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Westminster Hall

Tuesday 17 January 2012

[Sir Roger Gale in the Chair]

Care of the Dying

Motion made, and Question proposed, That the sitting be now adjourned.—(Michael Fabricant .)

9.30 am

Sir Roger Gale (in the Chair): Good morning, ladies and gentlemen. It will not have escaped your notice that a considerable number of hon. Members are present, and a significant number have indicated in writing that they wish to speak. Who gets called, other than in what order, is beyond my control. We have an hour and a half for this debate. The Front Benchers will traditionally want not less than 10 minutes each, so, if you do the math, as they say, it is up to you. If hon. Members confine their remarks to three minutes a head, we will get everybody in; that is, of course, other than the person who initiates the debate. If hon. Members take an inordinate amount of time, I have no power to curtail the length for which they speak, other than to say that they may not get called again in the near future. Please try to exercise some control, and we will endeavour to ensure that everybody gets heard. Those with less experience might like to pay attention to the fact that it is sometimes possible to make a point in an intervention, rather than in a formal speech.

9.31 am

Mr David Burrowes (Enfield, Southgate) (Con): I welcome the opportunity to talk about care of the dying. It is marked that so many hon. Members are attending the debate on a subject that so many people in our constituencies would rather not talk about.

Last year, a ComRes poll found that 67% of people are scared of being told that they are dying. More significantly, 83% are scared of dying in pain. As a nation, we need to get better at talking about dying, death and bereavement, but Parliament can take a lead in breaking the cycle that can result in a lack of care. With the public reluctant to discuss end-of-life care, many professionals do not feel confident to deliver it. Services are not available to everyone who needs them. The aptly named Dying Matters coalition, across the public, voluntary and private sector, should be commended and supported when it has its annual awareness week in May.

Too often in health care, dying equals failure rather than a normal process. This attitude ignores those who will not respond to treatment, but who can still be cared for significantly. Although death may be a tragic inevitability, palliative and hospice care can ensure that the remainder of life is still worth living. We have an opportunity today to show the mark of a civilised society and care for the vulnerable and largely forgotten—the dying.

The growth of palliative care, not legalisation for assisted suicide, should form the central debate about care for the dying. As a country, we must do all that we can to allow the terminally ill to live a dignified life until

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death, to make the intolerable tolerable and to replace hopelessness with hope and desperation with serenity. Too often, this essential part of health care is forgotten, or simply shrouded by the more high-profile issue of assisted suicide. Reading media reports this year, one could be forgiven for thinking that that is the only option for those suffering with terminal illness. Rather than legislating for an abrupt end to life, we need to find better ways to help care for the dying.

The good practice of palliative care, which hon. Members will no doubt illustrate this morning with constituency examples, makes the point that we in this country believe that life should be treated with dignity at every stage through to death. Some 50 years ago, Dame Cicely Saunders, founder of the modern hospice movement, said:

“You matter because you are you, and you matter to the last moment of your life. We will do all we can not only to help you die peacefully, but also to live until you die.”

What a refreshing contrast from what we have heard recently from those advocating assisted suicide. Take the chilling words of Baroness Warnock, who said:

“If you’re demented, you’re wasting people’s lives—your family’s lives—and you’re wasting the resources of the National Health Service.”

Suggesting that we have a “duty to die”, she said:

“I think that’s the way the future will go, putting it rather brutally, you’d be licensing people to put others down.”

Well, that is not a future I want to be a part of, and I am sure many of those present today agree. [Hon. Members: “Hear, hear!”] If we adopted the law of Oregon, the trickle of people wanting to be killed in places such as Dignitas would become a flow—some estimate that more than 1,000 people a year would take that path.

Andrew Selous (South West Bedfordshire) (Con): Does my hon. Friend agree that one of the most worrying things is that, if what he is talking about is introduced, many older people may feel that they are a burden and that they should bring an end to their lives?

Mr Burrowes: Indeed. We need to retain the present law, which continues to provide a strong deterrent to the exploitation of vulnerable people, while giving prosecutors discretion in hard cases. Parliament has agreed, through a detailed Select Committee inquiry and three votes in the past six years, to retain that protection. We have to recognise that it is easy, in the comfort of Parliament, to make fine-sounding points about terminal illness. I recognise that there are no easy answers for those who feel they are not valued and who may feel that they may be wasting resources or are a burden on their family or society. However, they are the very people who most need the protection of the law and the provision of good-quality palliative care. How do we best safeguard their dignity and autonomy?

When we talk about dignity in the context of a health debate, it can all too often be restricted to privacy and physical care, but palliative care recognises a wider, proper understanding of dignity. Good palliative care recognises the social, emotional, spiritual and psychological needs that put an embrace around a terminally ill patient, rather than the proposed arbitrary, so-called safeguards that put a straitjacket around patients and doctors. For example, the prognosis for a terminally ill patient is notoriously difficult to determine. The best

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safeguard is through specialist palliative care that helps a patient live with uncertainty. Take the case of a motor neurone disease sufferer who wants to end his life but, unknown to his GP, has developed fronto-temporal dementia and whose thinking has become distorted. Such a condition could only be noticeable if someone knew that patient very well before the illness. The best safeguard to help the patient live with those fluctuating moods and thoughts is specialist palliative care. The proper way to empower patients’ choice and protect the vulnerable is through driving up palliative care standards, not new legislation.

In 2010, the Economist Intelligence Unit ranked Britain, rightly, as top of the league of countries for the provision of end-of-life care. Much of the credit is no doubt due to the expansion of local charitable hospices that provide more than £700 million of care, the majority of which is donated by the communities that they serve. Additionally, more than 100,000 people donate their time to local hospices each year.

Nicky Morgan (Loughborough) (Con): I congratulate my hon. Friend on securing the debate. The fact that there are so many hon. Members here at 9.30 on a Tuesday morning shows what an important subject this is. He talks about local hospices. The Rainbows children’s hospice, which is in my constituency, now looks after young adults with life-limiting conditions as well. In this debate, we will perhaps focus on older people, but we should not forget children with life-limiting conditions. One point that the hospice has made to me—I think that my hon. Friend is coming on to this—is the fact that we need to integrate both health care and social care. Rainbows children’s hospice would like to see more of that from the Minister.

Mr Burrowes: I am grateful for that point. Integration is needed, and we see that in the context of hospices and palliative care. We hope for that future in the reforms that are going through Parliament.

Although we should be proud, rightly, of individual examples in our constituencies, we should not rest on our laurels. We need to build on that solid foundation, because far more can be done. End-of-life care is not available to everyone who needs it. In fact, the palliative care funding review found that 92,000 people die in England every year without access to the services that they need. That figure equates to nearly 500,000 people during the term of this Parliament, and 700 people in each of our constituencies dying without the good palliative care services that they deserve.

Nationally, hospices receive about a third of their funding from the NHS, but that can vary substantially across the country. Indeed, in my constituency in Enfield, the NHS contributes less than 20% of what the hospice spends on care for Enfield patients. One of the biggest issues facing the terminally ill is where they will die. Currently, more than half the people who die in England do so in hospitals and just 20% die at home, although various studies have shown that two thirds of people would choose to die at home.

In Enfield, there are excellent palliative care services. I pay tribute to Nightingale Cancer Support Centre and North London hospice, which provides a community

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service providing care in people’s homes alongside an in-patient unit. In Enfield, the North London hospice community team are able to ensure that only 28% of people cared for by the hospice die in hospital.

According to the Minister, the Government should consider allocating national resources to continue to promote and extend palliative care. I look forward to hearing from the Minister about the progress in implementing the new per-patient funding system for hospice and palliative care providers, which will provide incentives to enhance services within community settings.

Guy Opperman (Hexham) (Con): Will my hon. Friend give way?

Mr Burrowes: I will conclude in a moment, because a large number of colleagues want to contribute.

Jean Rostand, the French biologist, said:

“For my part I believe that there is no life so degraded, debased, deteriorated, or impoverished that it does not deserve respect and is not worth defending with zeal and conviction. I have the weakness to believe that it is an honour for our society to desire the expensive luxury of sustaining life for its useless, incompetent and incurably ill members. I would almost measure society’s degree of civilisation by the amount of effort and vigilance it imposes on itself out of pure respect for life.

I look forward to hearing hon. Members demonstrate that respect for life, for the dying, today.

9.41 am

Glenda Jackson (Hampstead and Kilburn) (Lab): May I congratulate the hon. Member for Enfield, Southgate (Mr Burrowes)on obtaining this debate? I agree with the bulk of what he said. There is something drastically wrong with a society that can contemplate legalising something that is, to my mind, murder. A change in the law would inevitably define the value of a life as dependent upon physical or mental capacity.

One of the greatest regrets of my life is that I was not present when either of my parents died. They did not die at the same time: both died in hospital and there was a period between each of them dying. One of the greatest privileges that can be afforded to a caring person—to us as human beings—is to be present at that moment when the last great adventure begins, when life slips away. A great strength of the Marie Curie hospice in my constituency is not that it exclusively treats the individual who is facing that last great adventure, but that it offers care and concern for the family, so that they can be included in that process.

Surely, we all deserve dignity in our death, whether or not that happens, as I think most of us would like to experience it, in our own home. Certainly, hospices provide the most extraordinary care. I agree with the hon. Gentleman that, regrettably, neither this Government nor the previous one took on board sufficiently the importance of hospices by financing them to the degree they warrant and deserve. As the hon. Member for Loughborough (Nicky Morgan) said, we are not simply discussing those who are elderly and facing death: this also applies to children and young people. The particular approach that hospices and palliative care can provide is of paramount importance.

I am somewhat shocked at the idea that hospices are somehow irrelevant, which is argued by some who seem to believe that advances made in medical science have,

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during our period on Earth, ground to a halt. I remember, because I am quite old—[Hon. Members: “No!”] I am sorry, but I am. The most frightening diseases when I was a child were cancer, and consumption—tuberculosis—which was deemed an absolutely incurable illness leading inevitably to death. We hear that its incidence has increased, but we do not hear much about it being an absolute death sentence.

We should all support the advances being made in medical science and research, not only in curing illnesses but in preventing their onset. In this instance, it is paramount that our society turn its face away from what could become legalised murder, and argue and press the case for increased funding, increased support for palliative care and, most markedly, support for hospices.

9.45 am

Mr David Amess (Southend West) (Con): I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on the strength and spirit of his speech. I also congratulate the hon. Member for Hampstead and Kilburn (Glenda Jackson) and very much agree with what she said. I was privileged to be present at my father’s death. My mother will, hopefully, shortly celebrate her 100th birthday.

All hon. Members came into politics because we care about life. We did not come into it to legislate about death. This is a sensitive and serious issue. One of our former colleagues is not in great shape at the moment. If he were able to attend he would support what my hon. Friend the Member for Enfield, Southgate said.

When I was Member of Parliament for Basildon I was privileged to lay the foundation stone for St Luke’s hospice. My hon. Friend the Member for Loughborough (Nicky Morgan) mentioned hospices in her constituency. In the area that I represent there is Fair Havens hospice and Little Havens hospice for children. I agree with the views of my hon. Friend the Member for Enfield, Southgate on what Dame Cicely Saunders said.

Britain is the world’s leading provider of end-of-life care. We are the only nation to offer palliative care as a specialist, medical discipline in its own right.

Mr Julian Brazier (Canterbury) (Con): Does my hon. Friend agree that, when Government budgets are under a great deal of stress and the amount of assistance received from the NHS by hospices such as his and the Pilgrims hospice in my constituency is being decided, it would send exactly the wrong message to those splendid hospices and to those making budgetary decisions in the NHS if the House decided to allow assisted suicide?

Mr Amess: I agree with my hon. Friend. His local hospice does splendid work.

Hospice workers require four years’ intensive training in order to practise. As a result, our hospitals and hospices are staffed by teams able to offer first rate end-of-life care when it is needed—all hon. Members will be familiar with the wonderful quality of care in our hospices—which puts Britain at the scientific forefront of palliative medicine, meaning that the care we can offer will only improve as advances are made. If we can offer this world-leading end-of-life care, why are we looking to euthanasia as an alternative solution?

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We can do even more with end-of-life care than we are doing at the moment. We should seek to provide appropriate care to everyone who needs it, as the hon. Member for Hampstead and Kilburn said, no matter who they are or where they are. Figures suggest that 700 people in every constituency die without access to the appropriate services they need. Of course, this needs to change.

