I have an idea of one or two points I'd like to make. Whatever I'm looking forward to hearing what Simon says.

Since I was a young lad on the farm, I've always hated cruelty to any living creature. To this day I will not watch TV or films that involve cruelty to fellow humans or animals. I'm not even keen on David Attenborough showing the chase and kill that takes place in the natural world. This probably started with the ritual annual killing of the farm pig. Might mention that tomorrow. And I gave up the occasional rough shooting when I was around 20 yrs old. Its epically ironic that the Daily Mirror has branded me a "Tory Gun Nut". When I took over the family farm, I banned any form of game shooting on my farm. I was a keen supporter of the RSPCA.

But I changed my approach. I realised that my farm was not being farmed for wildlife. Wildlife was paying the price for my conscience. So I allowed the hunt and rough shooters back in return for investment in habitat creation. Same sort of irony with the Hunting with Dogs ban. Never been hunting in my life, but was so outraged by the ban that I've become an avid supporter of the hunt - though still never tempted to join in. And I've become disillusioned by the 'political' approach of the RSPCA. Anyway, quite looking forwards to tomorrow's debate.

Sunday, January 27, 2013

Intersting Week in Westminster coming up

2.00 Sunday and setting off early to Westminster. Its going to be a full week. Unusually there are three debates I hope to contribute to if other commitments allow. Firstly, on Tues, there's 90 minutes on the RSPCA - a body for which I used to have a great deal of respect. But its clearly become a 'political' body and not a proper charity. I want our much loved RSPCA back. Secondly, on Thurs there's a debate to acknowledge the 30th anniversary of establishment of our much loved S4C. This is one for Welsh MPs. And I understand there's a debate about EU/UK relationship, following 'the speech' of last week on Wed. -- and on Wed evening I'll be reviewing the papers on BBC News Channel. And I think I have an article to write for the House magazine on the Liverpool Care Pathway. Daresay some things will fall.

But biggest issue for me this week by a constituency mile will be a vote on a Lords amendment on Tuesday which could sink the proposals to introduce new constituency boundaries in this Parliament. The amendment (to a completely unrelated bill) delays the change until 2018. I attended much of the debate in the Lords, and was quite shocked by the cynical oportunism on the opposition red benches. While I have nothing but disgust for what seems to me the improper way their Lordships have behaved over this issue, it does look as if, for the first time as an MP, I will forced into a position where I'll not be able to support my Government. Its not something I'm looking forward to at all, and have no doubt it will make me unpopular with (some) colleagues. Luckily there is no position I can be sacked from! All MPs have to strike a balance between 'the party' and the 'constituency'. If the Gov't wins, Montgomeryshire ceases to exist, representative democracy in Mid Wales will be greatly diminished, and I'll be announcing that I won't be contesting the next election. I desperately hope there's not a majority of one. All in all it should be an interesting week.

Percy Thrower - Centenary of an Inspiration

Today's Telegraph has a nice article on someone who had an influence on my life - Percy Thrower, who was born 100 yrs ago. Alan Titchmarsh reckons Percy Thrower inspired him to take up gardening (for the great benefit of all) and I used to watch Gardening World avidly when he was presenting it. Apart from Titchmarsh himself, Percy Thrower was the best gardening presenter of them all - though I do think Monty Don is quite good as well. In part that's because he was first and foremost a gardener, who turned out to be a good presenter as well. He was a big celebrity of his time. We also liked Arthur Billett, who lived at Clack's Farm in Worcs. who for a while did a double act with Percy Thrower.

I had no interest in gardening at all until I married my wife who had a love for growing things. She had grown a few seeds since infanthood. Anyway, I was required to dig over a patch here, and dig a trench there. Soon my obsessive streak took over. Began reading gardening mags, watching TV programmes and visiting gardens - including The Magnolias, Percy Throwers home just outside Shrewsbury. I ordered chrysanths from Woolman's of Shirley and onions from Robinsons of Preston (I think) as recommended by Percy Thrower, and began competing in horticultural shows - including Shrewsbury Flower Show, which was held in the parks where Percy Thrower was head gardener. I remember spending 5 hrs overnight building an arrangement in the pedestal competition. Not many rugby playing farmers doubled up as flower arrangers.

Anyway its Percy Thrower's centenary this week and this post is my way of remembering him, and his fuchsias, and his lithospermum Heavenly Blue, plants he was very keen on. With a business partner he bought Murrell's nurseries (of Hilda Murrell fame) in Shrewsbury and developed the successful Percy Thrower Garden Centre. Its off the old Shrewsbury by-pass and nothing like as handy to get to as the larger Dobbies on the new by-pass. I prefer it though. Percy Thrower died in 1988

Saturday, January 26, 2013

More on Liverpool Care Pathway.

A few weeks ago I instigated a debate in the House of Commons on the Liverpool Care Pathway. The gist of the speech with which I opened the debate was that in general, I support the principle of transferring the commitment to palliative care typical of hospices to hospitals and other forms of care - but that the Pathway must be implemented strictly in accordance with the principles on which is has been established. There seems to be much evidence that this has not always been the case. I asked that the Gov't thoroughly investigate recent publicity about patients being placed on the Pathway without consultation with them or their next of kin. This is not acceptable. There are also reports of other departures from proper procedures. A line which grabbed public attention and summed up my approach was that "we shouldn't scrap the LCP - we wouldn't scrap the Highway Code because there are some bad drivers on our roads".

Since the debate, the Gov't has appointed former Lib Dem peer, Baroness Neuberger to chair an independent inquiry. She is on record of being supportive of the Liverpool Care Pathway, but there is no reason to think she will not be thorough and objective. She will have read comments in yesterday's Telegraph by her former Lib Dem colleague, Lord Carlile of Berriew, which offer her some strongly worded advice. On this sort of issue, I usually agree with Lord Carlile.

While I do not disagree at a fundamental level with anything Alex Carlile is reported to have said, there is no doubt that the tone of his comments take him further than I went. He calls for the Liverpool Care Pathway to be replaced, and to be given a different name. I would support that if Baroness Neuberger recommended it, though my view is that the problems arise from the Pathway not being followed as it should be, rather than the Pathway itself. I do agree that 'Pathway' seem to me to be a particularly unfortunate name though. Alex is also reported to be calling for doctors who put patients on the LCP without telling next of kin to be reprimanded by the General Medical Council, even 'struck off'. Personally, I feel that continuing with regular checks every few hours to make certain that patients have not rallied enough to be taken off the Pathway is another crucial part of proper palliative care. Whatever, Its clear there's much uneasiness about how the Liverpool Care Pathway is being implemented, and we need the independent report delivered to Secretary of State for Health as soon as possible.

'Bedroom Tax' and building Social Housing

Met with Mid Wales Housing Association today. Two important issues to discuss - which though local have a wider relevance. I wanted to discuss the background to them. Montgomeryshire AM, Russell George came along as well. First issue is construction/repairs contracts letting. Second issue is what's become known as 'bedroom tax'. Lets look at them in turn, against a background of how I see things. Other eyes will see things differently.

Over recent years its become fashionable for Housing Associations (and Councils) to come together and form a 'purchasing' group. The theory is that the 'bulk buying' aspect of this will lead to lower prices for contracts. I never thought this process would deliver - for several reasons. One problem in a sparcely populated area is that local contractors would not be big and flashy enough to put in glossy tender documents that impress. And that the winning tenders would sub-contract the work back to local contractors instead. And so its turned out. One recent substantial Newtown contract was let to a North Wales firm, Waites, who then sub-contracted to local firm, J U Bowen, who in turn used local contractors to do most of the actual work. Where we are now is that Waites are sitting pretty, Bowen's has gone bust and local contractors have lost very large sums of money. I wanted an assurance that the Housing Association would try to ensure Bowens had been paid for all work done - and if not to try to ensure it was recovered from Waites and passed on to local contractors. The Association take the same view, which was good. Not sure how successful they'll be though. I was also pleased that a different way of tendering projects in future is being considered.

The second issue is more problematic for me. First the background. There are lots of people in our country with nowhere to sleep. There is a huge surplus of bedrooms - often in properties occupied by single people. And there is a need for the social welfare bill (including Housing Benefit) to be brought under control. So the Government intends to reduce the housing benefit for occupants of housing with unused spare bedrooms. At least, it sees no reason why the taxpayer should pay housing benefit to support them. The issues surrounding this policy change are fairly obvious. I wanted to get an idea of what it all means 'on the ground'.

