Oral Answers to Questions
Debate between Anne-Marie Trevelyan and Andrew Murrison(3 years, 5 months ago)
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Dr Andrew Murrison (South West Wiltshire) (Con)
The Minister for Business, Energy and Clean Growth (Anne-Marie Trevelyan)
All energy-from-waste plants in England are regulated by the Environment Agency and must comply with the strict emissions limits set in legislation. I am aware that Northacre Renewable Energy Ltd has applied for an environmental permit from the Environment Agency to operate an incinerator in Westbury, Wiltshire, and the Environment Agency is considering responses to the public consultation.
Oral Answers to Questions
Debate between Anne-Marie Trevelyan and Andrew Murrison(3 years, 9 months ago)
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Dr Andrew Murrison (South West Wiltshire) (Con)
The Minister for Business, Energy and Clean Growth (Anne-Marie Trevelyan)
I note and support my right hon. Friend’s concern and I will pass it on—particularly in terms of the UK leadership—to the Environment Minister. The work that we have done already in setting resources and waste strategy is leading the way and we as a country are looking to implement all avoidable waste by 2050. With so much of COP, it is about our leadership and proving that we are walking the walk by making these policy changes here at home. I will make sure that the Minister continues to work on that with him.
Oral Answers to Questions
Debate between Anne-Marie Trevelyan and Andrew Murrison(4 years, 8 months ago)
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Anne-Marie Trevelyan
I am absolutely committed to 0.7% and I am committed to spending it in value-for-money terms for the British taxpayers who are funding it and, most importantly, to ensuring that we help those countries that are most fragile and most in need of aid and then development, so that they can become strong independent countries themselves. Getting to that point involves doing lots of things, and not necessarily in the way we have done them before. We need to ensure that we have a long-term investment perspective to help those countries to become self-sufficient. I do not want countries always to be dependent on UK and international aid; I want them to be self-sufficient, proud countries that can stand on their own two feet.
Dr Andrew Murrison (South West Wiltshire) (Con)
Given the likely effect of covid-19 on populations that DFID works with, what plans exist to establish contingency funding to deal with mitigation for those populations and to shift funding to the development of a vaccine, which is a global equity?
Anne-Marie Trevelyan
I thank my right hon. Friend for his question, and for the enormous amount of work that he has done in previous iterations of his posts in this Department and others. He is absolutely right; the challenge of finding a vaccine for covid-19 is something that we are actively involved in, and we have already supported £5 million to the World Health Organisation. I was speaking to Dr Tedros yesterday to find out what other support we could bring, not only in cash terms but in expertise such as the skills of epidemiologists and logisticians, which could help the WHO to drive forwards in the weakest health systems across the world to ensure that they have the support they need.
Passchendaele
Debate between Anne-Marie Trevelyan and Andrew Murrison(7 years, 4 months ago)
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Dr Murrison
My right hon. Friend is absolutely right. The thing that impresses one most of all about this commemorative period is the extraordinary amount of work that has been done right across the country—some of it sponsored and assisted by the Government, some of it not, and some of it quite spontaneous in its evolution. Together, that forms a wonderful patchwork of commemorative activity, and it just shows the passion the public have for commemorating this period in our history. That suggests to me that there will, indeed, be a very rich legacy when we come towards the end of our four years.
Mrs Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con)
I commend my hon. Friend for the extraordinary work he has done to ensure that this commemoration period is given as wide a reach as it can be. Last year, he encouraged me to look at the Royal Northumberland Fusiliers—the young men from my constituency who went out to fight in the first world war. Those boys and young men were the same age as my son is now, which brings this home very bluntly to me. Last November, I went out to northern Italy to lay a wreath at the war graves at Tezze, in northern Italy. By chance, a group of Italian students of 17 and 18 was visiting. They had never been in the cemetery before, but they saw a woman in a red coat with a wreath, and they were curious, so they came over. Their teacher, who spoke perfect English, asked me to explain why I was there and why British soldiers had been fighting in their country. These children had had very little education about the first world war, because the fascist regime altered the way history was taught in Italy. To a young man and young woman, they were absolutely transfixed. They were enormously appreciative of, and slightly overwhelmed by, the fact that young men had come from far away—in this case, from Berwick in Northumberland—to fight for freedom. I commend my hon. Friend for the efforts he has made, which have given us the opportunity to share these things with those children across the water.
