Hunger: East Africa and the Horn of Africa

Debate between George Howarth and Jim Shannon

Tuesday 25th April 2023 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Glasgow North (Patrick Grady) for raising these issues and setting the scene so very well. He is a man of passion and understanding, and it is a real joy to sit alongside him in this debate. He and I often support each other in these types of debates.

I remember quite well the first time that I saw advertisements in the 1980s that showed children in Africa literally starving. It does not seem that long ago. My heart ached as I looked at my boys—I thank God that we were able to provide for them. I am always aware that there are people in the world who have literally nothing.

I am sad to say that many children are still starving. I am now a grandfather, and I feel that familiar tug in my heart today. I support many charities that have food programmes and operations in numerous countries in the horn of Africa, and they are stretched to capacity. They tell me that they are finding it very difficult to cope. Following five consecutive seasons of below-average rainfall, the horn of Africa is facing its longest drought in four decades. That is compounded by years of conflict and instability, the impact of climate change, covid-19—my goodness!—and rising food prices due to the war in Ukraine. Millions in the horn of Africa face acute hunger, and Ethiopia, Kenya and Somalia have been particularly affected.

In its most recent review of the horn of Africa, published on 3 November 2022, the United Nations reported that 36.4 million people, including almost 20 million children, were affected by the drought, and that 21.7 million people, including 11 million children, needed food assistance. Those figures illustrate the magnitude of the issue. UNICEF estimated that some 5.7 million children in the region require treatment for acute malnutrition, with 1.8 million children experiencing life-threatening malnutrition.

Although famine has not been officially declared in the horn of Africa, with projections of a sixth consecutive below-average rainy season, the famine early warning systems network has estimated that the horn of Africa, especially Somalia, will face a famine in 2023—right now, as we sit in Westminster Hall, that is a reality. With this knowledge comes responsibility. I have absolute confidence that the Minister is aware of this House’s responsibility to do the right thing and increase not simply food aid, but ascertain how best we can channel projects to help families to become sustainable.

[Sir George Howarth (Knowsley) (Lab)]

Like every other speaker, the hon. Gentleman is making a powerful case to make sure that properly targeted resources reach the places they are so desperately needed. Does he agree that the international response, in terms of both resources and resolving the conflicts behind this crisis, has been too slow and indecisive? It really does need a fresh start to ensure that the political conflicts that underlie all this are addressed urgently and effectively.

[Jim Shannon]

I certainly do agree, and I thank the right hon. Gentleman for that point. When the hon. Member for Glasgow North gave his introduction, he emphasised that very point, as others have as well. They are right: decisive action needs to be taken by the Minister and our Government. I am ever mindful that our Government and Ministers have been active, but we do require more incisiveness.

Some of my churches back home have been involved with a project where they were able to buy a pair of chickens, two pigs, two goats—small things, Mr Gray, but things that can really change a family’s life—with the idea that a family can breed those animals and live sustainably by selling the offspring. In the Upper Waiting Hall yesterday, and probably today, there was an exhibition on Yemen—one of the examples shown is that very project, which enables a family to be sustainable. The churches in my constituency of Strangford do that very thing.

Doctor Training

Debate between George Howarth and Jim Shannon

Tuesday 17th January 2023 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure, Sir George, to speak in this debate, which I thank the hon. Member for South Cambridgeshire (Anthony Browne) for leading. I am happy to support the thrust of it and am pleased to be the Opposition Member speaking for it—that does not take away from others who probably wished to be here.

There is no doubt that we have faced years of NHS turmoil, and one of the main issues is a lack of sufficient staffing across all aspects of the NHS—nursing and doctors being the most prominent. There are countless reasons why we should train more doctors, but there are domestic issues hindering us from doing so. The hon. Gentleman referred to them, and I will address them from a Northern Ireland perspective. I am my party’s health spokesperson, so I am happy to speak on these issues.

I first want to put on the record—others will undoubtedly do the same—my thanks to the doctors of the NHS for all they do for our health in the United Kingdom of Great Britain and Northern Ireland. We are fortunate to have two fabulous universities in Northern Ireland: Queen’s University Belfast and Ulster University. I have spoken to many students who say there seem to be some issues with the number of places available for those who want to become doctors. Northern Ireland prides itself on the opportunities we offer to international students. We have an amazing scheme, but Queen’s can offer only about 100 places a year for medicine, and there is therefore a shortfall. If that could be increased, it would benefit us in Northern Ireland and people across the United Kingdom. The Minister is always responsive to our requests, so will he outline whether he has had any discussions with the Northern Ireland Assembly and the Department back home?

The hon. Gentleman referred to levelling up, and obviously I want Northern Ireland to be part of the levelling-up process. I welcome that the Government are committed to that, but sometimes we need to see the small print, so I ask the Minister to share some thoughts on that.

I understand that more than 10% of the 100 medicine placements at Queen’s are awarded to international students. I stated earlier that there is still a fantastic opportunity for international students, but once they have completed their degrees, a large proportion do not stay in Northern Ireland and go back home to their own countries. That means there is a gap between the number of students who are trained here, and the number who enter professions and become, for example, junior doctors.

Let me give an example from back home. Two constituents I spoke to excelled in their GCSEs, AS-levels and A-levels—the hon. Gentleman referred to qualifications and the success of education. They were both A* students whose ambition was to stay at home, train and work in Northern Ireland. Unfortunately, they were not successful in obtaining a placement in Northern Ireland, and are now in Edinburgh and Wales, given that they had no other options. Those are not the options they wanted; they wanted to be at home. That is why I asked the Minister about the discussions back home.

Our junior doctors recently voted to strike. More than 173,000 members have agreed to a three-day walk-out due to staff pay, excessive rota hours and a lack of support from superiors. Those issues have to be addressed; they cannot be ignored. I have met some of those junior doctors, nurses and consultants to discuss the issues, and I must say that the excessive hours and shifts they are being asked to work are overwhelming. There is a burden on our junior doctors and those who wish to become junior doctors at a very early stage. Sometimes they work 12-hour shifts for four to five days. Just over the weekend, I heard about the pressures that an accident and emergency unit is under. Our junior doctors are tired and feel underappreciated. Again, the importance of addressing that is clear.

Hiring additional doctors seems like an easy answer to a complex problem. It is never as simple as that, of course. People say, “Well, just hire more. The country is crying out for junior doctors.” We know that, but how do we make it happen? Although that is true, the reality is that the NHS and its staff have been underfunded for years. We do not have the money to fund our junior doctor sector and ultimately hire more. The 100 university places at Northern Ireland’s largest university are simply not enough to meet the demand. It is therefore really important that we address the issue. We must encourage our students to stay and work here, but why should they do that when they feel defeated because they are not getting placements where they want—in our case, back in Northern Ireland?

The Health and Social Care Committee stated that stakeholders have recommended increasing the number of places by 5,000 a year—the hon. Gentleman referred to that—and others have suggested that the figure should be as high as 15,000 a year. As part of the levelling-up process, we need to see the benefits of levelling up for all the regions of this great nation.