Mid Wales Housing Assoc. has about 10% of its properties with spare bedrooms. No reason why other social landlords wouldn't be about the same. Some of these tenants will find a way of coping with reduced housing benefit; some may let out the spare bedrooms; and some may try to find a single person property. Inevitaby, its going to make life more difficult for some. Today, we agreed that future building should include more single person properties, which seems blatantly obvious. My view is that almost no other form of social housing should be built in the near future. Homes for families would be freed up by those moving into single person properties. Obvious problems though - particularly from delays. Houses can't be built in a day. Another related issue is that the level of social housing grant available to the housing association is being cut from 58% to 25%. Inevitably rents are going to have to rise substantially to deliver a return on investment.

Left the meeting chewing hard on the food for thought I'd just been fed. Gov't and public bodies have no option but to cut spending and secure value for money. But lets not pretend there are not unwelcome consequences.

Thursday, January 24, 2013

'Independence' crucial to quality social care standards

Some mildly disappointing news today. Longstanding visitors to my blog may recall my involvement with a social care company called EuropeanCare during the 3 yrs between my being an AM and an MP. I didn't actually work for this company, but after meeting its inspirational Chairman, Anoup Treon, I agreed to set up and chair a Welsh Advisory Board within the company. It was a sort of 'internal audit' system, but my board was to have complete independence to advise as we thought proper. First initiative we took (and the best) was to set up a Lay Visitor Scheme, where an approved team of individuals with relevant experience were appointed to call unannounced at any home, at any time, with rights to see anything they wanted (always in pairs) . All managers of EuropeanCare homes in Wales were signed up to the scheme, after some training. It was innovative and I thought it a terrific success, the key element being its total independence from the company. The scheme was so well regarded that it spread to other regions of the UK. I still think it was a real example of best practice. Lots of other key people thought it was as well.

When I was elected an MP, I stood down from my involvement with EuropeanCare. But I have retained an interest in what happens to the company. There has been much turbulence in the social care sector, and much in EuropeanCare as well. The then chair, Anoup, and senior personnel remain friends of mine but have left the company. Its now being run by a new team led by Ted Smith, whom I've met but do not know. Its to be expected that a new CEO will make changes, and he most certainly has. While its not for me to comment on these changes (and I don't in any case have the competence) I am disappointed to learn today that the Lay Visitor scheme is being disbanded. The company is putting in place an in-house team to supervise standards. It could be that the focus is to be on 'compliance' - hugely important but different from the Lay Visitor Scheme. My disappointment stems from its being in-house, which suggests to me that it is much more about compliance. My view is that the key to success of any quality standards scheme, and the only way it will win the confidence of national quality standards authorities if its at arms length - and not in-house.

This general area of social care audit has to be strengthened. This is why I retain an interest in how all social care providers deliver services. After the horrors in the sector that have littered our media over the last few years, supervision of quality standards has to be addressed by Government. Only last week, I joined former Lib Dem Minister, Paul Burstow in his attempt to introduce legislation establishing failures in 'corporate responsibility' as a criminal offence to punish the managers as well as the delivers of care services. Change is needed. It may well be that EuropeanCare's new system will prove effective, but it does leave me feeling disappointed. Seems to me to be going in the wrong direction. I hope it works out OK though - for the sake of the residents.

Wednesday, January 23, 2013

First Day supporting In/Out vote since 1975

Issue of the day has to be Prime Minister's Europe speech. Seems he was right about 'tantric' approach. the consummation has been thunderous. He entered the chamber like a Roman gladiator to a rousing approval. Best welcome of this Parliament. Stirring stuff. No sign of any plotters tonight. While I support the decision David Cameron has taken today, I'm not joining in all this exuberance. The joyfulness is too good to last and I'm a touch nervous. Perhaps I'm just one of nature's cautious creatures. Let me use this blogpost explore the basis of my uncertainty.

Until today I've never supported an In/Out referendum - not since 1975 anyway. Have never been willing to back one while I felt the Prime Minister of the day was not willing to actually withdraw from the EU if the voters said No. Well, David Cameron satisfied me today that if its a popular No vote in 2017, its the divorce court for the EU and UK. So I've been willing to publicly support the referendum today. And while I'm not prepared to say which way I'll vote myself (its a few years too soon) I believe there will be a sufficiently successful renegotiation to persuade UK voters to decide to remain married. Worry I have is that the 'integrationists' will take it as a green light - as they did in 1975.

Perhaps I'm too influenced by 1975 - the first political event I took any interest in. I was a committed campaigner for an 'Out' vote. We had a 2-1 lead in the polls at start of the campaign - and went down to comprehensive defeat. I've consistently warned my Ukip friends and the like-minded to be careful what they wish for. Well they have their wish. It looks as if the 'Europe' issue is going to dominate the next general election. And if the Conservatives win, the negotiations will dominate the early years of the next parliament. Now that we've decided what's going to happen on the European front, perhaps we can focus 100% on repairing the public finances. That will matter a lot more to the voters in 2015. I sense there's a lot of turbulence ahead.

Tuesday, January 22, 2013

Avoid a Stroke. Check your Pulse.

Today's post is a health lesson. Reading it could save your life. I chair the Atrial Fibrillation (AF) All Party Parliamentary Group (APPG). Its one of the myriad of complaints I've recovered from over the last few years. Recovery from illness is my specialist subject. Today we launched in the House of Commons a document titled 'Taking The Pulse'. Its about raising awareness of AF and about how to treat it. I thought I'd share some basic stuff with you about what AF is. There are a lot of you out there suffering from it.

AF is the most common arrhythmia (irregular heartbeat). This means the blood doesn't flow through all parts of the heart as it should, which can lead to some deposit growing in there, and breaking off as a clot in the bloodstream. Clot's first port of call is the brain - which can lead to a stroke. Suffering from AF will make you 5 times more likely to have a stroke, which is likely to be more serious, and more likely to lead to your death. So do not be stupid if you suffer a bit of breathlessness from time to time or anything that feels a bit odd. Ask your GP/district nurse to check your pulse and if in any doubt ask for an ECG. A third of over 75s suffer from AF, as do many younger people - even very fit athletes. Welsh dual Olympic gold medallist rower, Tom James is a sufferer.

Lot of discussion today was about what to do if you have AF. Treatment will probably involve a daily pill/pills to thin down your blood - usually of Warfarin. Biggest hassle is the regular blood tests to ensure correct dosage - which is very important. Too little and it doesn't work, while too much could lead to a internal bleed. Warfarin is cheap as chips, but the blood testing infrastructure is a bit of a pain and a cost on the NHS. There are new Warfarin replacement products coming onto the market but they are much more expensive at present. As with a lot of treatments, the up front cost of these new drugs would be an additional burden on the NHS, but the long term savings in reduced strokes would make it worthwhile. But the argument has to be made. Its short term cost against long term gain - never very appealing to Gov't.

Some of us can be fortunate enough to be able to correct the irregularity by attaching some jump leads to chest and back and shocking the heart back into sinus rhythm (normal). General anaesthetic so I knew nothing about it. Neither did Tony Blair when he was done. Most upsetting for me was having the manly covering of chest hair shaved off, and the itching on the parts of my back I couldn't reach as the back hair started to regrow. Fortunately my heartbeat has not slipped back into atrial fibrillation. Anyway, today's message is about 'Taking The Pulse'. You know it makes sense.

A Prime Minister on top of the job

Yet again today the Prime Minister showed us in the House of Commons that he is the overwhelmingly dominant politician in the UK. I thought his Statement on the Algeria Hostage Crisis was powerful and correct in all respects. Any Conservative MP who doesn't recognise his value as leader of the party and leader of our country is suffering from a nasty case of self-destructive delusion. But back to the Statement.

I was particularly pleased by the supportive comments made about the Algerians. The Prime Minister recognised the challenge that the Algerian Gov't had been forced to confront - over 30 terrorists hell-bent on murdering innocent people in a huge, remote and dangerous industrial complex. The attack was sudden - and the terrorists were ready to kill in cold blood. Immediately after acknowledging the awful tragedy of deaths of innocents, it was right for David Cameron to pay tribute to the resolve shown by the Algerians, and placing responsibility for the murders four-square on the terrorists (which for some unfathomable reason the BBC refer to as militants).

I was also relieved to know that the Prime Minister is aware of the scale of the problems European states face. While President Obama was talking about the end of ten years of conflict, David Cameron was warning us that we could have decades of conflict in front of us. The President seems incredibly complacent to me, as well as indicating a declining interest in the security problems of Europe. David Cameron on the other hand seems very aware of the security issues confronting Europe.

The Prime Minister ended his Statement by declaring the importance of an international response (which is why we will help the French in Mali) - tough, intelligent, patient and based on international partnerships. There is potential for development of terrorist activity right across the Sahel - on the doorstep of Europe. There is a massive job to do - militarily and through cooperation at all levels. Its right that international aid is more biased in favour of improving social conditions in support of peoples targeted by these evil terrorists. At least, the United Kingdom has a Prime Minister who understands what needs to be done.