Dr Murrison
I am grateful to my hon. Friend, and she is absolutely right. That gives me the opportunity to say that this is, of course, not just about the western front. I am pleased that she mentioned Italy. It is important, as part of this four-year commemorative period, that people do come to appreciate that the first world war was, indeed, a world war, and the Italian campaign is an important part of that.
May I also mention centenary interns while I am talking about young people? I hope this project will become an important part of our presence on what was the western front for people wishing to visit commemorative sites. The Canadians have, for a long time, had young people guiding visitors from Canada around sites on the western front that are particularly important to Canadians. It struck me that if the Canadians can do so well from a distance of 3,000 miles, we can probably do something rather similar from a distance of 200 miles. Right now, we have established the first tranche of our centenary interns, who will guide people around the principal sites for us—Tyne Cot and Thiepval—under the supervision of the Commonwealth War Graves Commission. When colleagues and others visit the western front and the cemeteries and sites of importance in northern France and Belgium, I hope they will look out for the very obvious orange T-shirt uniforms of our centenary interns. Those I met last week when I visited Tyne Cot were people of exceptional quality, and I am sure people will be very pleased to see them and to be guided by them around those sites.
It is remarkable that the third battle of Ypres was not only preceded by Messines—a victory that I think encouraged Hague in his dialogue with Lloyd George— but succeeded the success at Cambrai, which was remarkable for another reason, in that it introduced mechanised warfare realistically for the first time on the western front. That was the gathering note for what became a far more kinetic stage in the last 100 days of the war.
For most people in this country, what makes Passchendaele special, as it were, is the mud and blood. It was quite different from the Somme, which resulted in far more casualties. That mud was caused by rain, of course, but also by the inundation of Flanders following the barrage of artillery that completely destroyed all the dykes and engineering that held back the sea from that part of the world. Flanders is, of course, pasture land, and crops cannot be grown there, because it is far too wet. The reason it can be utilised for agricultural purposes at all is that it has an advanced system of water engineering. Bombardment means that that is completely destroyed. It was not for the first time in the first world war that the British Army knew the full consequences of the destruction of that system. The combination of heavy rainfall and the destruction of civil engineering in that area made it a complete quagmire, which gave Passchendaele its particular awfulness.
I would like to finish on a contemporary note. In two weeks’ time, many of us will be privileged to attend the commemorations in Ypres and Tyne Cot. We will stand there among the row upon row of headstones, we will look at the Menin Gate, with its rank upon rank of names carved in stone, and we will be left with a sense of wonder. We will try to work out what it all means. In the context of the debate we are having about our future in Europe, one wonders perhaps what others think of us, too. There are those in Europe who say that this country is somehow less than European—that we are poor Europeans. I would just say this: it has always been the case, and it is the case now—this country was certainly demonstrating this full well 100 years ago—that there is no country in Europe that is more engaged in Europe than the United Kingdom.
I would just ask colleagues, as they look among those headstones and gaze up among those names carved in stone, to reflect on this country’s contribution to European history. Whether we are Brexiteers or not—and I am a completely signed-up Brexiteer—we need to understand that we are Europeans; that is what we have always been, and that is what we will always be. We should take absolutely no nonsense from those who, for their own purposes, try to suggest that we are in some way disengaged from Europe. I am proud of our history. This country has always been there when Europe needed us—when we needed to face down the general disturber of the peace. I am confident that we will continue to do just that.
Two weeks’ time will be a solemn time for our country. The media will most certainly be focused on Tyne Cot and Ypres. We will be among friends in Belgium—a country that is extraordinarily sympathetic to this country and a good friend of ours. It is important that, whenever we have the opportunity, we reinforce in the minds of our friends and neighbours in Europe our solidarity and comradeship with them. There can be no more enduring testament to that European engagement than the Menin Gate in Ypres and Tyne Cot at Zonnebekke.
Rothbury Community Hospital
Debate between Anne-Marie Trevelyan and Andrew Murrison(7 years, 8 months ago)
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Mrs Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con)
It is an honour to have finally been successful in the debate ballot and to bring the issue of the proposed closure of in-patient care beds at Rothbury community hospital to the House and to the Minister today.
