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Having welcomed all those things, may I touch on some issues that I trust the Government will take on board? The Government are considering in what way the RIR and its personnel can be recognised. I know that, to some extent, the Army likes to keep a certain amount of control over the awarding of medals and I know that the Government will at least want to recognise the role of the regiment as a regiment. However, many of us in Northern Ireland believe that the individuals who have put their lives on the line should be recognised by the Government and that there should be a medal struck specifically for those who have served in the RIR. Although I hear some rumours in the MOD that it is looking at a regiment recognition, as opposed to a soldier recognition, I trust that the
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Government will look again at that important issue. It might not seem much to many outside the services, but for those who have served in the most horrible and dangerous of circumstances, it is due recognition for the contribution that they have made.

For the Ulster Defence Regiment, a matter relating to the accumulated campaign service medal continues to be a sore. The medal is available to full timers who complete 1,080 operational duties, or part timers who complete 1,000 operational duties. That would appear to make it fairly simple to determine who is entitled to the medal, but regrettably it does not work out that way. The Ministry of Defence says that, as a matter of policy, it has disposed of records that were completed manually, and it now relies on those available through IT. The problem is that, before 1984, records of operational duties were compiled manually, so the information is no longer available to the MOD.

I have been pressing the issue for a long time, and I thought that the problem had been cracked when the MOD made it clear that it was setting up a special group that would consider any applications, and that would take evidence from senior officers and others on whether a person had completed the necessary number of duties. However, it has not worked out. Many of my constituents complain that they completed that number of duties and more, and had letters from senior officers in the regiment saying that they had done so, but were turned down for the medal. One of the champions of the campaign is my constituent, Samuel Fisher. Although he has letters from senior officers not only stating that he completed the number of operational duties required, but listing the operational duties that he performed, he is still not being given the medal. It is unacceptable to leave people who have served their country so well with that kind of gripe. I trust that the MOD will look into the issue again.

I do not want to devalue the medal by simply making it available to anybody who applies and claims, on their honour, to have completed the duties required, but some combination of the soldier’s length of time in the regiment and the available records should be used to enable the MOD to reach a conclusion. Certainly, a more generous approach could be taken; there should be an assumption in favour of the soldier, rather than an presumption against, as seems to be the case at present. I trust that the Minister will relay that to his colleagues and will look sympathetically on the case of those who have served our country well. As we come out of conflict in Northern Ireland, I trust that we will remember those who stood by us when it was at its height.

5.18 pm

Ms Diane Abbott (Hackney, North and Stoke Newington) (Lab): I wish to speak on a subject of great concern to me and my constituents: the unfolding tragedy in Lebanon. It is worth reminding the House how the crisis began. It started two weeks ago, when Palestinians in Gaza captured an Israeli soldier with the intention of negotiating the release of some of the 9,000 Palestinian prisoners of war in Israel. Gaza took a pounding. There were attacks on electricity and water supplies and thousands of people suffered, but the rest of the world did nothing, including the Arab states.

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Hezbollah decided to do something about the situation and to pose as the champion of the Palestinian cause. It responded by capturing two more Israeli servicemen and, eventually, by firing rockets into Israel—most, if not all, of which were aimed at civilian targets. Of course, Israel absolutely has the right to defend itself and respond to the missile threats, but the issue for me, my constituents and most of the Governments in the world, with the exception of those of America and Britain, is Israel’s excessive use of force. Jan Egeland, the United Nations Under Secretary-General for Humanitarian Affairs, has described the Israeli response as a violation of humanitarian law.

Earlier in the debate hon. Members spoke of the need to strengthen the Lebanese state. Of course that is important, but I am not clear how killing 370 Lebanese civilians, forcing 500,000 people to flee, smashing the bridges and roads, blockading the port and smashing the capital, Beirut, will strengthen the Lebanese state and make Lebanon more stable. Of course, Israel has a right to self-defence, but as matters stand, casualties on the Israeli side and casualties on the Palestinian and Lebanese side are running at about 1:10 in favour of the Israelis.

