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11.32 am

The Secretary of State for Foreign and Commonwealth Affairs (Mr William Hague): With permission, I will make a statement to update the House on the crisis in Syria—a crisis that is still intensifying.

Some 60,000 Syrians are now believed to have died, 600,000 people have become refugees, 2 million are internally displaced and 4 million are in desperate need. To illustrate the true horror of the conflict, 1,000 civilians were reportedly killed in one six-day period over Christmas. On Christmas day, opposition activists reported that 17 people were executed at a checkpoint in the Damascus suburbs, nine of them from one family. The regime has used Scud missiles to target populated areas and deployed cluster munitions. Entire urban districts have been reduced to rubble in cities such as Homs and Aleppo. I know that the House will join me in expressing our solidarity with millions of courageous Syrian people in the face of this appalling brutality.

We continue to believe that the best way to end the bloodshed and to protect all Syria’s communities is through a political transition. Our country has a moral obligation to help save lives in Syria and a national interest in ensuring that the country provides no haven for terrorist activity. We know that to achieve lasting stability we must work with the Syrian opposition and countries of the region, not try to impose a political settlement from outside, and we are determined that all our actions will uphold UK and international law, and support justice and accountability for the Syrian people themselves.

In the coming weeks we will focus on six principal areas. First, we will intensify our diplomatic efforts to reach a political transition. We are actively supporting the efforts of the UN-Arab League special representative Lakhdar Brahimi, who has travelled to Damascus, and to Moscow for talks with the Russian Government, and who is due to hold trilateral talks with Russia and the United States this week. My ministerial colleagues and I are in regular contact with him and expect to hold further talks with him in London later this month. Our goal remains to persuade Russia and China to join us in putting the full weight of the UN Security Council behind a political transition plan for Syria.

Secondly, we will continue our work to help the Syrian National Coalition to develop its plans for the future of Syria. Since I last updated the House, I have attended the Friends of Syria meeting in Marrakesh, where the US and many other countries followed us in recognising the National Coalition as the sole legitimate representative of the Syrian people, and where $150 million was pledged to support the humanitarian effort. The coalition is enlarging its membership to include Christian, Kurdish and other minority communities. At a meeting in Istanbul this week, we saw encouraging signs of the coalition making every effort to broaden its support further and build on its legitimacy, although much work remains to be done.

We are working to strengthen moderate political forces in Syria committed to a democratic future for the country. We have provided £7.4 million of non-lethal support to the Syrian opposition, civil society and human rights defenders, and I can now announce that

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we will provide an additional £2 million of support, bringing the total to £9.4 million. All our assistance is designed to help to save lives, to mitigate the impact of the conflict or to support the people trying to achieve a free and democratic Syria. It includes solar powered lighting, generators, communication equipment and water purification kits to help opposition groups, as well as satellite communication devices for activists to document human rights violations and abuses so that one day the perpetrators of appalling crimes can be brought to justice.

Our assistance also involves support for local-level administration councils providing services to Syrian people during the conflict. We have given training to more than 300 Syrian journalists who are striving to develop alternative sources of media and freedom of the press in Syria, and we are training activists who are working to create a network of peace-building committees across five cities in Syria. We are also helping the National Coalition to co-ordinate the international humanitarian response, and we have provided a humanitarian adviser to work with it. At all times, we urge the coalition to ensure that all opposition groups meet their commitments on human rights.

Thirdly, we will continue to increase the pressure on the regime to stop the violence. In December, we argued that the EU sanctions regime on Syria, including the arms embargo, should be rolled over for three months until 1 March, rather than for 12 months, so that there would be an earlier review of it. We secured that position. We believed that it was important not to freeze EU policy for a whole year just as a new opposition coalition was being launched and while the conflict was intensifying on the ground.

No decisions have yet been made to change the support that we provide to the Syrian National Coalition or the Syrian people. However, European countries now have the flexibility to consider taking additional steps to try to save lives if there is no progress in the near future. Clearly, the best outcome for the Syrian people would be a diplomatic breakthrough, bringing an end to the bloodshed and establishing a new Syrian Government able to restore stability. However, we must keep open options to help save lives in Syria and to assist opposition groups that are opposed to extremism, if the violence continues. We should send strong signals to Assad that all options are on the table. We will therefore seek to amend the EU sanctions so that the possibility of additional assistance is not closed off.

No one can be sure how the situation in Syria will develop in the coming months. There is no guarantee that Mr Brahimi’s efforts to mediate will be successful. President Assad’s speech last week urged the Syrian people to unite in a “war” against his opponents. Given the regime’s intransigence and brutality, there is a serious risk that the violence will indeed worsen in the coming months. If that happens, the international community’s response will have to be stepped up. So we will not rule out any options to save lives and protect civilians in the absence of a political transition in Syria. We will ensure that our efforts are legal, that they are aimed at saving life and that they support at all times the objective of achieving a political transition and encouraging moderate political forces in Syria; we will keep the House properly informed.

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Fourthly, we continue to increase our life-saving humanitarian assistance to the Syrian people. The United Kingdom is the second largest bilateral donor to UN relief efforts, supporting more than 100,000 people across the region with food parcels, blankets and warm clothing. On 21 December, my right hon. Friend the International Development Secretary announced a further £15 million in humanitarian aid, bringing our total support to £68.5 million so far. Hon. Members will have seen images of Syrian refugees struggling with rain and cold in refugee camps across the region. The latest £15 million of funding will be used to provide food, clean water, blankets and shelter to help Syrians to cope with the misery of these winter months, as well as medical supplies to treat the sick and wounded since so many Syrian medical facilities have been destroyed, and armoured vehicles to enable humanitarian agencies to deliver aid safely inside the country.

The UN has appealed for $1.5 billion for the first six months of this year. This is the largest ever short-term UN appeal, but it remains seriously underfunded. At the donor conference hosted by Kuwait and the UN Secretary-General later this month, we will again call on other countries to pledge the additional humanitarian aid that is desperately needed.

I pay tribute to the 26 humanitarian workers who have been killed in Syria since the fighting began, and deplore the rise in attacks on medical facilities that are contrary to international law and an affront to basic humanity. We urge all parties to stop the violence and allow humanitarian agencies to deliver assistance safely and without interference, in accordance with international law.

Fifthly, we are continuing detailed planning for how we can help a future Syrian Government deal with the many challenges Syria will face during a transition. This process must be led by the Syrian people, but they will need help from the international community as they repair schools, roads and hospitals destroyed during the conflict, and restart their ravaged economy. Today we are hosting leading members of the Syrian opposition and representatives of 14 countries and international organisations at a Wilton Park conference designed to advance detailed planning of that support, including on political reform, security, institution building and the economy.

Sixthly, we are supporting UN efforts to document and deter human rights abuses in Syria. The Human Rights Council’s commission of inquiry on Syria published its latest report on 20 December. It shows that the human rights violations highlighted in its previous reports are continuing unabated. We will continue to do all we can to support its work, and we are providing specific leadership in efforts to confront rape and sexual violence in Syria. We have deployed experts to the region to provide training in how to respond to reports of sexual violence and to improve the prospect of future investigation and prosecutions—and we will urgently intensify this work.

We are also urging the Syrian National Coalition to commit itself to ensuring justice and accountability for the Syrian people, including by drawing its attention to the right of a future Government in Syria to refer

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the situation to the International Criminal Court, even though some members of the UN Security Council are blocking that option at present.

So this is our approach: intensifying our efforts to forge agreement at the UN; pursing a political transition on the ground, while ruling out no options to save lives if the situation deteriorates; supporting the opposition and the Syrian people; increasing the pressure on the regime and being prepared to do so in new ways if necessary; working to deter human rights violations and abuses; and planning to help Syria to get back on its feet once the conflict comes to an end. The Syrian people are enduring unimaginable suffering. They are at the heart of this crisis: their future is at stake, and our country and the world must not abandon them.

11.43 am

Mr Douglas Alexander (Paisley and Renfrewshire South) (Lab): I thank the Foreign Secretary for advance sight of the statement and I am grateful to him for updating the House this morning.

It is a matter of profound regret that the biggest single change we have seen since we last debated Syria in the House is simply the number of casualties. As the Foreign Secretary made clear, the United Nations estimated on 2 January that the war’s death toll has exceeded 60,000, of whom about half are thought to be civilians, and it predicts that the death toll will increase at a rate of 5,000 a month. The United Nations Arab League envoy Brahimi recently warned that as many as 100,000 people could die in the next year if a way cannot be found to end the country’s civil war. He described the situation as nothing less than the descent of a country into “hell”.

The scale of the suffering is such that an effective set of actions is required, so let me turn to the four substantive points in the Foreign Secretary’s statement. First, on diplomatic efforts to reach a political transition, the continued stalemate in the UN Security Council is beyond regrettable—it is utterly deplorable. Of course the position of the Russians remains central to this impasse, but recent statements by the Russian Foreign Minister, Sergei Lavrov, have suggested a possible shift of attitudes in Moscow. There is therefore a heavy responsibility not just on Lakhdar Brahimi, but on all P5 countries, including the United Kingdom, to try to break the present logjam. So does the Foreign Secretary accept that, rather than loudly condemning the Russians, a better course would be to talk to them quietly about how common ground can be established on the process of political transition in Syria? Will he tell the House when he last spoke to Foreign Minister Lavrov and when he is scheduled to speak to him next about the critical issue of Syria?

Secondly, may I ask about support for the Syrian National Coalition? Any diplomatic support that the Government can offer to the SNC to encourage it to draw up a credible transition plan for Syria is indeed to be welcomed. In that spirit, the Opposition welcome the conference that is taking place in Wilton Park, which is doing just that, and note the additional funding that has been announced today. However, can the Foreign Secretary set out what he believes are, and remain, the principal barriers to unity which have, to date, prevented the Syrian Opposition from uniting on that credible

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transition plan? We welcomed the Geneva plan that was drawn up last summer, but does the Foreign Secretary agree that, currently, neither side of the conflict in Syria appears to be committed to implementing it? Will he tell the House whether he is still encouraging the SNC to accept the Geneva plan as a basis for transition?

Thirdly, let me turn to the central issue in the statement, the current arms embargo and EU sanctions on Syria more generally. I note all that the Foreign Secretary said with continuing concern. May I urge him to provide more detail on the following matters? Will he set out, as far as he is able, the Government’s latest assessments of the role of al-Qaeda and other extremist organisations now operating in Syria? Given what he said in his statement, does he accept that Syria is currently awash with arms? Does he recognise the grave and continuing difficulty of guaranteeing the end use of weapons supplied to Syria, given the present uncertainty about the identity, intent and, indeed, tactics of some of the rebel forces? Does he accept that it is perfectly possible that, if Europe were to decide to arm the rebel forces, the Russians would simply increase their own supply of arms to the Assad regime? May I also ask him—not least in the light of recent comments by the Foreign Affairs Committee in an important report—what would encourage him to believe that intensifying the conflict would reduce the present appalling level of suffering of the Syrian people?

Finally, let me turn to the humanitarian consequences of the current violence. Last October I visited the Zaatari refugee camp on the Jordanian-Syrian border, one of many such camps that have been set up to house the fast-growing number of refugees who are fleeing the violence in Syria. During my visit, the aid workers to whom I talked warned of the onset of winter and of worsening conditions on the ground. Their worst nightmares have now been realised. Only this week, aid workers in the camp were attacked by refugees after fierce desert winds and torrential rains had swept through and devastated their tents. There are warnings of a major snowstorm later this week, which will bring even deeper misery to those who are already desperate.

The latest figures from the UN Refugee Agency show that 597,240 people have registered or are awaiting registration with the agency in Turkey, Lebanon, Jordan, Iraq and Egypt. The latest reports from the UN state that £620 million of aid is now needed to help Syrian refugees in countries around the middle east, while £312 million was required to help refugees in Jordan alone. Given the Foreign Secretary’s statement this morning that the UN appeal “remains seriously underfunded”, what steps will he and the Prime Minister take to help to secure those additional funds from the international community before the vital meeting that will take place in Kuwait later this month?

The principal responsibility for the appalling suffering being endured by the Syrian people rests, of course, with Assad and his brutish regime. Last week, in his latest speech, he once again demonstrated a truly callous disregard for human life by expressing no real intention of helping to bring the conflict to an end or to take responsibility for its beginning. However, the burden of responsibility on the international community remains a heavy one. The Opposition believe that, rather than directing their efforts towards intensifying the conflict, the British Government should continue to focus on

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building international agreement around an inclusive post-Assad Syria and meeting immediate humanitarian needs. I ask the Foreign Secretary, not least in his capacity as a distinguished parliamentarian, to guarantee to the House that we will be consulted again before any change is made in the present approach.