We need to help more with planning difficult situations. Understandably, thinking ahead can be traumatic for patients and families. None of us—I am the world’s biggest coward—wants to face the consequences of death. We must therefore do all we can to ensure that the end-of-life support received runs as smoothly as possible. We should focus on personalisation and integration.

Care needs to be developed throughout the community, so that the dying can spend those precious last moments in their local area, not in hospital.

We have already heard about the difficulties of legalisation in Oregon.

I could say much more, but I will not. I simply applaud the words of Dame Cicely, who said,

“Hospices are places where people come to live, not to die.”

Once again, I congratulate my hon. Friend the Member for Enfield, Southgate on providing the opportunity for us to debate this important issue.

9.49 am

Jim Shannon (Strangford) (DUP): I congratulate the hon. Member for Enfield, Southgate (Mr Burrowes) on bringing this matter to Westminster Hall; the number of Members present is an indication of its importance. Perhaps not coincidentally, we are about to recognise a memorial to the holocaust, to the 6 million Jews killed, as well as to all those people who were “socially unacceptable” or “mentally unstable”, according to the Nazis, who way back in that time took a decision to murder people whom they felt were not capable of contributing to society. I want to make some comments about that in the short time I have.

Cancer is a big killer. I can remember clearly what it meant for my own family when my father had it, on three occasions. He survived it, which I believe was because of his faith in God, as well as the medical profession and what it can do. Not everyone survives, however, and nor is cancer the only condition that can be terminal and need extensive care. Numerous other horrific illnesses include multiple sclerosis, lupus and HIV/AIDS. Some people classify those with such conditions as on the dying pathway, but, along with other speakers, I congratulate the UK on being top in the world for good palliative care, which is something to be incredibly proud of. However, sometimes palliative care is not the next step, and some steps might well be missed by those who are looking to make a diagnosis rather than to treat an illness long term. Some suffer from incurable illnesses, but others are simply elderly and infirm and need care, dignity and a programme tailored to their requirements. The word “dignity” has been mentioned by every speaker so far, and that underlines the issue clearly for me. People need dignity when they are not well.

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I recently visited an occupational therapist whom I had met during my 26 years as a councillor. I got to know her well, and she was diagnosed with cancer. The hon. Member for Hampstead and Kilburn (Glenda Jackson) commented on the work of the Marie Curie centre, and I had the opportunity to visit that lady at such a centre in Belfast. She had an aggressive strain of cancer, with six weeks between her initial diagnosis and the end of her life—the disease struck quickly and hard. I and her family could not but appreciate the good work done by the Marie Curie people. At a time when she needed help most, they made her life that wee bit more comfortable—if that is the word to use—and helped her family.

No one living in the UK can be unaware of the need for efficiency savings, but in some areas we cannot afford to cut, and palliative care is one of those. Health is a devolved matter in Northern Ireland, and the health service has said in its palliative care strategy:

“The vision of this Strategy is that any person, from diagnosis to the advanced non-curative stage of disease, lives well and dies well irrespective of their condition or care setting. This requires a philosophy of palliative and end of life care that is person-centred and which takes a holistic approach to planning, co-ordinating and delivering high quality reliable care enabling patients to retain control, dignity and crucially, choice in how and where their care is delivered to the end of their life.”

It is about the people who are ill and who need care at the right time and in the right way. The hon. Member for Enfield, Southgate mentioned personal beliefs, cultures, the practices of patients and so on, and I would hold to what he said in his introduction. It is about the practices of patients and their families and carers, and recognising the contribution that good palliative and end-of-life care can make to the quality of their lives and the lives of the people around them who have to sit back and watch their loved ones die.

The NHS is supported by many charities, and one is the Northern Ireland hospice. It was established in 1981 and provides palliative care for adults—the majority of whom have had a cancer diagnosis—although there are young people there as well. The service began in Somerton house for in-patients but developed to provide specialist community nursing services, a day hospice and hospice at home—the point is that the service can be at hospital or at home, and it supports the family. Everyone knows of the tremendous work of the Macmillan nurses—personally, in many cases, and as elected representatives—and although the people of Northern Ireland continue to give generously, that is not enough to sustain the high level of care and training.

It is important for us to remain top of the world in palliative care, not because we want to show off or show our prowess, but because we want those who are dying before their time to have the best care in order to ease their way, and to ease the pain of their families. We can show what sort of a society we are by the way we treat our vulnerable people. Along with everyone else present, I support the intention behind the debate, and I hope we can assist the people who need it most: the elderly, the infirm and those who are ill and dying.

9.55 am

Tony Baldry (Banbury) (Con): I do not intend to refer to the policy of the Director of Public Prosecutions in cases of encouraging or assisting suicide or to the

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report of the Commission on Assisted Dying because I note that my hon. Friend the Member for Croydon South (Richard Ottaway) has been given a debate by the Backbench Business Committee. Hopefully that debate, in which I suspect that many hon. Members present today will seek to catch Mr Speaker’s eye, will give us the opportunity to make our views known on those matters.

I fully endorse everything said so far today in the debate initiated by my hon. Friend the Member for Enfield, Southgate (Mr Burrowes), so I hope not to repeat anything. However, it is important for us to recognise that we will all die. As a society, we need to talk much more about dying and the care of the dying. As the psalmist says:

“The days of our age are threescore years and ten; and though men be so strong, that they come to fourscore years: yet is their strength then but labour and sorrow; so soon passeth it away, and we are gone.”

All too often in modern medicine death is seen as a failure in some way, but supporting those who are dying is an important part of modern medicine.

Three crucial things, therefore, ought to happen for anyone who is dying. They should be informed and fully know and understand, as far as possible, what is happening with their medical treatment. So far as is possible, they should be relieved of pain and should be able to die where they would most like to die. Most people, when asked, say that they would like to die at home, yet home hospice services in this country are pretty noticeable by their absence. I agree with the comments of hon. Members so far: we do have exceptionally good palliative care in this country—where it is good it is very good—but all too often it is mediocre.

Guy Opperman: I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing the debate. A lot of people present are passionate Christians and see the subject from a religious standpoint. I speak as someone who was given warning of death on 26 April, before my operation last year, and with respect I take the view that, of the choices faced by individuals, one is the choice of their death—when they would choose to go. Does my hon. Friend the Member for Banbury (Tony Baldry) accept, as a matter of both law and faith, that that choice belongs to us?

Tony Baldry: I want to resist the temptation to be drawn into a debate on assisted dying, because many people present want to talk about palliative care, but I state simply that the only person who should determine when we die is the Almighty—it is not us. If we get into a situation in which we pick and choose who dies and who lives, it is a slippery slope. However, I will wait until the debate to be initiated by my hon. Friend the Member for Croydon South before I develop those arguments.

On the need to enhance palliative care, I hope that much more emphasis can be given to junior doctors in particular. I understand that at present they get comparatively little training on palliative care and, given the pressures that junior doctors are under, they often feel that if a patient dies they have somehow failed that patient. They might not have: patients die, and it is a fact of life that people will die. Every hospital trust should have a clear policy on palliative care and on how

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to enhance it. We should never forget the role of hospital chaplains. People approaching death often need spiritual support as well as medical assistance. Spiritual support is no less worthy and necessary.

We should never underestimate the role of hospices. Hon. Members have referred to hospices in their constituencies, and I have the excellent Katharine House hospice in mine. However, we must try to ensure that they are better integrated in support of NHS palliative care services. Many moons ago, in the mid-1980s, Jack Ashley and I set up the all-party group on hospice support, which is now the all-party group on hospice and palliative care. Even then, we were concerned about the varying amount of support from the NHS to local hospices. I hope very much that NHS commissioners will, whenever possible, see local hospices not just as a resource in developing excellence in palliative care, but as an invaluable resource to help those who are dying and those who are terminally ill. I suspect that the voluntary hospice movement still needs to be much better integrated in supporting the NHS and those who are terminally ill. I hope that the introduction of new forms of commissioning will enable that to be done much better. How we support those who are dying is a measure not just of the NHS, but of us as a society, and we should be judged by how we care for those who are bereaved.

10.1 am

Fiona Bruce (Congleton) (Con): I support all that has been said by those hon. Members who have spoken today. I want to touch particularly on the importance of how we can develop the excellent hospice care that already exists in our country today. Dame Cecily Saunders has been quoted. She said that the hospice movement should have three components: care, research into good care and education of professionals and the community in care and end-of-life issues. Communities today need hospices to operate at that level not just within their buildings, but outside. Fantastic care is given in hospices, but to a relatively small number of people.

In Cheshire, for example, St. Luke’s hospice, which serves my constituency, has just 14 beds, but through various initiatives, it has a far greater beneficial impact on the wider community. I should like to share some of the initiatives that St. Luke’s is developing. It has recently been invited to share those initiatives with the all-party group on dying well. To give confidence and skills to others to share well the care of family members, it has a community outreach programme, and I will refer to one of those programmes in my constituency.

The village hall in a village near Alsager opened its doors one day a week, but that is now being extended, so that those who are not within the hospice may come for day care. Nurses from the hospice spend a day at the village hall, and a group of volunteers cook lunch for the community’s elderly residents, who are often in some difficulty with their physical and mental capabilities. They can have counselling in a private room, a massage, treatments such as manicures and pedicures and engage in hobbies. I saw some wonderful art work that they had done over a period of months. They are provided with an excellent lunch, preceded by a small glass of sherry if they want it. There is much laughter and much support, and that enables the people who visit the centre not only to remain in their communities, but to

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have their lives enhanced and supported by the work of the hospice, augmented by a substantial number of local volunteers. In turn, those volunteers go into those people’s homes.

Jeremy Lefroy (Stafford) (Con): I am grateful to my hon. Friend for describing the innovative care that hospices in our local communities provide. In my constituency, Katharine House hospice does the same. I want to draw her attention to the community lodges that the Douglas Macmillan hospice has set up in an area near her constituency. They allow families to come together and to support their loved ones in a lodge as they are dying.

Fiona Bruce: My hon. Friend is absolutely right. As Siobhan Horton, the director of St. Luke’s hospice said:

“Hospices need to actively transfer their enormous expertise in health and social care more broadly to ensure more benefit from high quality care”

for more people. St. Luke’s also provides education for all those in the Cheshire area who are involved in hospice work. I have visited the hospice. The ground floor contains 14 beds, and the first floor is a resource centre with a library, and advisers to inform and enable carers and professionals to extend their expertise throughout the Cheshire community and beyond. Hospices can do that excellently, because of their unique expertise, not only in this country, but throughout the world.

Another project that St. Luke’s is undertaking is to develop a public health approach to end-of-life issues, so that ageing well and dying well are part of living well. It is working with the local community to improve communication with family members who are coming to the end of their lives, to resolve outstanding issues, to reduce regrets, to open up conversations that others may be reluctant to engage in, to work with family members and to encourage the engagement of their wider community in supporting the family and individuals who are struggling to support themselves towards the end of a life in the family. The aim for all who are supported in that way is a good death. I think that we all have that aspiration: a death within the loving embrace of our family and local community. St. Luke’s is undertaking serious research into that, and I look forward to hearing more about its developing public health approach to end-of-life issues.

I want to touch on the work that St. Luke’s is doing in connection with care homes. It has been involved in care home education for many years, and although it believes that some care home care is excellent, it also believes that much expertise can be shared both ways. It is considering how to have a closer, more supportive relationship with care homes locally and is commissioning a report on strategic planning and what sort of relationship and support would make a positive difference to care home delivery of end-of-life care. Let us support such innovations and others throughout the country to develop the excellent work of the hospice movement here, of which we can all be proud. I look forward to hearing from the Minister how the country and the Government can continue to support and promote the extension of the excellent palliative care in this nation.

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10.9 am

Robert Halfon (Harlow) (Con): I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing this debate. I have known him as a good friend for nearly 30 years and his values have remained the same over that time.

I welcome this debate because I feel that we need to move the focus of the discussion away from assisted dying and towards quality of life. I became involved with this issue not by accident but through involvement with my local hospice, St Clare. It is one of the most wonderful community organisations with which I have ever had the privilege to be involved, both as a parliamentary candidate in Harlow for many years, and as its MP. St Clare is dedicated to promoting quality of life and care, and it has taught me much about the important role of palliative care and how it needs our support.