Saturday, January 19, 2013

Horse on the Menu

I've always been very suspicious of 'value' burgers, meat pies, sausages etc. Ever since I visited a prawn farm in West Scotland in the 1980s and saw all the seconds being tunched up in great vats into what looked like stinking sewage, I've liked as much certainty as possible about ingredients in what I eat. Have eaten only whole prawns ever since. It has come as no surprise to me at all that there are bits of horse in some 'value' beefburgers. I suspect there's quite a bit of other stuff in there that I wouldn't fancy on its own either. What really happened last week was that new investigative techniques, just as it did with Lance Armstrong, exposed the truth of what's been happening. What we don't know is the scale to which its being going on.

Lets look at what actually happened - at least as far as I can make it out. The Irish take food safety and authenticity very seriously indeed - and search out deceptions. Over recent years the Food Safety Authority of Ireland has discovered 'farmed salmon' being sold as 'wild salmon, Chinese honey being sold off as Irish honey, imported chicken fillets pumped up with water, and pollock being used in 'cod and chips' and a lot else besides. Last year the Food Safety Authority of Ireland raised the bar by setting up a 'food fraud task force', with access to new technologies. It was this task force which discovered traces of horse and pig meat in frozen beef products - with a lot more than a trace of horse in one case. The discoveries were the result of DNA testing, normally used to link criminals with the scene of the crime. Lots of these products were exported to the UK. Personally I think its wrong to criticise the Irish - certainly until we know a lot more. The Irish Gov't should be congratulated on raising the standards of food testing to a new higher level, and for being prepared to not keep it secret. We need to raise standards throughout Europe.

We do not know the full story yet, and cannot draw final conclusions. We don't know where the product (probably a filler of some sort) came from. We do not know whether the presence of horse meat was inadvertent or deliberate (which could well mean its criminal). And we have absolutely no idea of the scale of the problem, or for how long its been going on. And since there is no suggestion that the 'beefburgers' are in any way unfit for human consumption, it seems a dreadful waste that 10,000,000 burgers have been dumped. Ironically, there was a World Hunger seminar taking place in Dublin last week!'. There's nothing wrong with eating horses, or dogs or donkeys or squirrels. Its just that we Brits don't do it much. I've eaten horse myself, but not knowingly. It was on a rugby trip and tasted OK as I recall - though I admit that at the time anything would have tasted OK.

Every food retailer could be affected by this 'scandal' - and I was much impressed by the supermarkets swift response to clear their shelves (if shockingly wasteful). They know that customers must have confidence that what they are buying is what they think they are buying - or as the PM would say "what it says on the tin". British farmers are appalled to see the reputation of beef products so damaged, especially since the problem seems to elsewhere that the UK and Ireland. There should be an opportunistic 'Buy Local, Buy British' campaign. Personally, I see this as a serious commercial and 'foods standards' crisis - rather than a 'health' crisis. In the way I stared eating beef again when BSE struck, its now my patriotic duty to eat British beefburgers - and I suppose I could try a bit of horse (though Mrs D, as a horse lover wouldn't be willing to cook it).

Friday, January 18, 2013

Will the PM's EU Speech change much?

Events are conspiring to prevent the Prime Minister making his supposedly game-changing 'Speech' on Britain's relationship with the EU. On Thursday S4C interviewed me for Newyddion at 7.30 pm about what I was expecting and hoping for. I don't know whether it was pulled after David Cameron took the proper decision to postpone his Amsterdam speech an hour before it was due to be broadcast. I'm booked in to discuss the speech with Peter Kellner and Vaughan Roderick on Sunday supplement - but not sure if that's going ahead now that it won't have been delivered. Its been a week for big tragic stories, and the importance attached to the PM's speech seems to be withering a bit.

Reality is that we all now have a fair idea what's going to be in this speech. The Prime Minister is going to say that he wants the UK to remain an integral member of the EU, but as the Eurozone countries change relationships to take major steps towards economic and political union, its vital that the UK relationship changes as well. He is going to demand that some sovereignty is returned to the UK in a significant renegotiation - and when that process is done, there will be a referendum seeking the support of the British people for the new deal. This means there will be a timetable which envisages the referendum being held well after the next General Election (2018 perhaps).

On the face of it, while this will please me (and a few others), it might not please many other groups. It will certainly not please the Liberal Democrats - despite this not being far from the Lib Dem policy before the 2010 election. It will not please Lord Heseltine (whose words are suddenly being treated with great reverence by the BBC), Kenneth Clarke, the CBI etc.. It will not please the most Eurosceptic wing of the Conservative Party who want a commitment to an In/Out referendum without bothering to wait and see what's on offer - and it won't please the Daily Express which agrees with them. It won't please all those who have decided to tell pollsters they now support Ukip, who just want out whatever. And it won't please Labour - though they have not decided why yet.  But on balance it will please me - because I think it seems the best course for the UK at present.

There will be some big questions for other speeches on other days. Like what happens if our EU partners won't play ball at all. Or what will be the alternative if the people of the UK do not like the renegotiated position and refuse to vote for it. The Prime Minister and the Leader of the Opposition have talked about walking, almost unknowingly towards the EU exit. That's true. I'm not at all sure this speech, when eventually delivered, is going to do much to change that. But then, David Cameron has shown before an ability to herd cats while pulling a rabbit out of his hat. He might confound us all by doing it again.

David Lloyd George - 150 yrs old.

I joined a group of mostly Welsh persons at Parliament Square, Westminster this afternoon to remember David Lloyd George, contender for greatest British Prime Minister of the 20th Century. We sang Fy Hen Wlad Fy Nhadau in front of his statue, along with a male voice choir. He is certainly on the short short list. Today is the 150th anniversary of his birth (in Manchester - a standard quiz question). He is best known for 5 reasons - in no particular order. 1) Great war leader. 2) Laid foundations of modern welfare state 3) negotiated Treaty of Versailles and would have preferred less onerous reparations, thus reducing the risk of 2nd World War 4) So randy he was also known as 'the Goat' 5) Handed out honours for cash.

But for me the truly amazing achievement was to serve as 'effectively' the leader of the Conservative dominated Coalition from 1916-1922, until he overstretched Tories patience and was replaced by Andrew Bonar Law. How on earth does a second language English speaking Welsh radical from a little village in Gwynedd manage to lead the Tories for 6 yrs?

The most fascinating conversations I used to have with my good friend, the late Lord Hooson was when he was telling about his meetings and conversations with Lloyd George (and Churchill). He must have been the most amazing personality. I have visited the Lloyd George Museum at Llanystumdwy on two occasions, and felt overawed by his presence - even if his statue there is of him when a slim and short young man. The statue in Parliament Square is as we remember him as Prime Minister.

I strongly recommend Ffion Hague's biography (sort of) of the great man through the eyes of the women he loved, and who loved him, 'The Pain and the Priviledge'. His prodigious appetite for affection and female company led to his 'The Goat' nickname. And there can be no doubt that the Lloyd George ruthlessness played a big part in the end of the Liberal Party as a great force in British politics. It was nice to see a descendant of Asquith at today's celebrations - so perhaps the great rift is finally healed. Could be a good omen for Nick Clegg!

There were plenty of negatives and close shaves with Lloyd George. The Marconi shares, the honours for sale scandal and the serial womanising would have done for him today. But what an amazing man. When I did a radio programme, Beti a'i Phobl, involving invitations to dinner of 4 greatest persons in the history of man, my first guest was David Lloyd George. I would not have invited my wife along though- or given him her mobile no..

Thursday, January 17, 2013

'Presumed Consent' in Wales is a terrible mistake

Regular visitors will know of my opposition to the Welsh Gov't's proposals to change the organ donation system in Wales to one based on 'presumed consent'. Although there is an ethical dimension to this issue, my opposition is based entirely on efficacy. 'Presumed consent' will not increase the number of organs available for donation. There is not a shred of evidence to support the Welsh Gov't's assertion that it will.

Today I received a copy of a letter sent to the Assembly's Health Committee by the UK's foremost expert on this issue, Prof John Fabre, Professor Emeritus, Kings College London who points out that the Welsh Gov't's consultation process was fundamentally flawed and deeply misleading. Here's the first paragraph, which you should read if you care about the importance of organ donation;

Re: Explanatory Memorandum for the Human Transplantation (Wales) Bill.

I would like to bring to your attention a crucially important factual error in the memorandum, as well as other important points in the Memorandum that the Welsh Government needs to address.