Mr Hague: I am grateful to the right hon. Gentleman for his remarks, which illustrate that there remains a strong degree of unity on this terrible crisis across the House. I reiterate that I will continue to provide regular updates to the House; I think this is the seventh statement I have made on Syria recently. If there were to be any change in Government policy, I would, of course, bring that to the House.

The right hon. Gentleman rightly referred to what Mr Brahimi said about the possibility of 100,000 deaths this year. That underlines the worsening nature of this crisis. It is not just a continuing crisis; it is a worsening crisis. We have to look at everything we do in the light of that. We are doing a great deal, as I set out in my statement, but we must always be open to doing more and be open to ideas for doing more. We approach this issue in that spirit.

The right hon. Gentleman asked questions on four general areas. On the diplomatic situation, he asked, a bit pointedly, why, rather than condemning Russia, we do not talk to the Russians quietly. We do a great deal of talking to them quietly—we do that on a pretty much continuous basis—but that does not mean that we do not give our public views about their votes in the UN Security Council from time to time. I last met the Russian Foreign Minister for a substantial discussion about Syria in Dublin on 6 December, and I have invited him to visit London in the near future, so our contact with the Russians on this issue is pretty continuous. There has not been a substantial change in the Russian position, although there is, perhaps, a greater Russian interest in renewed discussions. The trilateral meeting between Mr Brahimi, the US and the Russians this week is further evidence of that. We will absolutely keep discussing the diplomatic way forward, based on the Geneva communiqué, which we did agree with the Russians. What we have never managed to agree with them is how to implement the Geneva communiqué. We see the wholehearted involvement of Russia, preferably in a UN Security Council resolution, as being required to bring that about. Russia has not changed its position on that, but we will keep working on it.

The right hon. Gentleman asked about support for the opposition and the barriers to unity. Opposition groups have grown up almost independently of each other, and have not been able to communicate very well on the ground in Syria, and it is therefore difficult to create a united opposition, particularly when some are inside the country and others are outside the country, but the National Coalition is doing a very good job of that—in my judgment, the best job that can be done. There have been well-known difficulties at many stages in bringing in Kurdish representatives, but that has been agreed. It has been agreed that the Kurds will take up a vice-presidency of the National Coalition, but the Kurds themselves have not yet agreed who will fill that position, which serves to illustrate the difficulties involved. The National Coalition is by far the best attempt we have

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seen so far to bring together responsible opposition forces in Syria. That is why we have chosen to recognise it and work with it.

In the right hon. Gentleman’s third set of questions he asked for more detail, but given the chaotic situation in Syria, it is not possible to quantify accurately the number of extremist, or al-Qaeda supporting, fighters in Syria. In the opinion of opposition leaders, they represent a small minority of what is perhaps a six-figure number of opposition fighters, but it is simply not possible to quantify the exact number. In light of any presence of extremists, however, it is important that we try to bring this situation to a conclusion as soon as possible and support moderate political forces. That is what much of our efforts are directed at.

The right hon. Gentleman rightly drew attention to the many hazards in supplying arms into a conflict area. I stress that we have made no change to our policy in this regard. We are trying to build flexibility into the EU position. It is also important to note that the arms embargo as it currently stands prohibits the supply to opposition groups of such items as body armour, helmets and certain types of communications equipment, so its definition of “arms” is quite broad. That must be borne in mind in any future flexibility that we might build in.

The right hon. Gentleman also asked, rightly, about what steps we are taking to encourage other countries to provide more humanitarian aid, as we have done. The Secretary of State for International Development and I are very busily engaged on that. I discussed it with the Arab League secretary-general, Nabil el-Araby, on Monday and I am raising it in all my bilateral meetings with European and Arab countries to try to build up, ahead of the Kuwait meeting, a greater degree of donations. I hope that I have given full answers to the right hon. Gentleman’s questions.

Sir Malcolm Rifkind (Kensington) (Con): The Foreign Secretary has said that the British Government accept a moral obligation to do what we can to save lives in Syria. Against that background, I warmly welcome his statement that the Government are now willing to “seek to amend the EU sanctions so that the possibility of additional assistance is not closed off.” Will he please confirm that that does not exclude the possibility that the Government may, at some stage, be willing to consider providing military equipment that could be used in a defensive way to save lives? He is aware—indeed he referred to the fact—that ballistic missiles had been used by the Syrian Government on several occasions this week against targets in the north. As NATO has agreed to provide and is currently deploying Patriot anti-missile batteries to protect Turkey, would it not be appropriate to consider providing similar support to Syrians, given that these anti-missile batteries cannot kill people—they can only save lives and therefore would be consistent with the objectives of Her Majesty’s Government?

Mr Hague: As I have said, we are not taking any options off the table; we are not excluding any option, given the worsening situation and given that no resolution to it is in sight at the moment. I also stress, as I did to the shadow Foreign Secretary, that we have not changed

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the British Government’s policy on what we will supply, but we are trying to build in the flexibility for the future. The direct answer to my right hon. and learned Friend’s question is therefore that we have not excluded that possibility; indeed, as I was pointing out in my answer to the shadow Foreign Secretary, there are many different categories of military equipment, many of which fall short of being equipment that has a lethal use. Large categories of equipment can be used to save lives and cannot be used offensively. So we have not excluded that possibility and we must keep all options open as the situation develops.

Mr Peter Hain (Neath) (Lab): Does the Foreign Secretary accept that his use of terms such as “flexibility” and leaving “all options” on the table could be a prelude to western-backed military intervention, and that that would be disastrous? The cross-party support for his condemnation of the barbarity of Assad’s regime and for political transition would disappear, because this is a civil war. This is not a barbarous dictator versus his people; it is an increasingly deepening civil war and it will not be resolved by military action.

Mr Hague: Let us be clear that it is a barbarous dictator oppressing his own people. I hope that the right hon. Gentleman will not feel it necessary to argue with something that I have not said; there was no mention in my statement of military intervention, nor any advocacy of that. He is setting himself up to argue with a position that the Government have not taken. [Interruption.] Yes, I am not ruling out options, but I do not think we can do so when we are facing a situation where a six-figure number of people might die this year. It would not be responsible to do that as we do not know how the situation will develop. So I am keeping our options open, but the dangers and drawbacks of military intervention are well understood in the House and in the Government.

Sir Menzies Campbell (North East Fife) (LD): Notwithstanding the terrible brutality taking place in Syria, may I ask my right hon. Friend to exercise the utmost restraint and caution in any extension of policy covered by the expression “all options” are on the table? I do so, first, because this is a civil war, and intervention in civil wars has a long history of failure; and secondly, because there is a risk that we will have a proxy war between Russia and NATO fought out on the streets of Syria by Syrians.

Mr Hague: I am very conscious of the points made by my right hon. and learned Friend and I hope that he will agree on the position we have taken. Although we are trying to help in the mass of ways I set out in my statement, we are cautious, in the light of all the lessons of history. As I was pointing out to the right hon. Member for Neath (Mr Hain), I am not standing here advocating military intervention. So we keep our options open, but that is not some sinister disguise for a change in Government policy; if there were to be a change, I would bring it to the House.

Ann Clwyd (Cynon Valley) (Lab): The Foreign Secretary has spelt it out very clearly that by the end of the year about 100,000 people might be dead in Syria. Will he

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confirm that although Security Council authorisation to use force for humanitarian purposes is now widely accepted, force can also be justified on the grounds of overwhelming humanitarian necessity without a UN Security Council resolution as long as certain criteria are met, such as that it is objectively clear that there is no practical alternative to the use of force if lives are to be saved?

Mr Hague: I agree with the right hon. Lady, as that is our broad understanding of international law. There is, of course, a further argument about the wisdom of such intervention, but in a situation of overwhelming humanitarian need with no clear alternative a strong legal case can be made.

Richard Ottaway (Croydon South) (Con): The Secretary of State has confirmed that from 1 March EU countries will have more room to manoeuvre. Does he agree that the composition of the opposition forces has now become less obvious and that their long-term intentions are less certain? Will he be very careful about who exactly he is helping before providing any extra assistance?

Mr Hague: Yes, of course, and we are very careful about that anyway. Part of the justification for giving the help we have given so far to the Syrian opposition is to strengthen the moderate forces and people who want to see a free and democratic Syria. Let me be clear that the flexibility I have talked about will be in place from 1 March—the whole sanctions regime on Syria has been rolled over only until then. We have not yet agreed in the EU whether or how we will amend the sanctions regime; those discussions will be going on over the next few weeks. The opportunity for flexibility has now been built in by our requesting a three-month roll-over.

Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab): I very much welcome what the Secretary of State says about Britain’s role in delivering humanitarian aid. I also welcome what he says about the European Union. On that point, and on the need to seek a political solution, will he endorse what the EU has done thus far, or does he have any other view?

Mr Hague: The European Union has also been engaged in trying to promote a political solution. For instance, the EU High Representative attended the Geneva talks in June. It is realistic, however, to point out that the diplomatic focus is on the permanent members of the UN Security Council and the Security Council as a whole. It is the work of nation states on the Security Council to try to settle our differences. In that respect, the EU has a more limited role, but there is a strong degree of unity across the European Union and the External Action Service strongly supports the actions we have taken.

Dr Julian Lewis (New Forest East) (Con): Even though the Government are being so helpful to the Syrian opposition, have we sought to extract an undertaking from them that any store of chemical weapons discovered will be handed over for destruction so that it cannot possibly fall into the hands of al-Qaeda?

Mr Hague: Yes, we have very much made that point and my hon. Friend is correct to bring it up. We have made it very clear to the National Coalition that we would expect any future Government of Syria to join and to adhere to the chemical weapons convention and

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the biological and toxin weapons convention. In all the conversations we have had with the national coalition, its horror of the chemical and biological weapons that all the evidence suggests have been amassed by the Assad regime is very clear. I hope that one thing that will happen in a future Syria will be the destruction and disposal of those weapons.

Mike Gapes (Ilford South) (Lab/Co-op): The United States has said that there is a red line if the Assad regime uses chemical weapons, but when the Foreign Secretary meets the Secretary of State designate, Senator John Kerry, as I think he will shortly, will he impress on the US that red lines should relate not just to chemical weapon use, but to the other crimes being carried out by the Assad regime?

Mr Hague: Yes. Our horror at the prospect of the use of chemical weapons should in no way mitigate or minimise our horror at the brutality across the board of the Assad regime. The United States has so far adopted very similar policies to the ones I set out to the House and is also engaged in the humanitarian relief and the provision of similar types of equipment to the Syrian Opposition. Of course I will discuss this in great detail with Senator Kerry over the coming weeks. Nevertheless, it was quite right that the United States—and we joined them in this—sent a particularly strong message to the regime about the use of chemical weapons. It may be that the communication of such a strong message helped to inhibit the use for now of such weapons, so it is right that we send a particularly powerful message on that.

Mr David Burrowes (Enfield, Southgate) (Con): With your generosity, Mr Speaker, and that of the Foreign Secretary, may I ask that we ensure that the resolve not to abandon the civilians on the borders of Syria is matched by similar resolve in respect of civilians on the borders of another country, Burma? I have just received an e-mail from a source in Kachin state that says:

“Five or six fighter jets and helicopter gunships are attacking the areas around Laiza every day. . . IDPs and innocent civilians are terrified . . . they have totally destroyed the peace building process.”

Mr Hague: Thank you, Mr Speaker, for allowing us to go a little wide of the situation in Syria—thousands of miles away. Of course we are deeply concerned about continuing conflicts in Burma, which are at the top of the list of what we raise with the Burmese Government; the Minister of State, my right hon. Friend the Member for East Devon (Mr Swire), who is sitting next to me, was there recently having those discussions. I will look at the report that my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) brings up and we will continue to communicate our views very clearly to the Burmese Government.

Mr David Hanson (Delyn) (Lab): There is a strong Syrian diaspora in the United Kingdom, including in my constituency. What assessment has the Foreign Secretary made of the number of refugees who may want to see Britain as their ultimate destination, and what discussions is he having with his right hon. Friend the Home Secretary to ensure a sympathetic response to any requests?

Mr Hague: The emphasis is very much on helping to look after refugees where they have arrived, as they clearly have in vast numbers on the borders of Lebanon,

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Jordan, Turkey and Iraq, and some of them are now in Egypt. I cannot give the right hon. Gentleman any guarantee about any individuals or any particular number that would be able to come to the United Kingdom, but of course as the situation continues to deteriorate and the numbers continue to mount we will have to keep that under review.

Bob Stewart (Beckenham) (Con): In view of the absence of unanimity among the permanent members of the Security Council, as a result of which instructions to the International Criminal Court are hamstrung, does my right hon. Friend agree that it is a key responsibility of whatever regime follows in Syria to indict alleged war criminals and bring them to trial, rather than pass them to the International Criminal Court?