I should like to make several brief points, the first of which concerns equity of funding. St Clare hospice in Harlow receives 24% of its funding from the local primary care trust, although other nearby hospices in other PCTs, such as Farleigh hospice or St Francis hospice, receive around 40% of their funding from the PCTs. I welcome the figure of 40% and do not deride it, but it is important to have greater equity of funding. There is also a cliff-edge issue: 70% of charitable hospices have agreements with their local PCT that last for just one year. We need longer-term agreements, so that hospices can plan ahead.

Although we often talk about the big society, the hospice movement existed before that was even mentioned. It has pioneered the big society for many years, and 157 charitable hospices in the United Kingdom receive the bulk of their funding from private and community sources. More than 100,000 people donate their time to local hospices. St Clare hospice has 500 volunteers, and on one occasion, I was pleased to work there as a receptionist. Given what the Government are trying to accomplish in many parts of the public sector, hospices deserve more recognition for their role as part of the big society. They are models of how charitable institutions can raise extra funds, invest in services and train the community, without resources coming simply from higher taxes.

Rehman Chishti (Gillingham and Rainham) (Con): I support everything that has been said so far about doing whatever we can to preserve life. Funding has been mentioned, as have the community and voluntary sectors. Medway contains the Wisdom hospice, where £539,000 is raised annually by the voluntary and charitable sectors. That is a great example of how communities want to preserve and support palliative care.

Robert Halfon: My hon. Friend makes a good point that is exactly right; his constituency is lucky to have him serving it so well.

I want to highlight bereavement counselling services. St Clare offers such a service, and about 40% of families that become involved with it receive bereavement counselling. That is a huge extra cost for something that the hospice does not have to provide but nevertheless offers as an extra service. Hospices receive little recognition for their work on bereavement care, and a UK study has

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shown that such care is often overlooked. In 2010, more than half of hospital maternity units still lacked dedicated bereavement support, thus leading families to turn to their local hospices. In 2007, an Oxford university survey of bereavement care in 10 Marie Curie hospices around the country showed that, although there are some great services, such care is patchy or non-existent in other areas. That is why hospices such as St Clare that go above and beyond the call of duty in the bereavement services that they offer deserve recognition and extra financial support.

To conclude, I should like to comment on the remarks made by my hon. Friend the Member for Hexham (Guy Opperman) who is no longer in his place. I have huge respect for him, but he mentioned choice in death. The problem with assisted dying and the move towards euthanasia is that people will be pressured into making choices. That is why I am passionately against any move towards assisted dying.

Robert Flello (Stoke-on-Trent South) (Lab): I congratulate the hon. Member for Enfield, Southgate (Mr Burrowes) on securing this debate, and I have been listening carefully to the hon. Member for Harlow (Robert Halfon). Is not part of the problem the fact that if this House eventually—sadly—legislates in favour of assisted dying, that would normalise the situation and mean that people and families who are vulnerable or in desperate straits may think, “That is normality; we will go down that route”? Does the hon. Gentleman agree that that is a dangerous route down which to go?

Robert Halfon: I agree passionately with the hon. Gentleman; we would be taking a hugely dangerous step were we to go down the road of assisted dying. We as a society devalue human life, whether through fiction, computer games or television, or in real life. I often wonder whether Harold Shipman would have got away with killing one patient after another if we as a society had not devalued human life in such a way. We need to move away from that in a big way and back towards dignity for the dying and strong support for palliative care.

10.15 am

Glyn Davies (Montgomeryshire) (Con): This is a complex subject about which one could probably speak for around half an hour. I will try to confine myself to three minutes and make an important point that I do not think has been made previously. I do not want to repeat points already made by other hon. Members.

I should begin by declaring an interest. I am a board member of Living and Dying Well, which is an active and committed organisation that examines and publishes evidence-based research into assisted dying. There are many aspects to this debate, and I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) not only on his speech but on the measured tone in which it was delivered.

I have probably received more communication from constituents about assisted dying than on any other subject. Most of those who have contacted me disagree with my point of view; I am totally opposed to any change in the law. All those people, however, approached me on the basis of compassion, usually for an individual whom they know—I am sure that many hon. Members

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present, and others, know of people whose lives are coming to an end and who are living in such difficult circumstances that it is almost a blessing when that happens. Such circumstances have led people to feel that there should be a change in the law. We, however, are parliamentarians, and although I feel compassion for the individual and understand and respect the views of those who disagree with me, we as legislators have a duty of compassion to society as a whole. In my view, we cannot introduce laws that are geared towards individual cases and are dangerous and could lead to situations such as those already mentioned where pressure is put on individuals and suicide is normalised.

In a perfect world, every terminally ill person would be clear thinking and not suffering from a mental illness from which they might recover; every doctor would be professional and competent to make a judgment about the end of life; and every relative would be full of compassion and motivated by nothing else. Our society, however, is not like that. We live in an imperfect society, and our laws must allow for those imperfections.

A debate to be held next spring will consider assisted dying, and we will all be able to make a huge number of points and provide evidence. I would be deeply sorry if we move towards legalising assisted dying and I think that it would be a dreadful mistake, but we should leave that discussion until that debate. Let us recognise that, as parliamentarians, we have a duty first to make a huge commitment to social and palliative care—which as a society we have never done—and to help people at the most vulnerable stage in their lives. We should not go down the road of making things convenient by simply removing those who are most vulnerable and most need our care away from our society altogether.

Several hon. Members rose

Sir Roger Gale (in the Chair): Order. Six hon. Members still wish to speak. I intend to call the Front Benchers from 10.40 am. Again, please do the sums.

10.19 am

Penny Mordaunt (Portsmouth North) (Con): I became interested in end-of-life care in part from having been a hospital visitor at my local hospital for eight years, largely attending those who had no advocate, friends or family and who were nearing the end of their life. I continue to work on these issues with a number of organisations, including the Royal College of Nursing, Age UK and the NHS Confederation.

We have known for some time that older people, in particular, are poorly served in both a hospital and a community setting. To give a recent example, a constituent of mine, who had no continence problems but was bedbound following an operation in hospital, repeatedly asked for a bedpan and at the sixth time of asking was told to wet herself because it was nearly suppertime and no one was around to fetch the pan for her. By that time, she was so desperate for the loo that she did just that, despite how unnatural and unpleasant it felt, and she then had to sit in wet sheets until the meal was over. Only then did the nursing team come and change her whole bed—a procedure that took more staff and time than the simple act of fetching her a bedpan in the first place.

We have had a succession of reports, including from the Care Quality Commission and the Equality and

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Human Rights Commission, calling for the Government to act. I hope that my hon. Friend the Minister will today update us on progress. With my hospital visitor hat on, I would particularly like to know whether she believes that there are opportunities with the Centre for Social Justice “End Loneliness” campaign, which is focused on befriending and visiting, to consider the support and advocacy services that could be developed to support those who have no one else as they near the end of their life.

I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing the debate. I am pleased that it has been focused on good-quality end-of-life care, rather than assisted dying, as that is the immediate issue. I am sorry that those two issues are often conflated or painted as an either/or. The Commission on Assisted Dying added its voice to the previous reports in relation to the patchy nature of good end-of-life care. It was highly critical of the practices at Dignitas and elsewhere, including Oregon. It highlighted the lack of research in the area that we are discussing. One of its key conclusions was that the Government must step up their drive to improve care in this area as a priority.

Poor-quality end-of-life care cannot be a reason for an assisted death. Indeed, one of the safeguards required by the commission’s model for assisted death in the UK would be verification that a terminally ill patient who requested an assisted death was receiving good care. However, the view that, if there were universal provision of good-quality care, there would be no demand for an assisted death is a false one. It assumes two things: good-quality end-of-life care can alleviate all pain and suffering, and the overriding motivation for seeking an assisted death is poor-quality care. Neither is true. Those who request an assisted death are often doing so because of issues about control and their identity, and we must recognise that even with very good care and advances in pain management, there will still be patients who are in considerable discomfort at the end of their life.

All in this place have great sympathy for those who wish to have an assisted death, whether or not we believe that they should be granted one. We have sympathy for the 400 people who commit suicide every year because of a terminal or chronic illness. We all know about the sale of suicide kits—those appalling suffocation devices, which often fail to kill and instead result in brain damage. I would like the Minister’s comments on whether we should be doing more to end that trade on the internet. We also know about the 160 people from the UK who have travelled to Dignitas. In my view and the view of the commission, that is a very unpleasant experience, and such people are often ending their lives very prematurely.

All of us have sympathy and compassion for the people to whom I have referred. Where we differ is in whether we think that measures to enable those people to have a good death, at the time of their choosing, come at too high a price for the rest of us. There are issues that are often discussed—safeguards, for example, are deemed too difficult and have not been thought through—and issues that are just as pressing but are not so often discussed, such as equality of access to such a death. Indeed, certain issues are barely debated at all. This is a difficult subject, but we should, as a Parliament, continue to discuss the plight of those people and their

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families, as their suffering is profound. I echo the comments of my hon. Friend the Member for Montgomeryshire (Glyn Davies); we should do that in the tone that he outlined.

Such suicides occur once or twice a day in the UK. These are a tiny minority of patients, a minuscale minority of Britons, but each of them, in my view, is entitled to a good and peaceful death.

10.24 am

Martin Vickers (Cleethorpes) (Con): I, too, congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing the debate. Bearing in mind your request for brevity, Sir Roger, I will be as brief as possible. I can only agree with much if not all of what has been said.

In considering what to contribute to the debate, I looked up a definition of palliative care. We tend to know what that means, but the definition that I came across last night is from the National Institute for Health and Clinical Excellence:

“Palliative care is the active holistic care of patients with advanced progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments.”

That seems to sum it up. Who could not support that statement?

One reason for my participation in the debate is to pay tribute to the hospices that serve my constituency, as many other hon. Members have paid tribute to the hospices that serve their constituencies. My Cleethorpes constituency is served by St Andrew’s hospice, based in Grimsby, and the Lindsey Lodge hospice in Scunthorpe. Both are wonderful organisations that rely on the work of their dedicated and skilled staff and volunteers. I have visited both hospices in the past 18 months; indeed, I visited St Andrew’s only a couple of weeks ago. St Andrew’s also has a children’s unit that serves the whole of the county of Lincolnshire.

I am more familiar with St Andrew’s hospice because my father spent his last weeks in its care and my mother died on the day on which she was due to be transferred to St Andrew’s. My father received care and attention that can only be described as superb. He suffered greatly in the time until he arrived at the hospice, but he seemed to be pain-free during those last few weeks in the hospice. He was in surroundings that allowed me, my mother and other family members to feel reassured that everything possible was being done to give him all the support that was necessary. That was as long ago as 1988. St Andrew’s has progressed enormously since then. It is now in a modern purpose-built building. The drugs and methods of care available have evolved beyond anything that we could have imagined 24 years ago. The advances that are likely to be made in the next 24 years will improve the lives of people who are in their last days beyond measure.

Human life is to be valued. Anything that denies that diminishes society as a whole. I shall conclude by noting one of the contributions made to Lord Mackay’s Select Committee in 2004. It states:

“I would rather die in a country where euthanasia is forbidden but where doctors do know how to look after a dying patient in a

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humane manner than I would in a country where palliative medicine is ignored but euthanasia can be easily arranged”.

That is the sort of country that I want to preserve.

10.28 am

Mark Field (Cities of London and Westminster) (Con): I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on obtaining this very important debate. We have heard a lot about palliative care and the hospice movement and we recognise what a patchwork of provision there is in different parts of the country. I take on board the warnings from my hon. Friend the Member for Portsmouth North (Penny Mordaunt) that that should not be used as an excuse to make assisted dying easier. I will concentrate my brief comments on assisted dying. In doing so, I will be taking up the challenge offered by my hon. Friend the Member for Hexham (Guy Opperman), who talked about whose choice this was. It perhaps was inevitable that, in answering that question, my hon. Friend the Member for Banbury (Tony Baldry), as the Second Church Estates Commissioner, took the view that the Almighty should make the determination. I recognise that many hon. Members present are strongly Christian, but I think that we have to face the fact that we live in a secular society. I do not think that that answer—perhaps slightly tongue-in-cheek—will do as we go forward. My own view—this is perhaps strange, given that I am a legislator and a former lawyer—is that the law is not the right place to make these changes. The empire of the law should not necessarily stretch into this area, and that takes on board elements of ethics and the fact that I have some belief.