The Royal College of Radiologists has been in touch with me to say that employing additional junior doctors could assist with the oncology backlogs, which we all know is a priority for many. It has stated that there is a shortfall of 17%, or 163 clinical oncology consultants, which is forecast to increase to 26% or 317 consultants by 2026 without action to tackle the workforce crisis. What we are doing today will avert a crisis down the line, which is what we are trying to achieve. That is just one example of how our lack of junior doctors ultimately has a knock-on impact on our ability to provide priority treatment.

I will conclude, because I am conscious that eight people want to speak and I want to give each and every one of them the same time, but there is much more I could say about this matter. It is important that workers in our healthcare sector know that they are valued and that we very much appreciate their endless efforts, which can go unnoticed by some. This issue arises from an enormous variety of sources, but we have consistently heard comments about how there simply are not enough university places for the students who are willing to help. Everyone in this room knows that underfunding is also a crucial factor, so let us get the job done to make sure our NHS staff have the protections they need, are not under extreme pressures and do not feel undervalued. Today’s debate gives us the opportunity to ask for that, and the hon. Member for South Cambridgeshire has done this nation proud in his introduction. I believe the other speakers will support him in his ask of the Minister.

[Sir George Howarth (in the Chair)]

For the information of Members present, I do not intend initially to put a formal limit on speeches, but an advisory recommendation is that if everybody sticks to five minutes, we should be able to call everybody.

Dialysis Care Outcomes

Debate between George Howarth and Jim Shannon

Thursday 19th May 2022 Westminster Hall

[Jim Shannon]

I thank all hon. Members who have spoken, and I thank the kidney charities that the Minister and everybody else referred to very much for what they have done.

The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) made some very pertinent points about depression, mental health and the psychological impact that dialysis treatment has on people. The Minister very kindly referred to that in her response, and she outlined the case.

The hon. Member for East Lothian (Kenny MacAskill) referred to the travel costs of taking children to the few centres, and he talked about the impact that has on families. He said that dialysis patients have higher levels of treatment. He also referred to prepayment meters, which can prevent people from accessing home dialysis treatment to start with. I know that is not the Minister’s responsibility, but the hon. Gentleman highlights an issue. We all know the Minister is very thorough, and that she will pass on the issues that have been brought up but are not her responsibility to the relevant Departments.

The shadow Minister referred to the two kidney patients she met yesterday. She also thanked the charities and referred to the 3.1 million people living with kidney disease in the United Kingdom. As we all did, she underlined the need for equal treatment, access and cost reimbursement across the whole of the United Kingdom.

I thank the Minister very much for her comprehensive, detailed response to the issues. She referred to the 11 renal networks and the regional care systems that feed into the transformation programme recommendations.

All hon. Members referred to rising costs. Energy tariffs are not the Minister’s responsivity, but perhaps she will be able to refer that to the right person, whoever it may be. Hon. Members also referred to proactivity and the need to reimburse people. As we were sitting here, Fiona Loud, who is in the Public Gallery, sent me a wee note that said that at least some of the people are getting their money. Perhaps people are taking note of the fact that this Westminster Hall debate is happening, because people are getting their money out—there is a commitment.

All NHS trusts must act and respond better. We need to address the reimbursement of moneys as soon as possible. The shadow Minister referred to that. It is great that the Minister and the Government are setting a target of 20% for home dialysis. We want to see that target achieved.

I welcome the chance to communicate with the Minister outside with the kidney charities, to understand better what the real problems are. We have to thank the charities for their campaigns. The reason I have knowledge is half the time because of them. Without them, none of us would be able to deliver the details, as the hon. Member for Rutherglen and Hamilton West has done.

I always look forward to the future. We bring forward issues to the Minister, and then we look forward to the response. The response we have listened to today sets out a programme of events, strategies and visions for the future. We want to see things improve. We will probably regularly come back to the Minister—I hope we do not have to, but we may have to. If we do, we will do that collectively in a positive fashion. In my life, I always try to do things positively. We bring things to the Minister and say, “Here’s where the shortfalls are. Here’s where we can do better.” What we heard today from the Minister has given us some heart, hope and confidence for the future. On behalf of all kidney charities, on behalf of the patients out there and on behalf of us all, we thank the Minister. I thank you, Sir George, as always, for the excellent way you chair these debates. I appreciate it very much.

[Sir George Howarth (in the Chair)]

I thank the Front Benchers and the Back Benchers for the constructive and consensual way in which this debate has been conducted. It is a model of how we should conduct all our debates.

Question put and agreed to.

Resolved,

That this House has considered dialysis care outcomes.

Criminal Justice System: Families Bereaved by Public Disasters

Debate between George Howarth and Jim Shannon

Thursday 16th September 2021 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Deputy Speaker, for giving me the chance to participate. Just last Friday, the hon. Member for Garston and Halewood (Maria Eagle) was here for the consideration of private Members’ Bills and referred to this debate. I wanted to come along—I do not provide support to any of the victims as an MP—to convey from my point of view our understanding of what the debate means to everyone here today. None of us could fail to feel the sorrow, hurt, loss and raw pain that we have all heard here today. The hon. Lady has been a stalwart in putting this matter forward, and I wanted to come and support her, and I am here today to do just that, and I put it on record.

If I may, I will refer to the right hon. Member for Maidenhead (Mrs May). I am always impressed—I have said this to her, so it is not something she has not heard before—that she is on the Back Benches contributing to debates. I am impressed every time I come here and she does that, because it shows the depth of her and her commitment to the issues she brings forward. We should all be impressed by that, including the Conservative side.

This is a very sensitive topic, and I know there are people listening today who are members of families who have lost loved ones due to public disasters. Many out there will resonate with what those MPs who have spoken today have said, as well as with those who have spoken before and are not here now, and they will understand where the Bill needs to go. We look to the Government to respond positively. We all know—I have written down “96 Liverpool fans”, but as the hon. Member for Liverpool, Riverside (Kim Johnson) reminds me, it is now 97—that the impact goes long beyond the event. I remember well that awful day and the vivid scenes that took place afterwards.

The previous Justice Secretary stated that the Government would

“always consider opportunities to review the law”.—[Official Report, 10 June 2021; Vol. 696, c. 1128.]

Well, today is the day, and the House is asking for that to happen. However, given the devastating situations that families were left in as a result of what many families perceived to be Government inaction after the Hillsborough disaster, it is fair to say that a review of the current law is the minimum action that could be taken. Steps must be taken, as every hon. and right hon. Member has referred to, to ensure that this process is never repeated in any way and that the correct process takes place not only for victims, but the victims’ families who have been left behind.

The motion for this debate is clear. It calls for reforms that

“better respond to families bereaved by public disasters”.

I want to take a moment to reflect on an event in the past that also supports the claim for reforming the criminal justice system. I refer to the Omagh bombings of 1998. I also remember that day. It was a Saturday, and I always remember it very well. It was 15 August, and 29 people were killed.

[Sir George Howarth]

The hon. Gentleman is right, as others have, to praise my hon. Friend the Member for Garston and Halewood (Maria Eagle). I add my thanks to the right hon. Member for Maidenhead (Mrs May) for all she has done to support the families. Does the hon. Gentleman agree that one of the major problems that has beset all this is the lack of a process that takes any account of the legitimate interests of those who either were bereaved or survived it? Does he therefore believe it is about time we put that right?