Mr Hague: A future Syrian Government can do either, as has been the position in Libya. It will be open to them to refer the situation in their own country to the International Criminal Court. It will also be open to them to pursue justice in their own country. We would express the hope that if they do that, they will act in line with international norms and human rights standards, but they can do either. It is up to them to decide in the future.

Keith Vaz (Leicester East) (Lab): Of the 600,000 refugees who fled Syria, 200,000 have ended up in Turkey. Given that last year 100,000 people crossed the border between Turkey and Greece, what specific help is being given to those two countries to deal with the problem?

Mr Hague: Officially, the latest figure for Turkey is 150,000, but there will be other people who are not caught by the official figures, so it is on an enormous scale. Turkey receives some of the assistance I have described. Our assistance is delivered primarily through international humanitarian agencies, which are working in all countries concerned, so it goes through that form. That includes Turkey, as it asked for international assistance. I am not aware of Greece asking for particular assistance. In many such cases people go to live with families, rather than in camps. Wherever assistance is needed, that of course is what the money we are providing is for.

Martin Horwood (Cheltenham) (LD): I strongly welcome the approach of cautious flexibility that the Foreign Secretary has set out but, in the interests of a peaceful and diplomatic outcome to the conflict, are we encouraging or facilitating any communications between the Syrian National Coalition and Russia, perhaps with a view to reassuring the Russians about any future security concerns that might be preventing them playing a more responsible part in resolving the conflict?

Mr Hague: I am grateful to my hon. Friend for welcoming the cautious flexibility, or the flexible caution, whichever he said—either could be applied. We are in favour of all concerned discussing these matters with each other. There has been a growing reluctance among Syrian opposition groups to discuss things with Russia because they are so appalled by its policy towards Syria, but we absolutely encourage discussions between the National Coalition and the Russian Government. That

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ought to reassure Russia, but no such discussions with the opposition over the past 23 months, since the crisis began, have yet produced any change in the Russian position.

Angus Robertson (Moray) (SNP): I thank the Foreign Secretary for his statement and for advance sight of it. In it, he stressed support for “the flexibility to consider taking additional steps to try to save lives if there is no progress in the near future.” Given the concerns we have heard about the potential for military intervention, can he be absolutely clear about what those additional steps might be?

Mr Hague: The broad answer is no, because the flexibility is designed to allow us to take a variety of steps in future, and we have not decided on any of them. The reason I stress that and make it clear to the House is that we secured a change in the duration of the EU sanctions regime when it came up for renewal in December. It was due to be renewed for 12 months, but we and France, in particular, argued that it should be renewed for only three months so that we can reconsider our policies at that stage. That was to provide flexibility, not because we have changed what we have decided to do. I pointed out in response to earlier questions that the arms embargo of course covers weapons that would have lethal effect, but it also covers body armour, helmets and certain types of communication equipment, so it is easy to see that there might be a case for greater flexibility.

Mr Crispin Blunt (Reigate) (Con): The Foreign Secretary has committed us to continued assistance for those opposition groups opposed to extremism. Plainly, there are opposition groups, both within the coalition and operating on the ground, that we have difficulty with because of their vision for Syria’s future. Will he share with the House his assessment of the balance of power within opposition forces between those whose vision for the future we would welcome and those whose vision we would be uncomfortable with?

Mr Hague: As I have mentioned, it is impossible from outside Syria, or even from inside, to quantify that balance precisely. It is the contention of leading figures in the National Coalition that the great majority of those taking part in the fighting, and those opposing the Assad regime peacefully, want a free future for their country and their people, want rid of the regime and do not have an ideological or religious fundamental agenda. Certainly, acquaintance with the leading figures of the National Coalition corroborates that view. Their sincere contention is to bring about a free and democratic Syria. The longer the conflict goes on, the greater the opportunity for extremist groups to establish themselves. I do not want to offer any quantification of that, but the balance of opinion among opposition forces is still, thankfully, on what we would call the moderate side.

Hugh Bayley (York Central) (Lab): I hope that the Patriot missiles and the American, Dutch and German troops operating them will deter further attacks and incursions from Syria into Turkey. Will the Foreign Secretary explain to the House under whose command the missiles are and in what circumstances an order could be given to use them?

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Mr Hague: The missiles are positioned in Turkey back from the border and are there to protect Turkish airspace. They are clearly not part of any intervention in Syria. They are not designed to do that and will not be positioned to do that. They are NATO equipment, so of course all the arrangements follow logically from that. It is a NATO deployment.

Mr Philip Hollobone (Kettering) (Con): With a population of 4 million, Lebanon is a small but very important neighbour to Syria, which has a population of 22 million. Lebanon is struggling to cope with the 200,000 refugees who have crossed its border. Is the Foreign Secretary on red alert, or amber alert, for the spread of the civil war across the border into Lebanon, and what humanitarian assistance can we offer its Government?

Mr Hague: We are very much on alert and active in assisting Lebanon. Over recent months our ambassador there has done an excellent job in supporting political stability on the ground in difficult circumstances. Of course, part of our humanitarian aid goes to Lebanon and we are ready to increase it if necessary. We have also doubled our assistance to the Lebanese armed forces to help them cope with this difficult situation.

Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op): There are reports that at the end of November the findings of Israeli intelligence led the United States, Russia and China to put pressure on President Assad to cease his programme of arming missiles with chemical weapons. Does the Foreign Secretary think that programme will resume?

Mr Hague: The hon. Lady knows that I cannot comment on intelligence matters in the House, but I can say that at the end of November the United States did issue the warning we discussed earlier, and indeed I brought it up in the House as well. As I made clear at the time, we had a reason to do that and to give a specific warning against the use of chemical weapons. I know that, due to the history in relation to Iraq, whenever Governments assert that there is no doubt about the existence of chemical or other weapons, people are entitled to their scepticism, but there can be no doubt about the existence of such weapons in Syria or that the Assad regime has deliberately manufactured and stockpiled large quantities of such weapons. If there was any chance that the Assad regime would survive in future, I am sure that it would continue that manufacturing and stockpiling.

Andrew Stephenson (Pendle) (Con): The Foreign Secretary rightly talks about chemical and biological weapons and will be aware how fearful the Syrian people are that the Assad regime could use those weapons against them. Is there currently any assistance the UK could provide to Syrian groups to detect or guard against the use of chemical or biological weapons?

Mr Hague: That is a good point, and it illustrates one of the complexities of the EU arms embargo. We are currently unable to supply chemical detection equipment to opposition groups in Syria because of the terms of the embargo. That is a good illustration of an area where flexibility might be needed in future.

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Rushanara Ali (Bethnal Green and Bow) (Lab): I have a constituent whose wife and children are stuck in Damascus and unable to get out due to the dangers. What help can the Foreign Office give to help them get out? That raises the wider question of humanitarian access and medical aid to people inside Syria who are stuck in the conflict. What progress is being made to help people inside the country?

Mr Hague: Progress has been made in some areas, but probably more than half the 4 million people in desperate need cannot currently be reached with humanitarian or medical assistance. That is why I reiterated the appeal to all concerned in Syria to allow peaceful humanitarian access. This is a major aspect of the crisis. Of course, there is nothing that we can do directly to change that other than to work with the agencies and the National Coalition and to call on the regime to allow such access.

On the hon. Lady’s point about her constituents, I will have a look at the specific case if she would like to give me the details. However, it is quite a long time now—about a year and a half ago—since we asked all British nationals to leave Syria. Our embassy had to be closed for safety reasons a long time ago. The Hungarians then very generously took over our consular responsibilities, but they have had to close for safety reasons as well. She can therefore understand that our ability to assist people on the ground in Damascus is now virtually non-existent.

Mr Andrew Turner (Isle of Wight) (Con): What steps is my right hon. Friend taking to ensure that the minority Christians, many of whom have given their acquiescence to the Government, would not face persecution if Assad’s regime were to fall in whole or in part?

Mr Hague: I am glad to say that Christian activists have joined in the opposition National Coalition. We stress at all times to the National Coalition the importance of not only maintaining the inclusion of Christian, Kurdish and other minority communities but constantly reiterating its commitment to a country where in future all those people have their rights acknowledged and can prosper and live together peacefully. That is very much the declared intention of the National Coalition, and we must hold it to it in future years.

Paul Flynn (Newport West) (Lab): Will the Foreign Secretary give an absolute guarantee that prior to the commitment of any UK troops there will be a debate and a vote in this House on the lines of the precedent of 2003? He has said that he believes in the UK punching above our weight. Does not that often mean spending beyond our interests and dying beyond our responsibilities?

Mr Hague: I say no to the second part of the question—I do not believe that it means that. It means many things. It means our country having a presence and an activity in the world of which our 260 diplomatic posts and our huge development programme are good examples. I hope that the hon. Gentleman is in favour of those things, which are aspects of our punching above our weight in the world.

On the commitment of forces, I stress again that I have not said anything today, or in any statement, advocating the commitment of UK forces. In any circumstances, in Syria or elsewhere, we now have a

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well-established convention in this House of which I personally am a strong advocate and in which the Government as a whole believe very strongly. So, yes, the hon. Gentleman can have a broad assurance about that.

Robert Halfon (Harlow) (Con): Given the stockpiles of chemical and biological weapons, given that their use would affect not only Syria but the neighbouring countries, and given that the regime, which it appears is about to fall, is more likely to use those weapons, does my right hon. Friend agree that it would be right in that circumstance for NATO to take preventive action under the responsibility to protect?

Mr Hague: It is right for us to have contingency plans. It is very difficult to lay down in advance what we would do in every situation, but we have sent a very strong warning to the regime about chemical weapons. The United States has led that warning. I cannot go into the details of the military contingency plans that we or NATO have to deal with a wide variety of situations, but I can assure my hon. Friend that our contingency plans do deal with a wide variety of situations.

Luciana Berger (Liverpool, Wavertree) (Lab/Co-op): I listened carefully to the Foreign Secretary, specifically to what he said about the UK’s relief efforts with regard to the 100,000 people to whom we are giving food parcels. He will know that the UN is warning that it can reach only 1.5 million of the estimated 2.5 million Syrians in need of food aid. What conversations has he had with leaders of the surrounding Arab countries to help UN agencies to get improved access to those in need of assistance?

Mr Hague: We have many such conversations; for instance, I discussed it with the Foreign Minister of Jordan yesterday afternoon. The problem is not about the willingness of the neighbouring Arab countries. We should pay tribute to them, because they very generously bear a great burden having welcomed into their countries hundreds of thousands of people. There are many people not only in the camps but staying in families and communities in Jordan, Lebanon, Iraq and Turkey. I absolutely pay tribute to those countries. They are not the problem; the problem is the attitude of the Assad regime, whose forces do not permit humanitarian access to large parts of the country, and the fighting in many other areas that makes it hard to get access. That is one reason why, as I said, we are providing funding for armoured vehicles that can carry humanitarian assistance into certain areas so that aid workers can provide it with a greater degree of safety. We have to keep working on this with the National Coalition, keep the international pressure on the regime, and encourage countries globally to provide the necessary funding.

Duncan Hames (Chippenham) (LD): Returning to the UN situation, when I spoke about Syria to China’s ambassador in London yesterday, he reiterated his country’s opposition to imposing regime change. Does the Foreign Secretary agree that it will be harder for Russia and China to establish good relations with the Syrian people and their next Government the longer they stand in the way of hastening an end to their painful struggle?

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Mr Hague: Yes, I very much agree with that. There is a diplomatic price in Syria and in the region for Russia and China in blocking, as they have, what we have tried to do at the UN Security Council. What we are calling for at the UN is not regime change but a transitional Government who can include members of the current regime and members of the opposition on the basis of mutual consent; of course, we understand that not to mean Assad and his immediate acolytes. China and Russia have agreed to that in our Geneva discussions, but they have never agreed to the UN Security Council putting its full weight behind a chapter VII resolution with the threat of consequences to bring it about. That is the leap that they have not been willing to make. I encourage all hon. Members to point out these things to diplomats of those countries, as the hon. Gentleman has been doing.

Diana Johnson (Kingston upon Hull North) (Lab): In previous statements the Foreign Secretary has identified specific money for work to do with sexual violence and the victims of sexual violence. In today’s statement, he said that we will intensify this work as a matter of urgency. Are further resources and funding going into that particular piece of work?

Mr Hague: Yes, they are. We have done specific work on this on the borders of Jordan. I have now assembled a team of 70 experts to work globally on an initiative to prevent sexual violence, including doctors, lawyers, people skilled in documenting such abuses, psychologists and so on. Last month we deployed part of the team to the Syrian borders; I did not announce their location for their own safety. There will be further such deployments of British experts. Following that first trial deployment, I expect to be able to deploy them further in the region in the coming months.