I have a great concern that a right to die will rapidly become a duty to die for elderly folk and disabled people. The way in which a society looks after its most vulnerable says much about it, and if we fail to look after such people, and allow the law to change, even in a relatively subtle way, whatever the so-called safeguards, that will be a dangerous step.

The reality is that much of this debate is happening in the context of tremendous funding problems in not only the national health service, but care for the elderly—an issue that has appeared across our newspapers in recent weeks. In a way, those funding problems and the issue of assisted dying are almost two sides of the same coin, with people looking at assisted dying as somehow being an easy way forward on those funding issues.

My concern about the law is that it is simply not the right instrument. It will not give anything like the safeguards we need; indeed, it might make life even more difficult for members of the medical profession and the police, who will be reluctant to do the right thing if the laws that are put in place notionally to provide safeguards simply regulate their lives more stringently in reality.

I speak slightly from my own experience. It is 21 years ago almost to the month that my father died. He was diagnosed with terminal cancer seven or eight months before he died. I was his next of kin, and I must confess that I was very happy that we had a long-standing family doctor. My instructions, and indeed my father’s instructions, to our doctor were that my father did not want to die in pain, and that probably meant that he had more morphine, which might well have accelerated

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his death by a matter of days or perhaps even weeks. Such decisions should be made by the medical profession, but my worry is that any change we make in the law will make that right decision much more difficult, because it will be a regulated legal decision.

Above all, the problem is that, if we try to introduce such changes in the law, which is natural for us as legislators, we will end up introducing a charter for those who think there are elderly, disabled and other people whose lives have less value than those of the rest of us. That is a very dangerous way forward.

Going forward, we will all have to fight. As my hon. Friend the Member for Montgomeryshire (Glyn Davies) rightly said, there is a vocal group that is keen to change the law. All of us must now get ready for a battle to stand up for the silent majority, who think, very much as we do, that the importance of life should not be underestimated at all.

10.32 am

Stuart Andrew (Pudsey) (Con): There is a famous saying that only two things in life are certain: death and taxes. In the short time I have been in this place, it seems we have talked a lot about taxes, but very little about dying. I worked in the hospice movement for more than 12 years, and the hospices have a wonderful saying that they cannot add days to people’s lives, but they can add life to people’s days. That is the fundamental point to make.

I want to talk about children’s hospices. I spent most of my time working for Martin House, which is a children’s hospice in Yorkshire. Children’s hospices are very different from adult hospices. Having also worked in an adult hospice, I have been able to see the differences between the two. Caring for a child with a life-limiting and terminal illness is incredibly difficult. The whole family need support, not just the patient. One father I spoke to said that, if he got up eight times in the night to go to his child, he considered he had had a good night’s sleep.

Many people are frightened of using a hospice, because the view is that that is where we go to die. In my experience, however, things really are much better than that, because hospices are about living and making the best of difficult lives. I want to give two examples, although I will try to be as brief as possible. Two parents came to see me after their six-week-old baby suddenly died. They had spent five weeks in hospital unable to touch the baby, but when they went to Martin House, they were allowed to hold the child. As they put it, they were allowed to be parents, rather than carers. That really shows the wonderful work that the hospice did.

Another thing also made me realise that, for many people suffering from terminal illnesses, the important thing is life and the issues surrounding it. I and other staff from the hospice were interviewing a young man who used it as part of a promotional video, for want of a better term, to help raise funds. The head of care asked him what the most difficult thing was about having a life-limiting illness. In my naivety, I thought he would say it was the fear of dying and the fact that his life would be short, but he said it was falling in love. I could not quite understand that at first, but he said, “Who is going to love me if I have a muscle-wasting

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disease?” I suddenly realised that the hospice movement was about helping young people who face not only a difficult disease, but the emotional difficulty of not being able to live their life in the way we do. Hospices do so much work to make the very best of difficult lives. The holistic approach they offer—the respite care, the emergency care, the terminal support and the bereavement support we have heard about—is vital to the families that need them.

While I was working at the hospice, it needed to raise £4 million a year. We got only 6% of that from the PCTs, which, frankly, is not good enough. We really should spend a lot more on providing excellent care to ensure that those who are coming to the end of their lives have the very best death possible. When the Minister looks at providing money for hospices, I urge her to recognise that children’s hospices provide very different care from adult hospices.

10.36 am

Mr Edward Leigh (Gainsborough) (Con): There is no doubt in my mind that, if we allow assisted dying, it will eventually become encouraged exit. G. K. Chesterton wrote that, when orthodoxy becomes voluntary, it will be prohibited, and we could be on a dangerous, slippery slope. One of the witnesses to the Falconer inquiry said:

“I think we can only go for terminal illness at the moment, so this doesn’t actually apply to the people who are probably about to go into care homes. But, you know, baby steps.”

That is a chilling statement.

There is a lot I could say about this issue, but time is short. We all know that it is virtually impossible to predict how long someone has to live—we know that even from the famous case of the Lockerbie bomber. We also know how people suffer from depression in their last months of life. We know what has gone on in Oregon and in the Netherlands, where 8% of all deaths are the result of euthanasia. We also know about the experience in the Northern Territory, in Australia.

However, I just want to make one simple point, and I apologise, because I suppose it is a moral point. I visited St Andrew’s hospice with my hon. Friend the Member for Cleethorpes (Martin Vickers). To us, this is a moral issue; we believe that the body is simply the mirror of the soul, and however old, crippled or useless someone might seem to society—our society seems to be dominated by the worship of youth and beauty—they are of immense value to society and should be sustained by society to the very end of their lives.

10.38 am

Dr Julian Lewis (New Forest East) (Con): If more hon. Members who support assisted suicide had participated in the debate, one word would have been heard above all others: safeguards. The only hon. Member who seemed to make the case for assisted suicide talked, in a brief intervention, about some people viewing these issues on a religious basis, by which I think he meant that we should judge them on a rational basis. I judge this issue entirely on the basis of rationality, rather than religion, and according to that rationality, it is impossible that the safeguards can be practical or reliable. Safeguards could not be applied to people choosing to end their

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lives, because the people who would try to apply them could not get into the minds of those people whose future was in question.

The case for assisted dying has been made by a small number of strong-minded and articulate people who have made up their minds that they want to die, but who cannot end their lives without help. If everyone relevant to the question were like that, there would be much less of a problem; but the real reason why safeguards are thought to be necessary is twofold. One is to prevent people from being subjected to subtle pressure, which no outside person could detect. However, as my hon. Friend the Member for South West Bedfordshire (Andrew Selous) said early in the debate, even without outside pressure, there would be a danger that people would feel they had to end their lives in a spirit of self-denial, so as not to be a burden on others. There is no way to erect safeguards to prevent subtle pressure from being applied undetectably; still less is there any way for such safeguards to prevent people from genuinely deciding, although they might want to continue with their lives, that they want still more to end them so that they will not be a burden to others. We cannot apply safeguards to those cases, and that is why the case for assisted dying based on the application of safeguards is fundamentally flawed.

10.41 am

Ms Diane Abbott (Hackney North and Stoke Newington) (Lab): First, I congratulate the hon. Member for Enfield, Southgate (Mr Burrowes) on securing the debate. We have lived through an era when MPs have been seen as irrelevant, not to say venal, and when Parliament has been seen as remote. However, increasingly, in this Parliament, we have found that we are seriously debating issues at the centre of current political debate. The present debate is one of them. I want to touch on policy issues that relate to palliative care and to say a little about assisted dying, but I will begin by saying that in a busy, urban 21st century society people seem increasingly reluctant to talk about death or even to face the possibility of death.

At the risk of generalising, I will mention that, as many hon. Members know, my family come from rural Jamaica. In such rural communities, people make a point of talking about death. People stay up all night with bereaved families, night after night. That may seem strange to some, but it is a way of saying, “Death is a reality, and we will support you through it. Your community is here for you.” In a way, the rather hurried, perfunctory and frightened way that we deal with death in modern urban Britain is not necessarily an advance on the way people deal with it in rural communities around the world.

End-of-life care is of course an important issue, not just because death will come to us all, but because it is a major issue for the NHS. It represents billions of pounds of NHS spending—a fifth of NHS costs and a total of £20 billion altogether. Yet, as hon. Members have said, whereas most people would prefer to die at home, most do not have that privilege. It has been a concern of successive Governments to find out how we can give people the range of choice that they want for end-of-life care and how we can improve the level and type of care that is available.

Among the published reports on the issue, the King’s Fund report identified improving the primary care

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management of end-of-life care as one of the top 10 priorities for new commissioners. We have heard about the unevenness of funding of hospices and end-of-life care, even within the same part of the country, so I should like to ask the Minister whether it is the Department of Health’s view that end-of-life care should be a national priority and how she proposes to deal with the considerable variation in quality, efficiency and funding. What is the Department doing to ensure that the NHS can support the voluntary sector hospices and other specialist palliative care providers? Can the Minister give the House some reassurance that the Government’s proposed commissioning arrangements in the Health and Social Care Bill, which is being considered in the other place, will ensure that there is planned 24/7 provision of community support, including care co-ordination, nursing and symptom control?

As I have said, we know that most people would prefer to end their life at home, but most cannot. We also know that half of all complaints to the NHS involve criticism of the circumstances in which someone died. Often the time when a relative is dying is one of the rare occasions when a whole family come together and perhaps watch the process minute by minute. Therefore, a focus on and concern with end-of-life care comes to us all, and we will all have a view on it. The Minister will be aware of the Demos report, “Dying for Change”. Demos made a number of recommendations and said:

“Unless we can devise ways to get people to talk about how they want to live while they are dying, our efforts to improve services will be like groping in the dark.”

That is a reminder of the need to talk about and face death and to say, while still well enough to give an unconstrained opinion, how we want things to happen. Demos referred to training in palliative care and the important question of linking hospices to groups of care homes, so that hospice skills and values can migrate to care homes. It said that services need to be commissioned in an integrated way. The Minister will also be aware of Age UK’s public policy proposals on those issues.

The House would expect me to say a word about Labour’s record. Under the previous Labour Government, the NHS end-of-life care strategy was launched in 2008. It covered all adults with advanced progressive illnesses and care in all settings. The 10-year strategy was backed by an extra £268 million. There is no question but that progress was made, as I am sure that the Minister will acknowledge. The number of staff using models of care specifically designed for the end of life rose. Those models are now used by 75% of GP practices and hospices and 85% of acute hospitals.

Is the Minister aware that the King’s Fund has warned of the dangers of losing momentum in the drive to improve end-of-life care? Is she also aware of the report of Dr Rachael Addicott, “Implementing the End of Life Care Strategy: lessons for good practice”? Dr Addicott expresses concern

“that the decision not to hold a review until 2013 risks losing momentum and missing the opportunity to build on the progress already made.”

I have been fortunate, as a Hackney MP, to have a close relationship with St Joseph’s hospice, which was set up in 1900 by five Sisters of Charity and is the place where, in the 1950s, Cicely Saunders developed the principles of modern hospice care. My respect for the

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men and women who run hospices cannot be bettered by anyone in the Chamber today.

As for assisted suicide, I do not want to take a position one way or another. I have great respect for colleagues who advance the case for it and for people in the media who earnestly want to be able to decide how and where they end their lives. However, I have represented a busy, kaleidoscopic urban constituency for 25 years. In Hackney, the best of life and the worst of life can be seen—and the best and the worst of people. I have seen what fantastic support families can give, even when the state lets people down; but in a tiny fraction of cases, I have seen how venal families can be.

My concern about assisted dying would be for that tiny handful of cases involving elderly people who did not want to be a burden—and how many times have hon. Members sat in advice sessions and heard elderly people say that? I would worry about the cases—tiny in number, but still representing the lives of actual people—in which, if we were to provide a legal framework to make assisted dying possible, such people might feel almost an obligation to move forward. I stress to the House that that is a personal view. It comes, as I have said, from seeing the best of people, but also the worst of people, in more than 20 years of being a Member of Parliament.

End-of-life care is one of those issues that is at the centre of people’s debate and concern, because death comes to us all. Advances have been made in recent times, partly through what has happened in the voluntary sector—in hospices all over the country, such as St Joseph’s, which is a wonderful hospice—and partly through conscious Government policy. I am interested in what the Minister has to say on policy going forward.