1. The factual error occurs in Clause 102, in the section entitled “Evidence Base to Establish Impact of Proposed Legislation”. It states “For example, an opt-out system is operated in Spain and it has the highest donation rate in the world with approximately 32 deceased donors per million of population”. Spain does not operate a presumed consent system. The Director of the Spanish Organ Donation Organisation (Organizacion Nacional de Trasplantes <www.ont.es>), Dr Rafael Matesanz, is on the public record several times making this point, most recently in an article published in the British Medical Journal on the 30th October 2010 (volume 341, pages 922-924). The authors of this article, listed on the last page, are myself, Paul Murphy (an intensive care physician), and Rafael Matesanz. I attach a copy of this article. If you read the middle column of the first page you will see “Crucially, Spain does not have an opt-out register for those who do not wish to become organ donors. Not a penny is spent on recording objections to organ donation by Spanish citizens, nor on public awareness of the 1979 legislation. Clearly, the presumed consent law in Spain is dormant, and it pre-dates key policy changes made in 1989. In these circumstances, Spain’s outstanding deceased organ donor rate cannot reasonably be attributed to its presumed consent laws”.

If you have any doubt on this point, you should contact Dr Matesanz on 00 34 902 300 224 or rmatesanz@msssi.es. Linking this factual error, about Spain and presumed consent, with the true fact that Spain has the best deceased donation rate in the world, in a section on the evidence base for the proposed legislation, is clearly and quite outrageously misleading. Any expert adviser will know that Spain does not operate a presumed consent system.

The Welsh Government must issue to Assembly Members and the Public a corrective statement along the lines of “The Welsh Government regrets that the statement in Clause 102 of the Explanatory Memorandum for the Human Transplantation (Wales) Bill is incorrect. Spain does not operate a presumed consent system, as stated in Clause 102, although it does have the highest rate of deceased organ donation in the world. Spain’s 1979 presumed consent legislation predates the key policy changes made in 1989. Spain does not have, and never has had, an opt-out register or other means of registering objections to organ donation by Spanish citizens. Spain does not spend any resources whatsoever to publicise the 1979 legislation”. It would be a scandal if the Bill were passed by Assembly Members given a manifestly misleading statement by the Government of Wales.

If the Welsh Government believes that the mere presence of the legislation in Spain somehow subliminally influences donation, then it should emulate Spain and pass the legislation but without a donor register and without spending resources on publicity.

There's a lot more as well. This is all deeply worrying.

Monday, January 14, 2013

Montgomeryshire still in business - thanks to their Lordships

Their Lordships have really put the proverbial cat among the pigeons tonight. They have voted 300-231 to amend the Electoral Registration and Administration Bill to postpone any review of Parliamentary constituency boundaries until 2018. I spent 90minutes at the bar of the House of Lords listening to the debate. Must admit I found the Government speakers more persuasive, but the opposition peers just voted the new boundaries down anyway. And I must also admit that my wife and I shared a bottle of House of Commons champagne over dinner as a sort of celebration. Best keep this quiet though.

The background to tonight's vote is constitutionally interesting - and a bit dodgy in my opinion. Getting on for two years ago both the Lords and Commons passed a law that the number of MPs should be reduced from 650 to 600. The law also decreed that the new constituencies should be redrawn to be of equal populations, and that there would be a vote to approve the new boundaries (as agreed by the Boundary Commissions) in Oct. 2013. After much soul searching I had decided that I would vote against them. This would have been my first rebellion. I have been suffering much anxiety about this.

But then, a small group of cross party peers put down an amendment to a totally unrelated bill proposing that the implementation of the new boundaries should be postponed until 2018. This was rather unusual, because amendments are supposed to be relevant to the Bill being amended. The Parliamentary officers who advice thought it was not an appropriate amendment, but the 'mischievour' peers went ahead anyway - and won comfortably.

So what on earth happens now. We don't know yet. Will the Gov't try to reverse the amedment and play ping pong with the Lords. Will the Gov't try to move an amendment with some other date. Will the Gov't accept the Lords amendment, through gritted teeth, and give up. I really don't know. Matters should become a bit clearer in the next few days. Anyway, as it stands tonight, the Montgomeryshire constituency is still in business. Top me up Bobbie.

Early thoughts on the UK/EU relationship

Seems that the Coalition Government is moving remorselessly to its 'date with destiny' confrontation about the future of the UK's relationship with the EU. I would much prefer if we could avoid it, but cannot see how this defining debate can be put off for much longer. Later this month, the Prime Minister will deliver a much vaunted speech on the issue. Rather him than me. How does it work when a significant chunk of his own party want a change in the relationship, tantamount to withdrawal, while his Coalition partners will not tolerate such a position. We are about to find out. There are Conservative MPs at every point on the spectrum. I very much hope not, but things could become a bit turbulent.

Very difficult to establish with certainty what my own position is on this. But I feel a need to use my blog to indulge in some thinking aloud. So here goes with a 'first step'. In 1975, when Harold Wilson's Gov't held a referendum, I was fiercely opposed to remaining a member of the European Economic Community that Edward Heath's Gov't had taken us into the year before. I was a teenage firebrand who thought this creature would develop into all-powerful bureaucracy that would devour democracy and expand until it collapsed under its own weight. Allowing for the hyperbole of youth, I'm not sure I was that far wrong - except that we don't see much sign of the 'collapse' bit yet.

During the 80s and early 90s I spent a fair bit of time on EU matters, promoting regional development and as part of Wales' bid for regional aid. When trying to secure best deals for Wales, it was easy to become too involved in the system to ask fundamental questions about the UK/EU relationship. But two things struck me which I remember well. Firstly, the massive building programmes and glass palaces in Brussels creating office space for the new European bureaucracy, and the impotence of MEPs. All they ever did was secure access to the officials who were the real decision makers.

My next brush with EU integration was the creation of the Euro - which I was totally opposed to. It always looked like a completely mad project to me. I could never see how a group of states could share the same currency without becoming a single political entity. Always thought those who wanted the UK to adopt the Euro, also wanted to end the UK as an independent political entity in any meaningful sense. I still think this outcome is inevitable. The Euro countries will become, in effect, one state, with the richer countries subsidising the poorer countries via a sort of Barnett Formula. Its this inevitable integrationist change that's driving us to confront the UK/EU relationship today.

It has to change. It cannot go on as it is. There must be a renegotiation - and meaningful. And it seems that there will have to be a referendum to agree the change. Many will want the alternative to approval of the newly agreed relationship to be complete withdrawal. If the PM has negotiated a new relationship he finds acceptable, I cannot see the point of the status quo being considered any further. Too soon to say which option I'd vote for at this stage. But like others, I do not rule out voting for withdrawal, but we would need to be sure that the economic and political disbenefit were not too high. The withdrawn UK would become a different type of country, perhaps no longer dining at the top table. A century ago, Gt Britain was the dominant power on earth, days which are long gone. Over the next few years we are going to have to make some big decisions about where we want to sit, and how big a role we want to play in the future.

Saturday, January 12, 2013

Severn Barrage - great or crazy idea?

Discussion about the Severn Barrage seems to be gathering pace. This week, on Tues. the Welsh Affairs Committee took evidence from Hafren Power (the developer), Bristol Dock Board reps and environmental group reps. The Energy and Climate Change Committee took evidence from a similar range of witnesses plus Peter Hain on Wed.  And it was main issue on ITV Wales' Sharp End on Thursday - where I was a guest alongside Dafydd Trystan and Eluned Parrott.

Adrian Masters seemed keen to know whether we support the scheme or not. Was tempted to say "How do you expect us to know. Truth is we know next to nothing about what's involved yet. All we know is that a new company named Hafren Power (backed up by some big names and big money) want to construct a barrage across the Severn Estuary from Lavernock Point in Sounth Wales to Brean Down in England. There would be no road or rail passage over the barrage, contrary to what many people think. The company claim there will be no need for any public capital investment whatsoever - but that there will have to be a 'strike price' agreed with the Government under the 'contracts for difference' procedures which will be guaranteed for 30 yrs. I suspect this will be quite high. The case for this is that since the life span of the Barrage would be at least 120 yrs - for 90 yrs there would be no public cost at all.

Peter Hain tells us this is an amazingly good deal for Wales. The Unite union in Wales seems to be backing him, though the Unite boss at Bristol Docks is vehemently against. We are told the Barrage will prevent any tsunami going up river and flooding the Severn Valley - but not where the stopped water will go instead. We're told it would create tens of thousands of jobs, including building the thousand plus turbines (Rolls Royce are involved). We are told by others that it would cost tens of thousands of jobs. Its clear that most environmental interest groups are also very much opposed.  We're also told that it would be illegal under current EU environmental legislation.

At present I have no idea whether I support the scheme or not. But the potential contribution to the UK's energy needs are such that I feel we need to travel further down the road before coming to a decision - so I'm joining Peter Hain's group of MPs working on this project in the House of Commons. I feel the same about shale gas. We need to know more about potential benefits and costs before final decisions can be made. The Severn Estuary has the most enormous renewable energy potential because of the massive tide in the estuary - but we do not yet know the best way in which to harness it. Better be prepared for a lot more discussion over the next few months.