Jason McCartney (Colne Valley) (Con): Will the Foreign Secretary tell me whether the United Kingdom is able to supply body armour, not necessarily to the armed groups but to the innocent Syrian civilians who are being caught in the crossfire?

Mr Hague: This is another very relevant point in our discussions about the arms embargo. We are not able to supply body armour at the moment. We supply the equipment that I set out in the statement, but body armour is another item that is caught by most definitions of the arms embargo as it stands. When we talk about flexibility in future, we have to bear it in mind that an arms embargo on the opposition covers equipment of this nature as well as lethal equipment.

Mark Lazarowicz (Edinburgh North and Leith) (Lab/Co-op): Given what the Secretary of State has said about the difficulty of getting emergency aid to the millions who need it, should not the UK Government and the world community give a high priority to putting pressure on all those who have influence over parties in the Syrian conflict to allow that humanitarian aid to access places in need? Russia is an obvious example, but we also have influence and we should use it in this conflict.

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Mr Hague: Yes, absolutely. We are constantly trying to do that and that includes the pressure that we put on Russia. A major point is that the Friends of Syria—more than 100 countries—have taken up trying to put that pressure together, but on this subject, as on so many others, no amount of international pressure has succeeded in changing the brutal attitude of the Assad regime, which sees any international presence as a threat to it, even when it is an international effort to deliver humanitarian aid.

Bob Blackman (Harrow East) (Con): Clearly, the Assad regime is dependent on Russian and Chinese diplomatic support, but what assessment has my right hon. Friend made of the possible logistical support and weapon rearmament provided by Iran to the Assad regime? If that is the case, what can be done to sever that link?

Mr Hague: There is a good deal of overwhelming evidence, as I have said in the House previously, of the tangible assistance given by Iran to the regime. It is another aspect of the deeply unhelpful policies pursued by Iran in the region. That assistance is likely to have included, in recent times, financial assistance to the regime, but also people to assist in the conflict itself and military equipment. We do everything we can to inhibit the supply of such equipment. I have taken up several times with the Iraqi Government the issue of the overfly over Iraq of Iranian flights into Syria. The Iraqi Government have given assurances about that and, indeed, have searched some flights in recent months. We will continue to take up that issue with Iraq and, indeed, try to expose Iran’s participation in the brutal oppression of the Syrian people.

Thomas Docherty (Dunfermline and West Fife) (Lab): The Foreign Secretary, as a former historian, has already alluded to the need to learn the lessons of history. May I press him a little more on what steps the Government are taking to make sure that the lessons from Libya for transition to the future are learned in Syria?

Mr Hague: Yes, we must learn those lessons. The situations are, of course, different. We must always respect the differences between these countries. The more that the national coalition can create a consensus among opposition groups about the basis, philosophy and principles on which they would like to see the country governed, the more successful Syria will be in future. That is more important than deciding which individuals will occupy which posts. It is important that they are in contact with and have influence over as many as possible of the armed groups and militias that support the opposition cause, because in Libya different groups fighting in different parts of the country did not have strong enough links for the subsequent government of the country.

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Rehman Chishti (Gillingham and Rainham) (Con): The Secretary of State will be aware of reports that President Assad has offered to exchange 2,000 captured opposition personnel in return for 43 Iranian military experts and that Iran has also given him missiles. In light of this imbalance of resources, what further support can the United Kingdom and other international partners give to the opposition?

Mr Hague: That relates to all the issues that we have been addressing over the past hour. We are giving the further, non-lethal practical support that I mentioned in my statement and we are trying to secure within the EU the flexibility to change or develop that as the situation changes in the future, for the reasons I have given. My hon. Friend the Member for Pendle (Andrew Stephenson) brought up the very good example of chemical detection equipment. We will have to look at those things if the situation continues to worsen.

We have all seen the reports of an exchange, and my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti) is right to bring that up. The fact that there are such large numbers of Iranian military experts in Syria whose release the Iranians have had to negotiate illustrates the point we have just been making about Iran’s involvement.

Jonathan Ashworth (Leicester South) (Lab): I welcome the Foreign Secretary’s commitment to continue to speak to his international counterparts about the humanitarian assistance needed. Given that this terrible situation will only get worse because of the first winter storms hitting many of the refugee camps in Lebanon, Jordan and elsewhere, will he undertake to speak to his international counterparts with a degree of urgency? The Foreign Secretary has also said that we are the second largest donor to the UN programmes at present. Does that suggest that richer countries are not putting in as much as they should, and is he confident that the UN target will be met?

Mr Hague: The hon. Gentleman is right that there is urgency to this matter. As I have mentioned, we are already speaking—we have been doing so for some time—to other countries about the need to supply more financial assistance to the humanitarian agencies involved, and the United Kingdom succeeds in setting a very good example. That is part of our daily discussions with other nations from all parts of the world. It is not possible to say, given the scale of the appeal for $1.5 billion and the world’s poor track record so far in meeting it, that we are confident that it will be met, but there will be an intense effort over the coming weeks. My right hon. Friend the International Development Secretary is heavily engaged in it and the hon. Gentleman can be assured that we will not waste any opportunity to encourage other countries to play their part.

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Events in Northern Ireland

12.36 pm

The Secretary of State for Northern Ireland (Mrs Theresa Villiers): With permission, Mr Speaker, I would like to make a statement about recent events in Northern Ireland.

Before updating the House on the protests and disorder, I wish to report on a serious attempted terrorist attack. On 30 December an officer of the Police Service of Northern Ireland discovered an improvised explosive device attached to the underneath of his car shortly before he was due to drive his wife and family to Sunday lunch. The IED was viable and were it not for the alertness of the officer in checking his car, it is highly likely that he and his family would all have lost their lives.

This despicable attack bears the hallmarks of the so-called dissident republicans and looks to be the latest example of the relentless attempts of these groupings to try to murder police officers. It underlines the need for continued vigilance and the Government will continue to do everything they can to help the PSNI combat the terrorist threat in Northern Ireland.

The House should also be aware that two individuals have been charged in relation to the murder of Prison Officer David Black.

Turning to the disturbances in Belfast and other parts of Northern Ireland, since I last reported to the House on 11 December protests over the flying of the Union flag at Belfast city hall have continued, with only sporadic respite over Christmas. Although many of these protests have been peaceful, even they have seen roads blocked and daily life disrupted. A significant number of protests have led to serious disorder, mainly concentrated in east Belfast.

Although, thankfully, there were no significant public order incidents last night, the violence during the preceding six days saw masonry, bricks, fireworks and petrol bombs thrown at police, and in once instance shots were fired. Police vehicles have been attacked with sledge hammers and, in total, 66 police officers have been injured since the protests first began. On 5 and 7 January, water cannon and AEP rounds—attenuating energy projectiles—were discharged. Threats and intimidation against elected representatives continue, with the office of the hon. Member for Belfast East (Naomi Long) still the subject of daily intimidation.

The intimidation and violence is unacceptable and intolerable. The Government condemn those responsible in the strongest possible terms. We reiterate our full support for the Chief Constable and his officers in their courageous attempts to maintain law and order. I take this opportunity to pay tribute to the bravery and professionalism of PSNI officers, who put their personal safety on the line every day to keep people in Northern Ireland safe and secure.

According to the Chief Constable, senior individual members of the Ulster Volunteer Force are involved in orchestrating the violence, although in his view this is not being sanctioned by the leadership of the group.

Since 3 December, 107 people have been arrested and 82 charged with various offences. The perpetrators of this violence should be in no doubt that, as the Chief Constable made clear on Monday, they will face the full

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rigour of the law. Those who continue to organise these protests and engage in violence need to ask themselves what they think they are achieving. The idea that hurling bricks at police officers is somehow defending the Union flag or protecting Britishness is incomprehensible. These people are not defending our national flag; they are dishonouring our national flag and our country. What is more, they are being reckless with the peace process and all that it has delivered.

The damage that those people are inflicting on Northern Ireland’s economy must be considerable. Huge efforts have been made in recent years to project a modern, confident, outward-looking Northern Ireland that is a great place to do business. However, the pictures of riots and disorder that are being beamed around the world make it far harder to compete in the global race for inward investment. Jobs and livelihoods are under threat. It is therefore essential that the protests and violence stop now.

Since the disturbances began, I have been in regular contact with the Chief Constable, the First and Deputy First Ministers, the Justice Minister and other political leaders. The Northern Ireland political parties need to work together to find a way forward. It should not be impossible to find a solution which sees decisions on flags made in a way that respects different views and takes into account the different traditions and identities present in today’s Northern Ireland. For that to happen, the issue needs to come off the streets to allow local politicians and community leaders the space to sit round a table and engage in constructive dialogue.

I have used recent weeks to highlight the urgent need to make progress in addressing the underlying divisions within the community in Northern Ireland, which can make decisions on issues such as flags so fraught with tension. On many occasions, Northern Ireland’s political leaders have expressed their firm commitment to building a shared society, free from sectarian division. That is a theme to which I and my predecessor, along with the Prime Minister, have returned many times.

So much has been achieved in the 20 years since the peace process really got under way. The overwhelming majority of people in Northern Ireland can lead their lives with a normality and freedom from fear that would have been impossible back in the dark days of the troubles. However, we all need to acknowledge that the process is not finished, and the stability delivered by the Belfast agreement should never be taken for granted.

For some, sectarian divisions remain deeply entrenched and it is time for bold moves by Northern Ireland’s political leadership to address them. We need to build a genuinely shared future for everyone in Northern Ireland. It will not be easy, but Northern Ireland’s political leaders have already shown themselves capable of taking difficult decisions in order to make progress on many matters. They have fixed tougher problems than the ones that we face today. I believe that they can rise to this challenge as they have to so many others over the past two decades. The UK Government stand ready to work with them and support their efforts to deliver a better and more cohesive future for Northern Ireland.

12.42 pm

Vernon Coaker (Gedling) (Lab): I thank the Secretary of State for her statement and for advance sight of it. I join her in condemning the disgraceful violence that

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we have seen over the past weeks. The serious rioting, attacks on the police and threats against elected representatives, including the hon. Member for Belfast East (Naomi Long), have been appalling. As the Secretary of State has said, the hon. Lady has behaved throughout with dignity and courage.

This violence would not be acceptable in London, Cardiff or Edinburgh, and it is not acceptable in Belfast. People in Northern Ireland need to know that the UK Government are giving this matter the highest priority and that Northern Ireland matters. May I therefore ask the Secretary of State what discussions she has had with the Prime Minister about the recent violence and what discussions he has had or intends to have with Northern Ireland Ministers about what might be done to support them further?

It was welcome that the Secretary of State updated the House on the attempt by dissident republican terrorists to murder a police officer and his family over Christmas, which was sickening. As she said, that reminds us of the ongoing threat from those who wish to destroy the peace and progress. It is good that the police have made arrests in relation to David Black’s murder. That sends out the clear message that the perpetrators of these crimes will be brought to justice wherever possible.

The public disorder and violence that we have seen on the streets began when the decision was taken by Belfast city council that the Union flag should be flown only on designated days. Will the Secretary of State join me in saying that in a democracy one cannot try to change decisions by the use of force, and that those who break the law can expect to be dealt with using the full force of the law? Violence can never be allowed to win.

As the Secretary of State said, the Police Service of Northern Ireland has shown exceptional bravery and courage, even at great personal cost, with 66 officers having been injured already. Let us all follow her in commending the police for their professionalism and dedication to duty.

The Chief Constable has stated clearly that senior figures from the Ulster Volunteer Force are involved in much of the violence. What assessment has the Secretary of State made of loyalist paramilitary involvement in the disturbances? Does she agree that attacks by paramilitaries on the police and elected politicians are matters of national security? Is she confident that the PSNI has the resources to continue its current level of commitment without impacting on its other policing duties?

Today, I was due to visit a project in Belfast that helps young people back to work. I have seen in communities across Northern Ireland, both nationalist and Unionist, initiatives to ensure that every young person has hope, that every community looks to the future, that jobs are created and that everything possible is done to overcome the sectarianism and divisions of the past. The responsibility for much of that is devolved, but will the Secretary of State ensure that the consequences of all her Government’s economic and social policies are fully considered with respect to Northern Ireland? Deprivation, disengagement and alienation are a challenge in any community, but if that challenge is not met in Northern Ireland, it can have dangerous consequences. As the Secretary of State said, we need to ensure that Britishness and Irishness are fully respected in Northern Ireland.

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Will the Secretary of State join me in saying that the scenes that we have seen on the TV do not represent the real Northern Ireland, and that we must do all that we can to ensure that positive messages about the new Northern Ireland are seen and heard across the world? There has been real progress over recent years in Northern Ireland. It is not easy and sometimes there will be setbacks. As I have said, we need to deal with the alienation that we see in some of the communities of Northern Ireland, and particularly in some of the most deprived communities. However, the setbacks must not be allowed to define Northern Ireland and its people or to derail the progress that has been made. Too much has been achieved for that and we must not allow the clock to be turned back.

