Last night's confidence vote has clearly demonstrated that there is no majority in the Conservative Party in the Commons, let alone across Parliament, for the hard Brexiteer's vision of Brexit. I supported the PM in last night's vote. The inescapable truth is that the Withdrawal Agreement and Future Framework will not pass the Commons either but it is the only realistic negotiated version of Brexit. We have reached deadlock and sooner or later the PM will have to take her deal direct to the people or risk us crashing out in a chaotic Brexit with inadequate transition arrangements in place. Britain is woefully unprepared for that and no responsible government could allow that to happen.
This whole episode was unwelcome and unnecessary but at least we will all be spared the weekly threats of the '48' letters for at least a year and the PM should now stop trying to appease the right wing of the Party.
I will be backing Theresa May in this evening's confidence vote. I hope that the ERG will finally be shown for what they are, a small and unrepresentative faction pushing for a version of Brexit that has no chance of passing the Conservative Party let alone the House of Commons. It was irresponsible and self-indulgent for a few individuals to be pushing their own leadership ambitions at such a time of national crisis and particularly to have done so whilst our Prime Minister was meeting EU leaders abroad.
No one should doubt Theresa May's personal integrity and sense of duty and the contrast with those scheming to take her place could not be in sharper relief. Whilst I continue to hope that the PM will move to take her deal direct to the people, I have great personal respect for her determined efforts to try to find a compromise through the Withdrawal Agreement and Future Framework.
I hope we will now be spared the ERG posturing for a while as, following an unsuccessful leadership challenge, there cannot be another for 12 months.
The Parliamentary vote on Tuesday has now been delayed and we are awaiting a Statement from the Prime Minister in the Commons at 3.30 today to set out what happens next. I hope that there will be an acknowledgement of the gridlock in Parliament and a pledge to return the decision on the final deal to the British people, with an option to remain with the deal we already have.
The European Court of Justice has this morning ruled that the UK can unilaterally withdraw Article 50 if that follows a democratic process and that if it did so we would remain on current terms. This matters because there has been some false speculation that Britain might face a penalty for remaining and this puts beyond doubt that this would not be the case.
Thank you to everyone who has written to me about Brexit and the Parliamentary votes due to take place on Tuesday. It used to be said that 'a week is a long time in politics', but the situation appears to be evolving far more rapidly than that.
As things stand, it looks certain that the Approval Motion for the Withdrawal Agreement and Future Framework will fail to pass the Commons. This defeat would then come on the heels of three avoidable defeats last week where the government was found in contempt of Parliament for refusing to abide by its own promise to publish its legal advice, and on the issue of Parliament's demand to be able to amend future motions on Brexit.
In 'normal' times, the official opposition would then move to a vote of no confidence in order to try to trigger a general election. That Labour now say that they will delay, this reflects their ongoing reluctance to come off the fence on the issue of a People's Vote, as they have long promised their members that they would move to back such a vote if their bid to trigger an election failed.
The simple reality of the situation we face is that both the main political parties are divided on Brexit. The same is true of our country, this constituency, communities and even within families.
Parliament has reached gridlock, with no majority in support of any of the options, not for the Prime Minister's compromise, not for the softest 'Norway' style Brexit, with or without a customs union, not for a Canada style free trade agreement and least of all, because of the scale of the consequences, for No Deal without any transition.
Once the approval motion falls, it is likely that the PM will try to seek further concessions from the EU but their position has remained united and that looks unlikely. Coming back to the Commons with cosmetic warm words will not yield a different result.
The fact is that this negotiation was always going to be far tougher than was claimed during the referendum campaign in 2016. Far from being 'the easiest deal in human history', breaking away from more than four decades of close ties will leave Britain poorer and more isolated. Brexit is about far more than free trade deals or being in the fourth division trading on WTO rules.
The uncomfortable Brexit reality is set out in the WA and FF, full of trade-offs, compromises and future uncertainties that please no one. If agreed this wouldn't end the wrangling, the real negotiations about our future relationship would just be beginning as set out in the 26 page wish list of the Future Framework, but with no leverage on the part of the UK.
