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PhilHunt2015.jpgPhilip Hunt on the need for greater public awareness of a killer in our midst

Today, the House of Lords will debate a huge but largely unknown killer in our midst: sepsis. More common than heart attacks, this affects quarter of a million people every year. A staggering 43,000 adults and 1,000 children die annually from sepsis but few people are even aware what it is, let alone the symptoms.

Sepsis occurs when the body damages its own tissues and organs by overreacting to an infection. The people most at risk are those undergoing surgery or treatment that lowers immune systems, those with long-term conditions (for example, diabetes or HIV), the very young or old, or pregnant women. It can also however, affect anyone who gets an infection.

Simple, timely interventions can halve the risk of dying from sepsis. Treatment usually involves antibiotics, giving fluids intravenously and oxygen. Even if you survive, there can still be long term complications, including amputation, irreversible damage to the heart, lungs or kidneys, cognitive dysfunction or post-traumatic stress disorder.

The earlier sepsis is identified, the easier it is to treat. Unfortunately, many sufferers are not given priority when they go to A&E. Far too often, a patient is not diagnosed or tested quickly enough.

For every hour’s delay in initiating life-saving therapy for someone with sepsis shock, the risk of death rises by 8%. The pioneering organisation, UK Sepsis Trust estimates that if the symptoms are noticed and treated sooner, as much as £2.8bn could be saved and 14,000 deaths would be prevented.

Since the Birmingham based Trust began work under the inspired leadership of Dr Ron Daniels, progress has been made. New NICE guidelines have been issued, and with government support, there has been a launch of a public awareness campaign on sepsis in children.

But much more remains to be done, and there needs to be a step change in the diagnosis of sepsis. Education programmes for healthcare professionals are urgently needed to make the quality of care consistent across the UK. There is too much of a postcode lottery at present.

It is also essential to have a nationwide campaign for adults who make up the overwhelming majority of victims. This need not be expensive in comparison to the £15.8bn that sepsis is costing our economy each year, yet it could reach millions of people. We also need the NHS to change the way it records sepsis. Better data will allow healthcare professionals to diagnose and treat it more quickly. With the right data distributed widely, doctors will be more likely to recognise the condition.

Sepsis causes more deaths than the combined mortality from bowel, breast and prostate cancer, and road accidents. Yet it is simply not a priority for the NHS. Today’s debate, prompted by Lord Grade, is an ideal platform for Ministers to put this right.

Lord Philip Hunt of Kings Heath is Shadow Health Minister in the House of Lords. He tweets @LordPhilofBrum

Thursday 14th September 2017

Sepsis

Philip Hunt on the need for greater public awareness of a killer in our midst

Angela_outside_Oct2016.JPGBaroness Angela Smith speech to the House of Lords 

Let me begin by thanking the Government for ensuring time for today’s debate. The Government is responsible for the business of Your Lordships House so we appreciate the efforts of the Chief Whip and the Noble Lady, Lady Anelay efforts to engage the House. I’m not so sure I agree with the NL when she said last week that the government was being ‘generous’ with this debate but we’re agreed that it is essential.

With talks well underway, it is clear that these position papers are really important documents. It would not normally be acceptable to publish so many key papers when Parliament is in recess, but we understand the time constraints. Can I also say to the Noble Lady that I welcomed our brief conversation earlier about the better sharing of information and improving the opportunities for effective engagement.

Our concerns about this have been reinforced by the EU Withdrawal Bill.  That will come to YLH in due course, but the very serious anxieties about the engagement and sovereignty of Parliament have been clearly set out by my colleagues in the Other Place. That Bill perpetuates the notion that Government sees Parliament as an irritant to which they occasionally need to pay homage; and that Parliament is only interested in tying Government’s hands in negotiations.

We have had little reporting back from the rounds of negotiations from the Secretary of State and the Lords European Union Committee is continuing to find it difficult to get him to appear.  