Spreading the Language of Heaven (Welsh)

The 2011 census showed that the number of people in Wales who speak the Welsh Language has fallen from 582,000 to 562,000 over the last 10 yrs - against the background of a rising population. These numbers translate into a fall from 21% to 19%. Demographic and migration factors may well account for some of this fall, but I must admit it was more than I expected. I must also admit to being surprised by the absence of any concern amongst 'significant' National Assembly personages whom I would have expected to be sounding the alarm. I know that non-Welsh speakers have moved in, but that's always been, and will continue. I also know that the age profile of Welsh speakers has an impact, which may reduce over time. But a 2% drop was still of concern to me. I'd hoped for flat-lining, which would have been very encouraging.

Anyway, I wanted to comment on a 'conference' of Welsh speaking communities at Aberystwyth today. It seems from reports that Menna Machreth is the driving force behind this. The idea, according to her is "language planning from the bottom up". The BBC reports her as saying "By bringing them (Welsh speaking communities) together we hope to start that discussion, and hopefully we can work together, inspire each other, share good practice and hopefully come up with ideas from our own communities". This is a terrifically positive and constructive approach. I wish Menna, and all who sail with her the best of following winds in their ambition.

Since I was a young lad, our attitude to the Welsh Language (Yr Iaith Cymraeg) has been transformed. In the 1950s/60s, Welsh was the 'language of failure', and Welsh speaking parents did not want their children to be able to speak it. Not long since, those who were caught speaking Welsh at many schools were punished - an official policy. My 5 sisters and I knew but a few simple words. It was only when I became an Assembly Member in 1999 that I decided to set about learning the language with serious intent. But since then, we have seen a revolution in attitude - helped by the creation of S4C, Education Acts which made teaching compulsory, and a Welsh Language Act (incidentally all implemented by Conservative Gov'ts). We've also seen changes in official status. All we need now is to build on these foundations is the right attitude - not hectoring, not aggressive towards non Welsh speakers, but ensuring those who speak and value Welsh actually use it when they can, at home. at work and at play. That's what I sense today's 'conference' is about. I hope it went well.

Friday, January 11, 2013

What's an MP worth

I do not think I have ever read of a more self-destructive suggestion that that put forward by MPs today that our salary as MPs should be increased by over 30%. Did not believe it to begin with. Sometimes you have to wonder about just how short sighted and 'out-of-touch' human beings can be. In fact this opinion is nothing to do with what an MP is 'worth'. Its about what an MP should be paid. There's a difference.

When I was first elected to represent Berriew on Montgomeryshire District Council, we were paid only a nominal 'attendance allowance'. For quite a while, I didn't bother to claim it. Representing my area was a privilege and an honour. It was accepted that there was a 'voluntary element' which gave satisfaction. When I was elected to a leading position on the Council, I began to claim my allowance - because I chose to do the job almost full-time. I've always claimed what I'm due ever since. Always considered myself lucky to be asked/chosen to do the various jobs I've done, and been happy with what I've been paid to do it. But to the real issue here.

Since the last election, most public sector workers have been as near as damn it on a pay freeze. They have had their pension entitlements reduced. Private sector workers on average have probably done even less well. These are big sacrifices, made necessary because of the mountainous debts that our nation is having to cope with. Previous Gov'ts maxed out the credit card, and its pay back time. There's been no discussion about what these jobs are 'worth'. And Parliament has just debated and approved a 1% limit on most benefit increases for years to come, irrespective of inflation levels. This was right and tough. Now it so happens that without discounting for a 'volunteer' element I reckon an MPs job is probably worth more than the current £65k when the comparison game is played. But there is the 'volunteer' element, which in my opinion is crucial. Being an MP is not a job for anyone who just wants to maximise income. Its a great job, and the current salary is just fine by me. And there is not a snowball's chance in H*** that this sort of increase will be approved anyway. So what on earth is all this about. Its just that a few MPs sat down and tried to think of something that would make us even more unpopular than we are. And they sure came up with a good one. Its not going to happen.

New Dialysis Unit in Montgomeryshire

This week was a big week for those suffering kidney disease in Montgomeryshire. A new permanent renal dialysis unit began taking patients. Its attached to the Victoria Hospital at Welshpool, but will serve the whole of Montgomeryshire plus a bit more. Its a day that's been awaited for a very long time. The decision to build the new unit was finally taken about two years ago, and a 6 station temporary unit was located in the Hospital car park at the same time, which will now be removed. The new unit has 12 stations. I've been involved in this 'project' for many years. I always think its worth remembering those who helped make it happen.

First up must be Assembly Member, Edwina Hart, who as the Welsh Gov't's Health Minister two years ago. During her period heading up the 'Health' brief, she made a determined commitment to renal dialysis across Wales. I suppose it will be the new Health Minister who takes the honours at the 'official' opening, which I'm told is likely to be in March. But for me the Gov't face of this will always be Edwina.

And we should remember my great friend Trudy Baynes Hill, who was an indefatigable campaigner for the new unit. We used to meet in The Exchange in Newtown for a coffee from time to time, where she worked the few hours her health allowed. Trudy had been the recipient of a heart a lung transplant at Papworth Hospital more than 20 years ago. Her kidneys also packed up and she had to dialyse regularly. She had so many health problems - and was a walking miracle. She was well less than 5' tall and was unfailingly feisty and cheerful. Sorry she died last year. It would have been great if she could have been around this week.

Despite losing my Assembly seat in 2007, I never lost interest in this project. I'm still involved as Treasurer of the North Powys Kidney Patients Assoc., which is wonderfully active and enthusiastic. Helen Corbett is the new Chair, and Julie Turner works closely with her. Some other great people involved as well. And the Hospital Lg. of Friends has been terrific.

 My involvement with the project led to my wider interest in promoting organ donation and greater support for renal disease patients. I am Co-chair of the Kidney Disease APPG at Westminster. Its also led me to become an implacable opponent of the Welsh Gov'ts proposals to change the organ donation system from one based on 'opting in' to one based on ' opting out' (presumed consent). This is a controversial issue, where there are contrary opinions. Trudy did not agree with me, and I had to research well to fight my corner against her. I do become a bit irritated when I hear supposed 'Statements of Fact' that the change will produce more organs for donation. If that were true, or there were evidence to support this assertion, I might be willing to change my position. But there is none. This issue is very distressing for me, because I know its the wrong way to go. Anyway, enough of that. Its making me agitated - and this post is about celebration, and recalling those who helped bring this wonderful day to fruition. 

Wednesday, January 09, 2013

Liverpool Care Pathway - My Speech

Since there was so much interest in the debate I led on the Liverpool Care Pathway yesterday, thought it might be interesting to those who offered me advice beforehand. So this is what I said;

Liverpool Care Pathway

Glyn Davies (Montgomeryshire) (Con): Mr Weir, I would like to say how much of a pleasure it is to serve under the chairmanship of a fellow Celt. I declare an interest as a board member of Living and Dying Well, which specialises in research into and opposition to the legalisation of assisted suicide.

I shall begin with a summary of the current position. The “Liverpool Care Pathway for the Dying Patient” was developed by the Marie Curie Palliative Care Institute Liverpool as a framework for health professionals to use to ensure that people who are dying have as comfortable and dignified a death as possible. The pathway was developed and has been in use since the 1990s. Today, about 130,000 of the 450,000 patients who die in hospital care every year die while being cared for on the pathway. It has also been exported and is now in use in more than 20 other countries.

However, during the past few months, the Liverpool care pathway has been the subject of some very serious criticisms and allegations in the media, which has led to questions about whether it is indeed a worthy process. I shall explain why I sought this debate and the outcomes that I would like to achieve before considering in greater detail the criticisms that have been made of the pathway.

By any measure, the Liverpool care pathway plays a very significant role in how the end of life is managed in our country. Its role is much greater than most of us realise: 30% of patients who die in hospital care die while on the pathway. The sheer scale of this is why I believe that debate about it is too important to be led by national newspapers, although I certainly do not criticise those newspapers for reporting stories in the way they have done. Indeed, they have served a valuable purpose by raising public awareness of such an important issue. However, there is, almost inevitably, a tendency for newspapers to couch the debate in sensationalist terms. It is up to us as parliamentarians to ensure that this complex and potentially controversial issue is subject to balanced and thorough debate in the House of Commons.

The outcome that I seek today is calm reflection by parliamentarians, including those on the Front Benches, on this most sensitive of issues—calm reflection on the issues without encouraging the spread of alarm and despondency among those entering care, which can result from sensationalist allegations. I also seek a response from Government—from the Minister—that they will ensure that the review on which they have already embarked includes careful and thorough investigation of the allegations that have been made of bad practice. It is important to know whether the allegations are accurate and, if they are, where the weaknesses lie and what needs to be done to put those matters right.