Israel insists that it is hitting only targets related to Hezbollah, but we can all see on our television screens the hundreds of civilians who are being hit, whether intentionally or unintentionally. Only yesterday television pictures were transmitted of two Red Cross vehicles clearly marked as Red Cross vehicles, lit as Red Cross vehicles, with Red Cross flags on top, which were deliberately bombed by the Israelis. Not only the patients inside the ambulances, but the Red Cross personnel were put in hospital.

We have heard terrible reports of some of the Israeli activity, which may yet be seen to verge on war crimes. There are several instances of the Israeli military ordering civilians to leave their homes and then firing rockets into the evacuation fleet, blasting women and children refugees inside. The rockets that killed them are believed to be Hellfire missiles made by Lockheed Martin in Florida.

The Israeli Government have not chosen the route of de-escalation and negotiation. Instead, they have chosen war. Britain and America are standing back and, as it is described, letting Israel deal with Hezbollah. What historical precedent is there for such military action successfully dealing with insurgent guerrillas, which is what Hezbollah is? Did it succeed in Malaysia, Cyprus or Kenya? How can it succeed in Lebanon?

The action that Israel is taking in Lebanon looks increasingly less like an attack on a terrorist organisation and more like an attack on a nation. It looks increasingly like the collective punishment of the Lebanese people for failing, in Israeli eyes, to do more to contain Hezbollah. That cannot be right or fair, it is contrary to the laws of natural justice, and it cannot work, because for every Lebanese civilian who dies as a result of the current Israeli action, there will be many more recruits for the Hezbollah extremists, so even in its own terms, neither militarily nor politically can the Israeli bombardment of Lebanon achieve the professed aims.

It is noticeable that even the strong middle east allies of Britain and America, such as the Iraqi Prime Minister
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yesterday, have clearly condemned what is happening. It is difficult for Britain and America to pose as people who wish to fight for human rights and national sovereignty across the world, when the Arab world sees what is happening to Lebanon. There is the never ending war in Afghanistan, the increasing devastation of Iraq, where thousands of people are dying, the continuing death and destruction in Gaza and the bombing of Beirut. How does that look on the Arab street? How does that make the world a safer place?

Mr. Nigel Evans (Ribble Valley) (Con): It seemed rather strange that no early ceasefire was sought by the United States or the United Kingdom; all that they talked about was an effective ceasefire. Surely any ceasefire that would have prevented the deaths of innocent men, women and children would have been an effective ceasefire. What does the hon. Lady believe the Arab states should be doing themselves to ensure that Hezbollah is properly removed from the area so that it cannot perpetrate its terrorism on Israel?

Ms Abbott: There is no question but that Syria and Iran could rein in Hezbollah if they so chose. But I agree that an effective ceasefire is one where the shooting stops, and if the shooting had stopped days ago, many hundreds of Lebanese men, women and children would be still alive and uninjured, and perhaps half a million Lebanese would not still be fleeing for their lives.

What is happening in Lebanon, and the failure of Britain and America to take immediate action, reflects poorly on us throughout the world, makes the world a more dangerous place, and puts us in Britain in danger, because it will be seen in the context of what is happening across the middle east.

I do not deny that Hezbollah and its patrons in Syria and Iran have a major responsibility for what is happening, but it is also the view of many of my constituents that Israel’s continuing excessive and counter-productive military response approaches a war crime. My constituents and others have written to me to say how saddened they are that they do not see a British Prime Minister taking a clearer position on this.

My hon. Friend the Member for Lewisham, Deptford (Joan Ruddock) said earlier how little the British Government have moved from being America’s poodle in these matters. If the British Government had stood with their European counterparts in calling for an immediate ceasefire, we would have won respect around the world. Israel clearly believes that it has informal approval from George Bush and from our Prime Minister to continue its assault on Lebanon, both from the air and in a series of ground incursions across the border.