The NL knows that YLH has been the primary body in Parliament to scrutinise EU legislation and many members have significant expertise that could and will be helpful to the Government. Let’s be clear, it is only through discussion and scrutiny that we can get the best out of these negotiations. The Secretary of State should therefore view our committees and YLH as a useful resource, and not something to be endured when he has the time.

We on these benches appreciate that this is a difficult process but we are concerned about the slow rate of progress in the negotiations so far.

By now, we would be expecting there to be emerging consensus on key issues, allowing formal agreements to be reached when we embark on the final round of phase 1 talks in October. Clearly it is not straightforward in some areas – not least Northern Ireland – but I know I speak for many in YLH when I say it feels like we’re failing to make substantial progress. 

We welcome that there are issues where both parties are moving towards an agreement and accept the need for both sides to reach a detailed understanding of the others’ position. But how long does the Government expect this exploratory phase to last? The clock is ticking and we need to move quickly to detailed negotiation and then to agreement. We seem a long way from that, other than on a small number of important but second-order issues.

And I hope she can also say something today about the real worries that Government’s position in negotiations is hampered by an irrational doggedness in rejecting a European court that would arbitrate in disputes between the EU and UK?

Divorces are never easy, especially after a long marriage, and when both parties want to remain on friendly terms afterwards, and especially when there are children involved. So it was inevitable that as the referendum reduced a complex and complicated issue to a simple yes or no on a ballot paper, the arguments were similarly reduced.

It was soon accepted that £350 million a week for the NHS wasn’t going to happen. But it was easy to understand. Certainly much easier than extolling the virtues of regulatory alignment, nuclear safety, trade agreements and policy for example.

But promises that Brexit would be easy and straightforward were far more deceptive.  Let’s look at some examples:

  • Michael Gove boldly declared that: “the day after we vote we hold all the cards and we can choose the path we want”.
  • Boris Johnson, assured us all that: “there will continue to be free trade and access to the single market”.
  • Liam Fox, now international Trade Secretary told us that a deal with the EU, would be: “one of the easiest in human history”.
  • And even David Davis told us to: “be under no doubt, we can do deals with our trading partners and do them quickly”.

If only. I really wish this were so. I wish they had all got it right and that was the position.

Unfortunately, ministers now need to understand that we don’t hold all the cards. Brave utterances about what we want are misleading, and they look foolish when they change their minds so often.

The Foreign Secretary having told the EU to “go whistle” if it wanted the UK to pay a divorce bill, within weeks had to eat his words and confirm that the UK will indeed meet its financial obligations. Pretending that complex negotiations are easy is doomed to failure. And none of us want to even contemplate that.

The Prime Minister’s mantra that “no deal is better than a bad deal” is irresponsible and dangerous. Neither outcome would be acceptable. Neither were promised by ministers. A good deal for the UK has to be worked at. We need wise negotiators and understanding and compromises on both sides.

Michel Barnier has praised the hard work and dedication of the UK negotiating team and I join him in that. Our negotiators are doing a difficult job under difficult circumstances, and in some cases are operating without a clear direction.

It is complex, it is complicated. That is why we welcome publication of these papers. But part of the problem is that the position papers were slow in coming forward and in some cases are pretty flimsy on detail.

For the Secretary of State to describe the track and trace proposal in the Government’s customs paper as “blue sky thinking” was as embarrassing as it was puzzling.

It’s a bit late to throw ideas up into the air and see where they fall.  It’s crunch time. Talks are happening – the sand is flowing through the timer. Our negotiators, as hard-working as they are, need clear positions to present to their counterparts.

But I do have some sympathy for the Secretary of State with the pressures on the forthcoming negotiating rounds, which is why he should seize on our support for a transitional period.

With just 18 months to go, the notion that we can negotiate a bespoke transitional deal that takes us out of the Single Market and Customs Union, and then to continue to negotiate a final long-term arrangement, and have all other trade agreements in place without falling off a cliff-edge is more suited to Peter Pan’s Never Never land than the UK.