10.50 am

The Parliamentary Under-Secretary of State for Health (Anne Milton): Thank you very much, Sir Roger. May I say what a pleasure it is to be able to say “Sir Roger”? I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing this debate. It is timely that the House is reminded of the excellent work that goes on, and we have had tributes from all parts of the House this morning for individual hospices and the work of individuals. I also want to congratulate my hon. Friend on his comments on the fears that surround death. Death is an inevitable consequence of life, albeit for some it is tragically premature. We do not find death and dying a comfortable subject. It is thought frightening and mysterious. If nothing else, debates such as this may demystify some of the issues around death.

I also want to mention in particular the hon. Member for Hampstead and Kilburn (Glenda Jackson) and her comments on the privilege it is to be present at a member of one’s family’s death. The hospice movement, as she rightly said, has enabled that to be possible for so many more people today.

Services in some parts of the country are excellent and in some parts of the country they are patchy at best. As my hon. Friend the Member for Portsmouth North (Penny Mordaunt) pointed out, the quality of care does not always live up to what we expect. It also does not live up to what we expect in the treatment of certain conditions and in end-of-life care.

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The Department of Health’s end-of-life care strategy was published in 2008 under the previous Government. I want to pay tribute to the progress that they made. It remains the blueprint for improving this area. Last September we published the third annual progress report on implementing the strategy. It is on the Department of Health’s website and I urge hon. Members to have a look at that.

Robert Flello: Will the Minister give way?

Anne Milton: I will not for the moment, because I have so little time.

Our plans for the NHS mean that we want people to have as much choice as possible in treatment in life but also in death. We want commissioners and providers to ensure that the right services, which include 24/7 community-based services, are available to support people at home.

Progress is frustratingly slow, but the examples around the country where it is working well are of note. We will review progress regularly to ensure that this becomes a reality for people. It is much overdue.

One development is the electronic palliative care co-ordination systems. I hate these names, but they can be effective tools. Through those, care providers can instantly share care plans and express preferences for care. We piloted that approach successfully in eight sites across the country and it is now being adopted more widely. We are also working to make sure care planning is a routine part of care for people who are dying. It is dreadful that care planning is not a routine part of care for all people. That has not been the case for some years, but it should be.

In November, NICE published its quality standard for end-of-life care of adults. That is an important contribution to this issue. It covers the whole of the end-of-care pathway, not just the medical bit. The 16 statements include social, practical, emotional and spiritual and religious support. We have also developed a national survey of bereaved relatives to get first-hand experiences of people’s care. The first survey should be completed by March. That will inform a new indicator on end-of-life care in the NHS outcomes framework.

To provide quality services, where and how people want them, hospices and other palliative care providers need support and funding. We will introduce a new per-patient funding system for all providers of palliative care, covering both adults’ and children’s services. We set up the independent palliative care funding review to help take that forward. The final report was published last year. It came up with some significant proposals, which we will consider in detail to ensure that we get that right. It is the first major step in local palliative care funding. We will have pilots to collect data and test the review’s recommendations, which will be established from April this year. The aim is to have the new funding system in place by 2015, which is a year earlier than was anticipated.

I also want to pay tribute to the voluntary sector. Palliative care was first developed in the voluntary sector and it still provides us with those beacons of best practice. Dame Cicely Saunders has already been mentioned and had tributes paid to her. She founded St Christopher’s hospice in 1967 and I want to associate myself with

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those tributes. I also pay tribute to people such as Dr Colin Murray Parkes, who has done so much in the area of bereavement and grief. That has been mentioned, but it possibly did not get the mention that it should.

The hon. Member for Strangford (Jim Shannon) and my hon. Friends the Members for Southend West (Mr Amess), for Congleton (Fiona Bruce), for Harlow (Robert Halfon), for Montgomeryshire (Glyn Davies) and for Portsmouth North all paid similar tributes. I would love to mention every contribution in detail, but they all surrounded the same issues: this is about dignity; this is about choice; this is about life. It is also about bereavement and the care of the relatives who live beyond the death.

My hon. Friend the hon. Member for Banbury (Tony Baldry) specifically mentioned assisted suicide, as have other hon. Members. This is a matter for Parliament as a whole to decide, not the Government. He talked about the perception of failure when someone dies. On a personal level, to be present at a good death is a privilege and an opportunity, not a failure. We need to right that balance a bit and see the success in someone dying well. As I have said, it is such an important part of the bereavement process.

We have a comparatively smaller number of people who die in a hospice, but so many more benefit from their services and expertise. We want to see hospices flourish and develop. In particular, we want to see them continuing to expand the care they give to those with illnesses other than cancer, as well as expanding into community-based support for patients, their families and their carers. That is where the work that we are doing on palliative care funding is so important. It will be key to moving us towards a fairer funding system for all providers, including hospices.

It would be remiss of me not to mention the one issue that has not been mentioned. In accepting that death is part of life, we also need to consider those who can be given the chance of life through another’s death. As

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I have ministerial responsibility for organ transplants, I have to mention that we need to make organ donation a normal part of end-of-life care. We need to recognise that through a sensitive approach to the family, we can, in death, give life to many others.

In conclusion, we come to this place to give our constituents and this country a better life, because we believe that everybody deserves a good life.

Robert Flello: Will the Minister give way?

Anne Milton: Very briefly.

Robert Flello: I just want to touch on the point that in my constituency, the Donna Louise Children’s Hospice Trust does some fantastic work. There is this difference between it and the work of the Douglas Macmillan hospice just outside the constituency. There is a mishmash and I would be grateful if the Minister looked at that in the future.

Anne Milton: We want to end any mishmash. We want a consistently high quality of care for everybody. Everybody deserves a good life and that is why we came to this place. This debate has allowed us to debate, discuss and share the opportunities that exist for Parliament to allow people a good death too, with dignity, without pain, in the company of those we love and at peace in death with the lives that we have led.

Sir Roger Gale (in the Chair): Order. Just before we move to the next debate and while I am awaiting the arrival of the Minister, who is not late, may I thank all hon. Members for the tone and the self-restraint that has been exercised this morning? As a result of that, we have managed to accommodate the views of 21 Back Benchers, in addition to those on the Front Bench. I regard that as exceptional. I hope that many people outside the Chamber will have heard the quality of the House of Commons at its absolute best. Thank you.

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Carbon Capture and Storage (Scotland)

11 am

Thomas Docherty (Dunfermline and West Fife) (Lab): Thank you, Sir Roger, for calling me to speak. I am grateful for the opportunity to serve under your chairmanship again. It is the first time that I have done so since your well deserved recognition in the new year’s honours list.

For the sake of clarity, I should draw Members’ attention to my entry in the Register of Members’ Financial Interests and point out that at the last election I received a donation from the union Unison, which has a small number of members at Longannet power station in my constituency.

As Members will be aware, Longannet power station sits at the most westerly point of my constituency. It has been generating electricity since 1970 and it has the capacity to put some 2,000 MW into the national grid. Scottish Power, or its parent company Iberdrola, has been the owner of Longannet power station for a number of years.

Members will be aware that the previous Labour Government established the carbon capture and storage competition, and I will say some more about that shortly. At the tail-end of last year, the current UK Government took the decision to end Longannet’s bidding for the £1 billion pot of money and today I hope to tease out from the Minister exactly where that decision leaves the future of carbon capture and storage, both in Scotland and more generally.

As I said, Longannet power station has been successfully putting up to 2,000 MW into the national grid in Scotland for more than four decades. Several years ago, it had a significant upgrade, which will give it a life through most of this decade. As is the case with all fine pieces of engineering, however, there is only a limited life span left for the power station and of course there are serious questions about how we will keep the lights on in Scotland.

Being a grown-up, I do not think that the Scottish National party’s rather ludicrous plan for 100% of Scotland’s electricity to come from wind turbines and other renewables is at all sensible or deliverable. If someone is a grown-up and has a real energy policy, they have to look at the alternatives to that plan. I firmly believe, as I have done for a number of years, that clean coal technology must be part of an energy mix including nuclear power stations. There should be some role for renewables and fossil fuels, mainly coal, although I accept that there is a limited role for gas. However, I was disturbed to learn from a much esteemed source this morning that 80% of the gas that we now use in the UK comes not from UK shores but from overseas. Security of supply is an important concept. For the benefit of the SNP, which clearly does not understand the concept, let me explain it. If we are dependent on overseas sources of energy, we must have comfort that those sources of energy are reliable, can be delivered safely and are not prone to outside threat.

Dr Eilidh Whiteford (Banff and Buchan) (SNP): Given recent events in Japan, does the hon. Gentleman think that nuclear power is reliable and safe?

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Thomas Docherty: Clearly, the hon. Lady was not listening two minutes ago when I said that nuclear power was part of a balanced energy policy. In the UK, nuclear power has been delivering electricity safely and securely for nearly six decades now. When she speaks in the debate later, I would be grateful if she could say whether she thinks that having a policy of 100% renewables is a saner option than having a balanced energy policy that does not put all the eggs in one basket. Moreover, perhaps she would like to tell me how many wind farms she has supported in her own constituency. I say that because one of the things that we often see is that certain politicians make great proclamations about their support for certain types of energy but the moment that anyone tries to put those types of energy in their own backyard they suddenly seem—bizarrely enough—to oppose that particular scheme. Unlike the SNP, I have always been consistent: I have always argued that we should have a balanced energy policy; I have always argued that we should keep the lights on; and I have always spelled out how and where I would do that.

Jo Swinson (East Dunbartonshire) (LD): I congratulate the hon. Gentleman on securing this debate on a very important issue. Does he agree that it is important to have carbon capture and storage not only for energy security but for environmental reasons? Even if Scotland, with its renewable potential, were able to have a much greater percentage of its energy supplied by renewables, that would not be the case in the rest of the UK and in other countries around the world. Consequently, if we are to tackle carbon dioxide emissions, clean coal and carbon capture and storage have to be a part of any solution we find.

Thomas Docherty: I am most grateful to the hon. Lady for making that point. She is entirely correct that this issue is not only about security of supply, although that is the single most important aspect.

Gordon Banks (Ochil and South Perthshire) (Lab): Following on from the comments of the hon. Member for East Dunbartonshire (Jo Swinson), does my hon. Friend agree that there is also an economic and industrial factor to carbon capture and storage, and that the decisions taken in Holyrood and Westminster do nothing to create the momentum for the UK to be a leader in carbon capture and storage?

Thomas Docherty: Yet again, I find myself in full agreement with my hon. Friend, who, as my neighbouring MP, has taken a close interest in Longannet power station. I hope that he will be able to make further points in the debate shortly. As I was saying, security of supply must be the biggest single priority, but as colleagues have just mentioned there are other issues and I will turn to each of them in due course.

Where do we go from here on the issue of security of supply? We have two choices. We can have a balanced energy policy that has clean coal technology, nuclear power, some renewables and, regrettably, a limited proportion of gas, or we can put all the eggs into one basket, as the SNP has said in its manifesto that it will do. As I said earlier, I hope that the hon. Member for Banff and Buchan (Dr Whiteford) will spell out exactly why we should have 100% windmills and hydro, and how she will achieve that goal during the next decade.

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As I have mentioned, a very regrettable decision was taken by the Government on 19 October last year that, for obvious reasons, was very disappointing for my constituents and indeed for the whole of Scotland. That decision was that the Longannet scheme was not going to go ahead. However, there is a recognition that that decision was a pragmatic one and that the Government have a duty to the taxpayer. The problem with carbon capture and storage is that it is an unproven technology. No Government or private company have yet come up with a viable, large-scale carbon capture and storage scheme. I must say that successive Governments have been very late to understand that there comes a point when people have to push back from the metaphorical table and say, “We could throw billions of pounds of taxpayers’ money at something and we still have no guarantee that that is going to work”.

Regrettably, successive Labour and Conservative Governments have had a very poor track record of backing winners when it comes to new technologies and there is a genuine debate about whether Governments should try to back winners or whether they have a duty simply to put in place a market for private companies to come up with winners. Perhaps the Minister will be able to say more about the Government’s thinking on that issue.