[Jim Shannon]

I thank the right hon. Gentleman for intervening. Absolutely, we want to associate ourselves with those who lost loved ones in Liverpool and their pain. We in Northern Ireland have had the same pain for some 23 years from the Omagh bombings in particular.

After multiple court cases and futile arrests, there was no real closure for those poor families. My point is: this is not a Northern Ireland-based dig-up of history but another illustration of how there is, as the right hon. Gentleman said, a lack of justice and judicial support for the families of the victims. For 23 years, the families of the Omagh victims have had no closure and no explanation. The process that they have been through shows again that we need to do better by victims of public disasters.

Such disasters should be treated no differently from individual cases. The mark left behind is the same. The pain is the same. The long-lasting hurt is the same. The feeling of losing a loved one hurts all the same, and more effort needs to be put into reforming the system to ensure that there is a better response to the families of the victims. They have waited for something to happen, but nothing has happened. That could be done through communication and better liaison between families and the police, emergency services and, ultimately, the courts. I look to the Minister for a response.

The Public Advocate (No. 2) Bill would allow for better scrutiny for investigations. The hon. Member for Garston and Halewood said that, as did the right hon. Member for Maidenhead—everyone has said it. Perhaps I sometimes look at things simplistically, but it looks simple enough—so just do it. I fear that, all too often, victims are left in the dark, making the process more devastating. An independent advocate would allow for those all-important questions to be answered from the aftermath of a tragedy that is still raw. We have witnessed that in recent years with Grenfell, which other hon. Members referred to, and the Manchester Arena bombings. Many of us did not cry tears at that, for people we did not know, but for the victims, the tears, the sorrow and the hurt are the same, and we need to help the victims. They and their families should be at the forefront of legislation. The authorities have a moral duty to ensure that information and investigative movements are transparent to all victims’ families.

One of the most prominent duties of hon. Members in this House—we all do this, hopefully to the best of our abilities—is to represent our constituents. I stand up here for all who have suffered loss with no closure or justice at all. Unfortunately, Northern Ireland knows only too well about victims, and there is often little to no closure. As we have heard from right hon. and hon. Members, it is crucial that no negligence or wrongful information has the potential to dissipate relations further. I cannot fail to be angered about that; I want the response to be as it should.

The core element of the Public Advocate (No. 2) Bill is to ensure that things are done properly from the start. The hon. Member for Garston and Halewood has raised this issue in Parliament over a great many years—long before I came here—and I hope that consideration will be given to the Bill. I urge the Minister, to whom I look as a friend, to work collectively with the victims’ families. It is not enough, and moreover it is not fair, that it is down to the families to set out their own methods of support and victims support groups. The Government must do more to ensure that the pain that victims’ families go through is met with understanding and support. If we cannot give support to our grieving and vulnerable, we as a society are failing and we in this seat of democracy as MPs have failed. Today we want to take failure and make it success, so we look to our Minister to make that happen.

I support the hon. Member for Garston and Halewood and everyone who has spoken across the Chamber. I would just say this: to their repeated efforts to secure this support in legislation, I add my voice—as one who represents Strangford in Northern Ireland and does, I believe, understand the pain—as I do to the request they have put forward today. That request in this House today will help us all in this great United Kingdom of Great Britain and Northern Ireland and, on behalf of the victims and on behalf of the families, make sure that we can learn from past mistakes and simply, but most importantly, do it better.

Diabetes: Tailored Prevention Messaging

Debate between George Howarth and Jim Shannon

Thursday 24th October 2019 Westminster Hall

[Jim Shannon]

Like my hon. Friend, my wife is younger than me. It must be a Northern Ireland DUP MP thing—we look for younger wives to keep us young. I am not sure if that is right or wrong, or if it is politically correct to say that, but my wife is nine years younger than me. She understands the issue of me and diabetes.

Some 10% of people with diabetes have type 1 and 90% have type 2. I will refer to both throughout my speech, and I encourage hon. Members to do the same and to acknowledge the different factors at play with each. We can manage type 2 with medication, provided we control what we eat and what we put in our bodies. Of those living with diabetes, we have the broadest cross-section of society. The condition affects all genders, ages, ethnicities and financial situations. However, too often I see that policy makers and clinicians fall into the trap of treating people with type 1 or type 2 diabetes as homogenous groups that will respond to the same approach and message, but they respond in different ways.

During this debate I want to focus on four things: the primary prevention of type 2 diabetes; the need to offer different messaging to ensure that the support is appropriate for each individual living with diabetes; the necessity of preventing the complications of all forms of diabetes; and innovations in technology—there is marvellous technology —and patient pathways that can improve outcomes for people living both type 1 and type 2 diabetes. I wish that I had known 12 months before I was diagnosed that the way I was living—the lifestyle, the stress—was putting me at risk. We all need a bit of stress; it is good and keeps us sharp, but high stress levels with the wrong eating and living habits is harmful. I do not drink fizzy lemonade any more because it was one of the things pushing me over the edge. That was probably why I lost most of the weight fairly quickly.

Let us talk about prevention. Today more than 12 million people are at increased risk of type 2 diabetes across the UK. More than half of all cases of type 2 diabetes could be prevented or delayed. If I had known a year before my diagnosis, I could have stopped the downward trend in my health, but I did not know, and I wish that I had done. Many in this House offer leadership on type 2 diabetes prevention; the right hon. Member for Leicester East is certainly one of them. England is a world leader on this front, having recently committed to doubling its national diabetes prevention programme.

I was pleased to attend a roundtable discussion last summer, chaired by the hon. Member for Enfield, Southgate (Bambos Charalambous), at which we considered the link between obesity and diabetes and the importance of tailored messaging for the different subsets of the population. During the discussion I met the inimitable Professor Valabhji, the national clinical director for obesity and diabetes at NHS England, whose leadership in this space should be celebrated. I put that on the record because his knowledge and help for those around him, and his research into and development of how we deal with diabetes, are incredible.

For people with type 2 diabetes, there is the additional aspiration of achieving remission. I echo colleagues’ congratulations to the deputy leader of the Labour party, the hon. Member for West Bromwich East (Tom Watson). We watched him almost shrink. One day I stopped him and said, “Tom, is everything all right?” He was losing so much weight, but it was his choice to diet as he did. He is an inspiration for many people because of what he has done, and I commend him for it. The concept of remission can be alienating, however, because it is not possible for every person with type 2 diabetes.

Central to the effectiveness of all types of support for the individual and the wider population is the messaging used, which is what this debate is about. Tailored messaging should be developed for the sub-groups most at risk of type 2 diabetes. For example, those in the most deprived areas of the country are nearly 50% more likely to be obese and have type 2 diabetes than those in the most affluent areas: there is type 2 diabetes in areas where people do not have the same standard of living.