It’s an even more unrealistic proposition if, as expected, Phase 1 talks are not closed in October, resulting in the all-important Phase 2 talks being pushed back.

A transitional deal within the Single Market and Customs Union has widespread support from across politics and business, because it is practical common sense. Businesses are making decisions on jobs and investment now. Some will be forced to implement contingency plans if they do not get answers in the very near future.

It was therefore significant that the CBI – not a Remain campaigner – has said that “remaining in the single market until a free trade agreement is in force is the simplest way to secure continuity for business operations.” And I’m grateful to the CBI for their briefing and for the examples they give as to the impact of no transitional deal, or one outside the Single Market and Customs Union on small and medium size businesses.

A comprehensive transitional arrangement is needed because businesses will be making investment and relocation decisions in the coming months. And following the transition agreement, negotiations should continue from where we are now.  For the Government to rule out certain options from the start, is to go into negotiations with one arm tied behind our backs. It may be an ideological position but it’s not a rational one when trying to get the best possible deal for the UK.

Looking at the papers published so far, it is impossible to deal with all of the issues in the papers published to date, including the today’s one on Foreign Policy, Defence and Development in the time available. But such debates will be helpful to the Government given the expertise and experience of NL. I have a few general comments and suggest a way forward:-

On EU nationals, when the Government published its paper in 26th June on EU nationals, it was like it was starting from the beginning, rather than responding to the EU paper from 29th May.

YLH offered the opportunity to resolve this issue early on, but despite the Government promising it was a priority, little progress has been made, and such a sensitive issue clearly impacts on wider negotiations.

It’s affecting EU citizens living here, UK citizens living in the EU and in a number of ways already affecting business, services and individuals in the UK. The position paper doesn’t really take us any further forward. Progress in areas such as healthcare and pensions is welcome, but a number of major questions still remain.

On Northern Ireland is one of the most complicated issues in the negotiations – and certainly the most sensitive – is the Irish border. My NL Lord McAvoy and also Noble Friends and former Secretary of States Lord Murphy and Lord Hain have consistently and continually raised this issue. We welcome the commitment of both the Government and the EU to address very complicated questions, but the EU is clear that the onus for presenting proposals for the future of the border is on the UK. This will require the Government to move beyond ‘blue sky thinking’ in areas such as customs and put forward a concrete and workable proposal on the table.

The publication of position papers and the EU Withdrawal Bill has once again highlighted the Government’s difficulties regarding the devolved administrations. It is essential that Ministers fully and effectively engage with them and recognise the constitutional, the practical, and the moral necessity of doing so.  There remain a number of outstanding issues that must be resolved.

It is essential that the PM earns the respect and understanding of those who hold influence in the process or are most affected by the referendum result. It’s reported that the PM has declined an invitation from the President of the European Parliament to attend a full public session, instead opting for a behind-closed-doors meeting with a select few. And back in January, the PM declined an invitation from the Irish Parliament – an invitation that was also extended to, and accepted by, Michel Barnier.

We all understand the difficulties, but it is the responsibility of the PM to ensure that our negotiations are against a backdrop of co-operation, and rejecting such invitations may not be at all helpful.  If NL can enlighten as to why, it would be extremely helpful.

On looking and planning ahead, whenever YLH has debated, expressed an opinion or passed an amendment on this issue, it has brought howls of protests – and worse - from some of the most ardent Brexiteers. My Lords, we are clear about our constitutional role and responsibilities. You could say – we know our place, we know our limits – and we also know that YLH has always mindful of the constitutional role of Parliament as a whole including the Primacy of the House of Commons, which is very different to the Primacy of the Executive.

There will be opportunities for YLH to discuss the Withdrawal Bill later and I hope that the Government will also reflect on this as the Brexit debates progress. Our Constitution Committee has expressed its “considerable regret” that the Bill has been drafted as it is, leaving many fundamental constitutional questions “unanswered”.