I make no criticism of Iberdrola or of Ministers for the decision that they ultimately made. Building on the excellent work of the Leader of the Opposition, my right hon. Friend the Member for Doncaster North (Edward Miliband), when he was Secretary of State for Energy and Climate Change, the current UK Government offered a £1 billion fund for carbon capture and storage. The only observation that I would make—as I say, it is not particularly a criticism but more a general observation—is that many colleagues misunderstood the nature of the competition. The competition was not a case of “last man standing wins the prize”; it was a marathon, and to qualify for the funding one had to reach the finish line. Regrettably, but for obvious reasons because Longannet was the last entrant in the competition, there was an assumption that it would receive the £1 billion. The UK Government and Iberdrola, the Spanish energy giant that owns Longannet, were clearly in the region of £500 million apart on the start-up and ongoing costs of Longannet. That is regrettable, particularly for my constituents, but I do not think this was doable for the UK Government.

What was bizarre was the intervention by our blustering First Minister, who outrageously leaked the confidential commercial information to a Scottish newspaper, showing, again, that he really is not a grown-up. Also, while he was pandering to the galleries and attacking the UK Government, I noticed from answers I received from UK Ministers that he did not offer a single penny of Scottish Government money to fill the gap. If the First Minister had been prepared to offer £500 million, we could have taken Longannet forward but, as ever with the SNP, all we get is bluster, grudge and grievance, with no solution. Perhaps when she speaks, the hon. Member for Banff and Buchan will spell out what the SNP Government would have done, because all they have done is their usual trick of having a pop at someone else and not offering any solutions.

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As the hon. Member for East Dunbartonshire (Jo Swinson) said, there are some genuine issues here about not just security of supply, but the environment. I firmly believe that carbon capture and storage is a technology worth pursuing, and my preference remains for a coal station for the simple reason I have spelt out already: that I would be reluctant to go down the route of investing in a gas technology over the next 30 years, because gas is not an indigenous supply. I recognise that there is a strong case for Peterhead, which has been championed by my hon. Friends the Members for Aberdeen South (Dame Anne Begg) and Rutherglen and Hamilton West (Tom Greatrex). I hope the Minister will be able to outline in some detail where we are with that.

Dame Anne Begg (Aberdeen South) (Lab): Part of the problem with the Longannet development was that it was coal-fired. It would have had better energy returns, because a large proportion of the UK’s energy still comes from coal-fired stations, but has not experimentation with carbon capture and storage for gas been more successful than the Longannet trial was proving to be?

Thomas Docherty: I am most grateful for my hon. Friend’s observations. She is indeed correct. There have been some positive signs. My note of caution, however, is that there is a danger that we will go down the route of that classic British tradition, whereby Europe and the United States pursue one path and the UK does its own thing. One need only look back at the nuclear programme. While the rest of the western world was going down the water reactor route, the British, in our own quaint way, went down the gas reactor route, meaning that we had wonderful technology—what I would call the Betamax technology of nuclear power stations—but technology that was not compatible with anyone else’s.

Gordon Banks: I will certainly not make any comments about Betamax or VHS. Does my hon. Friend not agree that, given the number of coal-fired power stations in the UK and the world, and the number of new ones coming on line in the developing world, the holy grail is carbon capture and storage for such stations? If we do not get our skates on, we will be left behind, economically and industrially, and will have to watch others develop the technology and create jobs in their economies, while having to import the technology and ability ourselves.

Thomas Docherty: My hon. Friend is exactly right. That is the holy grail. I am not sure if that makes my hon. Friend the Member for Rutherglen and Hamilton West the Sean Connery or the Indiana Jones of the analogy, but it is the holy grail that we should be pursuing, and it can be achieved. My point about Betamax is that it was a fine piece of technology, and our advanced gas-cooled reactors in particular were, and still are, superb engineering kit. I see that the SNP is now a convert to the case for AGRs, championing Hunterston and Torness having life extensions in the years ahead, but when the rest of the world is going down the VHS road, it is slightly disturbing to think that we are going to pursue gas at the expense of coal. Coal is the long-term priority, and there is a significant market, if we can get the technology to work: we can export it not just to developing countries, although that would be a big market, but to many western and European countries that are also very coal reliant.

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I should perhaps say a little about the technology itself, and its benefits for Scotland. As Members are undoubtedly aware, the trick with the technology is not just to capture the carbon but to store it. The Peterhead scheme is, as I understand it, very similar to that for Longannet, in that it would seek to push the captured carbon up into the North sea, into land owned by the Crown Estate. It is important to recognise the Crown Estate’s role, and perhaps the Minister can outline how that will work. Reuse of the now extinguished gas and oil fields off our UK shores is also provided for. Interestingly, the Longannet scheme was a tri-party approach, involving National Grid, Iberdrola and one of the largest oil and gas companies, which had an extinguished field. I hope the Minister can say more about how he will encourage the private sector to do more such partnership work.

It is worth saying that no short-term danger is posed to the Longannet power station by the current carbon capture and storage project not getting the go-ahead. The lights will not be turned off at the station tomorrow morning, but there is a question about its medium-term future. There is a genuine debate to be had about whether it would be the right decision to build another coal power station, whether Iberdrola should be encouraged to seek a further life extension, and if so what Government support could be offered, or whether, as at Cockenzie in East Lothian, a decision is made to shift the type of fuel. Whatever the options, I sincerely hope that the UK Government will do all they can to offer genuine support to Iberdrola as it seeks to take this forward, and I would be grateful if the Minister found time—for either himself or his colleague Lord Marland, who has, to be fair, been a big supporter of CCS—to meet with me. Whatever decision is made about Longannet, I hope, ultimately, that when we get successful CCS we can either retrofit the station or, if we do persuade Iberdrola to go for a new build, that we can get it included. For the benefit of my constituents, I would be grateful if the Minister spelt out what support the Government will be able to give to any new build fossil fuel plant that might be needed to keep the lights on.

I am conscious that other Members wish to speak, so I will draw my speech to a close.

David Mowat (Warrington South) (Con): I thank the hon. Gentleman for giving way. I have listened very careful to his arguments about coal and gas. It seems that this technology is a long way from being proven, and it would be a big win if we could get it to work for either gas or coal. I want to address the point about Longannet. The Government’s most recent publication, “The Carbon Plan”, which came out about a month ago, states that the first decision about an operational plant for CCS will be made in 2018. That is a long time after the current generation of coal is scheduled to be switched off, so there is an issue there if we expect this technology to save some of the coal stations that are planned to be switched off in the next five years.

Thomas Docherty: I am most grateful to the hon. Gentleman, because he has reminded me of an important issue. If the project had gone ahead at Longannet, the full 2,000 MW would not have been converted to a CCS scheme. Forgive me if my figures are slightly out, but roughly only 20% of the capacity would have moved across. He is entirely correct to say that it is a long-term

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technology. The problem with energy and its supply is that by its very nature it requires long-term decisions, which is what makes the SNP’s ludicrous plan for 100% renewables so unachievable. They have no “plan McB”—to use the First Minister’s slogan. When the hon. Member for Banff and Buchan addresses the Chamber, I would be grateful if she spelt out how an SNP plan McB would work, given that it is so clearly failing on its plan McA.

11.20 am

Ian Swales (Redcar) (LD): Congratulations, Sir Roger, on your ennoblement—that is not the right word, but congratulations on your award. I congratulate the hon. Member for Dunfermline and West Fife (Thomas Docherty) on securing the debate. It is an extremely important issue for the long-term future of our country from the point of view of both power and industry.

I have more than 25 years’ experience in the electricity and heavy process industries. The delay in carbon capture and storage implementation at Longannet is disappointing. The UK is in a great position to exploit CCS. As Lord Oxburgh, president of the Carbon Capture and Storage Association recently put it:

“Experience gained in the North Sea oil and gas industry, and the abundance of offshore geological sites where CO2 may be stored underground have allowed the UK to become one of the global leaders in CCS. Capitalising on this early leadership is vital”.

We certainly can be leaders. The same technology that has been so successful in the complicated job of extracting, storing and processing oil and gas from the North sea can be modified to put carbon dioxide back under the North sea. There is a skilled work force, and academia is already doing important support work. Professional bodies such as the Institute of Mechanical Engineers are very clear that the technology is perfectly practical, and there is a great future here if we move quickly. The global market in the technology alone is conservatively estimated at $10 billion.

A similar story could have been written some years ago about wind technology. We are one of the windiest countries in the world, but thanks to Government dithering and lack of public and private investment, we are playing catch-up and importing most of the technology and equipment. Having worked mainly in the private sector until May 2010, I am baffled at the interminable time scales I see in this job. When someone says something will take six months, my questions are: so what will happen tomorrow and the next day, and how can we shorten the critical path? I am then met by blank looks. I am sure that the giant new Tesco store being built in my constituency would not have gone from a green field to a functioning supermarket in six months with politicians and civil servants running the project. My challenge to the Minister is: how fast can we go and what is getting in the way?

We should be ambitious about CCS in the UK. It is needed to decarbonise our power production and our heavy industry. The areas that get CCS infrastructure will become magnets for new power and industrial investment. That means that we can protect energy-intensive industries, which are currently being challenged by European Union and United Kingdom climate measures, and help to reverse the decline in our manufacturing sector. Failure to act will lead to more announcements like the

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recent one on the closure of the UK’s last aluminium smelter. Ironically, it is in Northumberland next to the North sea, and the owners had considered using CCS to keep the plant going. It is now too late.

Where should CCS investment take place? Again, we should be ambitious. There are four obvious prime locations: the Aberdeen area, the Forth, the Tees and the Humber-south Yorkshire area. They all have merits, and the Department of Energy and Climate Change should kick-start development in them all. A long-term strategy should be developed for CCS infrastructure.

Thomas Docherty: I have listened carefully, and disturbingly I find that I must agree with a lot of what the hon. Gentleman says. On his point about funding all the schemes, surely the great challenge is that there is a finite pot of money. How should that problem be addressed?

Ian Swales: I thank the hon. Gentleman for that challenge. I do not necessarily see it as my job to represent the Treasury, but £1 billion for less than a quarter of the Longannet power station was not a good use of money. Having talked to people in the industry, I think that there are better ways. Conglomerates of private sector companies want to get into the sector, and we need to be more imaginative about how we make that happen.

Dame Anne Begg: One problem is that at the moment, the private sector cannot see that it is a worthwhile business proposition. One of the difficulties faced by CSS in this country is that the economic arguments do not yet stack up.

Ian Swales: The hon. Lady makes a good point, and that is where we must challenge the private sector and be imaginative about the schemes. I will come on to a scheme I am familiar with that is not in Scotland, but for which there is already a conglomerate of companies ready to roll—household names in the gas and pipeline industries and lots of different companies. It can be done.

To those who say that such development is highly expensive, I say that we need to look more at the overall longer-term finances for the Government, industry and energy generation. For example, it has been estimated that the CCS project proposed for Teesside can generate a peak of £1 billion a year in extra petroleum revenue tax for the Government, through oil companies using CO2 to get more oil from their North sea wells. That possible extra oil recovery from the North sea is estimated at 4 billion barrels. The use of CO2 for enhanced oil recovery is already widely practised in the United States.

The debate is about Scotland, but a project is ready to go in Teesside, and the necessary list of major players in pipelines, processing and so on are ready to start. More than 30 large CO2 emitters in the power and industrial sectors can be connected to the system. Interestingly, a few of those are using biomass, which raises the prospect of net carbon-negative power—sequestering CO2 from the atmosphere. By generating clean power and running clean industry, CCS can make a huge contribution to UK climate change targets. A clear and ambitious

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UK-wide strategy, action to remove roadblocks to progress and a sense of urgency are needed from DECC, so that the UK can genuinely lead in this exciting new industry.

11.28 am

Dr Eilidh Whiteford (Banff and Buchan) (SNP): I congratulate the hon. Member for Dunfermline and West Fife (Thomas Docherty) on securing the debate. I am rather disappointed that he chose to squander his opportunity today; instead of asking the Government about progress on the plans for carbon capture and storage in the UK, he preferred to take pot shots at the First Minister, who not only is not here but does not have the power to make decisions on CCS that will be made under the current constitutional arrangements.