Rothbury is a thriving small town at the heart of the Coquet valley community in my constituency, in Northumberland. The valley is a large, very rural and sparse community of over 5,000 people across hundreds of square miles, and it runs from the A697 at its eastern edge across to the Cheviot hills and the Scottish border to the west. Small villages and hamlets are dotted across traditional agricultural territory with mainly upland sheep farms, some of which are within the Northumberland national park and the Otterburn Ranges—the Army’s largest training base in England.
Families’ commitment to living in this idyllically beautiful but quite challenging day-to-day environment is vital to the land management necessary for our tourism, our farming and our military needs as a nation. Over 30% of those living in the valley are over the age of 65—a figure that will only grow, as Rothbury and the surrounding villages are wonderful places to retire to or for people to stay in long after their children have flown the nest. Therefore, we must plan for the right long-term, sustainable healthcare offer for this close-knit community of families and businesses and for the unique challenges they face.
The local community hospital has, until now, provided 12 in-patient beds, primarily for palliative, post-operative recovery and respite care. The clinical commissioning group reviewed activity data last year as it brought in a system-wide approach to discharging patients home, and average bed occupancy in Rothbury was 50% through 2015-16. The CCG declared that to be too low to be sustainable.
As a result of nursing workforce challenges across the Northumbria healthcare trust—albeit that we face fewer challenges than the rest of the UK, thanks to our excellent forward-thinking trust, doctors and managers—the reality is that we do not have the nursing capacity adequately to cover the 12 in-patient beds at Rothbury at present. A combination of those workforce challenges, and the under-occupancy concerns cited by the CCG, meant that the use of those in-patient beds was suspended temporarily in September 2016.
Where I part company from our hard-working CCG on this issue is that I believe that those beds have been empty not because of a lack of demand, but because decisions have been taken to send people home to receive community care, or to Alnwick infirmary to receive in-patient care. As a result, Alnwick infirmary has been running near to capacity for some time, and those in the north and east of my constituency who might otherwise have been sent there have been forced to remain in the urgent care beds at the UK’s first specialist emergency care hospital at Cramlington— our new specialist care hospital for the whole of Northumberland and north Tyneside—for longer, placing greater strain and expense on our healthcare system than necessary.
If this in-patient ward is permanently closed, that will have negative impacts on my Coquetdale community and greater financial implications for our NHS across Northumberland. In particular, the challenge is that we do not have anything like enough community nurses and carers adequately to support those older patients who are sent straight home with their transition back to independent living. It has always been a challenge for our community teams, working across rural Northumberland, to see anything like the number of patients in one day that they would see if they were based in a town or a city, because our CCG is not funded to commission enough community nurses to genuinely provide the amount of care to meet the extra challenges that this sparse and disparate community generates. If a community nurse needs to visit someone three times a day but her other patients are 30 miles away, she will make three or four visits a day rather than the 10 or so that an urban-based community nurse would be able to make. Many of our older people who have received medical interventions live alone or have elderly partners who are no longer able to be full-time carers themselves. The value of a step-down care transition provided by a few days of recuperation at Rothbury community hospital would have medical as well as psychological value for these communities.
Dr Andrew Murrison (South West Wiltshire) (Con)
I congratulate my hon. Friend on the powerful case she is making for her rural constituency. Has she been able to compare and contrast the cost of a community hospital bed with the cost of a bed in the district general hospital to which she referred? I suspect that she has done so and will have found that there is a yawning difference between the two—a very good argument for community hospital beds.
Mrs Trevelyan
I thank my hon. Friend for making that point. This issue is critical, and it has brought some confusion to the community, who felt that the financial model did not seem to make sense. Why keep someone in a very expensive acute bed for longer than necessary if there is the capacity to have a local relationship with nurses who know the community very well? This is part of the CCG’s work, obviously, but we need to be very clear about it to be sure that we are not making a bad financial decision in the longer term.
As a result of this consultation, residents across the Coquet valley who have needed admission to an acute ward may well now find themselves staying longer than necessary on that acute ward; being re-admitted to an acute ward for lack of adequate rehabilitation care at home; sent home with inadequate support from an over-stretched community nursing service; or, at best, sent to recuperate in a different community hospital much further from friends and family, placing extra pressure on alternative populations needing to use that provision.