Obesity is responsible for around 85% of someone’s risk of developing type 2 diabetes. Additionally, south Asians are six times more likely to develop type 2 diabetes than Europeans are. It is a well-known cliché that men are not so open or proactive—I can say this is true—about their health needs, and men are 26% more likely than women to develop type 2 diabetes. I am willing to speculate, as one who fell into that category, that that is in part due to messaging not being in a format that reaches men. I did not know what it was, did not know what it meant, did not know what the symptoms were, but it was happening.

We need to focus some of the messaging on the importance of prevention and the risk of type 2 diabetes for men. Will the Minister commit to ensuring that all messaging to support those with type 1 and type 2 diabetes, as well as for type 2 diabetes prevention, is tailored to the relevant sections of our society?

I have to manage my diabetes every day. I take my tablets in the morning and at night. I am careful about what I eat. By and large, I manage it. I check my sugar levels every morning. The doctor tells me to check and I do it every day so that I know where I am. I am a creature of habit; I do it all the time so that I know exactly where I am. Some days it is out of kilter, probably because I transgressed and had a cream bun when I knew it was the wrong thing to have. None the less, we do such things.

On self-management, the average person with diabetes will spend just three hours a year with a healthcare professional. That means that they will spend most of their time managing the condition themselves and will need appropriate education. The right hon. Member for Leicester East chairs the all-party parliamentary group on diabetes. He organised a seminar where we looked at healthcare professionals and how people manage their own condition and therefore need appropriate education. The current delivery of structured education does not reflect the varying needs of each individual living with diabetes. We are all different.

The best efforts of healthcare professionals and those who provide education often focus on perfect self-management or no self-management at all. In reality, the daily struggle of living with a long-term condition means that every marginal improvement should be seen as a true achievement. We have to manage it and encourage ourselves as we move forward. We have to make sure that by moving a step forward we can then move forward again. There has been an admirable drive to increase the uptake of education, but education alone will not help an individual manage the ups and downs of living with the condition. They need the tools and confidence, as well as the education, necessary to manage their condition.

When I speak to people in my constituency who live with diabetes, they often highlight the feeling of isolation. I am sure we can all agree today that there is a need to provide each of those individuals with the support they need to take away the isolation. Being a diabetic can be lonely if someone does not know how to manage it. They might think they are doing the right thing when they are not. Issues have been highlighted to me about the delivery and format of education programmes. Digital solutions and coaching services should be explored. The Minister referred to that in a conversation that we had prior to this debate. I look forward to her response. We always get something positive from her, and we will certainly get something positive today.

Will the Minister commit to ensuring that the delivery, format and content of structured education programmes is improved through the use of digital solutions, and that national guidelines are adapted to accommodate that? Health apps could also be used to refine and augment diabetes training programmes by enabling clinicians to learn from patients about what motivates them and therefore what support to provide.

I want to congratulate the hon. Member for Wolverhampton South West (Eleanor Smith) on her leadership on how health apps can be used to improve care and patient self-management. Many MPs in this House are diabetic or have an interest in diabetes. That is why we are here today. We are either diabetic or interested in the matter and here to make a contribution. I commend and thank right hon. and hon. Members for their commitment.

Will the Minister commit to undertaking an extensive public engagement and education programme, using digital platforms where appropriate, to showcase effective and evidence-based health apps and encourage their wider usage? Support needs to be tailored to individuals’ particular needs, in recognition that no single solution works in self-management for everyone. Everybody’s needs are different. I was the first diabetic in my family. When the doctor diagnosed me as a diabetic he asked me about my mum and dad and my wife’s mum and dad, and whether there was anybody in my family tree with the condition, but there was no one there. Unfortunately, my condition was caused by my diet and my lifestyle, so I created the problem. It was not hereditary, but it is how we deal with such things and tailor our responses that matters.

I have recently been convinced that health coaches—the Minister will comment on this—can play a key role in this space. Coaches can bring a distinct non-clinical skillset that poses questions for patients to help them devise the solutions that work for them, to help build their self-confidence and self-motivation—in stark contrast to the more prescriptive approach taken in clinical settings. Coaching needs to be clearly defined, and the full range of support that coaches can provide to support tailored prevention messaging needs to be identified. I look to the Minister’s response, because I believe it will have some positivity in relation to what we seek and what will happen.

It has been brought to my attention that the health service may ultimately need to decide whether to adopt a population-based approach to support improved outcomes across the entire population, or a more targeted approach aimed at those facing the greatest barriers to effective self-management. Will the Minister ensure that the health system explores the full range of ways in which health coaches can support people living with long-term health conditions, as well as carers and family members, through the development of an NHS definition of health coaching? Does she agree with me—and I hope with others in the House—that the UK has an opportunity to be an exemplar in the use of health coaches? It is an excellent opportunity and I hope that through the Minister we can make those changes.

I want finally to discuss the potential of innovations and technology in addressing issues related to self-management. That is what I do—I self-manage my diabetes. A flexible approach to the provision of structured education is vital to support self-management. Once equipped with the information and skills necessary to self-manage, people must have access to, and choice from, a range of proven technologies to help them manage their condition in everyday life. There has been a big investment in technology recently in the NHS.

We welcome the Government’s commitment to the extra spend on health, which we talk about regularly. All us in the House are particularly appreciative of the Government commitment. People with type 2 diabetes are now provided with glucose monitors; my hon. Friend the Member for South Antrim (Paul Girvan) referred to those in an intervention. However, people are offered little education on how to use them appropriately. There may be something more that we can do about that. It is good to have the technology, and to be taking steps forward, but it is also good for people to understand how to use it appropriately for management.

The level of investment in innovative hardware for people with type 1 diabetes is substantial and should be commended. However, individuals can be left lost if timely support is not available to help them to interpret and utilise those tools as a means of preventing complications. Many people with type 1 diabetes choose not to access the technologies now available to them. Why is that? I do not know the reason, but it is a question we must ask. I believe that it is partly because of a lack of individual awareness. In the case of my diabetes, that would be right. It could, potentially, be linked to a lack of information. If information is not being provided, I should hope that something could be done about that.

Later in the month an event is being held in Parliament, chaired by the right hon. Member for Knowsley (Sir George Howarth). The event, held in partnership with the type 1 diabetes charity JDRF, is to do with the development of a new report on access to technology for people with type 1 diabetes, “Pathway to Choice”. I look forward to reading the report when it is published, and I know the Minister will be keen to read it.

All of us with an interest in diabetes—and that is why Members are here for the debate—will be interested to read it. Can the Minister inform colleagues here today what measure will be introduced to ensure that all people living with either type 1 or type 2 diabetes can access the latest proven technologies that are right for their situation?

[Sir George Howarth (Knowsley) (Lab)]

The hon. Gentleman has highlighted two important themes: self-management and knowing how to go about it properly; and the more recent theme of the potential of technology to achieve good control. He knows I am keen on both. However, does he accept that artificial intelligence can never replace the human element of having someone to talk to, who can give good, accurate information about how to deal with the condition?

[Jim Shannon]

The right hon. Gentleman is absolutely right. Artificial intelligence is beneficial: it can help where it can help. However, it is better for people to have the chance to talk to someone who can instruct them. I think probably we all want to talk to someone face to face, so we can understand the issues better.