Mrs Villiers: If you will forgive me, Mr Speaker, I will answer at some length, given the number of important matters that have been raised.

Like the shadow Secretary of State, I pay tribute to the courage and dignity of the hon. Member for Belfast East (Naomi Long). It is intolerable that she and so many other elected representatives from Northern Ireland have been subject to death threats and intimidation.

I welcome, once again, the constructive and bipartisan tone of the Opposition on the matters that we are discussing. I wholeheartedly agree with the shadow Secretary of State that such violence is not acceptable on the streets of the United Kingdom, whether in Edinburgh, London, Cardiff, Manchester or Belfast. It is intolerable and deeply damaging.

The shadow Secretary of State asked for assurances about contacts with the Prime Minister. The Prime Minister is being briefed every day and I have had three face-to-face meetings with him on this matter, including one this morning. I am keeping in regular touch with him. He retains a close personal interest in Northern Ireland because he knows what a great place it is and what huge opportunities it has. That is one reason why it was his personal decision to take the G8 to Northern Ireland later this year. He is keeping a very close eye on all that is going on. I should also mention that I have briefed the Irish Government on these serious matters.

Like the shadow Secretary of State I think that although the headlines focus on the disorder, we should never forget that the ongoing terrorist threat is very serious. One risk associated with such disorder is that police officers are brought into vulnerable situations where they might become targets for dissident republican attacks. I also agree with the shadow Secretary of State that democratic decisions cannot be changed by violence. The history of Northern Ireland over the past 50 years demonstrates that it is sitting round a table, talking, engaging in a dialogue, and considering compromises and an inclusive way to resolve issues that lead to progress, rather than resorting to violence and rioting.

The shadow Secretary of State mentioned the role of the UVF, which we have discussed on a number of occasions. I have also discussed the issue with the Chief Constable and other PSNI officers. It is of concern that individual loyalist paramilitaries are involved in these matters, and crucial that the police do all they can to ensure the full rigour of the law is brought to bear on anyone engaging in violent conflicts, whether or not they are members of paramilitary organisations. As I

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have said, the Chief Constable’s view is that the orchestration is not coming from the leadership of the UVF, and that is consistent with my view.

Whether these issues raise matters of national security is a point I discussed with the Chief Constable and Drew Harris yesterday afternoon. In essence, there is always an overlap at the border between matters of national security and other areas of policing, but I assure the House that the PSNI and its partner agencies such as the Security Service are doing all they can to combat that threat. They are certainly not letting the borderline between national security and other matters get in the way of an effective response. However these incidents are categorised or classified, it is vital that the police bring to bear every means available to combat these disgraceful scenes of violence. On PSNI resources, the Chief Constable is confident that he has the capacity to deal with the disorder, but having resources tied up dealing with these riots leaves fewer resources for the community policing that is so important for confidence building and protecting people from crime.

Like the shadow Secretary of State I welcome the positive initiatives under way in Northern Ireland to give young people hope, and I reassure him that all the Government’s economic policies are thoroughly tested for their impact on low-income and disadvantaged communities. The reality is that it becomes much more difficult to fix the kinds of problems that may concern those involved in these protests—educational under- achievement, health care, jobs—if there is rioting on the streets. It is counter-productive for protesters to engage in violence; they are doing no service to the causes they espouse but instead making it more difficult for the Northern Ireland Executive to deliver a safe and prosperous Northern Ireland.

Like the shadow Secretary of State I believe that a key part of the Belfast agreement is that both Britishness and Irishness are fully respected as different identities in Northern Ireland. The success of the past 20 years demonstrates that those who define themselves as British and those who define themselves as Irish can co-exist peacefully in Northern Ireland and work constructively together.

Finally, I welcome the opportunity to emphasise the positive about Northern Ireland, and whatever has happened over the past six weeks should not blind us to the fact that it is a great place in which to live and invest. It could be a fantastic year for Northern Ireland with Derry/Londonderry already taking its place as a successful UK city of culture, the G8, and the world police and fire games—one of the biggest international sporting events in the world. All those things are an opportunity to project a modern, forward-looking Northern Ireland. We need to get back to that because the protests are undermining what could be a fantastic year for Northern Ireland.

Mr Laurence Robertson (Tewkesbury) (Con): I thank the Secretary of State for early sight of her statement and for keeping me, as Chairman of the Northern Ireland Affairs Committee, informed about what has been going on in Northern Ireland. I also join her in paying tribute to the dedication and bravery of the

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PSNI which, along with its predecessor the Royal Ulster Constabulary, has saved Northern Ireland from sinking into even deeper problems over many years.

We have heard it said that certain people in Northern Ireland have not reaped the benefits of the peace process. Although I agree there is a lot of work to do in that respect, does the Secretary of State agree that the underperformance of the economy in Northern Ireland is largely a result of violence over many years, the likes of which we have again witnessed over the past few weeks? Is not the way forward, as she has said, for both communities to sit round the table and discuss these matters, rather than carrying out terrible acts such as the murder of prison officers and the attempted murder of police officers?

Mrs Villiers: I very much agree with the Chairman of the Northern Ireland Affairs Committee. Many of the economic difficulties in Northern Ireland have their roots in the violence of the past. That is why it is so frustrating that rioting and violence today is undermining what have been incredibly successful efforts by the First and Deputy First Minister to attract inward investment. If any of the rioters are concerned about prosperity and jobs, going out on the streets and hurling bricks at police officers is the last thing that will improve that situation. Such behaviour is guaranteed to deter investors from coming and creating jobs.

Mr Peter Hain (Neath) (Lab): I say to the Secretary of State that condemning the deplorable violence is the easy bit, and will she do two further things? First, given her national security responsibilities will she engage directly with the loyalist groups and be willing to talk even to those who may be on the fringes of the violence—as we did to positive effect in 2006-07—who feel excluded from the political process? Secondly, will she come up with a package of resources to tackle the deplorable level of youth unemployment? Some of the young republicans—and in recent times the young loyalists—involved in this violent activity have no stake in the society. That does not justify their violence but it does explain why it is happening.

Mrs Villiers: I certainly think that part of the way forward is an inclusive dialogue that must be led by Northern Ireland’s political parties. Indeed, as part of our work I and the Minister of State engage in regular conversations and listen to the concerns of people across the community. Addressing youth unemployment is one of the UK Government’s highest priorities. Employment figures across the UK have been improving over recent weeks but there is still a very significant problem, particularly in Northern Ireland. The issue continues to be one of our highest priorities and we will continue to work with the Northern Ireland Executive on ways to grapple with it. One reason David Cameron chose to bring the G8 to Northern Ireland was to demonstrate his commitment and attract inward investment.

Mr Speaker: I know the Secretary of State was referring to the Prime Minister. We are clear.

Andrew Rosindell (Romford) (Con): The whole House agrees that the violence and intimidation taking place in Northern Ireland is totally counter-productive and undermines the very cause the protesters are protesting

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about. Does the Secretary of State agree with me that it is right that the flag of the United Kingdom of Great Britain and Northern Ireland should fly above city halls, town halls and all municipal buildings throughout the United Kingdom, as it does above the British Parliament?

Mrs Villiers: I agree that these violent protests are counter-productive and that those engaged in violence are undermining the cause they wish to support. It is important that decisions on flags are taken in an inclusive way with respect for different perspectives and points of view. Arguably, there is no one-size-fits-all solution, which is why I have been encouraging the leadership of the political parties to come together and engage in dialogue on the right solution for flags and symbols in Northern Ireland.

Mr Jeffrey M. Donaldson (Lagan Valley) (DUP): I am proud to be British and proud of our Union flag but the violence in Northern Ireland, whether from loyalists or dissident republicans, grieves me greatly. We have been unequivocal in our condemnation of all such violence and of attacks or threats against elected representatives. Before Christmas, I, my wife and my children were threatened with being shot because of the stand that I take in Northern Ireland. This House will stand with all Members from Northern Ireland who continue to uphold the standards and principles of democracy.

I echo the comments of the right hon. Member for Neath (Mr Hain): we need more than condemnation. The Good Friday agreement and the St Andrews agreement were about developing consensus politics in Northern Ireland. With respect, the decision of Belfast city council to remove the Union flag was not about consensus politics; in fact, it was a reversion to the very thing the nationalists say they detest—majority rule. We need to build a consensus, and Unionists must be included in such sensitive issues. If we exclude one community, we get not consensus but confrontation, which we need to move away from.

A shared future must include everyone—not just one side of the community, but both sides—and it must respect the identity and tradition of both sides. I therefore urge the Secretary of State to support Northern Ireland politicians, because I believe the Government have a role to play in that. Politics is the only answer. As the right hon. Member for Neath has said, we need to consider initiatives to tackle social deprivation in areas where there is a disconnect.

The DUP will provide leadership—the First Minister has stated that—but we need a level playing field. Right now, many people in Northern Ireland feel that the peace process has become skewed, and we need to correct that imbalance.

Mrs Villiers: It is a great regret and concern that the right hon. Gentleman and his family have been subjected to those threats and I pass on my sympathies to them. He is right that the way forward is to seek consensus, and one that respects the different identities present in modern Northern Ireland. I fully agree with him on the importance of the UK Government working closely with the Northern Ireland Executive on initiatives to regenerate and provide the economic prosperity that

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is vital to underpin the peace settlement in Northern Ireland. That is particularly important in deprived communities across Northern Ireland. I am happy to continue the work I have been doing since being appointed on how we can boost the Northern Ireland economy and attract jobs and inward investment from around the world.

Stephen Lloyd (Eastbourne) (LD): I thank the Secretary of State for her statement and join her in deploring the attempted murder on 30 December by dissident republican groups.

I am conscious of some of the figures the Secretary of State mentioned: there have been more than 100 arrests and 66 police officers have been injured. We should imagine the impact in England, Scotland or Wales if 66 police officers were injured over a period of about a month. There would be absolute uproar, so my appreciation and respect for the PSNI is second to none.

I should like to emphasise the flag issue. I have been doing research in the past few weeks. Interestingly, I discovered that, in the city of Lisburn, all the political parties have reached an agreement, led by the DUP and the Ulster Unionist party—

Mr Speaker: Order. I very gently say to the hon. Gentleman that I extended a degree of latitude to the right hon. Member for Lagan Valley (Mr Donaldson)—that was a matter of discretion—but this is a statement to which the responses must be brief questions. I feel sure that the hon. Gentleman is now approaching his question mark.

Stephen Lloyd: Thank you, Mr Speaker. I am grateful for your reminder—I am approaching my question. Does the Secretary of State agree that it is incredibly important at this time that the political parties provide leadership and maturity, and that the leading political party in Northern Ireland needs to go that one step further in providing that leadership by accepting that democracy trumps everything?

Mrs Villiers: It is very important for the political parties to provide leadership in Northern Ireland and I am confident that they are doing so. They take this matter seriously. The events are a wake-up call to all of us—a reminder that we need to address the underlying causes of the tension, and to find ways in which to bring different parts of the community together to build mutual understanding, so that it becomes easier to resolve flags and symbols issues without provoking such distressing scenes on our streets.

Naomi Long (Belfast East) (Alliance): I join the Secretary of State in condemning the attempted murder of a police officer and his wife and family in my constituency by dissident republicans. I also join her and the shadow Secretary of State in commending the police for their professionalism under extreme pressure during the loyalist disturbances and riots, and for holding the line on behalf of the whole community of Northern Ireland between the rule of law and descent into chaos.

The PSNI has assessed that senior members of the UVF in my constituency are involved in orchestrating that rioting and are participating in it. Combined with the dissident republican threat, we find ourselves in a

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grave situation in the general peace process. What role does the Secretary of State believe the UK Government can have in tackling not only that violent threat, but the deep-rooted sectarianism that is rampant in Northern Ireland, in trying to create a more stable foundation on which to build for the future? Does she agree that the only sustainable, lasting and enduring solutions in Northern Ireland will be found by our sharing responsibility and taking things forward on behalf of the whole community, and that such solutions will not be found in partisan and tribal options?

Mrs Villiers: I am grateful to the hon. Lady for her question. Yes, it remains a grave concern that individual members of the UVF are involved in the violence—I discussed that with the Chief Constable and the Justice Minister yesterday. Indeed, I passed on some names that had been provided to me on the matter.

On the dissident republican threat, the riots create dangers and vulnerabilities for the PSNI that it would not otherwise have, as I have said. The increased presence of members of DR organisations in nationalist areas such as Short Strand is gravely worrying. The hon. Lady is right that the threat is real—those who are engaging in the violence are being reckless with the peace process.