When, back in September, the decision was taken to temporarily suspend admissions to Rothbury community hospital for a period of three months, I wrote to every household across the valley calling on them to share with me their own experiences and concerns about the proposed threatened closure of the in-patient beds. The message came back loud and clear that being near family and their own community while they recuperated, or ending their days with dignity and privacy in the valley they have lived and worked in rather than dying at home alone, is invaluable. I know that this Government want our world-class NHS to provide not only the best medical interventions but the respect and provision of dignity for every patient while they are under its care.
The Coquet valley is frequently cut off during winter months, making travel to Alnwick infirmary to see loved ones receiving care especially difficult and sometimes not possible at all. Even during the summer months, there is little public transport to connect the valley and Rothbury to Alnwick. The ability of loved ones to visit patients receiving care at Rothbury community hospital was cited time and again to me as one of the primary reasons the in-patient beds are so vital to my constituents. The value of our community hospitals is often overlooked and certainly cannot be quantified when, too often, consultants have not been made aware of their option to transfer patients to receive care in Rothbury.
My constituents have come together in an extraordinary show of unity to speak in one voice under the banner of the Save Rothbury Hospital Campaign—4,500 people have signed the petition calling for the reopening of the ward. Our CCG has worked closely with the campaign team, for which I thank them, particularly Dr Alistair Blair, who has so many pressures on him and his team at this challenging time, and has invited us to bring forward a proposal that would see the beds made available for step-down and end-of-life care. I am concerned, however, that the CCG is telling me that because it does not commission respite or palliative care services, these cannot be part of a sustainable solution, as the valley residents would hope.
Northumbria Healthcare NHS Foundation Trust is one of NHS England’s vanguard trusts with its sustainability and transformation plan, and it will be the first accountable care organisation in England in the coming months, so surely we should be able to ensure that integrated care can work in one of our most challenging geographical locations. The University of Leeds is currently conducting a study called, “Cost Structure and Efficiency in Community Hospitals in the NHS in England”. The Public Accounts Committee, of which I am a member, regularly challenges NHS England on how it spends taxpayers’ money to deliver the best integrated health and social care provision. I know that the Minister is working hard to drive this forward, and we encourage him to go further, but until the results from the University of Leeds are published, the Minister has little economic evidence of the value of the intermediate care provided by community hospitals with which to work on the sort of sustainable solution that I want to see for our community hospital in Rothbury.
Dr Murrison
My hon. Friend is being generous in taking interventions. I am interested in the study to which she refers. Does she agree that a likely outcome of the configuration of healthcare in the longer term will be increasing specialisation at really quite large district general hospitals? If that is the case, there will be an even greater need for community hospital beds—step-down, step-up care—otherwise people’s only access to in-patient care will be at one of the huge regional or sub-regional centres that I suspect our NHS will be developing in the years to come.
Mrs Trevelyan
I thank my hon. Friend for his comments. We are unwittingly seeing what he suggests already. In Northumberland, we have an extraordinary specialist A&E hospital, with which we have led the way in England. It has drawn much more attention and patient focus than perhaps any of us expected, because there in one place are all the specialisms, with the best maternity care. The result is that patient needs have migrated to it.
However, we now rely much more than we should on sending patients straight home, whereas we should be using community hospital beds to provide the best step-down care for our older people, in particular, who really need that support to get back home. Getting home, getting up and about, making their own cups of tea, moving around and avoiding the risk of muscle wastage caused by staying in a hospital bed are real issues for them. As medical science moves on and that becomes more and more clear, in-patient bed units in community hospitals should probably adapt to reflect that. Such units must help to preserve the mobility of people who are taking that step-down approach to going back home; the term “in-patient bed” should not mean that they are stuck in their beds. We understand that continued movement and redevelopment of muscle are important in rehabilitation, and we must absolutely make sure that patients are not left in the wrong part of the NHS when they are trying to get back home after extraordinary medical interventions. Those interventions are now developing very quickly and giving us the opportunity to live much longer.