I cannot support it for that reason, but also because I do not think it has the valid consent of the British people. At the time of the original referendum, Brexit was sold on a false prospectus of unrealistic promises and at a time when no one could say which of the many versions would be the final outcome. We now know what Brexit looks like and people are in a position to weigh up the risks and benefits of the negotiated deal as opposed to unrealistic promises that cannot be delivered. Rather than plunge us into weeks of constitutional crisis or risk crashing out with no deal or transition, I hope the PM will take her deal to the people with a simple question about whether they wish to proceed on these terms or stick with the deal we already have. I will be supporting a People's Vote.
The message from clinicians and scientists is clear; Brexit is bad for our health. It will be harmful for people who rely on the NHS, research, social care and public health as well as for the workforce on which these depend. Having listened to the evidence presented to the Health and Social Care Committee in Parliament over the past couple of years, I cannot remain silent about the impact this will have on the communities I was elected to represent, especially in the event of a chaotic exit with no deal and no transition. Hard Brexit in particular would knowingly, and avoidably, inflict reckless damage to the close partnerships, built up over decades, in place at every stage from research and development to medicines and devices arriving on the community pharmacy or hospital shelf.
There is no version of Brexit which will benefit the NHS, social care, public health or our life sciences sector, only varying degrees of harm. This, together with the wider economic fallout from Brexit, will have the hardest impact on the most disadvantaged in society. We would not be insulated from the economic damage here in Devon.
Brexit reality is vastly different to the fantasy Brexit miss-sold to the public during the referendum campaign. The promise on the side of the bus of an extra £350m per week has crashed into the inconvenient truth that there is no Brexit bonanza for the NHS, only a Brexit penalty. A new report, Brexit and the Health and Social Care Workforce in the UK - by the National Institute of Economic and Social Research (NIESR) - also highlights the vital role of EEA nationals across social care as well as the NHS, and the scale of the threat to recruitment and retention as a result of Brexit.
It is likely that there will be provision for doctors and nurses coming to the UK after Brexit, albeit at extra cost and bureaucracy, if the government follows the guidance of the Migration Advisory Committee. But the effect on the social care workforce and those who rely on them for care will be particularly serious because of the salary threshold of £30,000. We already have a serious shortfall of healthcare assistants in social care in our area. We cannot afford to lose or further demoralise those who have given so much to our health and care services.
Brexit is major constitutional, economic and social surgery and we are all being wheeled into the operating theatre on the basis of a vague consent form signed over two years ago when no one knew which of the many versions of Brexit would be taken forward. It is time to insist that our politicians apply the principle of informed consent. The Withdrawal Agreement has been published alongside a draft Future Framework for our relationship with the EU after Brexit. Only now can we properly weigh up the risks and benefits of the proposed surgery rather than the fantasy Brexit touted in the referendum. Parliament is in gridlock and there is no majority for any of the options. It is wholly disingenuous for Mr Corbyn or the right wing of the Tory Party to pretend that they could negotiate a better deal with less than 130 days until we could end up crashing out with no deal and no transition. Neither will an irresponsible leadership challenge help in such a moment of national crisis.
The Government needs to recognise the stalemate and suspend Article 50 to allow the public their say on the only realistic deal that could be negotiated. That People's Vote should include the option to remain in the EU.
People may come to the same conclusion to leave the European Union. To proceed without informed consent, however, would not only be grossly unethical, it would also place the blame for the unintended consequences squarely at the feet of all those politicians from across both main Parties who allowed it to happen.
Alongside a group of current and former clinicians in Parliament, I plan to bring forward an 'informed consent' amendment to the 'meaningful vote' approval motion on the final deal that would make the deal conditional on a People's Vote. It is not acceptable for MPs to sit on the sidelines claiming that the people have already delivered their verdict. Without informed consent there is no valid consent.
If you were about to undergo surgery, you would expect to know what the operation involved and to be informed about all the risks and benefits. It's called informed consent and no decent surgeon would go ahead without it.
Brexit certainly is major surgery with far-reaching consequences and the government is about to proceed without informed consent.
At the time of the referendum the choice was simply to leave or to remain. The type of Brexit was not on the ballot paper, which is like a surgeon asking their patient to consent to an amputation in two years' time without either of them knowing whether this would involve a few toes or their whole leg.
Voters were assured that this would be the easiest deal in history and that the world, including the EU, would be queuing at our door to trade on our terms. There would be cake and we would be eating it, alongside every fish that swam in our waters.