An event that I attended here—with the hon. Member for Heywood and Middleton (Liz McInnes), I think—was about diabetes and also bariatric surgery. It may have been in the Thames Pavilion. I mention it because sometimes bariatric surgery may be the only way to reduce weight and enable someone to get to the other side, to address the issue of diabetes. That, as the right hon. Member for Knowsley said in his intervention, is something that people need to talk about. It needs to be discussed so they know what the options are. It is not for everyone, but it is for some people. A number of my constituents over the years have had that surgery and it has always been successful. It has reduced their weight in such a way as to control their diabetes. They are fortunate. Not everyone would have been able to have that surgical operation, but bariatric surgery is important.

To conclude, there is no one solution to diabetes prevention or management. Sometimes, no matter how well informed we are, diabetes can present new and potentially insurmountable challenges. I have some recommendations for the Minister. Primary prevention of type 2 diabetes should take a broad population approach, while ensuring that there is a range of programmes, including digital ones, so that no groups are excluded. There should be someone to speak to—access to someone to converse with who can advise and take things forward. Messaging should be varied and regularly re-evaluated, to ensure that there is engagement from those subsets of the population at the highest risk of type 2 diabetes. We cannot ignore the issue of obesity and diabetes. That was referred to at business questions and will probably be referred to during Health questions on Tuesday.

Finally, a holistic approach should be taken to diabetes care both to ensure value for the individual and to maximise the benefits to the NHS. When we are dealing with the NHS we must look at the money we have to spend, and how to spend it better. Prevention and early diagnosis are among the ways to do that, and the area of type 1 diabetes technology is important. Over the years I have had a number of constituents under the age of 10 who had early-onset type 1 diabetes. I can picture some of their faces, as I speak. They will always have to manage their diabetes. Mine came about through bad diet and bad management, but for some people it is hereditary. I ask the Minister to ensure that the Department for Health and Social Care will continue to focus on the important issue of messaging, in relation to diabetes.

Diabetes: Artificial Pancreas

Debate between George Howarth and Jim Shannon

Wednesday 12th December 2018 Commons Chamber

[Mr Howarth]

I am grateful to my hon. Friend for that intervention. I am aware of the #WeAreNotWaiting group and as recently as earlier today I had an email from one of them. I will not name them, because I do not have permission to do so.

[Jim Shannon (Strangford) (DUP)]

Will the right hon. Gentleman give way?

[Mr Howarth]

I will give way in a moment. I just want to finish answering the point made by my hon. Friend the Member for Birmingham, Selly Oak (Steve McCabe).

The email reads:

“As someone who has built an artificial pancreas using the open artificial pancreas system and is reaping the rewards from this technology, I just wanted to wish you good luck with this evening’s Adjournment debate. Having been a type 1 for 38 years, I can confirm that this is truly life-changing.”

Before I give way to the hon. Member for Strangford (Jim Shannon), I want to say a word about those who are manufacturing their own artificial pancreases. In some respects, we should celebrate that there are so many young people out there who have the ability to build what is in effect an artificial pancreas, while, at the same time, writing their own algorithms to link them together. That is truly amazing.

I have a background—this is a long time ago—in engineering and I cannot even conceive of doing that, so it is very encouraging that people are doing it. On the other hand, I worry. I have spoken to clinicians and one said to me, “I’ve looked at some of them and they are viable devices, but I worry about people building something that is not reliable and then relying upon it. There could be serious consequences down the line.” But this does show what is possible when people—in their bedrooms or in their mum and dad’s garage—are effectively able to control their own diabetes.

[Jim Shannon]

I congratulate the right hon. Gentleman on securing this debate on using modern technology to deal with diabetes. I declare an interest as a type 2 diabetic. I know other Members in the Chamber have similar ailments.

Northern Ireland has some of the highest levels of diabetes in the whole of the United Kingdom. We have the highest level of type 1 diabetics among children in the whole of the United Kingdom per head of population. That gives an idea of the importance of this debate.

I am very interested in the success of the artificial pancreas given to a teenager in Leeds. Does the right hon. Gentleman agree that this revolutionises both treatment and quality of life, but that it must be available throughout the whole of the United Kingdom of Great Britain and Northern Ireland? It must not be a postcode lottery. This must be available as a matter of course for those who fit the protocol. Will the Minister tell us how we can do that across the whole of the United Kingdom of Great Britain—Scotland, Wales, England—and Northern Ireland?

[Mr Howarth]

I am grateful to the hon. Gentleman, who must be psychic, because that is the very next point I was going to make.

There have been, as the hon. Gentleman says, postcode lottery-style problems with accessing the technology. For example, with FreeStyle Libre, a flash glucose monitoring device, patients in Liverpool are able to get it on prescription if they meet the criteria. That is very welcome, but many patients from outside the area cannot get one, as up to 30% of CCGs do not fund them. There needs to be more work done on that and I know the Government have made an announcement, which I will refer to in a moment.

Thanks to Diabetes UK’s campaign on 14 November, World Diabetes Day, NHS England announced that from April 2019 the FreeStyle Libre will be made available to all who meet the clinical criteria regardless of where they live. That is a very welcome development. I do not think it will apply to Northern Ireland, but I hope a similar policy is adopted in Northern Ireland. Innovation in diabetes technology is evolving rapidly in exciting ways.

--- Later in debate ---

[Mr Howarth]

The right hon. Gentleman is right, and it was an omission on my part not to have acknowledged that. Any parent of a diabetic child has to experience the disease—at second hand, but in very important ways. The younger the child, the more responsibility parents have to take, so that is important. By the way, training and other support for parents needs to be built into the system.

[Jim Shannon]

I just want to reinforce what we do for diabetics in Northern Ireland. The surgery that I belong to, in Cuan in Kircubbin, holds diabetic classes twice a year. The staff there do tests on all the diabetics—type 1 and type 2—including for their blood pressure, feet, eyes and all the other things they need to test in the clinics. The surgery then reports back on those tests. For instance, patients will get an eyesight test a month after they have been to the clinic. That shows that there are ways of dealing with this. I am not sure whether surgeries on the United Kingdom mainland do something just as good, but perhaps they should.

[Mr Howarth]

There are centres where people can access a lot of services in one place in a similar way to what the hon. Gentleman describes as happening in Northern Ireland.

I attended an interesting conference in Vancouver three or four years ago. I found out—the Minister or one of her colleagues might want to investigate this a bit further—that some of the smaller island states tend to provide all the services in one place because they do not have the capacity or resources to do anything else. It is an accident of geography that they are forced to do that, but it seems to work very well, particularly in some of the Pacific island areas, where there is a massive problem with type 2 diabetes.

Infection Prevention and Control

Debate between George Howarth and Jim Shannon

Tuesday 15th May 2018 Westminster Hall

[Jim Shannon]

The hon. Gentleman is absolutely right; we have got to get it right in our own hospitals and across the NHS and the whole United Kingdom of Great Britain and Northern Ireland, and then we can look further afield to other countries. He reminds me that last year I had occasion to be in hospital three times for various operations. I never had any infections. I had nothing but the best care. The surgeon’s knife went in the right direction and removed what had to removed. It was important to do that. The important thing is that we have hospitals and an NHS that are excellent. When the NHS works well, it is the best in the world, but sometimes we need to think about things.