I want to focus on CCS in Scotland. I share the hon. Gentleman’s disappointment and frustration over the abandonment of the Longannet project. It promised job security for the folk involved, offered technological innovation and would have brought significant investment to Fife. I regret that it hit the buffers, but it is not only the people of west Fife who have been frustrated by the slow progress of carbon capture projects in Scotland. Peterhead, in my constituency, has long been recognised as having leading potential as a site for CCS. Indeed, Scottish and Southern Energy asserted that Peterhead represents the best site in the UK for a gas demonstrator CCS project. By no means is that a new plan. The previous CCS plan for Peterhead was abandoned in 2007, after expectations were raised and then dashed. Frankly, delays and indecisiveness on the part of Government led BP to scrap its plans and turn its attention to projects overseas. The problem was that the previous Government were not decisive enough.

Thomas Docherty: The hon. Lady has commented on two decisions, but will she clarify whether a Scottish Government, if they had the powers, would have gone ahead with both those schemes? Would they have put up the £1.5 billion to £2 billion needed for Longannet and the sum needed for Peterhead?

Dr Whiteford: I do not deal in hypotheticals. I wish that the hon. Gentleman would turn his attention to where we are now and how we are going to progress, because important questions need to be answered.

Thomas Docherty: That is a no.

Dr Whiteford: No, it is not. The Scottish Government’s commitment to carbon capture and their involvement in discussions about Longannet and Peterhead have been constructive throughout the process. I hope the Minister will comment on how he has worked with the Scottish Government on the carbon capture and storage projects.

The Peterhead project was resurrected in 2010 when Scottish and Southern Energy Group revived the idea, and last November it joined forces with Shell to make progress on the plans. Those companies are committed to a gas demonstrator at Peterhead, using storage in the Goldeneye field and the existing North sea infrastructure going out from St Fergus. The Goldeneye field is available and has the right pressure and capacity to make the project viable in technical terms.

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I do not think there is much argument any more with the view that we need to mitigate the environmental impact of fossil fuels if we are to have any hope of meeting our international commitments and obligations in tackling climate change. We need to continue using fossil fuels, but we also need to make them cleaner. It is also evident—I was surprised by the hon. Gentleman’s comments on this—that gas will remain a crucial part of our energy mix. What are the Minister’s views on the role of gas in the UK’s energy supply? It is important to understand the role that CCS might play, not just from the perspective of energy security, but from that of the sustainability of our planet.

Thomas Docherty: Will the hon. Lady give way?

Dr Whiteford: I will, and I hope the hon. Gentleman’s intervention will be better than his previous one.

Thomas Docherty: I am not sure whether I heard the hon. Lady correctly, so will she clarify whether she thinks it a good thing that we would import 80% of our gas not from Norway, but from Kazakhstan, the middle east and other slightly insecure regions?

Dr Whiteford: I agree with the hon. Gentleman that energy security is crucial, but the point about gas is that I do not think we have a choice any more, and the reason why we will have to use gas, wherever it comes from, is the previous Government’s indecisiveness. They refused to make decisions, for example, on whether to have new coal at Kingsnorth. After 13 years in government, it is very easy for the previous Government to put pressure on the new Government, but they need to take some responsibility for their own decisions when they were in office and their failures, which have made us very dependent on external gas at present.

That, however, does not negate the argument for a CCS gas demonstrator project at Peterhead. We are where we are and we are dependent on gas, but the proposed Peterhead site fits in extremely well with both the UK’s strategic objectives and the EU’s strategic priorities. It is also very well located for old oilfields in the North sea. We are in a good position to use them—it is probably a better position than that of anywhere else in Europe at present.

David Mowat: I agree with the hon. Lady that gas is the default solution to energy where decisions have not been made. On gas from overseas, I think I am right in saying that the majority of our coal also comes from overseas at the moment, but we can rest assured that, from 2015, Europe is likely to be flooded with cheap shale gas from the US, so I think our concerns about that particular fuel source are misplaced.

Dr Whiteford: I am grateful to the hon. Gentleman, who has considerable expertise in this area, for making the important point that it is not just gas but coal that comes from overseas. The point about CCS technology is that it is extremely marketable and the UK has a comparative advantage in that market. A number of coal demonstrator projects are taking place elsewhere in Europe, whereas gas is not being explored to anything like the same extent internationally. That could give us a

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proper comparative advantage in gas CCS technology. It is about not just our domestic markets but international marketability.

The key issue is funding. There is no doubt that the collapse of the Longannet project and the Treasury’s announcement that it would reallocate the underspend has created a great deal of anxiety and uncertainty. However, Shell and SSE have made it clear that they would require funding in the next two to three years to make the project viable, and revenue support during the operational period. In that respect, the energy companies have argued that spreading the finance too thinly over too many projects risks jeopardising all of them.

What proportion of the funding will the Government make available during this Parliament? What discussions have been had about the prospects of levering in further investment from sources other than those in the public sector? What is the Government’s response to the argument that the UK needs to focus its efforts on funding and risk management? The Government have published a timeline for implementation. How likely is that timeline to be met and how is it progressing?

We have to recognise that this is a demonstrator plant. It carries investment risks and might not go smoothly and completely according to plan, but that is why it is so important for it to have Government backing. I hope the Peterhead project will progress apace.

11.36 am

Gordon Banks (Ochil and South Perthshire) (Lab): I congratulate my hon. Friend the Member for Dunfermline and West Fife (Thomas Docherty) on securing this debate, which is extremely important to Fife and central Scotland, as well as to the UK in general. I am disappointed with the Longannet decision. It affects my constituency, which borders that of my hon. Friend more or less at Longannet, very much. Many of my constituents work at Longannet and I would have had high hopes of many more of them finding employment in a successful carbon and capture storage plant there, but we are where we are.

It is vital that we have a balanced energy policy. We have to embrace renewables of all natures and there has to be a role for fossil fuels and, indeed, nuclear. We have to have a guarantee that, when we press the light switch, the light comes on. Unless we embrace all available technologies to ensure that that happens, we will find ourselves socially and economically challenged.

We need to determine—we can only do this through full-scale trials—whether carbon capture and storage is a real option for future economic prosperity, as well as for dealing with the knock-on environmental issues, which are the driving factor. It is equally important to determine what a successful CCS programme—developed and branded in the UK—could deliver to the UK economy in terms of revenue and the skills of our constituents.

The Scottish Government did not do anything in relation to the Longannet decision. There was a lot of hot air from the First Minister, and it is hot air that we are trying to stop. It would have been much more constructive for the Scottish Government to have done something to facilitate the development of Longannet. Did the Minister have any discussions of that nature with the First Minister?

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In an intervention, I made the point that, with coal-fired power stations in the UK and throughout the world—an increasing number are coming online in countries such as China—CCS is the real gain and the holy grail. We need to focus our minds on it in the UK, while bearing it in mind that both the public and private sectors have limited resources to invest. I will come to that in a moment.

Can the Minister confirm the expected release date of the CCS roadmap, because that is absolutely vital for the private sector embracing the challenge of this technology and seeing the Government as a partner in this? Unless the Government play their part, we cannot expect the private sector to play its part. That in itself will create jobs, technology and developmental skills that I hope we can build on and in some way export. CCS could create 13,000 jobs in Scotland and 14,000 jobs elsewhere in the UK. By 2025, the sector could be worth more than £10 billion a year to the economy, which, in addition to the environmental impact, makes CCS a bit of a no-brainer. We have touched on how many times we have been left behind.

Ian Swales: Does the hon. Gentleman agree that, if CCS is worth £10 billion to the economy, those who will benefit have an incentive to help to get things going? It does not seem to make sense to rely only on Government funding.

Gordon Banks: The hon. Gentleman is perfectly correct, but what the private sector needs is for the Government to show a willing lead. What happened at Longannet could be construed as not demonstrating that. The Government need to step up to the plate here and throw the gauntlet down to the private sector.

As I was saying, how many times have we been left behind and missed the boat in the UK in terms of various different technologies? The hon. Member for Redcar (Ian Swales) talked about wind technology. It is a crying shame that we are where we are with wind technology. We are largely importing the technology and the equipment to build turbines. That really has been a missed opportunity. Although CCS may be costly—I will come back to that matter—it is an opportunity we cannot afford to miss.

We need something from the Government to show that they are embracing CCS and that demonstrates to the private sector how serious they are. The hon. Member for Warrington South (David Mowat) raised the point about CCS being expensive. Yes, it is. There are no cheap or quick fixes to our energy position, but we have to consider what the fixes are and CCS is potentially one of them. Governments in Holyrood and Westminster need to step up to the plate, and I am not sure they are doing that.

Thomas Docherty: Does my hon. Friend have any views on what Governments can do in terms of the planning system, because it strikes me that one of the great challenges we face, particularly given the long lead-in time on a new-build plant, is ensuring that that type of decision is not held up unnecessarily through the planning process?

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Gordon Banks: My hon. Friend makes a valuable point. We must determine what becomes a priority in the United Kingdom and ensure that people’s lives are not blighted by decisions that are trying to make things better. There is a real need to recognise that we must have security on a core range of issues, one of which is energy. I embrace the possibility of ensuring that future CCS opportunities and, indeed, new build with carbon capture get the relevant scrutiny and are of benefit to the UK, Scotland and the immediate community. Future CCS opportunities need to be fully valued and evaluated in that process.

In conclusion, the Longannet decision was extremely disappointing. It did not send the right message to the energy sector or to the people working in it. Today, the Minister has an opportunity to try to undo some of that damage and I look forward to his comments with bated breath. I hope that he will take that opportunity on board.

11.44 am

David Mowat (Warrington South) (Con): Thank you for letting me speak, Sir Roger—I had not intended to do so. I want to make two points in relation to some of the comments I have heard: one in favour of CCS and one expressing some reservations. I will mention the latter one first, which relates to cost.

Many hon. Members have talked about the benefits of CCS technology. Of course, we live in a country where energy is still 90% fossil fuel generated, and anything that can enable us to make the transition from that in a carbon-free way, such as CCS, is attractive. Yet there seems to be something wrong. What the Government should be doing is setting a price for carbon and then letting the private sector do the work. We do not know the details about Longannet but, for whatever reason, that approach is not enough. People are saying that we have to invest a further £1 billion here and have a further pilot scheme there. What the Government’s role ought to be—this is the energy market reform—is, as it is with nuclear, to set a price for carbon, give industry that stability and let it make the investment. For example, let us consider Iberdrola.

Ian Swales: The hon. Gentleman might be interested to know that the pressure I feel in my constituency is essentially coming from industry, not from power generators, because industry can very much see what is happening to it competitively and so on through carbon pricing. Does he agree that there may be a carbon pricing method that can incentivise the power sector to play its part in bringing this new technology on board faster?

David Mowat: I do not, no. If this technology is to work, it has to be done on the same playing field as everything else. I mentioned the price of carbon. The other thing about CCS technology that is not in doubt is that it requires an injection of power over and above what a power station is currently using—in the order of 25% for coal. That is an immediate increase in emissions and everything else just to make CCS work.

Gordon Banks: I want to press the hon. Gentleman and ask him whether he is advocating that the Government should not be spending this £1 billion.

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David Mowat: I am willing to accept that this technology is new and that the Minister might therefore say it is a bet to try to get it to work in our country. I agree that our country is uniquely well suited for CCS because of the offshore gas fields. In places such as Germany, people have been resistant to CCS because the fields are onshore and they do not want CO2 under them. Our country is in a uniquely good position for CCS, as it is for wind, and I do not necessarily begrudge the Government spending the money. However, I repeat the point that, structurally, the energy market reform sets the price for carbon and we should let the market decide. We will watch with interest whether the market does decide that this technology is worth pursuing. That is my negative point. I shall now make my positive point.

Thomas Docherty: The hon. Gentleman is certainly bringing a different perspective to the debate. Does he not accept that Governments have given subsidies and financial support to both nuclear and renewables for a decade-plus and that CCS pump-priming would be no different from the support that those industries already get?

David Mowat: That is a fair point. In the energy market reform that has been published, the Government are very proud of the fact that they are giving no subsidies to nuclear in going forward—[ Interruption. ] Well, that is a different argument. The Government have subsidised and continue to subsidise renewables. That takes me to my next point.

Dame Anne Begg: Will the hon. Gentleman give way?

David Mowat: Certainly. I have clearly aroused some interest.

Dame Anne Begg: Does the hon. Gentleman accept that it is not simply about the economic argument because if we leave the market to decide, it will always go for the cheapest option? There is also an environmental argument and the Government need to be involved on that basis because this is still a new technology with demonstrator projects. Until the technology can be proven, the market and the industry will not make the investment. The Government may therefore need to make that investment to pump-prime and ensure that we get the environmental benefits.