I also agree with the hon. Lady that it is important for the UK Government to be engaged in efforts to help the Northern Ireland Executive to make progress on a shared future. That is why such progress has been the focus of pretty much everything I have said as Secretary of State, why my predecessor returned to it again and again, and why the Prime Minister highlights it every time he visits Northern Ireland. It is vital that we see progress, and we are keen to work with the Northern Ireland Executive on those matters.

I agree with the hon. Lady that sharing responsibility and building consensus is the way forward on sensitive issues such as flags, rather than seeking to change things through violence.

Conor Burns (Bournemouth West) (Con): May I associate myself with the Secretary of State’s words on the PSNI and the hon. Member for Belfast East (Naomi Long)?

Two very important points have been made by the shadow Secretary of State and the former Secretary of State, the right hon. Member for Neath (Mr Hain). This is not about flags, but about something much more profound. When visiting Northern Ireland over the new year period, I spoke with residents in the Sandy Row and Shore road areas of Belfast. There is a profound sense of alienation in the deprivation of those communities, and a real sense that they are not being listened to by those they have elected. Will the Secretary of State join me in urging all elected politicians in Northern Ireland—Members of the Assembly, councillors and Members of Parliament—to get into those communities and listen, and will she listen to what they tell her about what we can do to improve the conditions in those communities?

Mrs Villiers: Certainly, in any democracy, it is vital for elected representatives to engage at the grass roots with members of the community who feel alienated. I urge all those who feel a sense of detachment from the

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political process to come forward. I imagine that many people who are rioting on the streets are probably not even registered to vote. There are many ways for them to express their political views and to support Britishness, and many ways to support the flying of the Union flag, that are peaceful and constructive, and that will work. There is a way forward. There is openness and an opportunity for those who genuinely care about our national flag to get involved in a broad conversation on how we resolve those issues. I encourage them to do so.

Mr David Winnick (Walsall North) (Lab): While recognising the social problems that unfortunately continue to exist in Northern Ireland, is it not necessary to make it perfectly clear that there can be no excuse whatever for violence or intimidation from either side? Is it not the case that the large majority of people in Northern Ireland support the peace settlement, which was started by John Major and negotiated successfully, following a change of Government, by Tony Blair and Mo Mowlam? Moreover, as a result of those negotiations, articles 2 and 3 of the Irish constitution were removed—the very articles that caused such annoyance and complaints from the Unionist community over many years.

Mrs Villiers: The hon. Gentleman is right. We should not forget everything that has been achieved by the peace process. He is also right that there is no excuse for violence, regardless of social background. It is important to recognise that although there are problems with sectarian division in Northern Ireland, there are many people who no longer share those sectarian views and have left them behind. We need to ensure that that becomes more broadly based across the community.

Bob Stewart (Beckenham) (Con): The House is still in shock about the death of the prison officer David Black. The second incident on 30 December sends us again into shock. It is an appalling regression to what might have happened in the past, and let us hope that we can get a grip on it. May I ask my right hon. Friend whether there has been evidence of weapons either being seen or used in the riots in Belfast?

Mrs Villiers: As I said in my statement, in one incident shots were fired at the police. My understanding is that the rounds were blank, but I am afraid that there is a ballistic threat in relation to these riots.

Thomas Docherty (Dunfermline and West Fife) (Lab): Further to the point articulated by my hon. Friend the shadow Secretary of State, on education, and as one who, as a former student leader, worked with the National Union of Students-Union of Students in Ireland as long ago as the late ’90s, it is clear there is a generation of young male Protestants who have not achieved their full education potential, and have been educated in crumbling schools with no great drive to go on to further and higher education. Will the Secretary of State listen to the cross-party pleas to help the Executive to invest more in education to give all parts of the community in Northern Ireland a real future?

Mrs Villiers: The hon. Gentleman is absolutely right that educational opportunities are key to addressing some underlying problems. This is an issue I have discussed with a number of community groups, for example, a

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great organisation called the Resurgam Trust in the Lisburn area. There is a crucial opportunity for the early intervention programmes that have proved so successful in many parts of the United Kingdom. It is not for the UK Government to dictate to the Executive how much of a priority they give to that, but we are very supportive of the work that is being done. He is right that this is a key way to improve the current situation.

Oliver Colvile (Plymouth, Sutton and Devonport) (Con): I thank my right hon. Friend for her well-thought-through statement. Has she made an assessment on whether this is localised to Belfast, or is it a broader issue? May I also ask her what can we do to ensure better school results in Northern Ireland? I understand that there is success in some places, but that in others only 3% or 4% of children end up getting five GCSEs or more.

Mrs Villiers: The Northern Ireland education system has significant contrasts. For many children, it is spectacularly successful, and, of course, it has two world-class universities. However, there is a concern about those for whom it is not delivering and a concern about educational underachievement. As I said, this is a high priority for the Northern Ireland Executive and the Education Minister, and the UK Government continue to support them through the block grant they give to Northern Ireland. I am very happy to work with the Northern Ireland Executive on the good work they are doing to improve the current situation.

Kate Hoey (Vauxhall) (Lab): I agree wholeheartedly with the remarks made by the hon. Member for Bournemouth West (Conor Burns). There have been a lot of glib phrases about a shared future. Will the Secretary of State define for the House what she means by a shared future? Many people from the majority Unionist community feel bewildered that the British Government and the British Opposition are campaigning to keep Scotland part of the United Kingdom, while in Northern Ireland we are talking about a shared future. Why are we not talking about a shared future in Scotland, and why are we not putting the same resources and support into keeping Northern Ireland as part of the United Kingdom?

Mrs Villiers: As the hon. Lady will be aware, and I am sure she will agree with me, the question of Northern Ireland’s future in the Union is settled on the basis of consent. The Government are not neutral on the Union and we believe that Northern Ireland’s place in the United Kingdom is safer than it has been for many years. Regardless of that, it is crucial to find ways to unite the community in Northern Ireland. It is true that there remain sectarian divisions. On the subject of Scotland, I know that there are indeed some concerns about sectarianism there, although it does not manifest itself in the same ways as it does in Northern Ireland. It is true that many people in Northern Ireland have left those sectarian divisions behind, but not everyone has. We need to give children the opportunity to participate in shared education, and look at ways to have space that can be genuinely lived in, occupied and used by both parts of the community. In particular, I single out some

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of the education initiatives in County Fermanagh, which have demonstrated that it is possible to give children the opportunity to be educated alongside those from other backgrounds in a successful way. Those are the sorts of initiatives we need to deliver.

Dan Rogerson (North Cornwall) (LD): I thank the Secretary of State for her statement and join her in praising the PSNI for all it is doing to maintain peace in the Province of Northern Ireland. Does she agree, as we try to continue the peace process and move towards reconciliation, that all political leaders should be very careful in their use of language and what they put into print, to ensure that they do not create a climate that leads to a feeling of justification for other measures that people unfortunately take that are beyond the bounds of political debate?

Mrs Villiers: I agree that it is important that inflammatory language is avoided, because we can see the potentially disastrous consequences to which it can lead.

Paul Goggins (Wythenshawe and Sale East) (Lab): I join the Secretary of State in praising the bravery of PSNI officers, particularly in recent days and nights. She is right, and the Prime Minister was right yesterday, to underline the vital responsibility that every politician in Northern Ireland has to map out a shared future to which everybody, including disaffected loyalist communities, can feel they belong. One area that she retains responsibility for is the work of the Parades Commission. Given that we are just weeks away from the start of this year’s parading season, will she update the House on recent discussions she has had with members of the commission about the role that they can play, alongside police and community leaders, to make sure that parades, and indeed legitimate protests, are properly stewarded and responsibly organised?

Mrs Villiers: I met the whole Parades Commission just a few days ago to discuss its thoughts on the forthcoming year. Technically speaking, I think the parading season begins in mid-February. The commission takes its role very seriously and there was some progress last year on public order issues related to parading. It is focused on doing the best it can to make the right decisions that are balanced and fair, and to take into account competing considerations. I take this opportunity to pay tribute to the work of the right hon. Gentleman, and members of his Government, in building peace and calling for the same kind of shared future that the Prime Minister has focused on so strongly during his term of office.

Mr Andrew Turner (Isle of Wight) (Con): Further to the decision of Belfast city council on which days the Union flag may be flown, what steps is my right hon. Friend taking to ensure that all citizens of Northern Ireland feel that they can express their views, including by the ballot box, rather than being disengaged as so many seem to be?

Mrs Villiers: It is important for this House to send out a clear signal that there are a whole range of ways that people can get involved in the political process, whether they express their views by e-mailing their MP, using social media sites, or coming along to public

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meetings. That is the way to influence the outcome of important debates on the future of Northern Ireland—not by chucking bricks at police officers.

Gemma Doyle (West Dunbartonshire) (Lab/Co-op): It is my understanding that when Scotland hosted the G8, additional policing resources were not provided. I think the Secretary of State said that they would be provided in Northern Ireland this year—can she confirm that point? Will she also confirm whether the Chief Constable has asked for additional resources to deal with the ongoing violence?

Mrs Villiers: The Chief Constable has not asked for additional resources to deal with the ongoing violence, but he is making a careful assessment of the impact of the violence on his resources. The resources needed to police the G8 summit are under consideration, and we are working with colleagues in the Home Office and the PSNI to see what might be possible. It is also important to emphasise that the £200 million deployed by the Government to assist the security efforts in Northern Ireland have played an important part during the riots, not least because it has funded the vehicles that have come under attack—the capital renewal of the PSNI’s vehicle stock was partly funded by the extra £200 million.

Bob Blackman (Harrow East) (Con): The saddest aspect of this senseless violence is the potential deterrent effect on business investment and tourism. Will my hon. Friend update the House on conversations she has had with business leaders, retailers and other potential employers on improving the Northern Ireland economy, increasing investment and creating new jobs?

Mrs Villiers: Virtually every day I am in Northern Ireland, I am in those kinds of discussions, because it is crucial that Northern Ireland’s economy recovers. We saw some fabulous, successful events last year, including the Titanic centenary events and the Queen’s visit, and, as I have said, this year again we have opportunities to showcase all that is good about Northern Ireland. I am enthusiastically taking part in that, and I know that the

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Prime Minister will be doing so as well during his forthcoming visits to Northern Ireland, including for the G8. We are confident that we can host a successful and secure G8 summit, despite the recent disorder.

Toby Perkins (Chesterfield) (Lab): I was struck during the statement by the sense of disengagement in certain parts of the community, but I have been less clear about the Secretary of State’s strategic vision for dealing with that. Will she be a bit more specific about the steps that will be taken to try and engage some of these communities? Simply asking them to come forward is not a solution. Will she tell us specifically what she is doing, with the First Minister and Deputy First Minister, to engage some of these communities?

Mrs Villiers: As I said, I have regular discussions with the First Minister and Deputy First Minister. Today sees the first meeting of the Unionist forum, which will be engaging with members of the Unionist community, and, as I have said, I and the Minister of State are focused on wide and inclusive engagement on all the challenges facing Northern Ireland. It is important for the Northern Ireland Executive to continue the work to build a shared future and to engage with disaffected communities. A key way to do that is by focusing on educational under-achievement and the sorts of social problems we have debated this morning.

Andrew Stephenson (Pendle) (Con): I join my right hon. Friend in paying tribute to the PSNI, which has behaved with professionalism and bravery in the face of intense provocation and attacks over recent weeks. I expect it will be almost impossible to put a cost on the economic and reputational damage to Northern Ireland, but has she been able yet to estimate the policing costs so far of the recent protests and disorder?

Mrs Villiers: Various unofficial figures are circulating, and it is deeply regrettable that resources that could be going into visible community policing and confidence building are being taken up by rioting. As I said, the Chief Constable is looking carefully at the implications of the situation for his resources and will keep me updated.

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Backbench Business


Mr Deputy Speaker (Mr Nigel Evans): After Mr Burstow has finished his contribution, I will announce whether there is to be a time limit, and, if there is, what it is.

1.23 pm

Paul Burstow (Sutton and Cheam) (LD): I thank the Backbench Business Committee for the timely opportunity to debate on the Floor of the House this most important of issues. I also thank my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) for her commitment to, and interest in, these issues and her determination to ensure this debate took place today, and the right hon. Member for Salford and Eccles (Hazel Blears), who chairs the all-party group on dementia. Together, the three of us argued the case for this debate to come to the House, and I look forward to their contributions. They are both passionate about this issue.

Earlier this week, I was at an event at which the daughter of an 86-year-old woman with dementia said some things that spoke to what this debate is all about. She talked about being a full-time carer for her mother and about the agonising decision to move her mother into a care home. She said that although death and moving house were probably the two most traumatic events in our lives, dementia was a never-ending bereavement and that the daily trauma had robbed her and her mother of life. Such true-life experiences, many more of which I hope will come out in today’s debate, make it plain why dementia is now the disease most feared by the over-55s.