The Prime Minister should take advantage of the special relationship with the American President to put pressure on the US to demand a ceasefire. We must encourage all sides to respect each other’s sovereignty as well as international law, and work for the release of all prisoners held illegally without trial, as a means to end the current crisis. But above all, a negotiated settlement is the only route to a lasting peace in the middle east. The international community must make haste and contribute to bringing about the conditions necessary for the resumption of negotiations to allow
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humanitarian aid and the delivery of medicines and food to reach those in desperate need in order to avoid humanitarian catastrophe in the Lebanon.

What unfolds in the Lebanon this summer will, despite the fact that Parliament is formally in recess, engage the attention of many of us, and I hope that if there is a very pressing crisis it may be possible to recall the House for a full debate.

5.28 pm

Mr. Phil Willis (Harrogate and Knaresborough) (LD): It is a pleasure to make a brief contribution to this summer Adjournment debate. I wish to take this opportunity to raise just one issue that affects my constituency, but given the comments of many hon. Members it is the same issue that affects many of theirs—the crisis in health care in our constituencies.

I raise the issue of health care in Harrogate and Knaresborough with particular sadness, because throughout my time in the House I have been at pains to point out my thanks and admiration for all those clinicians, managers and support staff who have made health care in my constituency a beacon of excellence.

My constituency is blessed with arguably the finest and most dedicated group of general practitioners to be found anywhere in the UK. Those GPs have embraced reform, modernisation and the move to enhance the opportunities to deliver ever more services by primary care.

We also have a general hospital, the Harrogate and District NHS Foundation Trust, which was ranked as a three star hospital for three consecutive years before achieving compliance status as a foundation trust in 2006. It currently sees 100 per cent. of cancer patients within 14 days and treats them within 31 days of diagnosis. It also treats 100 per cent. of elective patients within 13 weeks, and it has one of the lowest rates of hospital MRSA in Britain. And it has balanced its books in every single year since 1992.

All that has been put at risk by the Government’s boom and bust policies and the arrogant tactics of the PCT, which appears more interested in pleasing its paymasters in London than patients in north Yorkshire as its officers scramble for posts in the new PCT structure. I say that with sadness, because until recently the Craven and Harrogate PCT delivered its services effectively, and it has remained in financial good health since its formation. In the space of six months, however, local GPs have come close to declaring a vote of no confidence in the chief executive of the PCT and are openly refusing to implement cuts in services that will put their patients at risk—good on them.

David Howarth (Cambridge) (LD): Does my hon. Friend agree that if local health authorities were democratically accountable, which they are not at the moment, very little of what he has described would have happened?

Mr. Willis: I would like to believe that, but the problem is that there is currently no accountability within the service. Unaccountable people in unaccountable quangos have made the decisions, which affect a significant number of my constituents.

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The GPs were up in arms after the PCT issued new guidelines effectively blocking all but critical and urgent referrals. The guidelines cancelled access to treatment such as dermatology and led to the vetting of referrals through an internal administrative sieve. The proposals, which were presented without consultation with GPs, ignore GPs’ ethical, professional and regulatory obligations. GPs provide the primary care bedrock to our NHS service, and it is important that we recognise their position. It is unacceptable for non-clinical staff to make judgments about GP referrals, as if GPs refer patients simply for the fun of it. Consultation is key in tackling any difficult situation in any organisation, and it is crucial in the NHS. I hope that the Deputy Leader of the House will persuade the Secretary of State for Health to make such consultation a statutory requirement, not an add-on, in future.

The GP referral issue impacts directly on both secondary and tertiary care, which means a direct impact on the Harrogate and District NHS Foundation Trust. Again, relationships have not simply broken down, because the two bodies are about to end up in court, where the worst case scenario is the closure of one of the country’s most modern and most successful hospitals. The hospital’s crime is that it treats patients too swiftly and too effectively. To deal with that, it must cut its activity by making patients wait for treatment until their conditions deteriorate, which means that staff and facilities will be under-utilised.

