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John Reid: I will, if the right hon. and gallant Gentleman will allow me, answer that point directly tomorrow. I know he speaks with some authority, having been in the British armed forces, possibly even the Scots Guards, if my memory does not deceive me, so he speaks with double authority.

Bob Russell (Colchester) (LD): The Secretary of State is aware that two battalions of the Parachute Regiment are officially stationed in Colchester. One is on a return visit to Iraq. There is a general feeling among military folk in Colchester and the wider population that the newspaper article is correct, and that the other battalion, along with other elements of 16th Air Assault Brigade, will be going to Afghanistan. Does he agree that the overreach of our troops and the fact that they are under strength are getting to the stage where cuts in the Army should be revisited?

John Reid: The assumption in certain quarters that 16th Air Assault Brigade may be involved could be due to the fact that people in Colchester, and hopefully at some stage the hon. Gentleman, read written ministerial statements that I make to the House. The one on 14 November stated:

that is, for deployment—

So that would be a rational conclusion drawn by soldiers whom the hon. Gentleman meets and, indeed, by journalists writing for some papers. Perhaps I should have mentioned earlier that not only has all the material that appears in the press this morning appeared in the press before, but much of it has appeared in written ministerial statements to the House. I shall send the hon. Gentleman a copy.

Mr. Michael Ancram (Devizes) (Con): The Secretary of State rightly complains about the damage that can be done by speculation about announcements about deployments, particularly in terms of unsettling the troops and their families, but is it not the case that the Government were prepared to make a statement on deployment in early November, which was postponed because the Dutch had second thoughts about the nature of their participation in the operation—the deployment to south?

John Reid: Yes.

Angus Robertson (Moray) (SNP): The Chief of the Air Staff, Sir Jock Stirrup, said that

simultaneous operations—


 
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The Ministry of Defence is aware that that already poses problems for the service personnel. The Minister of State kindly wrote to me yesterday saying:

Will the Secretary of State please bear that in mind before any announcement, to try and ensure that there is an optimal transport configuration and to minimise the inconvenience to personnel of all the services?

John Reid: Yes. I would love to make this three in a row.

Dr. William McCrea (South Antrim) (DUP): I thank the Secretary of State for his openness with the House today in his statement. Will he rest assured that my right hon. and hon. Friends will fully support the continued efforts of our troops in Afghanistan, and that we wait with interest for his statement, if it comes tomorrow?

John Reid: I very much thank the hon. Gentleman and his colleagues.

Patrick Mercer (Newark) (Con): I respect absolutely what the Secretary of State said, but there is no doubt that if the deployment goes ahead, yet again it will fall predominantly upon infantry soldiers. Will he look at whether we have the correct number of infantry soldiers, and will he guarantee that the brave and overworked men of the 3rd Battalion the Parachute Regiment will be given some time with their families to train and recuperate and to get their lives together when they come back from their latest dangerous mission?

John Reid: Without prejudice to any decisions, yes. I will look at that.

BILL PRESENTED


Police and Justice Bill

Mr. Secretary Clarke, supported by the Prime Minister, Mr. Secretary Prescott, Mr. Chancellor of the Exchequer, Secretary Ruth Kelly, Hazel Blears and Mr. David Miliband presented a Bill to establish a National Policing Improvement Agency; to make provision about police forces and police authorities; to make provision about police powers and about the powers and duties of community support officers, weights and measures inspectors and others; to make further provision for combating crime and disorder; to establish the office of Her Majesty's Chief Inspector for Justice, Community Safety and Custody; to amend the Computer Misuse Act 1990; to make provision about the forfeiture of indecent images of children; to provide for the conferring of functions on the Independent Police Complaints Commission in relation to the exercise of enforcement functions by officials involved with immigration and asylum; to amend the Extradition Act 2003; and for connected purposes: And the same was read the First time; and ordered to be read a Second time tomorrow, and to be printed. Explanatory notes to be printed [Bill 119].


 
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Point of Order

12.58 pm

David Taylor (North-West Leicestershire) (Lab/Co-op): On a point of order, Mr. Speaker. In the wake of "The World at One" on Monday, in which an Opposition Member who serves on the Education and Skills Committee made remarks on an unpublished report of that Committee, may I approach the Speaker's Office in writing or in some other way to establish whether a breach of trust or confidence may have occurred?

Mr. Speaker: On a matter of privilege, the best thing the hon. Gentleman could do would be to raise the matter with me in writing.


 
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Palliative Care for the Terminally Ill

12.59 pm

Jim Dobbin (Heywood and Middleton) (Lab/Co-op): I beg to move,

Palliative care is about enhancing quality of life and enabling patients to live as actively as possible until they die, naturally and peacefully and, whenever possible, with their families around them. I am proud of the fact that the UK leads the world in palliative care, but the reality is that we are not doing enough because the service remains underfunded.

The all-party parliamentary group on dying well was launched on 10 January to ensure that we all have the opportunity of a good death and that we die with dignity, by pressing for better and more widely available palliative care, by promoting greater support for friends and family members who care for the dying, by opposing euthanasia and assisted suicide, and by encouraging debate and promoting understanding of how people can achieve comfortable and natural deaths.