My interest in the issue goes back well over a decade and was started by a report that I read into the inappropriate and, in some cases almost abusive, use of anti-psychotic medication. Even then, the side effects were beginning to be well documented and understood, so it is no wonder that at the time these anti-psychotics were labelled as a chemical cosh. As the evidence has mounted over the last decade or so of the increased risk of stroke as a result of these drugs and of the fact that they can shorten lives, I was prompted to ask endless parliamentary questions to Ministers about the matter and to produce a series of reports. At times, it felt a bit like banging my head against a brick wall.

I am pleased to say that the wall has started to tumble and that things have begun to change, and, in the last two and a half years, we have seen a 52% reduction in the prescription of these drugs to individuals receiving them for inappropriate reasons. As a result, lives have been saved and lives have been changed. But—and it is an important but—the Prime Minister’s progress report on his dementia challenge made it clear that there is no room for complacency and that there is still too much regional variation in the use of these drugs to manage people with dementia and too much prescribing. I hope that the Minister will tell us what the next steps will be, when the next audit, which has been committed to, will take place and be published and what other steps he thinks will be necessary to ensure that we achieve the goal of a two-thirds reduction in prescribing.

I pay tribute to Clare Gerada, president of the Royal College of General Practitioners, who was instrumental in getting the co-operation of GPs for the necessary

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surveys to understand prescribing practice and who has led some of the change in culture and behaviour in this area. I also pay tribute to the last Labour Government—not something I always do—for producing the first national dementia strategy. It was one of the first in the world, in fact, and should be recognised as an important contribution.

When I became care services Minister in May 2010, I had to make a judgment: did we carry on the road laid out in that strategy, or did we start again? I took the view that we should use the strategy as the foundation for future action, and I am pleased to say that, as a result, the Government have done a lot to deliver on the strategy and go beyond it, through the creation of a dementia action alliance, bringing many different organisations together in a common cause, through clearer commissioning guidance, through collaboration with the Design Council and through funding the Life Story Network to run training courses. The latter is a small thing, but it makes a big, big difference: by telling our stories and understanding who we are, we start to look beyond the diagnosis of dementia, and, as a result, we start to treat the person, not just the disease.

Furthermore, the audit of dementia services has given us a handle on where different parts of the country have reached in developing their services and has led to new incentives in hospitals to support best practice and the much-valued—I hope—analytical tools that will help to drive up diagnosis rates, which are still far too low. Following the research call made just over a year ago, I was delighted to see just last week that £20 million of funding has now gone to new dementia research projects. That far exceeds what I expected at the time as a Minister and certainly what many officials in the Department expected. It really is fantastic news.

The Prime Minister’s dementia challenge has put dementia centre stage, promoting dementia-friendly communities and raising the bar for early diagnosis and quality of care, along with ensuring vital dementia research too. There is a lot happening and it can happen back in our constituencies as well. All of us have an opportunity—and, I believe, a responsibility—to challenge our local services to do more to become more dementia-friendly and ensure that they learn the lessons from best practice. However, there are some questions that the Minister needs to answer about what comes next. The current dementia strategy runs its course in 2014. What comes next? In my view, there has to be a successor strategy—one that is perhaps different from the current strategy in a number of ways, building on the work being done as a result of the Prime Minister’s dementia challenge.

That challenge is a challenge to the whole of Whitehall, not just the Department of Health. Every Department should be a catalyst for action on dementia within its sphere of responsibilities. Indeed, just before Christmas I tabled a series of parliamentary questions to try to establish what each Department was doing to support the dementia challenge. The answers I received were highly variable. Not all Departments seem to have clocked the fact that they could materially do something to make a difference in their sphere of responsibilities. I hope we can pick up on what the Prime Minister said about this being a challenge that cuts right across society, as well as ensuring that it is picked up and

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understood right across government. Any new strategy needs to embed dementia-friendly thinking right across Whitehall.

We cannot have a debate such as this and not talk about carers. It is important to stress and value the role that family carers play. That is why I was pleased to see recently that the National Institute for Health and Clinical Excellence has launched a consultation on new indicators in the quality and outcomes framework for identifying carers of people with dementia. That is fantastic, but what about all the carers who do not happen to be caring for someone with dementia? On this occasion I think it is wrong to single out one disease. I hope that others will make that comment in the consultation too. The most recent research by the Carers Trust into the NHS and carers’ breaks continues to make depressing reading, however. Too much of the NHS is still ignoring carers and not doing enough to passport the money that this Government have committed to carers’ breaks and make them a reality. As the NHS increasingly wakes up to the big challenge of supporting people with dementia and other long-term health conditions, it needs to wake up to its role in supporting carers too.

I have already mentioned that I was pleased to see the increased research funding that is coming through. I was delighted in 2010 when the coalition programme included a commitment to dementia research. That is a commitment that I lobbied the then Liberal Democrat health spokesman—now the Minister on the Front Bench—to include in our manifesto. Although there has been progress—with a road map now setting the direction of travel, a challenge group bringing various players together and a commitment to double research spending—I found myself becoming increasingly frustrated as a Minister by what I felt to be a poverty of ambition when measured against the burden of disease that dementia represents. We are not yet doing enough—we do not yet have the critical mass—to reach the scale and pace necessary to gain the understanding and insights that we need to make the breakthroughs. The £20 million from the research call is fantastic and I hope it will make a difference, but we still have lessons to learn from the journey made by the cancer research movement. I believe the dementia research challenge group itself needs to be challenged more. We need a long-term plan for dementia research and a sustained increase in funding for at least the next decade. This is about a common endeavour—a collaboration, as it were—between the research funders and the research community, so that we make a concerted effort to expand our knowledge of this disease, to diagnose and treat it and, ultimately, to understand and defeat it.

John Pugh (Southport) (LD): I am listening carefully to my right hon. Friend, but dementia is clearly not an English disease; rather, it is an international threat. Is there not scope for massive international collaboration on what is an issue confronting all nations?

Paul Burstow: My hon. Friend makes an important point. Yes, there is scope for that; indeed, many research organisations in this field are already collaborating internationally. However, as a country with a very reputable

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research tradition, it is important that we should be in the vanguard of that research and put in place the necessary infrastructure to drive it forward.

Huw Irranca-Davies (Ogmore) (Lab): I thank the right hon. Gentleman for giving way and welcome his very good introduction to this debate. I would make the same point about research within the UK. Post devolution, we often tend to look at it in terms of the different nations and regions in the UK. We should be sharing the best expertise and best practice right across the nations, because 800 of my constituents have been diagnosed—I suspect that there are many more who have not and they, too, need the very best assistance and support.

Paul Burstow: One of the great things about devolution is that we can try out different things in different jurisdictions, but it is great only if we learn from that by taking the best and using it elsewhere. I therefore agree entirely with the hon. Gentleman that that is an important part of this debate. The ability to exchange and learn—and, yes, sometimes reject things that others are doing—is important.

My final point is about reform. I hope this year might be a tipping point for dementia. Reform of our broken care and support system has never felt closer. For people with dementia and the families who care for them, it cannot come soon enough. When the Prime Minister launched the dementia challenge back in March last year, he acknowledged the catastrophic costs that some people incur as a result of drawing the card in the lottery of life that says “Dementia”. He said:

“We are determined to do the right thing by these people”.

A dementia diagnosis is traumatic enough, without the knowledge that care costs can often spiral out of control as the disease progresses. While care financing is left unreformed, people with dementia face the prospect of losing both who they are and everything they have ever worked for.

I therefore very much welcome the news in Monday’s mid-term progress report that the Government are to press ahead with a cap and increased means test, and the confirmation that the House received on Tuesday from my right hon. Friend the Deputy Prime Minister that the necessary legislation will be enacted in the lifetime of this Parliament. In my capacity as Chair of the parliamentary inquiry into the draft Care and Support Bill, let me tell the Minister that the Committee has made it clear to me—and I absolutely agree—that we expect as much detail as possible on any new clauses or other changes that will flow from the introduction of a capped cost system into the legislation, so that we can do the House the service that we have been asked to perform, which is to report on and scrutinise the provisions and help the Government to introduce the best possible legislation to Parliament.

The Minister of State, Department of Health (Norman Lamb): Let me confirm to my right hon. Friend that I want to do everything I can to ensure that the Committee is as informed as possible, so that it can do the important scrutiny work that it is charged with doing. Let me also take this opportunity to pay tribute to the work that he did as my predecessor to push the dementia debate forward and make substantial progress.

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Paul Burstow: I am grateful to my hon. Friend and look forward to that collaborative approach to the Committee’s work.

I want to end by quoting from an e-mail I received recently. Hon. Members might be aware that I made some comments last week about one way in which I thought this policy change might be paid for. That generated quite a lot of responses; this is one of the ones I think I can quote in the House. It says:

“Tonight I am sitting on my own in the kitchen of our family home surrounded by a lifetime of mum’s possessions, all full of memories from certain times of our lives, while mum is in a care home blissfully (and thankfully) ignorant of my turmoil.

This has to be the lowest point in my life.

Not only coming to terms with the complexities both mentally and physically of dementia, realising I’ve lost my mum even though she’s still here, but stumbling through the bureaucratic minefield of trying to obtain funding and the emotional pressure of raising money by selling off, in effect, mum’s ‘life’.”

That is really what this debate is about. It is about people’s lives and how we can make them better. It is about how we can make the terrible journey through dementia as good as it possibly can be, and how we can secure the common good of having the right services at the right time. I look forward to hearing other hon. Members’ contributions to the debate.

Several hon. Members rose

Mr Deputy Speaker (Mr Nigel Evans): Order. We are going to be brave—or foolish—and start without a time limit on Back-Bench speeches, but it would be helpful if Members aimed to speak for 10 to 12 minutes. Anything beyond that would not be helpful.

1.40 pm

Hazel Blears (Salford and Eccles) (Lab): I am grateful for your guidance, Mr Deputy Speaker. It is a pleasure to follow the right hon. Member for Sutton and Cheam (Paul Burstow). In my capacity as vice-chair of the all-party parliamentary group on dementia—the right hon. Gentleman elevated me in his speech; our group is incredibly well led by Baroness Sally Greengross—I want to pay tribute to his work in this field. I appreciated his personal drive on this issue; it has made a big difference. I should like to thank the Backbench Business Committee for allocating the time for this debate. I should also like to thank all the Members here today. This is a fantastically good turn-out for a one-line Whip, Back-Bench business debate on a Thursday afternoon, and it indicates just how deeply people feel about this issue. The hon. Member for Chatham and Aylesford (Tracey Crouch) has been a tremendous help on the all-party group, and I am delighted to be vice-chair alongside her. Her personal drive and commitment have made a big difference.

Nearly 1 million people will be living with dementia by 2020, and the issue now touches the lives of virtually every family in Britain. It is a big issue for the NHS, but it is also a big issue for all the public services. I entirely endorse the right hon. Gentleman’s point that we have to join up the services right across Whitehall if we are going to make the progress that we need to make.

Ten years ago, when I was a Health Minister, it is fair to say that dementia was not at the top of the agenda for Ministers or for the NHS. As ever, there were more pressing issues, such as cancer, heart disease, waiting

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lists, maternity services—the list goes on. The voices raising the issue of dementia, and of care for older people more generally, were not heard as clearly then as, thankfully, they are today. This is now a massive challenge facing all of us, and I believe that increasing pressure from the public has helped to focus the minds of politicians and practitioners on what can and should be done to support those with dementia and, crucially, the people who care for them.

I also want to depart from normal practice and pay a warm tribute to the Prime Minister. He has put his personal weight behind this issue, and I know from having been a Minister that having the Prime Minister behind a project can give it momentum and get the system moving. It can provide a kick-start and a catalyst. I want to say a genuine thank you to the Prime Minister on this issue. That does not mean that there is not much more to do, and there are certainly concerns about ongoing funding issues, but having the Prime Minister say, “This is my challenge; I am behind it” will get things moving in the system.

Like most people, I got involved in this issue because someone I love has dementia. It is my mum. Over the past five years, I have seen and experienced the impact of that on her and on my dad, who, at the age of 83, is still her full-time carer. I want to raise three issues today. I want to talk about diagnosis, support in the community and the research challenge that we face.

My mum’s diagnosis was absolutely appalling. She had been having problems with her memory for about a year and a half and, like many people, she thought that it was just because she was getting older that she could not remember day-to-day details. However, when she could not remember the day of the week and when she started constantly to repeat herself, we as a family thought that she would benefit from a bit of expert advice.