In the real world, instead of a bespoke deal we are all being marched briskly to the edge of the cliff. No deal and no transition look increasingly likely to be the outcome, and is the preferred option of those MPs who have deliberately and fatally undermined the Chequers plan.
The surgery looks set to be far more radical than anything set out in the referendum and the side-effects and complications of a hard, walk-away, no-deal Brexit with no transition are very different from the promised targeted surgical excision of just the parts of the EU that the Brexiteers didn't like. Shouldn't people have an opportunity to weigh up the risks and benefits before proceeding?
Once we know the final terms there is not just an opportunity but a duty to set out the unintended consequences as well as the potential benefits. There is a compelling case for that to be followed by a people's vote: we have to make it clear to government that it should not embark on potentially ruinous surgery without the informed consent of the British people.
It might be that a majority nevertheless decide to proceed, but there is no democratic mandate for Brexit until the choice is clear and an informed decision can be made. If the hard Brexiteers are confident about their walk-away, no-deal scenario they should be happy to agree.
The polls show that public opinion is turning on Brexit, especially as the sheer scale of the cost and consequences becomes clearer.
No responsible government should countenance deliberately and knowingly inflicting such economic and social harm on its people before at least checking that is what they really wanted.
During and after the referendum campaign I asked many people about the priorities behind their vote. The fact is that there was no one single issue. For some it was a promise on the side of a bus, for others, 'taking back control' over issues ranging from agriculture and fisheries to immigration and sovereignty. I met almost no one, then or now, who felt that we should accept being poorer as a result. As the reality hits home that the EU will reject sector by sector deals, 'the cake and eat it' approach, even if that means economic pain on both sides of the Channel, a stark choice lies ahead: Do we really want to march out through the exit door with no deal at all and with less than a year to put in place complex customs and borders arrangements? Rather than presenting a rose-tinted view, the hard Brexiteers need to level with the public on the scale of the unintended consequences. The government should not keep the economic impact analysis locked in a secret reading room accessible only to Parliamentarians but publish these so that everyone can examine the evidence.
In supporting New Clause 5, an amendment to the Trade Bill that would keep us in a form of customs union or customs arrangement after Brexit, I am not 'blocking' Brexit or 'obstructing the will of the people'. Britain is leaving the EU. This is an argument about the type of Brexit and that was not on the referendum ballot paper. The duty for MPs in carrying out the will of the people is to examine the evidence and press for the best possible Brexit, not to make their constituents poorer.
My view is that we should also opt for membership of the EEA and EFTA at least for the transition period. This would allow us to leave the Common Fisheries Policy and, like Norway, regain control over our fisheries, an issue of great importance to Brixham. But frictionless trade is also hugely important for both fishers and the processing sector, and in particular for exports to our most important markets in the EU.
Without a form of customs union or arrangement, border checks are an inconvenient inevitability. Without a customs union the current fudge over the border between North and South on the island of Ireland will inevitably become untenable. No one wants a return to the conflict of the past. The price of abandoning any kind of customs union is too high and I won't support it.
There is also a simple truth that there is no Parliamentary majority for a walk-away, no-deal Brexit. The small band of hard Brexiteer MPs need to stop throwing down red lines like spaghetti and stop threatening to remove the PM unless she bends to their will. The PM has herself spoken clearly of wanting a customs agreement with the EU and NC5 is compatible with that as it does not call for 'the' Customs Union on existing terms. My role as an MP is to read the evidence and to clearly state the case for what I believe is in the best interests of my constituency and the country even if that is sometimes wilfully misrepresented by those who simply want us to walk away, whatever the unintended consequences.
Below is an article I wrote for the Financial Times
There is nothing new about winter pressures in the NHS. What has changed is that those pressures have become relentless, extending year round into traditionally quieter months but deepening in intensity over the winter. The current crisis is not simply caused by the number of people turning up to A&E but because those who do are far more unwell and many more need admission. With hospital bed occupancy already running at unsustainably high levels and a growing shortfall in community beds and workforce, the health and care system can rapidly become overwhelmed. An upswing in norovirus and flu over the past fortnight seems to have been the final straw. NHS England had little choice but to implement its emergency plan to ease the acute pressure by cancelling routine surgery until the end of January. Unless we address the underlying issues across both health and social care this will however become the norm for every winter. Beyond that the unsustainable pressures will result in a collapse in routine waiting time standards.