I therefore call on the Minister to pause the CCG’s consultation and the plans to close permanently the in-patient beds until the results from the University of Leeds have been published. Northumbria Healthcare NHS Foundation Trust is leading the way in establishing an accountable care organisation—a model that many people buy into and understand the value of. We all instinctively assume that the NHS is one block, but of course it is not; it has always been made up of separate parts, which work better or less well depending on where they are. The accountable care organisation offers a real opportunity for streamlining and making the flows work much better. We will be the first to do that in Northumberland, so we should be the beacon for fully integrated community care—making the best use of our taxpayers’ money and ensuring that my constituents have the most appropriate and supportive care framework —rather than being a victim of the short-term workforce challenges with which the NHS is struggling.
Armed Forces Covenant
Debate between Anne-Marie Trevelyan and Andrew Murrison(7 years, 9 months ago)
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Mrs Trevelyan
My hon. Friend reflects the deep concerns about the way in which the survey was put together and the framing of the questions, which left a lot of personnel unable to give the answers that they wanted to give. I think the Minister is mindful of that, and I am glad to hear that no formal decisions have yet been made.
Dr Andrew Murrison (South West Wiltshire) (Con)
I do not want to get involved in a dispute between two of my hon. Friends, but does my hon. Friend the Member for Berwick-upon-Tweed (Mrs Trevelyan) agree that, of all the surveys published in recent times, the one that matters most is the monthly service personnel statistics of 19 January this year? They show, sadly, both reservists and regulars voting with their feet.
Mrs Trevelyan
Sadly, that is the reality. I talk continually about retention risk. That risk is very real, and we are suffering from it.
I want to take the Minister and the House a little further into the FAM survey. The survey talked about choices, but no one felt that SFA was a choice that the MOD wanted to keep on the table. The Minister and I will continue to discuss the matter, but that is what the personnel who completed the survey felt. Giving service personnel the choice to live where they want is fine, if the option to live with their family when not deployed during the week is real. However, housing costs in too many parts of the country where forces are based are too high, so the likely reality is that families will be spread across the country and unsupported. We cannot plan for a peaceful world when all our troops are at home.
We are undermanned, and, as my hon. Friend the Member for South West Wiltshire (Dr Murrison) says, our recruitment numbers are a challenge. The offer needs to hold up if recruits are to remain in service once they have families, and a key component is getting the housing offer right. Choice is a great thing, but it simply will not work to drive a policy change that breaks up patch life or creates effective salary drops because of housing market stresses.
The annual report shows the continuous work of the Department’s team to help to reduce disadvantage. That is commendable, but there is so much more to do. Not a single person here would ever want to hear the words that I have heard far too often: “This is just too hard; we are going to leave the service.” The most recent continuous attitude survey shows that there is a stark gap between the 76% of respondents who are proud of their service and the 45% who would suggest that one should join up. That is a gap that we cannot fix.
I hope that in the year ahead we can focus on actively encouraging service families to talk to their MPs when they have problems, so that a strong new constructive dialogue can begin. The covenant is one of the most powerful tools we have to drive through good decisions, to reduce the looming capability risk gap and to increase our servicemen and women’s belief in their value to us. I fervently hope that we can harness such a dialogue across the House in 2017.
Ministry of Defence Future Accommodation Model
Debate between Anne-Marie Trevelyan and Andrew Murrison(8 years, 1 month ago)
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Mrs Trevelyan
I thank my hon. Friend for that point. That is a wider debate; we will see whether we can persuade the authorities to allow us to have that wider conversation.
Dr Andrew Murrison (South West Wiltshire) (Con)
Does my hon. Friend agree that the key problem is the price that service families have to pay for their accommodation? It has been creeping up and up, and I am not aware—perhaps she can enlighten me—whether the Armed Forces Pay Review Body has factored that into its annual determination.
Mrs Trevelyan
I am afraid that I am not privy to the details of the pay review body’s work, but perhaps the Minister will answer that question for us later. I would also be grateful if he set out the present annual net cost of the SFA offer, to give the military families watching, who are very concerned, some idea of the funding available if they have to work with one of the proposed new options. We need to look starkly at what the FAM proposes, in terms of realistic housing accessibility from the private rental and purchase housing markets; realistic cost implications for families; and the real impact of the military community being broken up, leaving families unsupported at times of deployment.