The cost of infections to the NHS includes the immediate costs of treating patients in hospital, bed-blocking and so on. There are also issues with hospital capacity, which has reached 100% in some cases. The World Health Organisation estimates that 50% to 70% of hospital-acquired infections are transmitted by hands, so improving hand hygiene must play a central role in any strategy to reduce hospital infections. It would be remiss of me not to note the work carried out by the Secretary of State to improve patient safety in the NHS—let us give credit where credit is due. In November 2016, there was a commitment to halve gram-negative infections by 2020. The Secretary of State announced he would appoint a new national infection prevention lead, Dr Ruth May. Both are important steps in bringing down infection rates and show a commitment to do so.

Given that 50% to 70% of hospital infections are transmitted by hands, I was encouraged to see alongside those measures a commitment for the NHS to publish staff hand hygiene indicators for the first time. If hand hygiene is done—it should be, and perhaps there are indications of places where it has not been—then publishing hand hygiene indicators will allow benchmarking between hospitals and help drive up standards of hand hygiene. If we can have a system that can help drive hand hygiene, we should have it. Perhaps the Minister can respond to that point in his summing up.

The policy should not be implemented by weighing or counting cartridges used in hospital hand sanitiser dispensers. If it is done by the number of cartridges used, we might be under the impression that things are going the right way, but there has to be a wee bit more to it than that. Without factoring in patient bed numbers and staffing levels, the information is, I gently say, somewhat meaningless in showing hand hygiene compliance levels. The intention is right, but other factors need to be looked at.

The Secretary of State is a strong proponent of the use of reasonable technology in the NHS. Like me, he believes it has the power to radically change how we deliver care. Electronic monitoring technology can monitor hand hygiene to deliver real-time, accurate data to drive behavioural change. We want to see behavioural change where staff are not as active on hand hygiene as they should be.

Electronic monitoring is an innovative practice that is used internationally. Studies from a hospital in the US have shown that following the adoption of the technology, hand hygiene compliance improved by 30%. If we use that methodology, hopefully we can replicate what has happened in the US and reduce infections. That 30% increase corresponded with a 29% decrease in the number of MRSA infections, saving that one hospital more than $400,000. Here in the UK, electronic monitoring is being piloted at a number of hospital trusts in what the Care Quality Commission describes as “outstanding” and “innovative” practice. It goes back to what my hon. Friend the Member for Upper Bann (David Simpson) said in his intervention: where we see good things happening, we should be doing those things across the whole United Kingdom. My hon. Friend the Member for East Londonderry (Mr Campbell) also referred to that.

If the results from the US are replicated here in the UK—they can be—the national adoption of electronic monitoring technology could see 30,000 fewer infections, saving the NHS more than £93 million. More importantly, it would mean less infection, fewer people staying in hospital and fewer deaths. Dr Ruth May, the national infection prevention lead, said that,

“the collection, publication and intelligent use of data…will ensure organisations improve infection control and help…poor performers get the support they need”.

Those are very wise words. While I welcome the announcement of the hand hygiene indicator policy, it appears that progress on its implementation has stalled. I suppose that is the point I am coming to and the reason for this debate. The Department of Health and Social Care has missed its own deadline to publish the data by the end of 2017. Data is so important in drawing up a strategy, policy and vision of how we can address the issue.

We have been collecting mandatory data on the number of healthcare-associated infections, such as MRSA and Clostridium difficile, since 2004. When hand hygiene is so critical to reducing the number of healthcare-associated infections, it is difficult to see why it has taken more than 14 years to publish data on staff hand hygiene—data that we are yet to see. I find that incredible. I spoke to the Minister last night, so he knew I would raise this issue. The key issue for me is how we use the data we have to make a policy and a strategy from which we can all benefit. To mark World Hand Hygiene Day, the World Health Organisation is calling on Health Ministries worldwide to make hand hygiene a marker of care quality. If we do that right, we will be going in the right direction.

Will the Minister consider making hand hygiene a national marker of care quality? Will he, on behalf of the Secretary of State, outline who is responsible for the implementation of the policy? Will he set out a clear timeline for the collection and publication of this data, which is critical to driving up hand hygiene standards in hospitals? Someone walking through the door of any hospital will always first notice the smell. They will probably notice the warmth of the hospital, because it is there to care for patients and those who are ill. They will also see nurses running about with their gloves on. Hand hygiene is important for them, but we need to drive it a wee bit harder from the ministerial point of view and the local hospital point of view, to ensure that it happens.

Publishing data on hand hygiene compliance is a simple first step in improving hand hygiene, which is essential to raising standards of infection prevention and control in the NHS. It will save lives and money, and we cannot afford further delay. The UK and the NHS have been at the forefront of worldwide infection prevention and control strategies since the early 2000s. While a good deal of progress has been made since then—we welcome that progress, some of which has been significant—there is much work to be done to realise the Secretary of State’s ambition: that the NHS will be the safest health service in the world. We should strive to be the best. In many cases, we are the best, but we can certainly do better. The role of good hand hygiene in reducing hospital-acquired infections and improving patient safety cannot be overstated. We must also acknowledge that the current method of direct observation in monitoring hand hygiene in hospitals is no longer fit for purpose, and that technology can and should play a role in changing behaviours.

I look to the Minister for his response. I thank all Members for taking the time to come to Westminster Hall on a Tuesday morning to make a contribution. We look forward to those contributions.

[Mr George Howarth (in the Chair)]

I do not propose setting a time limit on speeches. It might be helpful by way of guidance to suggest that if everyone speaks for no more than 10 minutes, it should be possible to accommodate everyone who has indicated that they want to speak.

Cable Standards: Fire Safety

Debate between George Howarth and Jim Shannon

Monday 26th March 2018 Commons Chamber

[Mr George Howarth (Knowsley) (Lab)]

I will try to live up to your splendid introduction, Mr Speaker.

Last year’s Grenfell Tower tragedy was, without doubt, one of the most shocking and disturbing building safety failures in living memory. As we know, the likely cause was a shocking failure of our building control regulations, and as a result, the Government established an independent review of building regulations led by Dame Judith Hackitt. A long-overdue national debate about buildings and safety has been taking place alongside the review. In her interim report, Dame Judith rightly stated that Britain’s building regulations are “not fit for purpose”.

I would like to place on record my thanks to the Safer Structures campaign, Electrical Safety First, the Association of British Insurers, the Fire Brigades Union and the Merseyside fire and rescue service for providing me with a briefing for the debate.

The focus for Grenfell Tower is on the specification and installation of the cladding used on the building. This debate concerns the need to eradicate substandard cabling from the market, because there is an overwhelming argument that our existing regulation is too weak and, as a consequence, exposes structures and those who live and work in them to unacceptable levels of risk.