For a referendum fought on the principle of parliamentary sovereignty, I know many in YLH are bewildered by the scale of the power grab being attempted by ministers. Throughout the history of the 20th Century, no Bill has ever sought such powers before – not even during wars or civil emergencies. So we shall follow the debates in the Other Place with great interest.

In conclusion, we welcome the publication of the Government’s papers over recent months, but we still lack a clear strategy. For all the talk of a deep and special partnership with the EU, or of building a truly global Britain, we are yet to see a clear roadmap.

A roadmap, that doesn’t send us hurtling over that cliff edge, but guarantees the full engagement of the devolved administrations, outlines how relevant organisations, including employers organisations and trade unions, will be formally involved, and commits to interim arrangements that offer genuine certainty to businesses, consumers and workers alike.

It would be helpful if NL and Chief Whip to consider how future papers will be treated. Where possible, it seems only right that Parliament be given an opportunity to debate their content, whether in response to a formal ministerial statement or in a debate, as we do with EU Committee reports.

YLH is here to help. Debate on such issues will be an important contribution to the negotiations that the Ministers have and hopefully the experience of this House will be welcomed. I hope ministers will now accept this and choose to avail themselves of all that Parliament has to offer.

-Ends-

Baroness Angela Smith of Basildon is Shadow Leader of the House of Lords. She tweets at @LadyBasildon

Published 12th September 2017 

Speech in debate on Government's post-Brexit 'position-papers'

Baroness Angela Smith speech to the House of Lords 

PhilHunt2015.jpgPhilip Hunt on the scandal of high interest rates for student loans

Just what does the government have against university students? If trebling tuition fees, and then further raising the limit to £9,250 is not enough, they’ve now hiked the rate of interest on student loans by up to a third.

English undergraduates already pay the highest fees in the industrialised world. Even Universities UK, whose members and their Vice Chancellors have benefited the most from this sorry state of affairs, have urged Ministers for a review.

Monthly student loan repayments are linked to income not interest rates, so the main impact of the hike will be to prolong the repayment period and run up a massive debt. The Institute for Fiscal Studies (IFS) calculate that students from the poorest backgrounds will accrue debts of £57,000 for a three year degree.  

Outstanding debt is cancelled after 30 years and the IFS has estimated that 75% of former students will never repay the full amount. But over such a long period, significant payments have to be made with such debt often being the root of anxiety and depression.

The interest rates vary in relation to when a graduate studied and how much they earn. Since 2012, they have been fixed at 3% plus RPI, which since March has been 3.1%. From this month therefore, current students (along with some former ones) will be paying 6.1%.

Those with salaries from £21,000 to £41,000 or more will pay back their loan and accrue interest on a sliding scale – with the highest at 6.1% per cent, up from 4.6%. At the same time, those starting university between 1998 and 2011 will only be charged 1.25% per cent, and based on whichever is lowest: RPI or the Bank of England rate plus 1%. And students who entered university before 1998 will see their rate doubled to (3.1%) because it is tied to RPI – albeit still half of what post-2017 students will pay.

The use of RPI as the rate setter has become more questionable (as with its application to rail fares). Not least as CPI, used to calculate benefit and pension increases, is a much better measure of inflation. Indeed, Director-General of the Office for National Statistics, Jonathan Athow has labelled RPI: “a flawed measure of inflation with serious shortcomings.”

As a result, students starting this year will accrue an average of £5,800 in interest charges by graduation. Debt will increase and even less will be paid off at the end of 30 years. Meanwhile, universities will carry on regardless. So, in the Lords today, I will ask the Minister if – as a starting point for a major reform of this failing system – the government will not only cut the rate of interest but also cease its application to those students still at university.

Lord Philip Hunt of Kings Heath is a member of Labour’s shadow ministerial team in the House of Lords. He tweets @LordPhilofBrum

Published 11th September 2017

Sorry state of affairs

Philip Hunt on the scandal of high interest rates for student loans

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