Increasing life expectancy is one of the greatest successes of our age, but as we live longer and with more complex conditions, health funding has lagged behind. There has been an abject failure on the part of successive governments to plan for the sheer scale of the long term demand and costs associated with demographic change and for the change required to integrate of health and social care,
The House of Lords Select Committee set up to examine the long term sustainability of the NHS rapidly concluded that it could not do so without including social care. The government needs to take note before repeating the mistakes of the past. A green paper that looks solely at long term funding for social care will miss the point that these two systems cannot be considered in isolation from each other. Neither should anyone underestimate the challenge of delivering policy change in a hung Parliament or under a government whose energy is so consumed by Brexit.
There is a way forward but it will take political courage from both front benches and genuine willingness to put the public interest first. Before Christmas, 90 backbenchers from across both sides of the House of Commons, wrote to the Prime Minister urging a cross Party whole-system approach to the challenges and funding of the NHS, social care and public health. Select Committees could also play a role to help to build on existing work and set out the options for the public. Theresa May's former Chief of Staff has advocated a Royal Commission but we do not have the luxury of time to kick this important issue into such long grass.
Many of the options have already been described, for example by the Barker Commission and recent House of Lords inquiry. The reality is that we will all need to be prepared to contribute more if we want the NHS to remain a universal service, free at the point of delivery and meeting our needs both now as well as in the future. This cannot in my view fall entirely on working age employed adults but also needs to consider inter-generational fairness, wealth and contributions from those who are self employed. As graduates struggle with student loans it would be unfair to expect them also to shoulder the increasing costs of health and care for those in retirement irrespective of their wealth. We could look at ideas for a hypothecated health and care tax for example paid by those over forty and with income from any source above a set threshold. Some advocate introducing charging and top ups but these bring higher transaction costs and widen health inequality. The point is that all these options should be clearly set out alongside the consequences of a failure to invest more in the NHS, care, public health and prevention.
Since 2010, total health spending has risen by an average of just over 1% per year. This is far lower than the long term average increase of around 4% and comes at a time of extraordinary rise in demand and the costs of drugs and technologies. Real terms cuts to social care have added to the strains.
It is time to stop viewing health as a bottomless pit but rather as one of our greatest successes and make increasing investment a source of national pride. I cannot think of a better way for Theresa May to celebrate the 70th anniversary of the NHS than by helping to make sure that it has a sustainable long term future.
Below is an article that I wrote for the Sunday Express
There is nothing new about winter pressures in the NHS. What has changed is that those pressures are now year round but in winter the crisis is far deeper.
NHS England has put in place a plan to deal with this by cancelling routine surgery, but this will not feel 'routine' for those in pain awaiting a hip replacement for example. I understand the need to focus here and now on emergencies but we should not have to accept that cancelling this kind of life-changing surgery becomes the accepted annual response to winter.
The causes of these pressures are well known. It is of course great news we are living longer but as we do so we are living with far more complex long term conditions and the cost of treatment and technologies continues to rise faster than increases to the NHS budget. NHS staff have done an heroic job but they and the whole health and care system are stretched to the limit as they cope with far more people who are seriously unwell.
We cannot continue to provide the service we all expect on current finances, staffing and infrastructure. It is time for an urgent review to find the funding that both the NHS and social care need in order to make it happen.
We also need to end the culture of short termism and look not just at the here and now, but plan properly for the future and look at health, social care and public health together.
The public are being let down by a political failure over past decades to plan ahead, to be honest about the scale of the challenge and to work across Party lines to find a fair solution.
Before Christmas 90 back bench MPs from across political parties tried to change this, we wrote to the Prime Minister calling for this approach. Likewise in my role chairing the committee that calls the PM to give evidence, I told Theresa May that Select Committees (which work across Party political lines), stood ready to help. The fact is that no Party has a monopoly on good ideas on how this funding could be achieved and in a hung Parliament it needs cross Party working to get change such as this across the line.
No one wants to have to fork out but the truth is that we need to be prepared to pay more to support health and care services or services will decline. There are serious questions about whether it is fair for this to fall entirely on those of working age through taxes. My personal view is that it is not and that we should look at how it could be shared fairly across generations.