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. Gentleman on securing this salient debate. Does he agree that, with electrical fires being the cause of 20,000 fires in United Kingdom homes per year, we have a duty to ensure that people are able to check their cabling and understand how to do so to ensure that it is safe, for not only the people themselves but the councils, which have responsibility?

[Mr Howarth]

I am grateful to the hon. Gentleman for his intervention, and I will be giving some statistics that exemplify what he just said.

According to the Approved Cables Initiative, more than 27% of all electrical fires are attributable to faulty wire and cables, and there are serious concerns about the risks in our built environment that need to be urgently addressed.

A related concern is that current regulation is not being sufficiently well enforced. For example, in October 2017 the BBC published evidence from an investigation it carried out which exposed the fact that a now-defunct Turkish cable manufacturer, Atlas Kablo, has sold 11 million metres of cable to the UK that pose a deeply concerning fire risk. The Health and Safety Executive, which labours under severe resource restrictions, decided against a compulsory recall of all 11 million metres of that cable. Consequently, as far as I am able to ascertain, so far only 7 million metres has actually been recovered. That poses a real fire safety threat in cases where that cable is still being used.

Interviewed by the BBC, Sam Gluck, the technical manager at the electrical fire consultants Tower Electrical Fire & Safety, said that this approach had

“planted a bomb in the system”.

Mr Gluck added that

“if it overheats, it will ignite anything that touches it. If it’s against a plasterboard wall that will ignite”.

Dr Maurizio Bragagni, chief executive of Tratos—it has a factory in my constituency—and a founder of the Safer Structures campaign, added that

“it could be in any shopping centre, any venue, any building”.

Even where cable regulation is properly enforced, the standards are too weak. By way of background—the Minister will be aware of this—on 1 July 2017, the European Union introduced the construction products regulation. As a result, all cables sold in the EU now have to adhere to common standards, which should result in safer, more consistent building regulations and much improved public safety. The EU, however, has not been prescriptive in specifying which classification of cable performance should be used for buildings and infrastructure in each country. Instead, it is the responsibility of each EU member state’s regulator to decide this, and in the UK, this is the Ministry of Housing, Communities and Local Government.

At present, the Department has not specified which class of cable should be used for buildings, and instead requires all electrical installations in buildings to comply with British standard 7671—a minimum requirement equivalent to European class E. This means that flames can spread through a cable to 3 to 4 metres in under five minutes, and the fire will continue to propagate at the same rate, while at Euro class C, for example, the fire growth rate is limited to below 2 metres. On the range of Euro classes A to F, the A standard is virtually fireproof. Adoption of a higher standard at Euro class A, B1, B2 or C would lead to much greater resistance for permitted cables. In short, it would mean much improved levels of fire safety.

The official statistics on domestic fires make for sober reading. In 2016-17, 14,821 primary fires were caused by electrical distribution, space heating appliances and other electrical appliances. These three categories resulted in 44 fatalities and 1,353 non-fatal casualties. Another cause for concern is the electrical safety of white goods such as dishwashers, tumble dryers and fridge freezers, which are a major cause of electrical fires. In 2016, 1,873 fires were caused by domestic electrical white goods.

As you will recall, Mr Speaker, on 1 November 2017 there was an excellent Westminster Hall debate on the subject of product safety and fire risk in residential premises, led by my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick). I will not go over that ground again, other than to say that this is a serious problem and it needs to be addressed urgently.

Analysis by the Fire Brigades Union indicates that the number of fires and fire deaths is increasing. In the year ending September 2017, there were 346 fire-related fatalities compared with 253 in the previous year, which is a 37% increase—and it was even up by 9% if the tragic deaths at Grenfell Tower are not included. An improvement in standards must, by definition, lead to reduced fire deaths, less property damage and lower demands on already overstretched fire and rescue services. We should bear in mind that, since 2010, more than 11,000 firefighter jobs have been cut across the UK, and that represents one in five frontline firefighter jobs.

There are, as I have highlighted, genuine concerns about buildings such as Grenfell Tower and fire safety. I also have serious concerns about the growing private rented sector, which is far too lightly regulated. Electrical Safety First recommended that properties in the private rented sector should be subject to mandatory five-year checks and the fitting of residual current devices. This would enable substandard cabling to be identified, rather than, as at present, leaving it undetected until it causes serious property damage, injury or even death.

The post-Brexit landscape for regulation and compliance must, at the minimum, maintain the current protections afforded to consumers. There should be no deregulation of the product safety standards currently implemented. Following our exit, the UK should continue working closely with European friends to ensure that products entering the UK market are safe, and dangerous products are intercepted and reported.

One further point I want to make before I move to a conclusion concerns regional variations. Merseyside had 53% of its fires recorded as being electrical in origin, which is below the national average. During the same time, Manchester had 61%, and Norfolk, the Isle of Wight and Cornwall had in excess of 70%, of dwelling fires recorded as electrical. Of the 628 incidents defined as electrical fires on Merseyside, 133 were deemed to be “structural/fixtures/fittings”, and cables would fall into that category.

To conclude, I ask the Minister to consider the following questions. First, Dame Judith Hackitt’s review of building regulations must inevitably go through all the evidence thoroughly, and I accept that that will take time. However, in the case of cabling, would the Minister consider introducing immediate measures to properly regulate cable standards along the lines I referred to? The evidence is already there.

Secondly, will the Minister consider providing the resources to enable the Health and Safety Executive to identify the remaining 4 million metres of Atlas Kablo cable so that it can be recalled? Thirdly, will she undertake to see what further action can be taken on white goods to more fully identify the risks and any action that could be taken to eradicate those risks?

Fourthly, will the Minister carry out a review of the regions most prone to electrical fires to identify the common characteristics and what more can be done to deal with the problem? Finally, following our exit from the EU, will she commit to ensuring that there is no deregulation of cable standards in the UK?

I hope the Minister will accept that this is a very serious issue and that it is in need of urgent attention from her Department. I hope she will inject some energy into the work the Government need to do to combat it.

European Union (Notification of Withdrawal) Bill

Debate between George Howarth and Jim Shannon

Committee: 1st sitting: House of Commons
Monday 6th February 2017 Commons Chamber

[The Temporary Chair (Mr George Howarth)]

I call Jim Shannon. Before he starts, may I say that there is one more Member to be accommodated in the time available? I realise that time is tight, but if he could be brief that would be helpful.

[Jim Shannon (Strangford) (DUP)]

I must start by thanking the Government for keeping the promise in the referendum. The Government said that they would listen to the will of the people and, in true democratic form, they have adhered to that. People in the referendum said that they wanted article 50 to be triggered by 31 March. That is part of the exceptional circumstances under which we are operating, and that is why we are debating this matter tonight.

My constituency voted 54% to 46% to leave the EU—

Burma (Persecution of Minorities)

Debate between George Howarth and Jim Shannon

Wednesday 25th June 2014 Westminster Hall

[Jim Shannon]

I thank the hon. Lady. I will comment on that particular incident, which clearly illustrates what we need to address.

Burma Partnership continues:

“And yet, the military regime has not been held accountable for these acts; impunity prevails in Burma.”

In other words, people do it and get away with it, if they are a part of the Government. There is no accountability.