I am a supporter of the Liverpool care pathway, but my aim today is not to defend or to attack the pathway, those who have made allegations of shocking bad practice, or the media, which have given the allegations such great publicity. It is to promote open and genuine debate in Parliament. In any case, I am not in a position to judge how much substance there is to the various criticisms that have been made, but I do know that we cannot avoid death and I also believe that most people do not fear death so much as they fear the process of death. The aim of the Liverpool care pathway is to ensure that the process is as compassionate, dignified and free from pain and discomfort as possible and, importantly, consistent with public safety. Our aim should be that the pathway is used in a way that retains public confidence—that it is being used in accordance with the principles on which the Marie Curie Palliative Care Institute developed it.

I hope that the Minister will agree that we must ensure that the pathway is subject to the very highest levels of scrutiny and that the framework can be allowed to be implemented only against a background of total transparency. There must be discussion with patients or with patients’ families or carers and there must be clearly available avenues through which complaints and concerns can be channeled. I hope that the Minister will assure us that the very serious allegations reported in the media will be thoroughly investigated and that, if any examples of bad practice are found, action will be taken to expose those responsible, to hold them to account and to do everything possible to prevent it from happening again. The experiences at Winterbourne View and hospitals in Worcestershire and the appalling and chilling events that took place in Stafford are too raw in the memory to allow anything else. It is only through audit and disciplinary measures, if and when appropriate, that the Liverpool care pathway will retain the integrity needed for it to be acceptable and the confidence of those who might use it.

Two years ago, I had never heard of the Liverpool care pathway. I first took an interest in it as a consequence of my concerns about and opposition to the legalisation of assisted dying. I was hugely surprised by how widely the pathway was in use. I had no idea that 130,000 patients in hospital care died while on the pathway every year and I do not think that many people realise that today.

Jonathan Evans (Cardiff North) (Con): I am grateful to my hon. Friend for giving way to a fellow Celt. I congratulate him not just on securing the debate, but on the tone in which he has introduced it. He referred to the number of people who are on the Liverpool care pathway, but to help the debate has he done any work on the expansion in numbers since the 1990s? Did we swiftly move to 130,000? Is that a consistent number, or has there been a gradual increase over time? I ask that because of course it is the rolling out of the pathway that may lead to some people having less expertise—less skill—and then, as a result of that, some of the instances that my hon. Friend refers to some poor reporting of?

Glyn Davies: My hon. Friend makes a very important point about the need for training and expertise for all those who are responsible for putting people on the pathway and for looking after them when they are on it. I want to come to that later in my comments.

The negative coverage in our national media has probably increased awareness of the Liverpool care pathway. To that extent, I think that it has been a very good thing, but because I do not believe that the scale of the pathway is widely known, I think that it is right to say something about what the Liverpool care pathway is and what it is not in order to set out the context of the debate. It is certainly not and must never be any form of “euthanasia by the back door”—a phrase that I have heard—nor is it a form of clinical treatment or even any specific type of care. It does not instruct doctors or nurses to provide this or that treatment. What it does is prompt them to consider whether certain treatments are appropriate in individual circumstances. It supports—it does not replace—clinical care. It is no more than a framework of good practice, backed up by training and education, to guide doctors, nurses and other health professionals towards delivering the high levels of palliative care that have been available in hospices for many years. It enables them to be transferred to hospitals, care homes and patients’ homes. It is about the appropriate way to look after a patient who is clearly dying through the last few days and hours of life.

Some other points should be made in this debate. The Liverpool care pathway does not recommend, as some have suggested, that dying patients should be deprived of food and water, although food and water may be withdrawn in individual cases if clinicians believe that that is the right step to take. The Liverpool care pathway does recommend to doctors and nurses that they explain to dying patients, or more often their next of kin, exactly what is happening and why. Secrecy forms no part of the Liverpool care pathway whatever.

It is also important to emphasise that there is nothing irreversible about being placed on the Liverpool care pathway.

Andrew Bridgen (North West Leicestershire) (Con): Will my hon. Friend give way on that point?

Glyn Davies: On that point, I will, yes.

Andrew Bridgen: I thank my hon. Friend for calling this very important debate. I, too, share some of his concerns about the consistency with which the Liverpool care pathway is implemented across the country. I made some inquiries in the hospitals that serve my constituents, but information seemed to be lacking on the implementation of the care pathway. I am particularly concerned that patients placed on the pathway may have no opportunity to be taken off it if they improve. There are no figures on the number of patients for whom care has been reintroduced after being placed on the pathway. One of the hospitals told me, anecdotally, that no one there could remember anyone being taken off the pathway. I find that worrying.

Glyn Davies: My hon. Friend makes a very good point. Patients on the pathway should be monitored regularly, and if the patient shows signs of rallying, as does happen in a minority of cases, the treatment should be modified to support recovery. If that is not happening, the pathway is not being implemented properly. The Liverpool care pathway is not a pathway to death —a phrase I have seen used often, but which I think is unbelievably awful. It is a travesty of the truth to describe it as a form of euthanasia.

Why have we reached the point of huge public controversy, which has caused so much angst and fear? It has arisen from allegations—serious allegations, some of them from doctors and nurses—that the pattern of end-of-life care I have described has not been followed in some cases. There have been stories of dying patients being deprived of the food and water they needed and others being kept continuously sedated until they died; and of patients being placed on the pathway especially shocking, and I hope the Minister will comment specifically on the issue of targets.

Let me look at some of the allegations in more detail. According to the Daily Mail in June last year,

“NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds”.

The report is based on a presentation to the Royal Society of Medicine by Professor Patrick Pullicino, a consultant neurologist. He stated:

“The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway.”

That is the debate being led by the Daily Mail. Professor Pullicino continued:

“Very likely many elderly patients who could live substantially longer are being killed by the LCP.”

Imagine how a frail elderly person entering hospital a few weeks after reading that would feel. Professor Pullicino added:

“Patients are frequently put on the pathway without a proper analysis of their condition.”

According to the Daily Telegraph, in September, a group of experts stated in a letter that

“dying patients…can…have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.”

The letter—again according to the Daily Telegraph—spoke of a “national crisis” in patient care, and

“a national wave of discontent…building up, as family and friends witness the denial of fluids and food to patients.”

According to the newspaper, some patients were wrongly being put on the pathway, which created a “self-fulfilling prophecy” that they would die. The report continued:

“Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway”,


“many doctors were not checking the progress of patients enough to notice improvement in their condition.”

Those are shockingly serious allegations. If they are true, urgent corrective action is needed.

There is another side to the equation, however. More than 20 respected organisations, including the Department of Health, Age UK, the Alzheimer’s Society, Macmillan Cancer Support, and the Royal Colleges of Physicians, General Practitioners and Nursing, have signed a declaration that:

“Since the late 1990s, the Liverpool Care Pathway has been helping to spread elements of the hospice model of care into other healthcare settings”.

It mentions:

“Published misconceptions and often inaccurate information”—

referring, I think, to the stories in national newspapers I have quoted. Our task and the Minister’s is to reconcile the support of all those organisations for the Liverpool care pathway with the allegations made—in good faith, I am sure—by people who believe that the pathway is what they call a pathway to death.

Any tool is only as good as the workman who uses it. The declaration states clearly that the Liverpool care pathway:

“Relies on staff being trained to have a thorough understanding of how to care for people who are in their last days or hours of life.”

We have to face the fact that, in most professions, there are instances of excellence and malpractice, and health care is no exception. It would be surprising if, when 130,000 people a year are dying on the Liverpool care pathway, there were no cases in which the pathway had been misapplied. That applies to every branch of medicine and, indeed, every occupation. There are good and less good doctors and nurses; there are well run and less well run hospitals; but to lay the blame at the door of the Liverpool care pathway is like tearing up “The Highway Code” because there are some bad drivers. Where there is bad practice and poor care, it should be rooted out and replaced with good care.

It seems to me that the review the Government recently launched provides an excellent opportunity to consider thoroughly all those issues. It is urgently needed. The review should call for any evidence of poor end-of-life care. We need the Minister to assure us this afternoon that the stories I have quoted will not simply be taken at face value, but will be investigated in detail, so that we can establish the scale of poor end-of-life care, and understand the causes and correct them.

Lilian Greenwood (Nottingham South) (Lab): I am listening carefully to the important points the hon. Gentleman is making. My constituents John and Mary Roche lost their mother five years ago. They came to see me because, having seen the media reports, they were concerned about her care toward the end of her life—she had been admitted to hospital and subsequently had her food and nutrition withdrawn. Does he think my constituents and others like them should be encouraged to share their stories, so that they can be taken into account in the Government’s review of the Liverpool care pathway and its appropriate use?