There is strong objection to the recent attempt by the Voluntary Euthanasia Society to rename itself Dignity in Dying—a name synonymous with the hospice movement and with palliative care. The chief executives of Marie Curie Cancer Care, Help the Hospices, and the National Council for Palliative Care said yesterday:

They added:

The quality of palliative care in Britain has made huge strides during the past 10 to 20 years, but its quantity and distribution have not kept pace. As a result, there is something of a postcode lottery for the terminally ill. Inadequate funding is allocated to palliative care in the NHS and there are not enough trained specialists in practice. Two recent parliamentary reports drew attention to these shortfalls and the Government have indicated that they are investing more money in palliative care. For example, in 2003–04, the NHS cancer plan promised an extra £50 million per annum specifically for specialist palliative care. That addition is welcome, but it is thinly spread across the country. Progress is slow and not all the resources are reaching front-line specialists.

In a recent Adjournment debate initiated by the hon. Member for Tiverton and Honiton (Angela Browning) on care of the dying, the Under-Secretary of State for Health, my hon. Friend the Member for Birmingham, Hodge Hill (Mr. Byrne), reaffirmed the Government's commitment to


 
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I welcome that commitment, but much more needs to be done. According to a survey commissioned by Marie Curie Cancer Care, 90 per cent. of people believe that the Government have responsibility for maintaining and improving the standards of care for terminally ill people. My Bill seeks to oblige the Government to meet that responsibility.

In the same Adjournment debate, the Minister highlighted the fact that palliative care was "heavily weighted" towards cancer patients. The National Council for Palliative Care estimates that, while 95 per cent. of patients using hospice or palliative care have cancer, 300,000 people with other terminal diseases are excluded. It is a fact that cancer patients have access to the most and the best palliative care. Yet even for those with cancer, the provision is far from satisfactory. According to Marie Curie Cancer Care, more than 155,000 people die of cancer every year, yet Help the Hospices points out that there are only 3,250 hospice beds available, and that 2,489 of them are supplied by the voluntary sector. Half of all patients diagnosed with motor neurone disease die within 14 months of diagnosis, yet a survey carried out in 2005 found that only 39 per cent. of such patients were referred to specialist palliative care services. Is it any wonder that people take fright when diagnosed with MND?

My Bill will seek to broaden the scope of palliative care so that it encompasses all those with a terminal illness. This is an ambitious aim, but it can be achieved with sustained Government investment and support. Only last December, the NHS Confederation report highlighted the pressing need to improve end-of-life care for the terminally ill. The report pointed out that 56 per cent. of terminally ill patients would prefer to die at home, but that only 20 per cent. do so. Another statistic showed that only 11 per cent. of people want to die in hospital, yet 56 per cent. spend their final hours there.

Inconsistent community provision and ineffective co-ordination between service providers affect people's ability to die where they choose. Unless we get to grips with the problem, the situation will get worse. According to the NHS Confederation, care of the dying is the cause of repeated complaints to the health service ombudsman. As far as the NHS Confederation is concerned, all that points to an increased need for integration of "health and social agendas". Just as pregnant mothers have birth plans, there should be advanced end-of-life care plans, to be based on a full assessment of each patient's needs, including the need for good-quality palliative care. Good examples of such plans are already in place, including the gold standards framework, the NHS end-of-life care programme and the Liverpool care pathway. I hope that the Government will use their forthcoming White Paper on
 
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health and social care outside the hospital to show how they will meet the five key recommendations in the NHS Confederation report.

Palliative care does not require expensive treatments or technology, because its essence lies in specialist knowledge of how to use pain-relieving drugs and how to give holistic care to ease the dying process. A relatively small refocusing of NHS resources could bring disproportionate benefit compared with other branches of medicine. Only a minority of us will need cardiac surgery or neurosurgery, but one in two of us will be in need of good palliative care when we die.

Marie Curie Cancer Care points out in its "Dying at Home" report that every pound invested in home palliative care services will free up £2 in the national health service. By extending palliative care to all terminally ill patients, the Government would save the NHS money. That is an attractive proposition, yet, despite increased funding commitments, the number of cancer patients dying at home has remained the same, and 80 per cent. of the resources allocated to specialist palliative care are allocated to hospital-based care.

A Help the Aged report found that older people were

Children are at a disadvantage, too. There is an acute shortage of paediatric palliative care medicine consultants. That is not surprising, when one considers that children's hospices receive only about 5 per cent. of their funding from official sources, while adult hospices receive 30 per cent. from the same sources.

Comprehensive palliative care legislation should be our priority. Legalising euthanasia or physician-assisted suicide would undermine the values and ethos of palliative care, a field in which Britain has led the world. For that reason, my Bill will specifically prohibit the wilful killing of patients. It will ensure that everyone has the right to a good death, regardless of age, diagnosis, ethnicity, background or postcode. I commend this patient-centred Bill to the House.

Question put and agreed to.

Bill ordered to be brought in by Jim Dobbin, Mr. Frank Field, Dr. Brian Iddon, Mr. David Crausby, Mr. Lindsay Hoyle, Mr. Iain Duncan Smith, Mrs. Claire Curtis-Thomas, Paul Rowen, Mr. David Amess, Mr. Julian Brazier, John Robertson and Mr. Joe Benton.


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