More than £1 million of activity is being purchased from the private sector as part of a bizarre notion of choice. My constituents have been told that they can choose a hospital for their treatment provided that it is not their local NHS trust, which is the politics of the madhouse. Last year, the Harrogate trust was actively encouraged to take on more work, treat more patients and decrease waiting times and lists, all of which was in line with the Government policy of payment by results. The trust delivered the results: £3 million worth of extra patients in record time with top quality results, but the PCT has refused to pay up. The patients have been treated and the hospital has incurred the costs. At no time did the PCT discourage the activity, but it now claims that it does not have to pay and that the hospital should absorb the costs in the coming year. No business in the land could operate in that way, let alone one with a hugely expensive infrastructure. My local hospital cannot survive having its base budget slashed while being told to maintain current levels of activity. The Government must intervene in this dispute, if only to clarify their own policy. Foundation trusts are paid by activity or they are cash limited with their activity determined by an outside non-clinical body—one cannot have it both ways. They cannot be expected to ride two horses at the same time. The Secretary of State must accept that the £3 million deficit that my trust faces should be managed over an equivalent number of years and that from now on all activity commissioned must be paid for by PCTs.

The future of health care in Harrogate hangs by a thread as we speak. If the current policies of the PCT go unchallenged—I suspect that a new chief executive and a new board will be required to win back the confidence of the clinicians—Harrogate could see its hospital closed and its GPs become ever more disillusioned. I sincerely hope that the Minister’s right hon. Friend, the Health Secretary, is able to step in before it is too late.

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5.35 pm

Michael Jabez Foster (Hastings and Rye) (Lab): I am afraid that my contribution may be repetitious in that it, too, relates to health. Later today, I will have the honour and privilege of presenting a petition bearing some 20,000 names organised by John and Margaret Baker on behalf of the Friends of Conquest Hospital in Hastings. That petition—the 20,000 names are only “on account”, as many more thousands are still signing—will tell the health authorities and the Government that we will not agree to the closure of our accident and emergency department. Given the massive record investment in health by this Labour Government, which has produced so much in recent years, it seems bizarre that such a petition is necessary, so what on earth is happening?

I worry that many of the decisions being taken are similar to those described by other hon. Members—decisions by managers that create a democratic deficit even greater than any apparent financial deficit. Why is it that at the top Ministers seem to make sound and sensible proposals, but at the local level we Members of Parliament appear to be impotent, incapable and unable to be any part of the decision making?

Sarah Teather: I am facing a similar situation in my constituency, where the trust is consulting on the reconfiguration of services, which may include the closure of an ambulatory care and diagnostics centre—a brand new unit opened by the Prime Minister in 1999—or the downgrading of an accident and emergency unit at Central Middlesex hospital to a minor A and E unit. People are afraid that even when the hospital consults, it may not listen to what they say.

Michael Jabez Foster: I appreciate the hon. Lady’s concerns for her own area. Of course I do not know the details, but what is happening there might be similar to my local situation.

The position is even worse than I have suggested, because the problem is not just the decisions but the way in which they are taken. Every week, we see graphic, dramatic, crisis-ridden headlines saying that 1,000 jobs are to go. Of course they are not, but the fact that such statements are allowed to be made is creating trauma in the local community. It is bad for our blood pressure as Members of Parliament to see such bizarre headlines. In any case, they are making a drama out of a non-crisis, because in fact the funding is not far behind—it is the decision making that is far behind.

I want to encourage my very able right hon. and hon. Friends in the Department of Health to take back control—not only to take responsibility, which I know that they do, but to become more hands-on and work out for themselves what is happening in trusts that are allowing such decisions to be made.

I appreciate that we are conducting the annual whinge debate, during which we all have a go about the terrible things that are happening in our constituencies. In fact, many wonderful things are happening in Hastings and Rye. Regeneration progresses apace and the health service is wonderful. Why do we keep pretending that it is not? Why do we keep threatening our local community with unnecessary dire predictions of closing various services?

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