Mum’s GP was not bad. He referred her to the mental health team for older people. She was just 70 at the time. What happened after that, however, was absolutely terrible. My mum and dad received a visit from a local psychiatrist whom they had never met before. She sat herself down on the settee without any formalities and proceeded to ask my mum 10 questions about the day, the date and who the Prime Minister was—I can think of lots of people who would not have known who the Prime Minister was—and after just a few minutes, announced to my mum and dad that it was very clear that my mum had Alzheimer’s. As Members can imagine, they were stunned and upset. They had no idea what that meant for them or what the future might hold. They were frightened and bewildered.

That was just the kind of brutal diagnosis that we used to hear about in relation to cancer sufferers, but here it was happening to the people I love. Suffice it to say that, after a formal complaint, we did not see that psychiatrist again, but the incident brought home to me how many people in those circumstances are subject to such hurtful and damaging insensitivity. Better dementia diagnosis has to be a priority. Yes, this is about earlier diagnosis, but it is also about sensitivity, understanding and finding the right circumstances in which to make a diagnosis that will fundamentally affect people’s lives.

Diagnosis rates in this country are low and incredibly varied. In general, just over 40% of people with dementia receive a formal diagnosis. The lowest rate is 26%, in

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Dorset, and the highest is nearly 70%, in Belfast. There must be a reason for such a dramatic variation. We have made little progress in recent years towards driving up diagnosis rates, yet diagnosis is key, because without it a person cannot gain access to the support services and the help that they need.

Sir Tony Baldry (Banbury) (Con): Is it not part of the problem that many GPs are anxious not to diagnose dementia because they feel frustrated that they do not know what to do following such a diagnosis? They do not know what to offer the patient, and there seems to be an inclination to avoid that frustration by not making a diagnosis of dementia at all.

Hazel Blears: The hon. Gentleman is absolutely right. In fact, the recent all-party group inquiry into diagnosis revealed exactly that situation, which is a real concern. Many GPs are uncomfortable about making a diagnosis of dementia. They sometimes feel that such a diagnosis is pointless if the necessary drug treatments or wraparound care and support services are not available. Increasing the confidence of GPs at that point to enable them to make a diagnosis is of fundamental importance.

The figures on diagnosis are quite stunning. Only half the GPs questioned said that they had sufficient training in this area, and a third of them believed that a lack of access to drug treatments was a barrier to early diagnosis. Almost a third were not confident about making a diagnosis of dementia, and only a third felt that they had had enough training to go through the diagnosis process. Unless we tackle that, we will not get the increase in diagnosis that the Prime Minister and all of us want.

Nick de Bois (Enfield North) (Con): I have listened carefully to what the right hon. Lady has said. She mentioned that Belfast had a high rate of diagnosis, at 70%. The figure in my constituency is around 36%. During her inquiry, was there any attempt to establish why best practice or prevailing factors could not be transferred and learned across the spectrum, in order to improve the situation?

Hazel Blears: Yes, there was. The all-party group had an interesting presentation from the Scottish Health Department. Diagnosis rates in Scotland are very high indeed, and we learned that the highly organised, managed and focused system there was driving up diagnosis. It is driven, to some extent, from the centre, and I know that that is not always popular these days, but the drive from the centre out to the GPs is really making a difference. I think that there is room for us to adopt a more driven process—it need not necessarily be more centralised—in which GPs are more accountable and in which they report back on rates of diagnosis. There is much more that we can do in that regard.

Diagnosis is a problem, but once a diagnosis has been made, the availability of support in the community becomes relevant. There are many problems in that area. Our inquiry revealed that many carers felt that nothing happened after the diagnosis, because there was no help or support available. In my area in Salford, we are lucky. We have one of the 10 national demonstration

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projects established under the national dementia strategy in 2009, and we are developing some really innovative services in the community. I should perhaps declare an interest: my mum attends the centre two days a week, and I sit on the strategic board that drives the process there. I have seen that when people are really committed to such projects, they can make a huge difference.

Our centre is the result of a partnership between the local authority and the Humphrey Booth charity, which has existed in Salford since the year 1600. It is a marvellous example of people working together. The centre is known as the Poppy centre, and its facilities include a dementia singing group, on a Wednesday, which attracts 150 people. That is an incredible resource. The centre also offers day centre services, art work, music, personal tailored care, a dementia café for when friends and family drop in, living history, hairdressing and hand massage. It is a wonderful place, staffed by brilliant people.

Alison McGovern (Wirral South) (Lab): I apologise to my right hon. Friend and other Members because I cannot stay for the whole debate. The lesson I have learned from her expertise and from the evidence I have heard about Salford on this and other occasions is that we cannot think in the old way about how we help people with dementia; we have to be creative and provide the best range of services possible.

Hazel Blears: My hon. Friend is absolutely right. We are at the beginning of the kind of innovative care that she talks about. One thing we need to do is to get more young people and more young clinicians involved in this area, because that is how we will see innovation coming through.

We have a brilliant centre in Salford run by the manager Sue Skeer. There is also Sue Smyth and Nicola Fletcher, and users and carers are on our board. Margaret and Fred Pickering are an inspiration: Fred has dementia, Margaret is his carer and the whole of our practice is driven by users and carers at the centre. We are lucky, but many places have nothing like the Poppy day centre to support them.

We want to make Salford a dementia-friendly community and to make sure that transport, housing, leisure and local shops are all aware of the issues around dementia. My local university in Salford is setting up a dementia centre—a collaboration between the department of the built environment, including architects, and the department of social care. Design is being looked at really seriously. A marvellous Italian Professor Ricardo Codinhoto and a wonderful nurse, Natalie Yates-Bolton have inaugurated not just the design centre at Salford university, but now a European collaboration so that we will have an international design network on how we can make dementia-friendly communities work.

My question to the Minister on dementia-friendly communities, which we hope to be in Salford and which York, Plymouth and other places are pursuing, is: what resources have the Government committed to support the work of these communities, and how will it be sustained in the long term? We can push on, but we need a resource to make it happen. Yesterday, I met Duncan Selbie, the new director of Public Health England, who is going to make dementia a national priority for

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public health, so there really is commitment and energy behind all this. I want to hear from the Government what they can do to help.

Let me briefly cover my second theme—I have accepted two interventions—which is about the research challenge. I met the Wellcome Trust this week, and I was hugely encouraged by its willingness to put serious research funding into this area. It is looking not just at clinical research, which it might have done in the past, but at research on “living well with dementia”, recognising the importance of a holistic approach. I was impressed, too, when I met David Lynn and Dr John Williams. They acknowledged the difficulty of this area because there is so much that we still do not know about the brain. Nevertheless, despite the failure of the recent clinical trials, the data from them could prove very useful in taking us forward to the next steps, which we hope will help us find drugs that will at least slow down or delay the onset of Alzheimer’s. What everyone who has Alzheimer’s wants is a cure; they are desperate to get some progress here.

If we have a really big push on research, I feel that progress could be made. Our scientists are some of the best in the world in this area, yet for every six scientists working on cancer, only one works on dementia. Only 2.5% of the Government’s research budget goes to dementia, with 25% going to cancer. We should look at the progress made in cancer over the last 20 or 30 years; I do not want to wait another 25 or 30 years to make the same progress for the hundreds of thousands of people who are suffering from dementia now. The Government really must press on.

There are many people out there who want to help us. Just this week, the Daily Mail featured a long article about the possible benefits of coconut oil and the work done on that at Oxford. I have no idea whether that is likely to help people. It has helped some families, but we can see from that the absolute desperation people have to try to find something that can help the life of their loved one. Research is thus a huge challenge, as is help in the community.

I want to express some concerns about where we are at the moment. It is a time of great change in the health service. We are moving from primary care trusts to clinical commissioning groups, and it could be a time of instability. I am worried about the expertise—or lack of it—in the clinical commissioning groups when it comes to commissioning for something as complex as dementia. I want every CCG to have a lead for dementia, developing expertise and knowledge so that they know how to get the best from the money available. I would like to hear the Minister say that he wants to see a dementia lead in every CCG.

My final point is about the resources available to us. Over the last three years, my local authority has faced cuts of £876,000—30% of the adult social care budget. I know the Government will say that they have put £1 billion back in and that £1 billion has been lost, but when the budget is not ring-fenced, it can easily get spent on other issues. It is virtually impossible for councils to meet their targets without looking at the adult social care budget, which is 40% of their overall expenditure. That is why we can see day centres closing. They are an essential support network, providing a lifeline for carers, yet they are being cut. I am very worried indeed—not just about local authority cuts, but

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about buddying services provided by Age Concern. These voluntary and third-sector groups, so essential to people, are now quite fragile.

I am sure that the future funding of social care is going to be discussed. I make a plea: please may we have the cap at a level that helps the majority of families that need to be helped? If it is set at £75,000, I will be worried that those who really need the help will not receive it.

I think we are now at a point where progress can be made of the kind that has probably not been made for years. I really hope that we can press forward on a cross-party basis. We need a long-term settlement so that we can support people at what is probably the most difficult and frightening time of their lives.

I remember what it felt like to discover that my mum had dementia and that her future would be so different from the one that her and my dad planned together. We have been lucky in that we have been able to speak up and get help and support from the fantastic caring people at the Poppy centre, but it is hard for many people who might not have a strong voice or someone to advocate on their behalf. My mum instilled in me that sense of justice and fairness, which has driven me throughout my political life. I know that she would want me to continue to fight for all those who often find themselves bewildered and powerless, and to make sure that they are treated with care and dignity. We owe them all nothing less.

1.56 pm

Tracey Crouch (Chatham and Aylesford) (Con): It is an honour and a pleasure to follow what ended as a very moving speech by the right hon. Member for Salford and Eccles (Hazel Blears). She is a fantastic fellow vice-chairman of the all-party group, and a real champion on this issue. I would also like to take the opportunity to pay tribute to the right hon. Member for Sutton and Cheam (Paul Burstow), who I thought progressed this issue as a Minister much further and much quicker than did previous Ministers.

I start my comments this afternoon with an explanation of what sparked my interest in this incredibly important issue. As a parliamentary candidate, two events collided and aroused an immense passion about dementia that will stay with me for ever. I cannot quite recall the precise sequence of events, but one was personal and one was professional.

The first was my father calling me to tell me that his mother, Nana Crouch, had been diagnosed with dementia. My beloved grandfather passed away when I was a teenager. Following her diagnosis with this awful condition, nana regressed quickly and was transferred into residential care for her own safety. I went to see her, but she was so confused about who I was that she became quite frightened and I left concerned for her own mental well-being. It was very upsetting to see a lady I respected and loved hide in a corner cowering with fear.

The second event involved me knocking on the door of a man called Maurice. He and I remain friends today, despite our political differences. At the time, Maurice’s wife was still alive but was in a care home suffering from dementia. Maurice is a great man, one with a military background and one who had his whole world of traditional male-female relationships turned

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upside down when he suddenly had to care for his wife. The challenges that Maurice faced are ones that many carers are exposed to, but his real concern—one I now share—was the poor care his wife received while she was in hospital for a minor injury, where her health care needs were exacerbated by her dementia.

This issue of inadequate hospital care for dementia sufferers is a substantial one. While there is much evidence of good practice, there is an unacceptable variation in the quality of care. Maurice has become a pain in the proverbial, albeit in a good way, to local health care organisations. He champions the need for better care for dementia sufferers in hospitals—and rightly so. Of the carers responding to the Alzheimer’s Society’s “Counting the Cost” report, 77% stated that they were dissatisfied with the overall quality of care provided to people with dementia in hospitals. The key reasons included nurses not recognising or understanding dementia, lack of person-centred care, patients not being helped to eat or drink and patients being shown a lack of dignity and respect.

The issue has been highlighted many times, most recently in a report from the Royal College of Nursing. Staff training, for which nurses themselves are calling, would constitute a vital step towards the addressing of those inadequacies. However, we must also achieve the correct balance between health care assistants and nursing staff, which is vital to the provision of personalised care in hospitals. All too frequently the problem is not the number of staff, but the fact that the ratio of health care assistants to nurses is too large, and nurses are therefore unable to support staff sufficiently.

Unnecessary admissions and prolonged stays in hospital are expensive, and much too often they have negative effects on health and well-being. The all-party group looked into that and the cost to the NHS. I personally favour the notion of the halfway house: a service that could provide a primary care facility for those requiring medical attention for, say, a broken bone or a superficial wound, but in a less hospitalised environment. Not only might that be more cost-effective for the NHS, but it could address the issue of institutionalisation. One in four people in hospital beds have dementia, and, on average, people with dementia stay in hospital a week longer than those without dementia who are being treated for the same injury.

People with dementia often become extremely distressed by ordinary events, such as meal times, and need extra help. If food is just left in front of them, they will not necessarily eat it even if they are hungry. It might be helpful for carers or family members to be present when they are served their food, but most hospitals do not currently allow visitors at meal times. I am keen to hear from the Minister what measures are being introduced to make hospitals more dementia-friendly, and, in particular, what action is being taken to increase dementia awareness and understanding among hospital staff.