Glyn Davies: I thank the hon. Lady for making that point, because I most certainly do agree. I hope that, as a result of today’s debate, more people will come forward to put their experiences, especially of bad practice, in front of the Minister and the review.

We must not forget that it is necessary not to allow the shortcomings of some end-of-life care providers to undermine the outstanding work that the majority of doctors and nurses perform. It is easy to forget that, for those caring for people in the last days and hours of their life, alarmist stories cause real problems, misleading vulnerable people and their relatives into thinking that the unhappy experiences reported so prominently are typical of end-of-life care as a whole, making them reluctant to accept care that is genuinely beneficial, and generating fear of going into any sort of care setting. My sense is that the high profile given to these serious allegations, unaccompanied by supporting evidence, is analogous to shouting “Fire!” in a crowded theatre. We need to know that the Minister will consider all the allegations that are made, including those that have been reported, look at the evidence, and institute whatever changes are needed to ensure safety and thereby confidence in the integrity of the Liverpool care pathway.

I end with a general observation. I was appalled, as I am sure everyone in the Chamber was, by the recent revelations of poor care in a Worcestershire hospital, in Winterbourne View and in Stafford hospital. I was moved, as many of us will have been, by the observations made in the main Chamber before the Christmas recess by the right hon. Member for Cynon Valley (Ann Clwyd) regarding the inadequate and cruel care given to her late husband. We are reading about too many such cases. Considerable advances have been made in medical science, but we must ensure that, at the same time, we do not lose commitment in the NHS to basic care. I cannot help wondering whether the examples of poor end-of-life care that some relatives believe was given to their loved ones stem from the wider malaise of forgetting how to care for the sick, rather than from any specific clinical protocols such as the Liverpool care pathway.

Sunday, January 06, 2013

Lets love bomb Ukip.

Seems that our Prime Minister is still not over-enamoured with Ukip activists/supporters. On Marr today he said some of them were 'pretty odd', which is being interpreted as 'insulting'. Since I think being 'pretty odd' is an essential requirement of anyone taking an active interest in politics, I do not consider this to be at all insulting. I've certainly been called a lot worse, without feeling at all offended. And I think David Cameron has called Ukip supporters something like 'fruitcakes, loonies and closet racists' in the past, so the relationship is clearly 'warming'.

The most ludicrous aspect of stories currently running about Ukip is the extrapolation of existing polling figures into a General Election result.  National newspapers are even predicting the current Conservative MPs who will be ousted as a result of Ukip votes. My good colleagues, Guto Bebb and Stephen Crabb are fingered here. If this sort of nonsense was for real, Electoral Calculus has me as the only safe Tory bet in Wales in 2015. Well, I suppose they have to fill their columns with something. Probably because politicians are generally a bit odd, some MPs are thrashing around like headless chickens, searching for an 'answer' to the 'Ukip problem'. Here's my suggestion.

The Government (and the Conservative Party) should focus on what is right for the UK, and smile benignly on our Ukip friends. Thank them for their contribution to political discourse, and for floating interesting ideas. Then buy coffees all round and get back to work. We know that the deficit has to be significantly reduced by 2015. We know that immigration numbers have to be significantly reduced as well. And we know that welfare spending has to be brought under control by, and that we must negotiate a different relationship with the EU by 2015. Plus a few other things as well. We need to do these things because they are right -and nothing whatsoever to do with Ukip. Normally, when UK Governments are embarked on difficult programmes, opinion polls tend to record big swings to the 'the third party', in past times, the Liberal Democrats. But the Lib Dems are now in Gov't so voters are backing Ukip to show displeasure. Lot better than the BNP. The increase in Ukip support is only in small part to do with 'policy'.

Most Ukippers I know are sensible patriotic people who detest bureaucracy, hate public sector waste, and are generally good and friendly folk. I also always find their instinct generally quite 'Conservative'. Can't recall engaging a Ukipper in conversation that I didn't like. Of course I don't agree with Ukip on everything, but we as Coalition partners don't agree on everything either. In fact I don't agree with my own party on everything. I just think we should address Ukip with Rees-Moggian politeness and style, and let them know how much we love them, and how much we would like them back in the fold. I reckon that in 2015, most of them will be.

Saturday, January 05, 2013

Liverpool Care Pathway

Next Tuesday afternoon at 2.30, I will be opening a 90 minute debate on the Liverpool Care Pathway in Westminster Hall. I expect to speak for about 20 minutes, with perhaps another 10 minutes if there are a lot of interventions from fellow MPs. I may shorten my speech if there are many other MPs wanting to contribute as well. I intend to order my thoughts on this important issue on Monday, but this post is meant as an opportunity for visitors to this site to influence what I say.

The reason I asked for the debate was the horror with which I have been reading articles in the Mail/Telegraph (and others) describing the LCP as a 'Pathway to Death' and describing it as tantamount to euthanasia. I'm not in a position to challenge the truth of these allegations, but this debate cannot be conducted only in the sensationalist way that newspapers tend to do. Its vital that Parliament discusses all aspects of the issue in a considered and responsible way. We must try to limit the fear that this 'shocking' publicity must be creating in the minds of people suffering terminal illness, or of the frail elderly simply going into hospital. I hope we can have that responsible debate on Tuesday.

I will want to begin my speech by stating what the LCP is and what it is not. In the late 1990's the LCP was designed by the Marie Curie Palliative Care Institute in Liverpool, and is now widely used across hospitals in England - aand the world! The aim is to replicate in hospitals, care homes and at home, the high levels of palliative care that has long been typical of hospices. The LCP is not a treatment, but a set of 'guidelines' to help doctors and nurses who are caring for patients in the last hours/days of their lives. It does not instruct doctors in how to treat patients, but prompts them to consider whether certain care regimes or treatments are appropriate in the circumstances of individuals who are dying. And every case must be treated as 'individual'. Its also crucial that there be no 'secrecy' and that the patient (if appropriate) and/or next of kin are involved in the discussions.  The LCP is not about ending life, but about providing the best possible end-of-life care.

We will not be able to ignore the serious allegations that have been made. The reality, as in every occupation or branch of medicine is that there will be examples of excellence and bad practise. Tens of thousands of people die on the LCP every year. Its seems probable that there will be instances of bad practise (hopefully rare). We must do all possible to eliminate these instances. When allegations are made (and there should always be avenues through which its easy to make them) they should be thoroughly investigated. If not, the integrity of the LCP was be seriously compromised.

The Gov't is conducting a review of how the LCP 'guidelines' are being used. I hope its comprehensive, and ruthless in its honesty. The LCP  is hugely important in ensuring that end-of-life care is delivered with compassion and as little suffering as possible. Over 20 of the leading health-related voluntary organisations and the Dep't of Health have signed a 'declaration' in support of the LCP. I agree with them. But on its own, this will be not enough. Its vital that allegations which have the potential to undermine trust in the LCP are faced and investigated. It must not be left to the media. These are the messages I hope will emerge from Tuesday's debate.

Friday, January 04, 2013

GM Crops are here to stay.

I never completely trust people who have Damascene conversions but Mark Lynas is an interesting man. He's certainly caused something of a stir today with his speech to the Oxford Farming Conference. I have just watched a recording of it. Quite compelling. He explained with simplistic clarity why he changed from being a GM crop trashing 'green' activist into a raging enthusiast without any doubts - and roundly rubbishes those who don't agree, including the 'greens'. No-one as certain as the convert! Personally, I've always had a rather uncertain attitude towards GM, not having been prepared to accept commercial growing without comprehensive trials to establish safety. I was much involved in this debate as Chair of successive 'rural' committees over several years when a member of the National Assembly for Wales. Problem with my approach, which demanded successful 'pilot' schemes before GM crops could be grown commercially  was that all trials in Wales were being 'trashed' by people like Mark Lynas! So wales was declared GM Free.

Now lets look at Mark's position today. He has apologised fulsomely for his previous attitudes and actions. He now concedes that he was completely wrong. Science has shown him that it was a mistake in the past to have opposed GM. GM crops use far less damaging insecticides. GM crops bring benefits to poorer nations of the world and will reduce poverty and malnutrition. GM crops will succeed with less need for water. GM crops will feed the projected world population of 9.5 billion in 2050. He also reckons that organic farming can co-exist peacefully with GM. I'm not at all sure that these are all unchallengeable assertions.