I would like to know clearly from the Minister what discussions have taken place and what the response has been from the Government. Is there accountability in this process? If not, we have to find ways to make them accountable. Why has the military regime in Burma not been held accountable for such acts? What pressure, if any, have the British Government put on Burma so that it desists and takes action to stop those acts?

It has always been known that Burma was religiously intolerant, but that is becoming clearer as an increasing number of stories about the treatment of the Rohingya emerge. The UN believes that, since mid-2012, when sectarian violence broke out, more than 86,000 Rohingya have attempted to flee Burma to neighbouring countries. In 2013, 615 people died during the flight for freedom. It is believed that the outbreak of pogroms against the Muslim Rohingya has left around 140,000 people in squalid displacement camps, a point well illustrated by the hon. Member for Bradford East.

What steps have the British Government taken to help and protect the Rohingya? Are we providing aid to Burma’s neighbours to help cater for the influx of asylum seekers? What medical help is available to those in displacement camps? Is there sufficient help for them in relation to housing and temporary accommodation? There is a risk of disease breaking out; that is bound to happen, in confined places. Have we been able to assist? If not, what can we do?

Another issue that has come to our attention is the theft of land. I said at the beginning that there are large veins of minerals in the country. What international economic pressure has been put on Burma? Ordinary, good peasants who own a bit of land are victimised, pushed and discriminated to hand it over. What is happening about that?

On Friday the 20th of this month, the Burmese Government closed the consultation window on its proposed religious conversion law, to which my hon. Friend the Member for Upper Bann referred a few minutes ago. It would require Buddhist women to seek permission from their parents and the authorities before marrying outside the Buddhist faith. The law states that those people found to be applying for conversion

“with the intent of insulting or destroying a religion”

can face imprisonment for up to two years. Clearly, this is a human rights and an equality issue, and the Burmese Government must respond to it. This law is a poorly disguised form of religious persecution and it will affect those from all religions who are not Buddhist.

Have the British Government had discussions with the Burmese about this proposed law? What steps have been taken to ensure that it is not ratified? What pressure are we applying? When it comes to applying pressure, it is not only the Minister who can do it but all the European countries, as well as the US, by acting together. We must combine and use our collective power to influence the Burmese Government.

This issue has been discussed in Parliament before and it has now raised its head again. Would the Government care to give more information about how British taxpayers’ money is being spent on training the Burmese army? In introducing the debate, the hon. Member for Bradford East mentioned that subject—the training that the British Army gives the Burmese army. We find out through reports and other information that the Burmese army have subsequently been involved in atrocities—vile, evil, wicked atrocities—against the ethnic groups across Burma. We get annoyed that our Army has trained their army in tactics and that then their army uses those tactics against their own people. There has to be a system whereby we can make the Burmese army accountable for that. Whether such training is for warfare or not, do the British Government intend to continue working alongside this brutal regime?

In her intervention, the hon. Member for Walsall South (Valerie Vaz) talked about the allegations of systematic war crimes. Burma Campaign UK, a human rights group, has produced a report called, “Rape and Sexual Violence by the Burmese Army”. Within the Burmese army, there is clearly a systematic and orchestrated campaign of attacks on women and young girls, such that rape and sexual violence are the norm rather than the exception. This Parliament has taken a strong stance on this issue. Through early-day motions and other contributions, we have urged that more action be taken right across the world to combat such violence.

I will give an example of what has happened in Burma. Since January, there have been fresh allegations of rape against the small number of Christians in the Kachin province; Christians there are being brutally denied their rights, too. The hon. Lady referred to the case of the 17-year-old girl who was raped by two Burmese army soldiers. Again, there is no accountability for that. Such people seem to have immunity from prosecution and from accountability for their actions, and I certainly feel strongly about that.

Christians are one of the other minorities who face severe persecution in Burma. Release International reports that many Christians there still have to engage in forced labour, that huge numbers of them have been removed from their homes, and that rape is used as a weapon of war against minorities. Christians in Burma have had to deal with the Burmese Government’s catchphrase, “To be Burmese is to be Buddhist”, and Christianity is commonly referred to as the “C-virus”. Christians are denied the right to maintain and build places of worship, as my hon. Friend the Member for Upper Bann said earlier. When they do maintain or build places of worship, the buildings are often burned down. In Karen state, Buddhist propaganda is played during Christian services and Christians in the military or Government are denied promotion. Clearly, we have many concerns about all of that.

In Kachin province, some people practise Christianity; it reflects their language and culture in what is predominantly a Buddhist country. Kachin province is rich in jade and timber, but Christians there have stated that they are fighting for their culture and history. They are also fighting for their lives against a Burmese army focused on trying to destroy them.

The Burmese army broke a 17-year-old ceasefire on 11 June and since then up to 1,000 people have been killed or injured, while another 120,000 people have been displaced from Kachin province. Some have fled to China; others have sought shelter in refugee camps elsewhere throughout the region. Clearly, there are a number of places in Burma where there are abuses of human rights, which affect not only the individuals involved but their families.

The Kachin leader is General Gun Maw, who is also the chief negotiator. He had a meeting in Washington with President Obama. Talks were held, with great hopes for peace, but peace did not materialise. The uncertain peace was broken by the junta, and that has cast a dark shadow over Kachin province and the way forward.

There have been multiple recordings of the issues in Burma. I will quickly quote Human Rights Watch:

“There have been long standing and well documented reports for many years that the Burmese army perpetrates widespread sexual violence against women and young girls in ethnic conflict areas, often with utter impunity and denials. The Burmese government’s admission that it had investigated and punished eight perpetrators”—

just eight—

“from the military is obviously a fraction of the scale of this repugnant practice, and the Burmese military has a long way to go in tackling this problem and reigning its rampant troops in to accord to the rule of war.”

They also have to teach their troops what is right and what is wrong. Human Rights Watch continued:

“Even Ban Ki-moon recently called for an investigation by the Burmese government into sexual violence in conflict.”

When a country’s army is engaged in something as odious as sexual violence, it is time that its troops were held accountable too. The issue also brings into question our relationship with Burma, particularly in relation to our training of their troops. Action has to be taken in all cases of sexual violence and reports of prosecution of offenders in courts should be published.

Burma Campaign UK has said that last year 133 Burmese civil society organisations wrote to our Prime Minister about Burma, but they have not had the response that they had hoped for. I hope that today the Minister can give us some indication of the way forward.

In conclusion, this abuse that I have talked about is just the tip of the iceberg. We are greatly troubled by it, and we seek the Minister’s response and thoughts on how we can go forward in a constructive fashion. What can the EU do to assist us to help the Burmese people? What is the United States of America and its Government doing to ensure that we can address these issues together? What are the Burmese Government doing to protect Christians and other minority groups in Burma? What steps can be taken to ensure that Burma complies with international standards of human rights?

[Mr George Howarth (in the Chair)]

It might help if I point out that a considerable amount of time is available to the two Front-Bench spokesmen. They are not obliged to use it all, because there is a provision for me to suspend the sitting until 11 o’clock if we happen to finish early. It is their decision, not mine, whether to use the time.