I know many people argue it is time to introduce charges to the NHS but this risks widening inequalities and also introduces costs and bureaucracy associated with collecting these relatively small payments. I know, as a former GP, that many of my sickest patients struggling on low incomes would have delayed coming to see me had there been a charge. This can end up not only with worse consequences for health but costing the NHS more in the long run. I also feel strongly that charging for appointments would go against one of the great founding principles of our NHS, that it is free at the point of need. It's what makes our system the fairest in the world and we should beware undermining that.
I believe the best way forward is stick with our tax and National Insurance based system as the core funding but look again at how National Insurance is collected and from whom so it can became dedicated to funding the NHS and social care.
It is time for an NHS and care convention to explore all the funding options and explain these clearly to the public and to look again at the options for sharing the costs of social care so that we no longer have the awful care costs lottery of one in ten people over 65 facing catastrophic costs.
A convention should not ignore the ongoing need to reduce waste in our NHS and I hear many examples of this in my work as chair of the Health Select Committee. Making sure that all areas learn from the best performing Trusts for example. Progress is being made in many areas already, for example driving down the huge variation in the amount the NHS pays for identical products. We also have to go further on prevention. Anyone who has spent time in an emergency department on a Friday or Saturday night will know how much drunkenness adds to the workload and avoidably ramps up waiting times.
It's easy to focus on the negative stories but the fact remains that our NHS and is doing a remarkable job and in its 70th year we should should celebrate it's successes and grasp the opportunity to make sure that it can not just survive but thrive. Rather than seeing health and care spending as a 'bottomless pit' we should view funding these properly as a source of national pride. These discussions have now become a national emergency and its time to ditch the Party politicical bickering and make it happen for the whole system our NHS, social care and public health.
This week I voted for an amendment to the European Union Withdrawal Bill because it was necessary to guarantee that there can be Parliamentary scrutiny and sovereignty as we return control of our laws from Brussels. There have been strong opinions on both sides of the argument about this, and even suggestions that by backing this amendment I have somehow blocked Brexit, or increased the likelihood of another election. This is not true. I respect the referendum result and voted to trigger Article 50. We are leaving the European Union but need to do so in a way that leads to as few unintended consequences as possible.
In returning powers from Brussels we must not exchange one system with poor democratic oversight for another. As we take back control of our laws, Parliament has an important role to play in scrutinising the government's work. Both in my role as Chair of the Health Committee and as a Constituency MP it is my duty to be look closely at both the pitfalls and opportunities of the various options for the type of Brexit ahead.
Clause 9, which I and colleagues voted to amend, had such far reaching consequences that I have copied it verbatim below:
A Minister of the Crown may by regulations make such provision as the Minister considers appropriate for the purposes of implementing the withdrawal agreement if the Minister considers that such provision should be in force on or before exit day.
If left unamended, this clause would have been incompatible with the Prime Minister's pledge to give Parliament a 'meaningful vote' on the deal. In effect, it allowed Ministers to make changes to laws with no democratic check by Parliament. Its breadth even concerned Brexiteers like Jacob Rees-Mogg, who said during the debate, "clause 9 gives some powers that trouble even Eurosceptics. I have never felt comfortable with the self-amending part of the Bill."
I and my colleagues had made our concerns clear to government for many weeks ahead of the vote and we feel that this vote was entirely avoidable. The clause should have been removed and the government could easily have done so. This would have avoided the need for an amendment.
Far from obstructing Brexit, this vote strengthened its democratic underpinnings, preventing major constitutional change from potentially being pushed through purely by ministerial decree.
I have been dismayed with how irresponsibly my vote has been misrepresented in some parts of the press. I welcome robust debate and I am always willing to listen and to defend what I believe. Labelling MPs 'traitors' for defending a fundamental democratic principle or judges 'enemies of the people' for upholding the law, just fuels a hateful division. It also entirely misrepresents why I voted as I did and why I felt it was necessary.
As we build an independent Britain – we will need to work constructively with our European neighbours. The more I hear, during Select committee hearings, about the consequences that would arise from a disruptive and chaotic Brexit, the more I feel that we must try to achieve a soft landing. The consequences of no deal and no transition would be very serious indeed.