All this is very interesting to a Welsh politician because of Wales' is 'GM Free' status - whatever that means. Mark Lynas was particularly scathing about Wales. The Welsh 'declaration' was agreed because GM's safety has not been proven in Wales. I still recall discussions where I used to ask how the safety of GM could ever be proven if it was not allowed to be grown in trials! I supposed that trials would have to take place in England - which is pretty much what happened. I remember visiting a site in Sealand, nr Chester to discuss the whole issue with a GM grower. He showed me some of his trashed crop plants. Activists had turned up wearing white 'space suits' to do their thing. At the time I thought they were damn stupid - and seen no reason to change my view since.

Anyway, I do think Mark Lynas moved the debate on today. We already have Owen Paterson, new Environment Secretary giving GM a big thumbs up. We have a colleague of mine, George Freeman MP campaigning strongly on GM's behalf in Parliament. For me, its what it always has been - a development about which I am wary and suspicious. But as with other scientific developments, the genie cannot be put back in the bottle. GM crops are going to be grown around the world, whether we like it or not. Just turning our backs on GM as some sort of gesture is not good enough. We must proceed with care and transparency - but proceed we must. Mark Lynas has probably persuaded several today.

Thursday, January 03, 2013

Paul Burstow makes a good mark - even if confused.

Lib Dem MP, and former Minister, Paul Burstow has been hitting the headlines big-time today. He has been sharing his ideas with us on two policy areas - which for some illogical reason he has linked. But I must admit, it seems to have worked rather well in that it has generated some terrific headlines. The two issues are interesting enough to instigate this blog post.

Firstly, Paul is proposing that some support payments for the elderly should become means tested. He knows this cannot happen before the next General Election, so I'm not sure why he's raised the issue today. No doubt it will be an issue for parties to consider as preparing manifestos for the 2015 election. I would be deeply disappointed if the Prime Minister were to go back on his firm promise that these benefits would not be changed during the current Parliament. I also feel there should be detailed debate on the implications of such a policy change. I don't like means testing in principle. It disincentivises people from improving their own position, encourages behavioural activity which seeks to understate income, and carries significant administration costs. The pressure on Gov't to cut public spending is driving the means testing agenda - but I just don't like it, and don't support it unless it makes a significant and clear difference..

Another thing I don't like is the 'hypothecation' principle in Gov't spending that underpins today's publicity. Each Gov't decision should be justified on their merits, and not as justification for some other totally unconnected policy change. Its just about presentation. In today's instance, its served the purpose and secured a lot of publicity - but its led to confused debate. The two issues will have to be decided separately. Which brings me to the second.

There is no doubt in my mind that UK Gov'ts over a long period have not addressed the consequences of an ageing population. We are not looking after those who have become frail and vulnerable in our ever-ageing population. Many changes, some involving cost to the Treasury are needed. One of them is Gov't response to the Dilnot Report, which recommends a cap on care home costs - subject of Paul Burstow's comments today. We are anyway expecting an announcement on this in the imminent Mid Term Review (programme for the 2nd half of the current parliament). We need more investment in palliative care, more support for dementia, and a whole lot else as well.

Even though I cannot see the logic of linking two separate issues as Paul Burstow has done today, I think its terrific that he's put the need for greater support for the elderly on the front pages.

Wednesday, January 02, 2013

David Cameron into battle for UK's future in EU

Sometimes constituents ask me whether the Coalition will last until 2015. Or how I think the second half of this parliament will work out. My response is that I believe it will go the distance, and that we will carry on much as we have since May 2010 - with one very big ' question mark. Its been hovering there since the beginning. Europe. It is simply not possible to know how this issue will play out. If I had been leader of the Conservative Party over the last five years, I would have done the same as David Cameron, and done my best to prevent 'Europe' rearing its destructive head. The unknown is how much longer can this continue. I fear not very long at all. This is where the uncertainty lies.

I can hear the thunder of angry disagreement about the UK's relationship with the EU rolling ever closer. The Prime Minister is soon to enter the ring to take on the 'integrationists' while the surrounding seats are being taken up by the 'sceptics' and the 'outers'. No-one slips blows as well as David Cameron, but even Mohammed Ali was caught in the end. What sort of a new relationship between the UK and the EU can he negotiate to be in a position to offer an In/Out referendum - if he were to decide that is the best way forward.

My first experience of public political debate was in 1975, when I argued for the withdrawal of the UK from the then EEC. I thought it would become a undemocratic, expensive bureaucracy. Was on the losing side. In 1990s I was ferociously opposed to the UK entering the Euro - believing it may well collapse in armed conflict in Europe again. I well recall being called an 'extremist' at an NFU public panel meeting. On the winning side that time - though the growth of militarist groups in some European states suggests that the concern about conflicts was not that fanciful. What sort of 'detached status' or 'associate membership' can be negotiated - if at all? We really do not know. I have just read a book about the life of Disraeli, who managed to emerge smelling of roses from the unlikeliest of political middens. I do think if anyone can pull off an acceptable compromise, David Cameron can.

But its going to be an interesting few weeks on the EU front. We MPs will be sitting in the front row seats. I will be there to hear the Prime Minister report back. After that I may be able to answer my constituents about the future of this parliament with a bit more certainty.

The damage that deer do to wildlife

Month or so ago, the Daily Mirror gave me a bit of a going over for contemplating shooting a handsome stag that was grazing enthusiastically and destructively on my shrub border. All fair enough. Mirror now refers to me as a Tory Gun Nut - despite my not having shot anything for 45 yrs. What wasn't fair enough though was the behaviour of the RSPCA which was about as hypocritical as you can get. Condemned me. And day or so later praised Dr Brian May (who holds some position with the RSPCA) for managing deer sustainably after he'd paid a 'hired gun' to kill a whole 'collective noun' of them -  because they were damaging trees on his 'estate'. Actually, they were right to support Dr May, who was acting in the wider interests of wildlife - which brings me to a story that the BBC is reporting today.

The British Ecological Society have worked with Durham University and FERA to research the impact of roe deer on wildlife diversity. Roe and Red deer are the only two 'natural' British deer, though the Fallow has been about for a millennium. The Muntjac, Sika and Chinese water deer are all comparative newcomers. The deer which cause me stress through degradation of our garden are the Red and Fallow. Anyway, it seems that the research shows that deer eat saplings, debark young trees and eliminate much of the under-storey of vegetation. People who understand the countryside knew that already. The result of this deer activity when numbers are not controlled is a huge reduction in biodiversity, particularly of bird life. People who support the idea of greater diversity of wildlife should campaign in support of stalking and culling deer.

And while the British Ecological Society are at it, they should commission research into the impact of the great increase in badger numbers on birds which nest on the ground or in the base of hedges. And we know the damage to diversity causes by the hated mink - and that the rat-like grey squirrel has all but killed off our lovely native reds. The point I make is that this idea that all creatures in the wild should always be protected actually causes huge damage to wildlife diversity. The attack on me in the Daily Mirror certainly caused damage to my previously supportive attitude towards the RSPCA. You can tell it still rankles six weeks later.

Tuesday, January 01, 2013

Sound of 'Saesneg' in the Valleys.

I blog for enjoyment, or to bring order to the chaos of my mind, or to stimulate others to response through expression of my own opinions. But this post is a plea for information which might help me understand what on earth is going on at Radio Cymru. Its like watching a dear friend, having fallen seriously ill, and through ignorance of what medication is needed, being helpless to offer advice. Lets just consider the facts as I understand them. And I am open to correction.

In 2007, the Performing Rights Society decided that Welsh recording artists were being overpaid 'appearance money' when their music was being played on Radio Cymru. The PRS claimed it had calculated the payments on a mistaken formula, and 'corrected' the position by reducing the payments very significantly. The performers were and remain understandably disgruntled, and 331 of them have formed an 'negotiating body' called Eos, which has been negotiating with the BBC to establish a new payment regime. The BBC, on the other hand, reckon they have offered a generous increase. Eos disagree with this. From today there is impasse. We observers look on with incomprehension at what looks like a uncontrolled trip over a fiscal cliff, and all set to English music.

Radio Cymru, from today is playing music in mostly the English Language. This is a catastrophe for Radio Cymru. Its a catastrophe for the Welsh Language. And its a catastrophe for the artists who perform 'yn yr Iaith Cymraeg'. No other way of putting it. Radio Cymru receives annually £13.5 million of licence fee money, and has a weekly audience of about 150,000 - and its not even playing Welsh Language music, the point of its existence. This is lose/lose/lose.

And now to the advice and help I need. Are the artists demanding an unrealistic fee of Radio Cymru for the use of their music when there is no other output in the market for it? Or is the BBC trying to manipulate a monopoly position to secure rights to use music performed by Welsh Language artists on the unacceptable 'cheap'? No idea. Only hope I can see of extricating Radio Cymru from this total 'llanast' is through the extraordinary negotiating skills of Elan Clos Stephens. There will be many, like me, who are shaking their heads in bewilderment at what looks like self-inflicted damage.