David Mowat: Just to be clear, I completely buy into the Climate Change Act 2008 and its requirements. However, the way that the Government have chosen to meet their environmental obligation is by setting a price to carbon. That is what makes CCS viable because, obviously, the companies will save the money from burning the carbon at whatever the rate is—£30 or £50 a tonne—and so on. That is my point. The level playing field that the Government are trying to obtain through the energy market reforms is being achieved over the medium term by the price of carbon.

Let me now make my point about CCS from a more positive point of view. What worries me a little about the Government’s position on CCS is a little similar to what worries me about the Government’s position on nuclear. Both CCS and nuclear have one thing in common: they are extremely good at reducing carbon, but they are not renewables. The Government have an issue to

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work through, and I have said this in other forums. The Climate Change Act 2008 requires us to reduce our carbon emissions by 80%—a huge and difficult target, but it is right that we are trying. My concern is that, in 2009, the EU 20-20-20 directive required us to increase our use of renewables by a factor of five over a decade or so. That objective is not necessarily consistent with the objective of reducing carbon.

It is possible that CCS may lose out, like nuclear, through a little bit more ambivalence on the part of Government. I looked at the Government’s carbon plan. It estimates how much of our electricity will be produced from CCS by 2030 and how much will be produced from renewables. I am not anti-renewable at all, if it can be made to work in a cost-effective way. The Government’s estimate for 2030 is a factor of five difference between renewables and CCS. I do not know whether CCS will be made to work or not. We should try, and it would be great if it did, but I am worried that the emphasis of policy is not on carbon reduction. The emphasis of policy is on renewables, and that might take us to, or down, a sub-optimal path.

Ian Swales: Just one point of clarification: those two things are not necessarily entirely separate. A new 300 MW biomass power station has been announced for Teesport. A CCS network in the area could actually feed into that. As I said earlier, we could end up with carbon negative power as a result of doing that, so they are not entirely separate. While 300 MW is not a huge amount, it is worth noting that the Longannet project was only 400 MW.

David Mowat: I agree. I mentioned CCS and nuclear as opportunities. Biomass is also an opportunity. In common with the first two, it is also not a renewable. As I said, I am concerned that the emphasis of policy is in the wrong place. The 2008 Act was a hugely ambitious plan to try to achieve. We should not be diverted from doing so and we should look very hard at optimising that.

[Mr George Howarth in the Chair]

Finally, we have not really covered nuclear in any detail, other than an exchange at the start between two hon. Members from north of the border—the hon. Member for Dunfermline and West Fife (Thomas Docherty) and the hon. Member for Banff and Buchan (Dr Whiteford). People say to me that there is no cost-effective option. On the facts, it would appear that nuclear is cheaper than some of the other options, but of course the market needs to determine that. I agree with that. The carbon price will allow that to happen. That needs to be the case with CCS.

11.53 am

Tom Greatrex (Rutherglen and Hamilton West) (Lab/Co-op): It is a pleasure to serve under your chairmanship, Mr Howarth.

We have had an interesting and wide-ranging debate on CCS in Scotland and other related factors. It is not a surprise that the debate has sometimes ranged beyond CCS projects in Scotland, because so many aspects of energy policy and energy considerations are tied up with the potential—the potential projects and the success, or otherwise—of CCS. I am sure there are many other

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issues, from the contributions we have heard, that the Minister will wish to reflect on. He missed the very start of the debate, but what is gratifyingly clear from the whole of the debate is that—despite one comment from the hon. Member for Warrington South (David Mowat)—nobody taking part in the debate fails to see the potential of CCS and its impact. From time to time there is a view that, because CCS is unproven and has not been demonstrated on a commercial basis, it is a distraction. I do not believe it is a distraction. It is integral to achieving the right, balanced energy policy and the right mix of energy sources, and to reducing carbon emissions at the same time. It is interesting and positive, therefore, that that view has not been expressed during the debate.

I congratulate my hon. Friend the Member for Dunfermline and West Fife (Thomas Docherty) on securing the debate. He touched on many issues from the perspective of representing the Longannet power station. Everybody felt disappointed with the announcement that Iberdrola and the Government had concluded that the Longannet project was not able to go any further without significant additional funds. In fact, even with the significant addition of funds, there may well have been other technical issues that made it impossible to go further. That decision was not necessarily a party political issue. It is, I think, a deep disappointment to everybody who is interested and committed to energy policy.

Some of the commentary around the issue was unhelpful. I had the pleasure—it was not that much of a pleasure—of rereading some of the comments made by the First Minister and other members of the SNP immediately after that decision. While I understand that the predecessor of the hon. Member for Banff and Buchan (Dr Whiteford) was caught up in the moment at his party conference shortly afterwards, his description of the Government turning their back on a world-leading technology and £1 billion of investment not being there was perhaps going further than the facts allowed. That was disappointing in many ways, but not necessarily that surprising.

Thomas Docherty: Does my hon. Friend think it is interesting that, for all the bluff, bluster and ranting from the SNP, when push comes to shove they would not have put a single penny into the scheme? We have heard nothing today about how much it is prepared to fund.

Tom Greatrex: I think my hon. Friend is trying to tempt me into one aspect of a constitutional debate that we will have, and I am sure we will have plenty of opportunities. I join other hon. Members in seeking clarification from the Minister on what offers of funding for CCS were made, if any, from the Scottish Government. It would be interesting to learn more about that issue if he has the opportunity to address it in his winding-up speech.

I want to reflect on some of the contributions to the debate, because so many aspects of energy policy are tied up in them. My hon. Friend the Member for Dunfermline and West Fife touched on security of supply. My hon. Friend the Member for Ochil and South Perthshire (Gordon Banks) touched on the importance of the industrial and technological potential

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that undoubtedly exists in the UK. The clock is ticking, however, and he gave an apposite warning about the potential for missing out on that, as indeed did the hon. Member for Redcar (Ian Swales), who has experience in the industry and related industries. The hon. Member for East Dunbartonshire (Jo Swinson) made the important point that this is also about reducing carbon emissions, which is fundamental to our energy future.

Scotland has had a relatively long, and sometimes chequered, past—and present—with CCS: from Peterhead to Longannet, and back to Peterhead again. There is also the potential of the Hunterston project, which is currently caught up in the planning process. Other hon. Members referred to the difficulties that can arise with the planning process.

At various points, there has been lots of excitement about the potential of all those projects in Scotland. There is a real opportunity for Scotland to be a world leader in this low-carbon technology. Much of the academic expertise is in the UK, particularly in Scotland, notably Edinburgh. It would be a shame if that potential was not realised first in the UK. As my hon. Friend the Member for Ochil and South Perthshire made clear, we should not overlook the potential for jobs and the value to the economy. Many hon. Members have touched on Scotland’s potential, particularly within the UK. It has access to geological formations off the North sea that are ideally suited to carbon storage, and we have heard about the issues in Germany and elsewhere regarding under-land storage.

All those things make it important that the Government remain committed to CCS, including, potentially, in Scotland. That does not mean that the decision on Longannet was not disappointing, as I have said: it was bad news for the plant, for the local economy and for Scotland. My two hon. Friends here today with local connections made that point eloquently. However, as my hon. Friend the Member for Ochil and South Perthshire said, we are where we are and we have to deal with the realities. The important thing now is that the potential demonstrated in the work at Longannet is not lost, so that we do not have to start from scratch.

I am pleased to have found out in my discussions with Scottish and Southern Energy—or SSE as it is now formally known—that some work undertaken at Longannet is being used to help inform current work in relation to Peterhead. It is important that we do not have to start from scratch each time, because then our ability to get ahead of the game would almost certainly be lost.

It is important and significant that we understand the difference between CCS being encouraged through other aspects of energy policy, including carbon pricing, in the longer term—as the hon. Member for Warrington South mentioned—and where we are now, because this technology has not yet been proved commercially on a significant scale. The real potential has been demonstrated, but it is reasonably widely accepted, if not universally, that to get that benefit Government intervention and support is needed in the initial stages.

The hon. Member for Banff and Buchan touched on the Peterhead project, and many hon. Members who are not here have commented on the decisions made in 2007. I am tying this issue into Longannet because sometimes, as I have said, party politics gets in the way of the realities of projects that have potential but, for whatever reason, cannot be taken further forward.

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The predecessor of the hon. Member for Banff and Buchan talked about the Peterhead project being lost to Abu Dhabi. He is a frequent traveller, at the moment, to that part of the world. I wonder whether he would, either through the hon. Lady or at some other point, inform us what happened in Abu Dhabi, because I understand that BP’s hydrogen power project has still yet to get the go-ahead there. Sometimes the simplistic sloganising around this issue does a disservice to the technological, practical and engineering hurdles that we still need to get over. Sometimes, the degeneration of this important matter into an “England versus Scotland” or a “Scotland being done down” debate does it a disservice.

Funding is important and I am sure the Minister will have expected me to mention that, given that I have used many opportunities in the past few months to seek answers on this issue. It is important that we get clarity from the Minister today, including about the funding that is available going forward. At the time of the Longannet decision, the Minister’s boss, the Secretary of State for Energy and Climate Change, said at Energy questions that there would be no backsliding from the Treasury, that the £1 billion would be available for CCS funding, and that that was an absolute commitment. Yet the day before the autumn statement—I am sure the Minister recalls the radio interview—the Chief Secretary to the Treasury made it clear that the £1 billion for CCS would be subsumed within the £5 billion infrastructure plan, although he was not clear about what would then be available for CCS. The ramifications of the interview on 5 Live that morning were pretty significant and have caused a degree of concern in the industry that has not yet abated. Perhaps the Minister will comment on that and say what that means for the timeline for the development of CCS.

The subject of the debate is projects in Scotland. The Minister will be aware of SSE’s projections regarding when it expects such projects to be up and running: that is, before the end of current comprehensive spending review period. There is a degree of doubt and concern about that, because the Government are saying that the £1 billion will be available, but not necessarily in this Parliament. How can they make that commitment ahead of the next CSR? The industry is concerned about certainty and stability in relation to that funding; it is important that it know exactly where it stands.

Again, will the Minister make clear how much of the £1 billion that his boss said there would be no backsliding on will be available during the current CSR period? How much of the £1 billion previously set aside for CCS will now be used for other infrastructure projects? Will those other infrastructure projects in the Treasury infrastructure fund exclude CCS, and is the money being double-counted? What form will the remaining funding take? Will it be up-front capital, or fixed or variable payments over time?

I am asking the Minister these questions again because on 29 November 2011, I asked the Chancellor during his autumn statement to provide some clarity, but he was not able to do so. On 1 December I asked the Secretary of State for Energy and Climate Change to provide some clarity, but I am afraid his answer was not clear. On 6 December I asked the Chief Secretary again to provide further clarity, but, again, he was unable to do so. On 15 December I even asked the Leader of the

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House to provide some clarity, and he said that he thought the issue had been dealt with with the appropriate degree of clarity beforehand.

Four Cabinet Ministers were, in the space of 11 sitting days, given an opportunity on the Floor of the House to spell out clearly and without ambiguity exactly how much money was available for CCS in this Parliament, what the impact would be on the timeline for distributing that funding and whether the funding was, potentially, being spread far too thinly to have a positive impact. On each occasion the Government were found wanting: rather than providing potential investors with the clarity they were asking for, they preferred to provide further confusion.

The Energy Minister even claimed, in a written answer to me, that the Chief Secretary to the Treasury had not made any announcement on CCS funding. People who heard the interview I have mentioned would beg to differ: although it may not have been a formal announcement to Parliament, that statement by the Chief Secretary has caused such a degree of concern that it is incumbent on the Government to provide the clarity we need now.

I should like to touch on the European NER300 funding package. The lack of clarity about Government funding for CCS projects has a knock-on effect on other sources of funding, which hon. Members have mentioned, whether private or public. One such source is the European Union NER300 programme. The six CCS projects competing for funding from the UK are also doing so at European level.

The Peterhead project is seeking funding. The chief executive of SSE, Ian Marchant, has made it clear that the development of the commercial-scale CCS demonstration is dependent, to some extent, on levels of support from both the EU and the UK Government. The criteria for accessing EU funding are clear. Before any allocation of EU money for a CCS project that is seeking both member state and EU funding: