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House of Commons Hansard
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Commons Chamber
11 October 2016
Volume 615

House of Commons

Tuesday 11 October 2016

The House met at half-past Eleven o’clock

Prayers

[Mr Speaker in the Chair]

Oral Answers to Questions

Health

The Secretary of State was asked—

GP Interventions: Physical Activity

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1. What steps he has taken to support GPs in prescribing effective interventions to change behaviour and promote physical activity. [906489]

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The National Institute for Health and Care Excellence recommends that exercise referral schemes should be provided for people at increased risk of ill health, and it is right that such schemes are developed on a local basis to meet the needs of the population. Our NHS five year forward view strategy prioritises prevention, and the GP physical activity clinical champion programme has taught more than 4,500 healthcare professionals to provide advice on physical activity in routine clinical consultations.

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In the north-east, only 33% of adults participate in weekly sport, compared with 38% in London. This has a knock-on effect on people’s health throughout their lives. What are the Government doing to address these geographical health inequalities?

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The hon. Lady is absolutely right to raise this question. Inactivity costs England an estimated £7.4 billion a year, and regular physical activity reduces the risk of developing many health conditions by between 20% and 40%. People who exercise regularly can reduce their risk of developing certain kinds of cancer. We are particularly pleased that, in addition to the GP physical activity clinical champion programme, Public Health England has secured funding from Sport England to pilot an education cascade model involving midwives, physiotherapists and mental health nurses and, with the support of the Burdett Trust for Nursing, will soon be launching a pilot involving 21 clinical nurse champion programmes to embed this knowledge in practising nurses. It will, however, be up to local areas to ensure that they make the best of these programmes by targeting them at their local area.

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On the behaviour part of the question, what can the Minister do to combat what seems to be an emerging picture of over-consumption of painkillers and to enforce NICE guidelines on their use?

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The hon. Gentleman raises an important issue relating to drug and alcohol misuse. We have prioritised this question as one of the local statutory requirements. We have given £16 billion to local health authorities for public health delivery, and we will expect them to prioritise this issue.

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Lack of physical activity contributes to obesity. With today’s Health questions falling on World Obesity Day, as I am sure the Minister is aware, it is vital that we recommit our efforts to reversing rising obesity levels in the UK. An opportune moment would have been the childhood obesity strategy—sorry, the plan—that was published over the summer, but sadly it did not go far enough. Therefore, will the Minister commit today to ensuring that the plan is fully realised as a preventive strategy to change behaviours and help to make the next generation healthier than the last?

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I congratulate the hon. Lady on her appointment. I am particularly pleased to see her in her place. She has played an important role in the all-party parliamentary group on breast cancer. We are very proud of the childhood obesity plan. It is based on the best available evidence, and it will make a real difference to obesity rates in this country. The Government are also consulting on the soft drinks industry levy, and we have launched a broad sugar reduction strategy. She is absolutely right to say that we must now work hard to ensure that we deliver on that with the NHS, local authorities and other partners as we move into the delivery phase of the plan. We are proud that it is a world-leading plan.

Health and Social Care: Plymouth

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2. If he will visit Plymouth to discuss how its city council has pooled health and social care budgets. [906490]

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Plymouth has gone further and faster in integrating health and social care than many parts of the country have done. The integrated fund that it has set up covers housing and leisure as well as health and care. I would be delighted to visit Plymouth and to learn more about how the fund is working in practice.

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As my hon. Friend points out, Plymouth has taken innovative steps to try to address some of the funding inequalities at play within the Northern, Eastern and Western Devon clinical commissioning group. However, between the calculated spend and the actual spend, there is a funding shortfall of £30 million. Will he agree to work with local MPs, stakeholders and those involved in the wider Devon sustainability and transformation plan to develop a written agreement to address these inequalities?

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My hon. Friend refers to the time lag that can exist between target and actual funding. When I visit, I will be delighted to meet stakeholders not only to understand the allocation issues to which he refers but to congratulate the health and social care leadership on the progress they have made with their fund and on the above-average satisfaction ratings that have been achieved in Plymouth.

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12. When the Minister is in Devon, will he meet patients’ groups and NHS staff, who are very worried about the proposals under the Government’s Orwellian Success regime, which include the closure of scores of community hospital beds, including the only community hospital beds in Exeter at Whipton hospital? Although it may make sense to integrate, and it certainly makes sense to move money from beds and buildings to better care for people in their homes, does he accept that it is simply not deliverable against a backdrop of massive cuts in social care budgets? [906501]

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Yes, I am happy to meet in that context. The right hon. Gentleman is right that the Success regime is about a transfer of resources from the community hospitals to care at home and domiciliary care. That is not necessarily the wrong thing to do, but it must be done right, and I am happy to meet.

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I welcome greater integration, but the Minister will be aware that there are grave concerns about the effect of cuts to social care on the NHS. More and more patients are spending greater time in more expensive settings in hospital when they could be better looked after in their own homes or in the community, but cuts to social care make that impossible. Will the Minister set out what appraisal the Government are making of the effect and the damage to the NHS of cuts to social care?

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My hon. Friend is right: social care funding is tight. It is also true to say that those parts of the country that do the best in this regard—there are some that do considerably better than others—have integrated social care and health most effectively. On the budget itself, there is some disparity among different local authorities. About a quarter of local authorities have increased their adult social care budget by 5% or more this year.

Alcohol Consumption Guidelines

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3. If he will publish the full scientific evidential basis for his Department’s alcohol consumption guidelines; and what representations he has received on those guidelines. [906491]

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The scientific evidence for the UK chief medical officer’s low-risk alcohol guidelines is available on the gov.uk website. The guidelines were published in August, following testing through public consultation to ensure that the advice is as clear and usable as possible. We received 1,019 responses to the consultation.

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There is an overwhelming scientific evidence base that shows the health benefits of moderate drinking—something to which I can attest. Does the Minister not agree that the chief medical officer should highlight those benefits more?

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For many people, drinking alcohol is part of their normal social lives, and we are perfectly clear that these guidelines are advisory. They are in place to help people make informed decisions about how they drink and decide whether they want to take fewer risks with their drinking. They are not designed to label everyone who drinks as a problem drinker or to prevent everyone who wants to drink from drinking, but I point out to the hon. Gentleman that Rochdale has more than double the number of admissions to hospital where alcohol is a factor than the best authorities in England.

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Following on from that answer, will the Minister reassure the House that public health guidance given to consumers of alcohol is realistic and will not undermine responsible drinking campaigns, penalise responsible drinkers or damage the vital role that pubs play in our communities?

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As I have said, these guidelines are simply intended to be advisory. They are intended to give the best possible information and advice and to put all the evidence in one place so that people can make the best possible decisions with their drinking.

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Campaigners on alcohol abuse have acknowledged the importance of the pub, which is a controlled sociable environment in which to enjoy a drink compared with the unrestricted supermarkets. Will the Minister have a word with her colleagues in the Department for Communities and Local Government who continue to preside over a system in which profitable wanted pubs are demolished and in which supermarkets are built on the site against the wishes of local communities?

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The hon. Gentleman plays a very important role as chair of the all-party save the pub group and has been a dogged campaigner for the pub. We are very clear that social drinking is not the target of these low-risk guidelines. I am happy to meet and discuss this issue with my DCLG colleagues.

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Sadly, very few people are aware of the link between alcohol consumption and obesity and of the long-term impacts of life-limiting diseases—not just cirrhosis. To ensure that the impact of obesity is integral to the alcohol consumption guidelines, will the Minister, on World Obesity Day, put tackling both adult and childhood obesity even higher up the Department’s agenda?

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The hon. Lady is right to raise the hidden risks of alcohol consumption, which is exactly why a widespread analysis of the evidence was conducted through this guideline exercise. She is right to say that obesity should be a top priority for the Government. We will analyse her question and look into it.

PFI Health Projects

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4. What estimate he has made of the value of assets funded by PFI health projects which will remain in private ownership after the contracts for those projects have concluded. [906492]

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Between 1997 and 2010, 103 NHS hospital PFI schemes reached financial close, creating liabilities for the NHS of £77 billion. Three legacy PFI schemes have been signed since 2010 on stricter terms, with liabilities of £1.7 billion, and one scheme has been signed under the new PF2 model, worth £340 million. In nearly all cases, except for a few of the early schemes, ownership of the hospital reverts to the NHS at the end of the PFI contract. But even in those schemes, the NHS always has the first option on whether to end or continue with the contract.

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Effectively, those figures will mean even more debt for the next generation. Will the Minister commit the Government to abandoning all PFI? It always was an idiotic scheme. No more PFI, no more PF2, etc—just abandon it, Minister.

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The hon. Gentleman has a consistent track record in opposing PFI, even when the vast majority of the schemes were put under contract by the Government of which he was a member—so I will not take any lectures from him about how to deal with PFI. We will continue to use the new stricter terms as and when appropriate.

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The National Audit Office concluded that the PFI contract for the Norfolk and Norwich hospital was a bad deal for the taxpayer and for the NHS, yet last year Octagon Healthcare made a record profit as the Norfolk and Norwich’s finances sank ever further into the red. Will the Minister consider making a formal approach to Octagon Healthcare to ask it to forgo part of its profit to help confront the enormous financial black hole that the trust faces?

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We have provided access for seven of the worst affected trusts with obligations under PFI to a support fund of some £1.5 billion to help them with those obligations. I am not sure whether Norfolk is one of them; I suspect that it is not. I would be happy to talk to the right hon. Gentleman about this, but rather than raising his hopes inappropriately I have to say to him that many of the schemes are too costly to divert resource to pay them off completely.

Clinical Commissioning Groups: “Five Year Forward View”

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5. If he will take steps to ensure that clinical commissioning groups publish their proposals for implementing the NHS “Five Year Forward View”. [906493]

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The “Five Year Forward View” will be delivered through sustainability and transformation plans which are currently being developed by clinical commissioning groups in collaboration with local authorities and providers. NHS England expects that all STPs will be published, although in some areas discussions are already taking place.

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I am led to understand that in Wycombe we should expect no dramatic changes and possibly no publication of a strategic plan. Does my hon. Friend agree that public confidence would be much enhanced by the clear articulation in public of a strategy for meeting the “Five Year Forward View”?

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I agree with my hon. Friend, and I will try to give a clear answer. NHS England is determined that all 44 areas will publish their plans shortly. For those that have not already done so, publication will take place after the formal checkpoint review at the end of October. Areas are working to different timescales, but the plans will all be published by the end of November. For the avoidance of doubt, that includes the STP for Buckinghamshire, Oxfordshire and Berkshire West.

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The NHS “Five Year Forward View” called for a radical upgrade in prevention and public health. How does the Minister square that with the Government’s subsequent cuts to public health, including £200 million in-year cuts and further cuts expected by 2020?

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The STP process is an attempt to upgrade our public health and mental health provision and cancer outcomes. Every STP will be expected to provide an assessment of local public health priorities and the timetable for progress towards that.

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Wantage community hospital in my constituency has recently closed because of the threat of Legionnaires’ disease, and it will not reopen until we have finally concluded consultation on the sustainability and transformation plan—if it reopens at all. This consultation has been delayed, and that naturally worries my constituents. Will the Minister join me in urging Oxfordshire to get on with consulting on this very important plan, so that we can have a reasonable discussion?

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I will join my right hon. Friend in doing that. I am not familiar with the specifics of the Wantage case, but it does not sound right that it is an ongoing thing that is not fixed quickly.

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May I congratulate the Minister on his appointment to the Front Bench, as well as the Under-Secretary of State for Health, the hon. Member for Oxford West and Abingdon (Nicola Blackwood), on hers? I am sure that they will do a terrific job in their posts.

As a type 2 diabetic, I am very concerned about the fact that local clinical commissioning groups are just not providing information on preventive work against diabetes. Will the hon. Gentleman confirm that diabetes will be referred to once these plans have been published?

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I will confirm that. There is a national diabetes plan, as the right hon. Gentleman will be aware. Diabetes is one of a number of long-term conditions in which these plans are charged to deliver improvements, and it would not be acceptable for a plan to be signed off or completed unless progress on diabetes had been made.

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When the Minister looks at new treatment options in the forward view, will he consider the example of Velindre NHS Trust in south-east Wales, which treats 1.5 million cancer patients every year and is now using reflexology, reiki healing, aromatherapy, and breathing and relaxation techniques to alleviate anxiety, pain, side effects and symptoms? If that was more widely spread over the health service in England, cost savings and patient satisfaction would increase.

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The STP process is locally led, not led from the centre, but I would expect clinical judgments of the type mentioned to be made if they could be confirmed on the basis of scientific and trial-based evidence.

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Central to the aim of the five year forward plan for the NHS is a sustainable health service in which all patients receive the right care at the right time in the right place. With that in mind, can the Minister tell me what action he is taking to address the problem of delayed hospital discharges, which have risen by 20% so far this year? That amounts to an additional 926 people every day condemned to stay in hospital longer than is medically necessary.

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First, may I welcome the hon. Lady to her post and wish her luck in the new job? There has been an increase in delayed discharges in England over the past year. Only a part of that increase is due to difficulties in the integration between social care and the NHS—a large part of it comes from within the NHS itself—but it is not uniform across local authorities. Indeed, many local authorities are improving in this regard. What is very clear is that those making the most progress the most quickly are those that have gone furthest in integrating social care and healthcare.

Lyme Disease

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6. What the timetable is for the review of the diagnosis, treatment and transmission of Lyme disease announced on 10 May 2016. [906494]

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The Department of Health has commissioned three separate reviews on the diagnosis, treatment and transmission of Lyme disease. The work will be carried out by the epicentre of University College and be clinically driven and evidence-based, and it will be published in late 2017.

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Although I am delighted that the Government are looking into this serious and important disease, as the reviews progress thousands of people contract Lyme disease each year, particularly in areas such as Wiltshire, and they can receive inadequate treatment, so will the Minister look into speeding up these reviews?

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It is fair challenge that this work is high priority, and we need to go as fast as possible, but we are working with research teams. The work will be trial-based and needs to be as definitive as possible. In the meantime, early diagnosis is the key way to make progress. Public Health England continues to work with GPs and the public on it.

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My mother recently died of motor neurone disease. In some areas of my constituency, there are 13 sufferers per 10,000 people, whereas the UK average is two per 100,000. Will the Minister please agree to meet me and representatives of the Motor Neurone Disease Association to discuss how the UK Government could lend their weight to combating this awful and debilitating disease?

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Yes, I would be happy to meet the hon. Gentleman to discuss that subject.

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I am extremely grateful to the Minister for his response on that matter.

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Bearing in mind that cases of Lyme disease have quadrupled in the past 12 years, and that some of those cases have been in my constituency of Strangford in Northern Ireland, what has been done with the devolved Assemblies in the United Kingdom of Great Britain and Northern Ireland to ensure that a UK-wide strategy is put in place to address this trend and to provide effective diagnosis and treatment?

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The principal thing that we need to do with Lyme disease is to make progress on diagnosis, treatment and transmission through a definitive approach. When the results of the study that I mentioned are published, of course they will be available across all parts of the United Kingdom.

NHS Procurement

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7. What steps his Department is taking to improve NHS procurement. [906495]

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I agree with my hon. Friend that this is an important area. In his report earlier this year, Lord Carter identified potential annual savings of £700 million from reducing the variation in procurement performance between providers. We have announced a first tranche of 12 standardised products for all NHS providers to use; this will boost procurement volumes and bring about economies of scale, securing lower prices. These initial products, including commodity items such as gloves and needles, cover £100 million of trust spending. We expect this to result in savings of up to 25%.

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Innovative private sector suppliers have successfully partnered with the NHS since its inception, and it is quite right to say that for that relationship to be sustainable, those suppliers must make a profit. However, does the Minister agree that rogue companies that exploit the NHS’s lack of commercial expertise could be named and shamed, because they are making a lot of money at taxpayers’ expense?

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We believe that the right approach to securing procurement savings is to take advantage of the immense amount of data available across the NHS. That is why we have set up the purchasing price index benchmarking tool. Data on more than £8 billion of expenditure, covering over 30 million separate procurement transactions, has been collated and will be analysed. We will use that information judiciously to save the taxpayer money. We think that that is the right way to start, rather than naming and shaming.

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I urge the Minister, when thinking about national procurement and national commissioning, to look at the national strategies that can underpin them—for example, at why we need to renew the national stroke strategy. Some 100,000 people a year suffer a stroke, and nearly 1 million people in this country have had a stroke. They care very much about rehabilitation and other services.

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The Minister’s challenge is to relate that very important matter to the equally important issue that happens to be the subject of the question: procurement.

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I am grateful to you, Mr Speaker, for drawing the hon. Gentleman’s attention to the fact that the topic is procurement. The hon. Gentleman is right to highlight the fact that we have looked at an acute heart treatment strategy. We are creating centres of excellence across the country to ensure that if people suffer from an acute heart incident or a stroke, they are treated by the specialists who will give them the best prospects for recovery.

Hospitals in Special Measures

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8. What progress his Department is making on turning around hospitals in special measures. [906496]

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In the last four years, 29 trusts have been put into special measures; that is more than one in 10 of all NHS trusts. Of those, 12 have now come out, having demonstrated sustainable improvements in safety and quality of care. There are nearly 1,300 more doctors and 4,200 nurses working in trusts that have been put into special measures.

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The Secretary of State will be aware because he visited it last year, that the Queen Elizabeth hospital in my constituency has come out of special measures. It has made excellent progress, not least by introducing Saturday lists for in-patients and putting in place numerous measures to transform the out-patients department. Will he join me in paying tribute to all staff of the hospital, particularly the chief executive, Dorothy Hosein, and the chairman, Edward Libbey, for the excellent progress that they have made?

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I am very happy to do that, and I very much enjoyed my visit to the QE with my hon. Friend a couple of years ago. This is a very good example of how trusts can be transformed when they go into special measures. Since coming out of special measures, the QE has opened a state-of-the-art laparoscopic theatre, got a dedicated breast unit, and expanded its A&E. It has got 72 more nurses over the past few years. It is a good example to many other trusts in special measures, and it shows that that really can be a turning point, bringing about benefits for patients and staff.

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The problem is that many trusts are still in a financial mess and have a deficit. If hospitals and the wider health service are to solve that, they need more funding, and councils, too, need funding for care. What is the Secretary of State doing to fight for more funding for his Department to ensure that we deal with those problems properly?

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The hon. Gentleman will have noticed that in last year’s spending review the NHS got the biggest funding increase of any Government Department. We have committed to the NHS’s own plan, which asks for £10 billion more a year during the course of this Parliament in real terms. However, I do not disagree that there are still very real financial pressures in the NHS and particularly in the social care system. The trusts that are delivering the highest standards of care are those with the lowest deficits. Delivering unsafe care is one of the most expensive things people can do, which is why this is an important agenda.

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15. Will the Secretary of State join me in congratulating all the staff at Bolton NHS Foundation Trust, which has recently been rated “good” by the Care Quality Commission just four years after it was deemed to be a red risk. It is now in the top 25% of trusts. [906505]

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The staff at Bolton have done a fantastic job. I absolutely congratulate them, and I thank my hon. Friend for his work in supporting them as well.

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The Secretary of State will know that in my own area of Calderdale and Huddersfield there is a dreadful situation for the trust that has been caused by the behaviour of the clinical commissioning group and the way in which it procures. He has received a large petition from thousands of people in the Huddersfield area about the closure of the A&E. Will he look at that seriously and intervene, because the competence of local CCGs is not up to the mark?

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I am well aware of that issue and have received a number of representations from hon. Members on both sides of the House. There is a mechanism by which these issues end up on my desk—they have to be referred by a local council’s overview and scrutiny committee and then I get an independent recommendation—but I will look at this carefully if that process is followed.

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To cope with rapid population increases in my constituency, Basingstoke has advanced plans to build a critical treatment hospital and cancer centre, with the support of more than three quarters of the population. Does my right hon. Friend expect sustainability and transformation plans to provide clear, timely direction on plans for this new model of care in the community?

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I can absolutely reassure my right hon. Friend on that. One of the main purposes of STPs is to make sure that we deliver our cancer plan, which will introduce a maximum four-week wait between GP referral and ultimate diagnosis. If we get it right, that might result in around 30,000 lives a year being saved, so this is a big priority for every STP.

NHS Staff Recruitment and Retention

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9. What steps he plans to take to address shortfalls in staff recruitment and retention in the NHS. [906497]

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I join the Secretary of State in welcoming the dedication and commitment of everyone who works in the NHS. We are taking active steps to encourage more people to become doctors, nurses and support staff. Only last week, my right hon. Friend announced a commitment to recruit an additional 25% of doctors to train in the NHS, which is 1,500 more doctors on top of the 6,000 currently trained every year.

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Net temporary and agency staff expenditure has risen by 40% since 2013. It accounted for 8% of total staff expenditure in 2015-16, which equates to £4.13 billion. Does the Minister agree that rising agency costs point to a recruitment crisis, and will he make a statement to the House outlining his plans to address that crisis?

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We recognise, absolutely, that bills for agency staff have become unsustainable, which is why we have taken deliberate action, including by introducing price caps on hourly rates last November, which has had a significant impact on reducing agency costs. In the year to date, agency costs are some £550 million less than they were last year.

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I welcome last week’s announcement about the increase in the number of medical school places. What plans does the Department have to ensure that there are sufficient clinical training places for those medical students?

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I can reassure my hon. Friend that there is considerable excess demand from UK-based students to train to become a clinician in this country—only half of those who apply to train in medical school are accepted at present—so we are confident that there will be plenty of take-up for those extra places. With regard to clinical placements, we are in discussions with universities, colleges and teaching hospitals to ensure that there are adequate numbers of places.

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I welcome the 25% expansion in medical student places, but I reject tying that to the elimination of 25% of overseas doctors who currently work in our NHS. With 10% of posts unfilled and ever-rising patient demand, the Secretary of State must know that we will always need international graduates in the future. Does he not recognise that he is creating unrealistic expectations and conflict with this idea of a British-only medical service?

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I am grateful to the hon. Lady for giving me the opportunity to set the record straight and stop this scaremongering, which is undoubtedly unsettling many of the very valuable doctors, nurses and other foreign nationals who are currently providing vital services to the NHS. Last week’s announcement was about adding more doctors to be trained who are UK-based. We are not changing any of the present arrangements for international students being trained here, or doctors and nurses working here.

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The Government might not be changing their position right now, but with one in 10 posts currently unfilled, and given the rhetoric used last week, how does the Minister expect us even to retain foreign doctors, let alone attract them to fill those posts?

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There was no rhetoric used. In making that announcement, my right hon. Friend the Prime Minister used no rhetoric whatsoever regarding the very valuable contribution of foreign clinicians to our health service, and that remains the case.

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Staff shortages this summer led United Lincolnshire Hospitals NHS Trust to introduce a temporary closure of Grantham A&E, causing huge concern to my constituents. Will the Secretary of State agree to meet me and Jody Clark, the founder of a local campaign group, to discuss how we can resolve this unacceptable situation?

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I am well aware, from representations made by my hon. Friend and other neighbouring MPs, of the concerns that that has caused locally. The Secretary of State has already indicated to me that he does intend to meet my hon. Friend and campaigners in due course.

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The Minister says that no rhetoric or scaremongering was used last week. Can he explain to the House what the Prime Minister meant when she said:

“there will be staff here from overseas in the interim period until the further numbers of British doctors are trained and come on board in terms of being able to work in our hospitals”?

What did that mean? What should we expect next—ambulances plastered with “Go home” slogans?

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That is exactly the kind of ill-judged remark I have been talking about, and I am surprised that the hon. Gentleman has used it in his first appearance in his new post. By the way, I congratulate him on that new post, but I very much hope that he will use more measured language in the future, rather than spreading that kind of inappropriate rumour. The interim period referred to is the period during which doctors will be trained. We will not get new doctors coming in under the increased allocation until 2023, and during that time we will clearly need to use all measures to ensure that we fill the spaces that I acknowledge we have across several of our hospitals.

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I appreciate the Minister’s warm welcome, and I can tell him that I am very much looking forward to shadowing the Secretary of State, but his comments on ill-judged remarks should be directed at the Prime Minister, not me. We have seen 8,000 fewer nurses, student nurse bursaries are set to be cut, there is a reliance on agency staff and a failure to train enough doctors, and now, after six years in office, the Government are talking about self-sufficiency. Given the concerns that these plans do not go far enough, will the Minister tell us what steps he will take to ensure that no staff from the EU lose their jobs, and will the NHS still be able to recruit from the EU if necessary post Brexit?

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Health Ministers have been very clear about reassuring all the 53,000 EU citizens working in our NHS that their roles are secure. Regarding clinicians, I remind the hon. Gentleman that, although we have some vacancy rates, which are acknowledged, we now have 7,800 more consultants employed in the NHS than in May 2010, 8,500 more doctors than in May 2010, and over 10,500 more nurses working on our wards. We have gone through a very consistent policy of recruiting more people to work in the NHS under this Government.

Cancer Diagnosis

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10. What steps his Department is taking to model the potential cost savings to the NHS budget of earlier diagnosis of cancers. [906498]

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The independent cancer taskforce highlighted the report “Saving lives, averting costs”, which identified cost savings resulting from earlier diagnosis, in particular for colon, rectal and ovary cancers. We have committed to a further £300 million for earlier diagnosis, one major product of which will be the 28-day diagnosis standard to which the Secretary of State referred earlier.

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In welcoming the Minister to his post, may I highlight evidence to show that early diagnosis, in addition to making for better survival rates, offers substantial cost savings? Colon cancer costs £3,000 per patient per year to treat at stage 1, compared with over £12,000 if it is diagnosed and treated at stage 4. We have a shortage of health economists in the NHS, so will the Minister go further and actually commission a study to look at this issue on behalf of the taxpayer, because it requires further detail?

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We agree that early diagnosis saves lives and can lead to cost savings. Just as an example, we know that GP referrals are up by 91% since 2010—an additional 800,000 people are getting early diagnosis—and we are beginning to see the results of that coming through in the one-year survival figures. On my hon. Friend’s specific point about further study, Public Health England and Macmillan have commissioned recent studies on modelling, one part of which will be on the cost impact of earlier diagnosis, and we look forward to seeing the results of those studies.

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GPs play a central role in the early diagnosis of cancer. In the 1990s, Sunderland was one of the most under-resourced areas in England in terms of the GP workforce, and we now face a similar and growing problem, even though action was taken then. Will the Minister set out how he intends to make sure not only that we train more family doctors, but that they are encouraged to work in areas where there is an acute shortage?

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We are training 3,250 extra GPs every year, and we have a target of 5,000 additional doctors working in general practice by 2020. However, as well as new GPs, we must do much better with retention. That means keeping the GP population that we have, and there are a number of steps that the Government are taking to do that. On the specific point about Sunderland, there is a bursary scheme that is aimed at attracting GPs to areas where they may not necessarily have wished to work previously.

NHS Efficiency Savings

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11. What estimate his Department has made of the amount accrued to the public purse from efficiency savings in the NHS since May 2010. [906500]

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In 2010 a target was set by NHS leaders to make £20 billion of efficiency savings by 2015 in order to make more funds available for treating patients and to allow the NHS to respond to changing demand and new technology. Under my right hon. Friend’s inspirational leadership as a Health Minister, the NHS broadly delivered on this original challenge, reporting savings of £19.4 billion over this period. All these savings have been reinvested into front-line NHS services.

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As Members would imagine, I warmly welcome that answer from the Minister. Would he confirm that those savings were achieved through greater efficiency and effectiveness in the delivery of care and by cutting waste in the NHS that occurred between 2002 and 2007? Can he confirm that the benefit of that achievement to the NHS is that not a single penny of those savings goes to the Treasury, but is reinvested in the NHS and front-line services?

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My right hon. Friend managed to include several questions in his impressive supplementary. I can confirm that much of the waste that took place in the years he cited—2002 to 2007—related to projects of the previous Labour Government that they themselves then cancelled, such as the IT project. I can also confirm that savings generated in the NHS are kept in the NHS. Lord Carter, whose report I referred to earlier, has identified £5 billion of efficiency savings, which we hope to deliver during this Parliament.

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There is a distinction to be drawn between realistic efficiency targets and systematic underfunding. Only last month, Simon Stevens told the Public Accounts Committee that for three of the next five years

“we did not get what we originally asked for”.

Chris Hopson, chief executive of NHS Providers, also said last month that

“we’ve got a huge gap coming… it’s the chairs and chief executives on the front line…who are saying they cannot make this add up any longer.”

On funding, the Government keep saying that the NHS is getting all that it has asked for; those actually running the NHS say something quite different. Who is right?

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The hon. Gentleman stood on a manifesto 18 months ago in which his party was not prepared to commit the funding that our party was prepared to commit. Labour committed £5.5 billion to the NHS; we committed £8 billion, and we have delivered £10 billion.

Male Suicide

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13. What steps his Department is taking to reduce the number of men who take their own life. [906502]

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Tragically, suicide is now the biggest single cause of death in men under 50. There are 13 suicides every day, of which three quarters are men. I am currently reviewing our suicide strategy to make sure we leave no stone unturned in trying to reduce the totally unacceptable level of these tragedies.

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Yesterday marked the launch of the mental health awareness and suicide prevention campaign called “It takes balls to talk” across Coventry and Warwickshire. The campaign is a public information programme targeted at male-dominated sporting venues, which aims to direct men to help and support when they need it to promote positive mental health and reduce the incidence of male suicide. With suicide being the single most common cause of death in men under 45, will the Secretary of State take the opportunity to welcome and support this important new campaign?

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I am happy to do just that. I would like to thank the hon. Lady for bringing up this very important and difficult issue. We are making progress in reducing suicide rates, but we can do an awful lot better. The thing that troubles me most is that nearly three quarters of people who kill themselves have had no contact with specialist NHS mental health services in the previous year, even though in many cases we actually know who they are because, sadly, most of them have tried before. I am very happy to commend the “It takes balls to talk” campaign. She may want to put the campaign in touch with the national sport mental health charter, which is another scheme designed to use sport to try to boost the psychological wellbeing of men.

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A recent survey showed that one in four members of the emergency services experienced mental health problems, and that a number of them experienced suicidal thoughts. What is the Secretary of State doing to protect our vital paramedics and other ambulance staff, and to ensure that they get the support they need in dealing with absolutely appalling situations?

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Again, I thank the hon. Lady for raising that. She will be pleased to know that the NHS has introduced a scheme, backed with funding, to encourage NHS trusts to look after the mental wellbeing of their own staff. I particularly want to pay tribute to the courage of people who work in the air ambulance service, because they see—day in, day out—some of the most difficult and distressing cases. They have to cope with the pressure of that when they take it home every day, and we all salute them.

Elderly Patients (Care Support)

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14. What clothing and other support the NHS provides to elderly people discharged from hospital into care homes for the first time. [906504]

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Every patient discharged from hospital into a care home should have a care plan or discharge assessment. This should include a clear assessment of their needs, covering transport, carers, GP notification, medication and, where necessary, clothing requirements.

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I have been approached by a number of constituents concerned about cases of elderly and vulnerable people who have been discharged from hospital straight into care homes, often without any basic personal effects or clothing because their family cannot or are not willing to supply them. Does the Minister recognise this, and what can the Government do to tackle it?

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As I said earlier, there is a national process in the form of the care plan. Where the family is not able to or will not provide support, typically the voluntary sector is asked to do so. If that does not work, local authorities can increase the personal expenses allowance to provide clothing. I am interested to hear about the cases that my hon. Friend mentions in his constituency, and I am very happy to talk to him to understand better why the process has failed there.

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And have a cup of tea with the fella.

Topical Questions

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T1. If he will make a statement on his departmental responsibilities. [906469]

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Last week, I announced plans to make the NHS self-sufficient in the supply of newly qualified doctors by the end of the next Parliament. We recognise the brilliant work that is done by the many outstanding overseas doctors who work in the NHS and have made it clear that, whether or not they are from the EU, we wish that work to continue post-Brexit. However, as the fifth largest economy in the world, Britain should be training all the doctors it needs. While there will always be beneficial exchanges of doctors and researchers between countries, we have a global obligation to train enough doctors for our own needs, otherwise the inevitable consequence will be to denude poorer countries of doctors whose skills are desperately needed.

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Thornbury health centre is crying out for redevelopment to cater for the growing local population. Will my right hon. Friend meet me, representatives of the health centre and NHS Property Services to see how we can take a co-ordinated approach that will move the health centre forward?

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I can do better than that, because I have said that I am prepared to go to the health centre. I remember a very good visit to Thornbury community hospital during the general election campaign. I understand what those at the health centre are trying to do and they are absolutely right to be thinking about how they can improve out-of-hospital services.

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Will the Secretary of State look into the creation of a sideways move for a chief executive of a trust that was criticised for failing to investigate patient deaths? Six weeks after the special recruitment exercise by Southern Health, Katrina Percy has resigned from her advisory role, with a substantial 12-month salary payoff that has been signed off by the Department of Health and the Treasury. The campaign group, Justice for LB, has called that “utterly disgraceful” and I agree. Will the Secretary of State investigate?

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I agree with the hon. Lady that the way this case was handled was by no means satisfactory. The truth is that it took some time to establish precisely what had gone wrong at Southern Health. As this House knows, because we made a statement at the time—I think it was an urgent question, actually—there was a failure to investigate unexplained deaths. I do not think the NHS handled the matter as well as it should, but we now have much more transparency and we do not have a situation where people go on and get other jobs in the NHS, which happened so often in the past.

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T4. What will the Government do to scrutinise and assist the London ambulance service, which has had an appalling and consistently poor record on call-out times for category A emergencies? [906472]

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My hon. Friend is right to highlight the fact that the London ambulance service is in special measures and has been for some time. I visited it this summer and am pleased to confirm that some £63 million of additional funding has been provided to the ambulance service since April 2015. The service is starting to make significant inroads in increasing the number of paramedics who are available on call, with some 250 more being added over the last couple of years.

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T2. Last October, the then Health Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), confirmed that my constituency fell far below the national average in terms of NHS dental provision. In fact, it is one of the worst in the country. Unfortunately, nothing has changed since then. Does the Secretary of State believe it is acceptable that my constituents, including many children, are unable to get an NHS dentist? [906470]

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It is clearly unacceptable if the situation that the hon. Lady sets out is the case. I am happy to meet her and work with her to take the action that is needed to make things better.

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T6. The Government have provided a welcome increase in funding for mental health support, yet it does not appear to be reaching my constituency effectively, particularly for children. Now there are concerns that the Millbrook unit at nearby Macclesfield hospital might close. Will the Secretary of State look into those concerns? [906474]

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I am very happy to do that. My hon. Friend is right to highlight the fact that the provision of mental health services to children is one of the biggest weak spots in NHS provision today. It is an area that we are putting a big focus on. I would be happy to talk to her about the situation in her constituency.

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T3. I know that this is a devolved matter, but I look forward to the Union working together on it. In Northern Ireland, the health service is in crisis. To give cancer as an example, 6.7% of those with breast cancer are called in to be checked within 14 days—not 100%—and yet we have 392,000 people on the waiting list. Will the Secretary of State or his officials meet us to find a better way forward, so that we can all work together? [906471]

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I have made it clear that we should all be working together to defeat cancer. We know that the best way of doing so is early diagnosis. We have made a lot of progress on that in England over the past few years but have a lot further to go. We are of course willing to talk to the devolved Administration about what they can learn from us—and perhaps vice versa.

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T7. Will the Secretary of State look again at the decision not to fund second stem cell transplants for adults and children with blood cancers, given the significant clinical evidence of their benefit for those who relapse? He should not just take my word for it but should take it from the Anthony Nolan Trust and the 36 specialists who have written to him asking him to review the decision. [906475]

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This is a very difficult area, but decisions on priority are clinically driven and must continue to be based on peer-reviewed data. The most recent review determined that less than one third of second transplants would result in survival after five years; that is why they were not funded. There will, however, be a further review next April, and to the extent that the data have changed there will be a new evaluation at that time.

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T5. Deer Park medical centre in Witney faces closure, and patients will be dispersed a long way into other practices in an area where one in four already waits more than a week to see their GP. Duncan Enright, who is Labour’s candidate in the Witney by-election, is campaigning to save the centre. Will the Secretary of State reward his campaign by saving it today? [906473]

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The Conservative candidate in the Witney by-election will be saying very clearly that because of the extra funding from this Government we are aiming to have 5,000 more doctors working in general practice by the end of this Parliament, something that would not have been possible with the increase of less than half that amount promised by the Labour party.

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T8. As Ministers will be aware, this week is baby loss awareness week. Access to neonatal cots and neonatal transport services are vital parts of the care of premature and sick babies. What assurances will my right hon. Friend give that his Department is continuing to review the findings of the Bliss report, and when can we expect to hear more? [906477]

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I am grateful to my hon. Friend for raising baby loss awareness week. I am sure that, along with other hon. Members, she will be participating in the Backbench Business debate on that later this week. In February the independent maternity review, Better Births, made a number of recommendations, including on neonatal critical care. We are studying those recommendations and are due to report initial findings from our work in December.

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I listened very closely to the Secretary of State’s comments earlier on mental health. On 9 December he stood at that Dispatch Box and said that

“CCGs are committed to increasing the proportion of their funding that goes into mental health.”—[Official Report, 9 December 2015; Vol. 603, c. 1012.]

However, my research shows that 57% of clinical commissioning groups are reducing the proportion they spend on mental health—yet another broken promise. When will we have real equality from this Government for mental health?

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I will tell the hon. Lady what this Government have done. We have legislated for parity of esteem for mental health. We are treating 1,400 more people every single day for mental health conditions compared with six years ago. We have a new plan that will see 1 million more people treated every year by 2020, including a transformation of child and adolescent mental health services. That is possible because we are putting into the NHS extra money that her party refused to commit to.

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T9. Does my right hon. Friend agree that the Government have a moral obligation to end the raid on poorer countries for their skilled doctors and nurses and to make our NHS recruitment more self-sufficient? [906478]

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My hon. Friend is absolutely right. I find it extraordinary that the Labour party said that our plan to train more doctors was “nonsense”. We currently have 800 doctors in the NHS from Sri Lanka, 600 from Nigeria, 400 from Sudan and 200 from Myanmar. They are doing a brilliant job and I want them to continue doing that job, but we have to ask ourselves whether it is ethical for us to continue to recruit doctors from much poorer countries that really need their skills.

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I was alarmed to read at the weekend that NHS chiefs are warning that hospitals in England are on the brink of collapse. Is it the Government’s intention to cut the public supply of healthcare in order to create demand for a private healthcare system, or will they give the NHS the additional funds it needs?

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Let me remind the hon. Lady that the party that introduced the most outsourcing to the private sector was her Labour Government under the previous Health Secretary, Alan Milburn. Our view is that we should be completely neutral as to whether local doctors decide to commission their care from the public sector or private sector. We want the best care for patients.

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I welcomed last week’s NHS Improvement report which states that there are now sufficient staff for Chorley and South Ribble hospital’s A&E department to reopen, but I am dismayed that the trust is delaying the reopening until January next year. Will the Minister reassure me that he will work with me and other stakeholders to oblige the trust to open as soon as possible?

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My hon. Friend has been a doughty champion of Chorley, in combination with another Member of the House and local campaigners, who visited the Houses of Parliament yesterday to meet local MPs. While welcoming the reopening of the A&E from January, I am happy to continue to work with my hon. Friend to see whether it can be brought forward.

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The other doughty champion of the hospital is of course the right hon. Member for Chorley (Mr Hoyle), who regularly deputises for me in this Chair. I am sure the House will want to acknowledge that important fact.

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I heard the Minister’s response earlier. He was of course right that sustainability and transformation plans are led locally, but he failed to acknowledge that the Government have given a mandate to make cuts attached to STPs. Without consultation, my local hospital has been downgraded. What on earth will the Secretary of State say to my constituents who may lose loved ones because they have had to travel miles further to another hospital?

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If I may, I will give a quote:

“To reshape services over the next 10 years, the NHS will need the freedom to collaborate, integrate and merge across organisational divides.”

That comes from the 2015 Labour manifesto. The STP process is designed to bring about better care and health, and better productivity. We should be critical friends of the process because we all want a better national health service.

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Local health commissioners have concluded that Telford’s brand new women and children’s centre, which serves some of the most deprived populations in the country, should be closed and moved to a more affluent area where health is better than the national average. The commissioning process has lost the confidence of local people. Will the Secretary of State intervene and ensure that local health commissioners fulfil their legal duty to reduce health inequalities?

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I thank my hon. Friend for standing up for her constituents—it is absolutely right that she should do so. She would agree that that has to be a local matter led by commissioners locally, but she can be reassured that we are always watching what is happening to ensure that people follow due process, and that the results of any changes proposed benefit patients as intended. I will therefore watch very carefully what is happening in Telford and in Shropshire more broadly.

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About half a dozen times in the last hour, the Secretary of State has bragged about the extra money he is putting in to the national health service, so why is Bolsover hospital, like many others that have been referred to in the past half hour, due to close? Why are neighbouring hospitals in countless constituencies in Derbyshire closing? Why does he not use some of that money to save the Derbyshire hospitals?

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The extra money we are putting in to the NHS is going to better cancer care, better mental health care and better GP provision—it is going to all the things that Members on both sides of the House know matter. It will also mean that we can support our hospitals better. With our ageing population, we will continue to have great demand for hospital care, but the best way to relieve pressure on those hospitals is to invest in better out-of-hospital care, which has not been done for many years.

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Kettering general hospital is treating a record number of patients with increasingly world-class treatments, yet despite being located in an area of rapid population growth, due to an historic anomaly, the funding for the local clinical commissioning groups is among the worst in the country in relative terms. What can Her Majesty’s Government do to correct that?

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I am happy to look at that particular funding issue for my hon. Friend. I know that Kettering hospital is under a great deal of pressure. The one thing that it could do to relieve its financial pressures is to look at the number of agency and locum staff that it employs. As with many hospitals, there are big savings to be made in that respect in ways that improve rather than decrease the quality of clinical care.

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The Secretary of State will be aware that the Public Accounts Committee has questioned both the Department of Health and NHS England on the parlous state of NHS accounts this year, following the comments by the Comptroller and Auditor General. It is clear that STPs are the only plan on the table. Will the Secretary of State make clear his support to the NHS to deliver the STPs in the teeth of opposition from his own Back Benchers? If he will not, what is plan B?

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I do not recognise the picture the hon. Lady paints about opposition to STPs. We need to ensure we have good plans that will deliver better care for NHS patients by bringing together and integrating the health and social care system, and improving the quality of out-of-hospital plans. While we are in a period where those plans have not been published there will obviously be a degree of uncertainty, which we will do everything we can to alleviate, but she is right to say that these plans are very important for the future of the NHS. The process has our full support.

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The Secretary of State will be aware of the concern in my constituency about the future of Paignton hospital, which prompted hundreds to turn up to a recent meeting. Does he agree with me that it is vital the clinical commissioning group, in publishing its plans, does not just publish what it will remove but the details of what it will replace them with?

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Considerable efforts are going into sorting out some of the historical challenges in the provision of both acute and community care in Devon. I hosted a meeting for a number of colleagues who are concerned about this and I am happy to continue to engage with colleagues across the county.

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Two years ago, Nottingham University Hospitals NHS trust privatised support services, including cleaning, handing them over to Carillion in an effort to save money. Since then there have been shortages of equipment, shortages of staff and an appalling decline in standards of cleanliness. Will the Secretary of State condemn Carillion for putting patients at risk? When will he ensure that hospital services in Nottingham are properly funded?

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The decision on whether to outsource services must be a matter for local hospitals. I know that that hospital has been struggling with its deficit. I have been to visit the hospital myself and I know it has been trying very hard to improve clinical care. If the contract is not working and the quality is not right, I would expect the hospital to change it, but it must be its decision.

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I am sorry, but, rather as in the health service under any Government, demand has exceeded supply and we must move on.

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rose—

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I was keeping the hon. Lady waiting for only a moment, so that there was a due sense of anticipation in the House. That sense now definitely exists.

Point of Order

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On a point of order, Mr Speaker. It is rather frustrating to hear Ministers and some Back Benchers continually referring to the Government having invested, or intending to invest, £10 billion into our NHS over the course of this Parliament. You may be aware, Mr Speaker, that I sit on the Health Committee. I would like to read you the following extract from a report:

“Last year’s Spending Review announced that the NHS would receive an additional £8.4 billion above inflation by 2020-21. But whilst previous spending reviews define health spending as the whole of the Department of Health's budget, the 2015 Spending Review defines it in terms of NHS England’s budget, which excludes, for example, spending on public health”—

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I am extremely grateful to the hon. Lady. She is nothing if not persistent and she has put that thought on the record. I say to her in all courtesy, however, that she is not the first person to do this—I probably did it myself in the very distant past—and I do not suppose she will be the last. It is a very interesting point, but it is a continuation of debate. There is no matter for the Chair here. For that reason, and that reason alone, I must ask her to desist at this stage, but I have a feeling she will find ingenious ways of returning to her point on other occasions.

Perhaps we can leave it there, because we are short of time and I want to proceed. Unless there are further points of order—I am not exactly looking for them—then we will come on to the ten-minute rule motion. I call Conor McGinn.

Unlawful Killing (Recovery of Remains)

Motion for leave to bring in a Bill (Standing Order No. 23)

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I beg to move,

That leave be given to bring in a Bill to establish a presumption against eligibility for parole in cases where a person, convicted of unlawfully killing another person, has not provided relevant knowledge in their possession for the purposes of facilitating the location and recovery of the remains of the victim; to create a separate offence of withholding such information; to make provision about the available sentences for such an offence; and for connected purposes.

For a parent to suffer the anguish of losing a child is beyond words, but the horror of having such a loved one murdered is surely too awful even to contemplate, so it is harder still, if even possible, to imagine the pain of being denied the chance to hold a proper funeral and lay that loved one to rest. My constituent Marie McCourt does not need to imagine it, because for 28 years she has been forced to endure what she describes as the special kind of torture of knowing she could die without ever discovering where her daughter’s body is or being able to lay her daughter to rest with the dignity she deserves.

Marie’s daughter Helen was murdered at the age of just 22 by Ian Simms in February 1988, as she travelled home from work in the village of Billinge in my constituency. In a landmark conviction, he was found guilty of murder based on overwhelming DNA evidence, even though Helen’s body was not found. For almost three decades, Marie has been tormented because he refuses to reveal what happened to her daughter’s body. Despite this brutal act of callousness and lack of remorse, he could soon be released from jail. This is not the justice that Marie and her family deserve. Killers who inflict this kind of suffering on their victims’ families should not be released on parole. That goes to the heart of the Bill I am bringing forward today.

Before I continue, I want to say something about Marie. She had Helen taken from her in the cruellest circumstances, only to be denied the sacred right to bury her daughter. Few could have found the strength to carry on, let alone mount such a formidable campaign to have the law changed so that others do not suffer in the way she has suffered. Her quiet dignity and powerful determination are an example to us all.

Our campaign for Helen’s law, led by Marie, calls on the Government to introduce a “no body, no parole” policy for murderers. The online petition has already attracted the support of over 340,000 signatures, and in February I was honoured to accompany Marie to No. 10 Downing Street to present the petition. The Government responded to the overwhelming public support for the campaign by asking the Parole Board to review the guidelines around convicted murderers. We await the outcome of that review, which is at least welcome progress, but as Marie has so eloquently and repeatedly said, this campaign is not just about her or Helen; it is about ensuring that others who find themselves in such horrific circumstances do not have such added pain visited on them.

Just yesterday, the Home Office revealed to me that since 2007 alone there have been 30 murders in England and Wales where no body has been recovered, but as it currently stands the English legal system does not require a convicted murderer, at the end of their determined tariff, to admit guilt or reveal the location of a victim’s remains before being released. Marie believes that if parole is granted to Helen’s killer, her hopes of finding her daughter will never be realised. As I have said, she is also determined that no other family should have to live that ordeal.

My Bill seeks to acknowledge, and in some cases mitigate, the pain and distress caused to the families of missing murder victims. There are three main elements to it: first, denying parole to murderers for as long as they refuse to disclose the whereabouts of their victim’s remains; secondly, passing a full-life tariff, denying parole or release, until the murderer discloses the location and enables the recovery of their victim’s remains; and thirdly, applying the rarely used common-law offences in murder trials without a body of preventing the burial of a corpse and conspiracy to prevent the burial of a corpse, disposing of a corpse or obstructing a coroner. In essence, the proposals are simple: if a convicted killer refuses to give information to reveal the location of a victim’s body, they should not be considered eligible for parole and they should stay in prison. The proposals would effectively mean a whole-life tariff for murderers who refuse to disclose the location of their victims and enable their remains to be recovered to give families a chance to pay their last respects.

Let me be clear: the modern system of parole is widely understood to involve a prisoner earning their conditional release through good behaviour. I believe in and support the rehabilitative purpose of our penal system, but while the current tariff system for the most serious crimes reflects the consensus that the majority will at some point be able to rejoin society, one is bound to ask in what sense a murderer who is content to torment the family of their victims in such a way could ever have earnt their freedom.

In recent years, Parliament and the legal profession have begun to take the rights of victims more seriously, and I believe that this Bill would be a further step towards ensuring that victims are at the heart of our criminal justice system—where they should always be.

Let me make it clear that the proposals in the Bill would not affect any individual’s fundamental right to maintain their innocence. The law changes I propose would not impinge in any way on the rights of convicted killers to retain full access and full recourse to the appeals process. It is worth noting, however, that in the case of Helen McCourt’s killer, his guilt has only been further confirmed at every single appeals stage because of enhanced DNA evidence against him.

Let me also say that my Bill will have no impact on the work of the Independent Commission for the Location of Victims’ Remains in respect of those referred to as “the disappeared”; nor would it impact on arrangements set out in relation to sentencing for offences committed during the troubles or indeed any future arrangements on addressing the legacy of the past in Northern Ireland. I want to acknowledge, however, that the pain and anguish felt by the families of the disappeared are the same as for any family who has lost a loved one in such awful circumstances.

We are not alone in this country in seeking to find a workable legal solution. In Australia, “no body, no parole” laws have already been passed at state level and are being examined at federal level. Quite simply, the introduction of Helen’s law is the only chance that the McCourts and other families like them have of securing some peace and the justice they deserve.

I want to acknowledge some of the families who are visiting Parliament today to attend this debate. Sheila Dolton and her daughter Nina are here. Their son and brother, Jonathan, was murdered in 2004. The family has continually written to his killer, begging for information about the son’s body, but has received no reply. Sam Gillingham was just 16 when her mum, Carole Packman, disappeared from the family home in Bournemouth in 1985, while Tracy Richardson’s mum, Michelle Gunshon, vanished in December 2004 while working at the NEC in Birmingham. Sadly, this Bill comes too late for Winnie Johnson who went to her grave never knowing where Moors murderers Ian Brady and Myra Hindley buried her 12-year-old son, Keith Bennett. But there is still time for Marie McCourt and other grieving mothers such as Joan Morson and Jean Taylor who also saw their children’s killers go to jail without revealing where their victims’ bodies lay. Denying a final resting place is perhaps the last heinous act by killers who have no place in a civilised society. The agony and torment caused to those who cannot lay a murdered loved one to rest is incalculable.

The families of victims quite rightly expect the law to act in their favour, instead of seeing the justice system rewarding with parole killers who decide to remain silent. For those who have had to face the loss of a loved one at the hands of a callous murderer, there is nothing we can do to make up for their loss, but if there is a way to help them receive the justice they deserve, we must take it. If there is a way to compel those who have committed the most awful crimes to assist in this task, we must do it. Most importantly of all, if there is a way to ensure that no family has to endure the suffering that Marie McCourt and so many others have, we—in this of all places—have a duty to act.

Question put and agreed to.

Ordered,

That Conor McGinn, Tom Tugendhat, Mr George Howarth, Siobhain McDonagh, Tom Elliott, Vernon Coaker, Marie Rimmer, Nusrat Ghani, Sir Jeffrey M. Donaldson, Carol Monaghan, Diana Johnson and Mr Alan Campbell present the Bill.

Conor McGinn accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 3 February 2017, and to be printed (Bill 73).

Aleppo and Syria

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I beg to move,

That this House has considered the unfolding humanitarian catastrophe in Aleppo and more widely across Syria.

Thank you, Mr Speaker, for granting this emergency debate on the unfolding humanitarian catastrophe in Aleppo and more widely across Syria. Although it was I who moved the motion applying for the debate under Standing Order No. 24, it has the strong support of the all-party parliamentary group for Friends of Syria, particularly my co-chairman, the hon. Member for Wirral South (Alison McGovern), the hon. Member for Barrow and Furness (John Woodcock), and my hon. Friend the Member for Beckenham (Bob Stewart). I am most grateful to them for the work that they do in the all-party group.

I am particularly pleased to see that the Foreign Secretary is present. The whole House will be grateful for the importance that he attaches to the debate. He has written and spoken about Syria, and I know that it is a subject on which he feels strongly. We are very pleased that the House is to hear from him this afternoon on what I think will be his first debate as Foreign Secretary

Yesterday, Mr Speaker, you had a choice between a Standing Order No. 24 application for a debate on Brexit and another for a debate on Syria. Everyone in the House will know that you made the right decision, and you explained your reasons, but I now submit that the effects of the crisis in Syria on our children and our grandchildren will be every bit as great as the effects of Brexit. Today’s debate will be watched by many people: civil society across much of the world will take an interest in the tone and the view that the House of Commons adopts this afternoon, and that is a very good thing.

At about 10 o’clock this morning there was a series of further air raids on civilian areas in Aleppo, and there are already reports of yet further casualties, maimings and deaths. As we look back at the Syrian crisis over recent years, we see that, at every turn, progress towards a solution has, alas, eluded us. First, at a relatively early stage, there was the plan put forward by Kofi Annan, the former United Nations Secretary-General, who stated specifically that as Assad was part of the problem he would by definition be part of the solution. Kofi Annan believed that Assad should be part of the negotiations, but that was vetoed by the Americans, and indeed—alas—by the British Government. Now, many years later, we understand how important it is that Assad should at least be present at the initial negotiations. He is not going to be beaten militarily, in my view, and it is clearly right for him to be there for the early part of the negotiations, as the Syrian opposition accept. However, more time has been lost.

Secondly, there was Obama’s failure to stand by the red lines that he had clearly asserted on the use of chemical weapons. That was a disastrous decision, and one from which we will suffer in the future.

Thirdly, there was the failure to provide safe havens. Much of civil society believed in the importance of providing refuge for the—now—more than 5 million Syrian men, women and children who are on the move in Syria, having been driven out of their homes. Those safe havens could, with political will, have been set up in both Idlib, which is in the north of Syria, and Daraa, which is near the Jordanian border in the south. We could, as many people have advocated, have set up no-bombing zones, but we have not done so. Today, 5 million people in Syria and 6 million outside are on the move, often unprotected, unfed and unhoused. That is the reality: nearly half the country’s population of 22 million are on the move, either inside Syria or beyond its borders.

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My right hon. Friend is making a powerful case. Does he agree that, militarily, there is no reason why we could not enforce a no-fly zone when so many people are being affected? The helicopters that are dropping barrel bombs could easily be brought down by rockets based in Turkey or Lebanon, or, indeed, by our own type 45s in the Mediterranean.

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My hon. Friend knows far more about such military matters than I do. That is my understanding of the position: that a no-fly zone—and I will say more about this later—is perfectly feasible. It is a question of whether the international community has the political will to face down the Russians and the Syrian helicopters by setting one up.

Fourthly, there was the failure to secure unfettered access for the United Nations. It is unprecedented in recent years for those bent solely on looking after their fellow citizens to be unable to gain unfettered access to very dangerous zones. This gives me an opportunity to pay tribute to the extraordinary bravery of those who work in the humanitarian world, doing nothing other than try to assist their fellow human beings and bring them sustenance, help, medicine and support.

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What roles does the right hon. Gentleman envisage for Syria’s near neighbours and for the west, including Britain, in the protection of people in the safe havens to which he referred earlier?

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That is an extremely good point, and I shall come to it shortly.

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Is not the tragedy of Syria that none of us can imagine a future Syrian Government who would have both the power to take charge and the wisdom to govern in a peaceful and unifying way?

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I shall come to that point as well, but let me say now that the whole purpose of the efforts of the International Syria Support Group—and those of other elements, under Staffan de Mistura—is to answer the question that my right hon. Friend has so eloquently posed.

The fifth failure lies in the surrounding countries, particularly Jordan, Lebanon and Turkey. Although they have acted heroically in dealing with the extraordinary number of people who have fled across the borders, often under gunfire, there has been a lack of support from the international community for countries whose populations have ballooned, given that one in three of the people in Jordan and Lebanon has fled from Syria. Britain has undoubtedly done her stuff. I am pleased to see that the Secretary of State for International Development is present; she can be extremely proud of the Department that she has inherited for the outstanding work that Britain has done in helping refugees in the surrounding countries—more, I might add, than has been done by the whole of the rest of the European Union.

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My right hon. Friend may well be aware that, in a fairly short space of time, far more Syrian than Lebanese children will be being educated in Lebanese state schools. Does that not speak volumes for the hospitality of the Lebanese?

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My hon. Friend has made his point with great eloquence.

We are not using the opportunity—if I may put it in that way—to provide an education for the children in the camps, given that they at least constitute a captive audience. Every child in a camp in one of the surrounding countries should be receiving an education. There should be education and training, and, indeed, there should be opportunities for the countries that are receiving all the refugees to have free access to the European Union for their goods and services. That is not happening. Moreover, because some countries have failed to pay their dues to the United Nations in some of the camps, the children and adults there are receiving only half the rations that they should be receiving, and they are down to starvation rations at that.

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I recently received a parliamentary answer from the Minister of State, Department for International Development, the hon. Member for Penrith and The Border (Rory Stewart), on the subject of air drops. He stated:

“The use of air drops to deliver aid is high risk and should only be considered as a last resort when all other means have failed”.

Does my right hon. Friend agree that it would seem that “all other means” have indeed failed?

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Not in respect of the camp. On the basis of my knowledge of these matters, I think that my hon. Friend the Minister of State was right to say that air drops should be used only as a last resort, but clearly they should be used if we reach that point.

The sixth and final barrier to progress has, of course, been the reception of refugees in Europe, where there has not been proper processing. Many of these people have cast themselves into the hands of the modern-day equivalent of the slave trader in the hope of reaching a more prosperous and safer shore. I think that Europe as a whole—which, admittedly, has its inward-facing problems—has failed to address this problem adequately, and to show proper solidarity with Greece and Italy as they tackle a very severe problem.

There are only two ways in which this can end: a military victory by one side or the other, or through negotiation. I submit that there is no way in which a military victory will be secured by any side in Syria. We must therefore hope that the fighting stops as soon as possible in order to create the space in which negotiations for the future can take place. We have all seen the heroic work that has been done by Staffan de Mistura, and the backing provided to him and the International Syria Support Group is essential. I will say more about that in a moment. To bring about a cessation in fighting we need the influence of the United Nations, of the great powers and of the countries in the region who have influence over some of the protagonists, in particular Iran and the Saudis. Where a country is able to exercise influence to stop the fighting and create the space for politicians to engage, in Geneva and elsewhere, it is absolutely essential that it should do so.

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I commend my right hon. Friend for securing this debate. Does he agree that the Russian military has a deep history with the Syrian military, and that it is in Russia’s gift to deliver a peace process? When we visited Russia as part of the Foreign Affairs Committee, the Russian politicians kept reminding us they wanted to be taken seriously by the whole world and that they were a serious power. In order to be taken seriously, however, they really should be following the rule of law and international law. They should not be aiding and abetting war criminals such as Assad.

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My hon. Friend makes an extremely good point.

The extraordinary misfortune of timing that I mentioned is being exacerbated by international attention being elsewhere. In Europe, Brexit, the issues with the euro, Greece, the German banks and the focus on migration have all meant that the focus has been on the symptoms rather than the causes of this conflict. In the United States, politicians have turned in on themselves as the election approaches, and Obama has underwritten an isolationist approach. However, there are people such as Senator Lindsey Graham and Secretary Kerry who are seized of the importance of this moment in tackling what Russia is doing. Then of course there is Russia, to which my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi) has alluded. It is behaving like a rogue elephant, shredding international humanitarian law and abusing its veto powers in the UN Security Council. It is using the veto to protect itself from its own war crimes.

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The right hon. Gentleman is making an incredibly compelling case. The situation in Aleppo is beyond appalling. Does he agree that our own Government should follow the example of the French in supporting a referral of Russia to the International Criminal Court? Also, I completely understand the case that he is making for a no-fly zone, but does he recognise the risks involved in establishing such a zone? How would he best protect against the risk of an expansion of the mission if it were not initially successful?

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I shall come on to the hon. Lady’s second point in a moment. On her first point, I agree with her. The UN Secretary general called for such a referral only yesterday.

The attack on the convoy marked a new low, with 18 humanitarian workers killed, food and medicines destroyed and warehouses and medical facilities seriously damaged. We should be clear about what is happening in Aleppo. The Russians are not attacking military formations. They are not engaging with militias and fighters. They are attacking hospitals and a terrified population, which is now down from 2 million to under 250,000. People are hiding in the cellars and the rubble that is Aleppo today. Last week, the M10 underground hospital was attacked by bunker-busting bombs to break through its roof and by cluster bombs aimed specifically at harming and injuring individual people. The location of that hospital was known to every combatant. There is no doubt that attacking that hospital was an international war crime.

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My right hon. Friend is making an incredibly strong case. When it comes to Russia, are we not living in some kind of parallel universe? On the one hand, we see the Russians dropping bunker bombs on hospitals. On the other, we are allowing them to come and trade in our country as though nothing was going on. Do we not need a general review of our relationship with Russia?

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The Russians are doing to the United Nations precisely what Italy and Germany did to the League of Nations in the 1930s, and they are doing to Aleppo precisely what the Nazis did to Guernica during the Spanish civil war.

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I join my right hon. Friend in supporting no-bombing zones, as well as aid drops in memory of our former colleague and my Yorkshire neighbour, Jo Cox. On the issue of no-fly zones, I served in the Royal Air Force on the no-fly zone over northern Iraq. Does he agree that one message we could send out from this House today would be that, using our E-3 Sentry AWACS reconnaissance aircraft, any war crimes perpetrated by air forces would be identified and logged, and that the perpetrators would feel the full force of the law as a result?

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My hon. Friend is on to an extremely good point.

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The right hon. Gentleman mentioned Guernica. In the 1930s, there was united condemnation of what the Nazis and their air force were doing in Spain in support of the fascist regime. Is it not time that we had a united, unambiguous, explicit, direct condemnation of what Putin is doing in support of Assad in Aleppo at this moment, not just from the Government but from the Opposition Benches unanimously?

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The hon. Gentleman is on to an extremely good point. What is needed is a concerted effort by the international community uniting to make Russia feel the cost of its support of and participation in the barbaric bombardment of Aleppo.

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I congratulate the right hon. Gentleman on securing this debate. His comparison with the actions of the Nazi regime and the League of Nations is very powerful. Is this not a warning to the United Nations that unless it fulfils its duties and faces up to the atrocities that Russia is perpetrating, it might well go the same way as the League of Nations did?

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That is the very point I was making.

We should single Russia out as a pariah. Like any bully, the Kremlin craves relevance, and it is winning as long as no one stands up to it. Russia must be confronted for its attacks on innocent civilians, both diplomatically and using hard power including sanctions and economic measures. We must seek to build support for multilateral military action to discharge our responsibility to protect. This is not about attacking Russia. It is about defending innocent civilians. It is about basic humanitarian decency and protection from the kind of barbarism and tyranny we hoped we had consigned to the last century.

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I completely concur with the right hon. Gentleman’s words about Russia and the atrocities that it is committing against the people of Syria, but should we not also look at this in the context of Russia’s previous actions in Ukraine and Crimea? Ought we not to remember that Russia as a state is increasingly out of control? It is not playing by the rules, and we absolutely have to confront its behaviour internationally.

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The hon. Lady makes an extremely powerful point. We cannot do this alone. We must use Britain’s outstanding connections, not least through our diplomatic reach, our membership of NATO, our relationship with America and our centrality in the European firmament—Brexit notwithstanding.

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I am most grateful to the right hon. Gentleman, not only for securing this debate but for allowing so many interventions. Would it not be appropriate for the Government to bring forward a debate asking this House to put forward its views on Russia’s behaviour not only in Aleppo but in previous situations? We need the Government to lead on such a debate, so that the House can send out the very clear message that we are watching what Russia is doing and will not forget what it is doing, and that, when it comes to it, we will see those responsible answering for their war crimes.

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I think the hon. Gentleman would agree that, by having this three-hour debate today, we are moving some way in that direction.

I have a number of specific questions for the Foreign Secretary to address when he answers this debate. First, he has said that the UK is taking the lead on sanctions on Russia. Will he tell the House what steps the Foreign Office has taken towards increasing bilateral or EU sanctions on Russia itself? Secondly, there are plans for a new addition to the Nord Stream gas pipeline running from Russia to western Europe—Nord Stream 2—allowing Russia to bypass transit countries and, therefore, transit costs in eastern Europe. Will the Foreign Office be working with our east European allies to block the new pipeline?

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I presume that we are talking about the gas pipeline that runs from Kurdistan through Turkey and the Black sea and bypasses Ukraine and the eastern provinces. The signing of that deal was agreed yesterday between Erdogan and Putin. A relationship seems to be building up between those two. Does the right hon. Gentleman have any view on that, because that movement of Turkey towards Russia is concerning?

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The Foreign Secretary has recently been in Turkey. I am sure that the House will be interested in his comments.

My third question for the Foreign Secretary is, what work has been done to catalogue and record human rights abuses—both individual and collective—in Syria? Will he update the House on the work of the Foreign Office, which was started and commissioned by the National Security Council in 2011, to collect evidence that can be used in the future to hold human rights abusers to account no matter how long it takes?

Fourthly, what steps has the Foreign Secretary taken with his colleagues in the Ministry of Defence to explore the feasibility of imposing and enforcing a no-fly zone over specific areas in Syria? Does he agree that, with the use of naval and air assets in the eastern Mediterranean, it is entirely possible both to monitor and enforce a no-fly zone with our allies? What steps will he take to make it clear to the international community that a no-fly zone is a matter of will and not of practicality?

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I have operated under a no-fly zone. It is practical and it can work, but it is quite difficult at a low level. That requires us to have seriously good surveillance over the target areas. If we have that, we can deal with it. We cannot have just a no-fly zone; we need good surveillance as well.

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I have no doubt that the Foreign Secretary will want to comment on those remarks, to which my hon. Friend brings his expert knowledge and understanding.

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As one of the four Opposition Members who did not oppose military action on that fateful day in August 2013, I fully support any measure to impose a no-fly zone. I assure the Government that, if they were to bring forward such a proposal, I will vote with them, and I guess quite a lot of my colleagues will do so as well.

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That is extremely welcome news both inside the House and outside.

I have one final point on the no-fly zone. Will my right hon. Friend make a specific point of meeting the former Prime Minister John Major to explore his experiences in imposing a no-fly zone and a safe haven in northern Iraq during the 1990s?

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I thank my right hon. Friend for giving way and I congratulate him on securing this debate. Given the discussion that there is over a no-fly zone, does he share my concern that Russia has moved very advanced surface-to-air missile systems into Syria when clearly Daesh or the al-Nusra front do not have a fast-jet capability. At whom might those missiles be targeted?

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My hon. Friend makes a good point, but those S-300 missiles do not affect the viability of imposing a no-fly zone.

My final question for the Foreign Secretary is, what steps are he and his Department taking to support and enhance the work of the International Syria Support Group? Staffan de Mistura has said that the suspension of bilateral negotiations between the two chairs, US and Russia, “should not and will not” affect the existence of the group. What steps is Britain taking to provide financial, diplomatic and political support to the International Syria Support Group? This group includes all of the five permanent members, Italy, Turkey, Japan, Iran, and the key Arab countries. It represents the UN, the EU and the Arab League. It needs to be greatly expanded. There should be an office, for example, working with and adjacent to the Geneva talks. It should carry out work on the key ingredients for a peace whenever that may come, and we should give very strong support to it.

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May I add a question to the ones that the right hon. Gentleman has posed to the Foreign Secretary? He has spoken very powerfully. Members of the House have described Russia as a pariah. He has compared it with the Nazi regime of the 1930s. Is it not utterly ludicrous that, in two years’ time, the greatest sporting spectacle on earth—the World cup—will be held in Russia, but not a single country is pulling out of it? If we are really serious about sending a message to Putin that is heard on the ground, should we not be questioning whether the World cup should take place in Russia?

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The hon. Gentleman makes an extremely good point. I hope that when he is considering sanctions, both economic and otherwise, the Foreign Secretary will have a view on that.

The international community faces a choice. Are we so cowed and so poleaxed by recent history in Iraq and Afghanistan that we are incapable now of taking action? Was all the international handwringing after Rwanda, Bosnia and Srebrenica when we said “never again” just hot air? Is all the work on the responsibility to protect—RtoP—which was unanimously adopted by the United Nations Security Council and agreed by the entire international community just so many words? Let us at least be clear here among ourselves. We have a choice: we can turn away from the misery and suffering of children and humanity in Aleppo; we can once again, on our watch, appease today’s international law breaker, Russia, and continue to find eloquent excuses for inaction; or we can be seen to take a lead to explore the situation energetically and with determination with our allies in NATO, Europe, America, and the United Nations and refuse to take no for an answer. We can look at every possible way of ending this barbarism and this tyranny, which is threatening the international rules-based system, destroying international order and engulfing the Syrian people.

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May I start by welcoming the right hon. Member for Witham (Priti Patel) to her new position? I also welcome to his post the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), whom I have not seen in this place until today. I hope that they will both find their new roles fulfilling.

I pay tribute to the right hon. Member for Sutton Coldfield (Mr Mitchell) for securing this debate, and for the eloquent and passionate way in which he has spoken up for the people of Aleppo. He spoke up for them throughout his time as International Development Secretary. He stood on the side of the poor and oppressed throughout the world, and he has done so again today. He also understood how much the commitment to spend 0.7% of national income on helping those most in need mattered, which is something from which his successors could learn. He agrees with me that Britain’s work in international development reveals the better part of ourselves and is something about which we should be inordinately proud.

The situation for innocent civilians in Aleppo is truly a hell on earth. They are trapped, impoverished and desperately in need of food, clean water and medical care. That would be bad in any circumstances, but they are also living in daily fear of death coming from the skies—from airstrikes in the east of Aleppo and from mortar bombs in the west. The scale of suffering is beyond our comprehension. We should be in no doubt that the parties responsible for that—whether it is the Russian forces and the Assad regime on one side, or the jihadists of Jabhat Fateh al-Sham, otherwise known as the al-Nusra Front or al-Qaeda—stand equally condemned in the eyes of public opinion and are equally guilty of crimes against humanity. In time, there must be a reckoning for those crimes. That is why we support the efforts of France to enforce a tougher approach at the Security Council to the violations of international humanitarian law. Will the Foreign Secretary be supporting the French Government in those efforts?

Equally, the effort to hold the Russian forces and others to account for their actions, and the anger that people rightly feel here, must not prevent us, difficult as it is, from seeking to work with the Russian Government to restore the Kerry-Lavrov peace process. That means securing and maintaining a ceasefire, isolating the jihadi extremists, opening safe—

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There is no ceasefire.

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Absolutely there is not a ceasefire now; that is what I am moving on to. Of course there is no ceasefire, and there needs to be an initiative. In the end, we all know that we can move forward only by way of negotiations, and that no negotiations will happen without a ceasefire.

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Can my hon. Friend present us with the evidence that she clearly has that it is realistic to believe that the Russians will seriously engage in further ceasefire negotiations? Does she think for a minute that they will stop bombing Aleppo while they are doing that?

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I have thought about this a great deal and spoken to a number of experts about it, and I have some suggestions that I wish to make to the House and to put before the Secretary of State. We want to be helpful. If she will give me a moment, I will explain.

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If the peace that we all want is not achievable, will the hon. Lady support the application of military force, if it is needed?

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I am not a pacifist, personally. I believe in using military force when it can be effective, if we can achieve the ends that we have identified, and if we know what we want to achieve. I believe that in a multi-layered, multifaceted civil war such as that in Syria, the last thing that we need is more parties bombing. We need a ceasefire and for people to draw back.

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While we all look for peace, does the hon. Lady agree that sometimes backing down, looking weak and hiding one’s head achieves quite the reverse? It encourages violence, treachery and the brutality that we are seeing today.

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Yes, I agree, but let us be strong about this and let us put forward a plan that might work. If the hon. Gentleman will give me a moment, I will explain what I am suggesting.

I was recommending that, despite the difficulties and the anger that many parties feel, we work with the Russian Government to restore the Kerry-Lavrov peace process. That means securing and maintaining a ceasefire, isolating the jihadis and opening safe channels for humanitarian aid—we should make that the basis to negotiate a lasting peace. Looking at the situation today, we accept that that could not look further away or seem more difficult, but we need to have that goal in mind. It is the only conceivable solution and the only way to bring relief to the people of Aleppo, so how do we do it?

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We had a ceasefire; it was brutally blown apart by Russian and Syrian air power. I still have not heard from my hon. Friend a clear and unequivocal condemnation of Russia’s and Assad’s action. I have not heard her call it out as it is—a war crime.

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I apologise to my right hon. Friend. I thought that that was exactly what I said. For the avoidance of any doubt—obviously, it is now in Hansard—of course the actions of the Russians can well be seen as war crimes. A number of war crimes have been committed during this terrible war, and as I said at the outset, there are the war crimes of Assad and Russia, and the war crimes of the jihadis. In time, we will expect those war crimes to come before the international courts, and those people should and must be held to account. It was for that reason—perhaps my right hon. Friend did not hear me—that I urged the Government to support French efforts to ensure that more initiatives are taken to bring the parties to international justice.

Mr Speaker, many people are getting impatient that I have not yet put forward my plan, so perhaps I will not take any more interventions at the moment so that I can actually do that.

What is the only conceivable way of bringing relief to the people of Aleppo? I believe that it will require strong statesmanship on all sides and not more brinkmanship. We need to talk to experts in the field. Their concern is not just how we stop the conflict as it stands, but how we avoid it escalating further. Yesterday, one expert said to me:

“On the ground, we are just one bad decision away…from Russian and American forces ending up in armed conflict.”

Facing that chilling prospect, we must all work for the alternative, and we need to start by looking carefully at the plan put forward by the UN Syria envoy Staffan de Mistura. The right hon. Member for Sutton Coldfield has already referred to it, and I respectfully agree with him. Staffan de Mistura has bravely promised that if the jihadi forces of Jabhat Fateh al-Sham agree to leave the city of Aleppo, he will personally escort them from the siege to Idlib, or wherever they wish to go. Such a move would isolate the jihadi fighters from the moderate rebels inside Aleppo and remove from the Russians and the Syrian forces their current pretext for the bombardment of east Aleppo. That process could—I stress it only could—provide the basis to restore talks on a ceasefire and on opening up the humanitarian channels that we all wish to see.

There is a precedent for such a step in the way the Jabhat fighters were escorted out of Homs and other towns in Syria. While we must treat the Russian assurances with caution, it is an approach that Sergei Lavrov has said they are ready to support and can persuade the Assad regime to agree to, so will the Government lend their support to the plan put forward by the United Nations? The Government have yet to respond to the initiative at all. I believe that it is a serious initiative with some prospect of hope in it, and that it should not be ignored. Will they persuade their French and US counterparts to do likewise and seek to use this pragmatic proposal as the basis to restart talks?

While we are rightly focused on Syria today, we know that many other countries in the world will listen to what we say about Syria, look at the values that we claim to uphold and ask whether we are true to those values when it comes to other countries and conflicts. Today we will hear Members from all parties rightly condemn Russia and Assad for the airstrikes against civilian targets. We will hear calls for independent UN investigations into breaches of international humanitarian law. We will hear calls to take further action against Russia to oblige it to cease the bombardment. While that is all correct, if we say those things about Russia and Aleppo, we must be prepared for what is said about Saudi Arabia and Yemen. We cannot condemn one and continue selling arms to the other. We cannot call for investigations into one and say that we are happy for the other to investigate themselves. We cannot pour scorn on the assurances of one that they have not hit civilian targets while blithely accepting the assurances of the other. Most of all, we cannot cry for the people of Aleppo and the suffering that they face while turning a blind eye to the 1 million children in Yemen facing starvation today. So I ask the Foreign Secretary to tell the House how the actions that the Government propose in Syria compare with the actions that they are taking in Yemen.

The suffering of Aleppo has gone on for too long. Every day that it continues, we must redouble our efforts to end it. We suggest a four-point plan to the Government. We suggest that we begin with more statesmanship and less brinkmanship. Secondly, we must adopt the UN plan to escort the jihadis from Aleppo. Thirdly, the Kerry-Lavrov plan needs to be revived and we must work together towards a lasting peace. Fourthly, we must de-escalate overseas military involvement in the conflict from all 14 other nations involved, including ourselves. That is how we will create safe corridors for aid, stop the destruction of Aleppo by Christmas and end the suffering of its people.

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Order. Before we proceed further, I have seen how many people wish to contribute. I do not want to impose a time limit on Back-Bench speeches at this stage, but if, by voluntary co-operation, we can achieve the objective, that would be better. If each Back Bencher spoke for no more than seven minutes, everybody would get in, and there should be general contentment. There is never universal contentment, but I would settle for general contentment. We will be led in this mission by no less a figure than Mr Alistair Burt.

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Thank you, Mr Speaker. I start by congratulating my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) on initiating the debate and on opening it in such an extraordinary fashion. His deep personal commitment, which he has exhibited over a number of years, to those in the Syrian National Coalition and the High Negotiations Committee and others has been evident in what he has said. He has long championed their needs, and that was evident today.

I thank the hon. Member for Islington South and Finsbury (Emily Thornberry), who spoke for the Opposition, for proposing a difficult case in trying to find an answer. There are no easy answers, but I hope that a little bit of background will help further.

I pay tribute to those in the Syrian National Coalition and those who have worked for peace in Syria over a lengthy period. I met members of the Syrian National Coalition. I met them in Gaziantep. I met them in Jordan. I met them Paris. I met them in London. I met Riad Hijab. Part of the background is to recognise that what has happened in Syria today did not just spring out of events in 2011—the Syrian regime has long been repressive, and the roots go back a long time and are very deep—but not to recognise the extraordinary courage of people in Syria to make a political case for change, which has been the cause of so many deaths in Syria over many decades, is to miss something. They have consistently proposed a plan for a democratic Syria, with the engagement of all elements of the community, and they have done so for several years. Again, any future for Syria must recognise that the SNC and the High Negotiations Committee have had a plan for a long time, and I wish they had been listened to even earlier.

While in Gaziantep in Turkey I met members of the White Helmets. At that time, the Foreign Office was working to support its members and give them training in their work, and they have done an extraordinary job in the chaos and disaster that is Syria. The work of the White Helmets has been quite extraordinary. Again, we need to pay tribute to the White Helmets, as we do to those such as David Nott, the surgeon who has worked in the extraordinary circumstances of the hospitals in Syria and who writes so eloquently on the subject.

The United Kingdom has to look at many parts of this issue in terms of what has been achieved. We have played a part in trying to alleviate some of the suffering. There is little need, I am sure, to elaborate further on the degree of suffering. We have seen it on the television. We have seen the brave films produced by BBC “Panorama”, giving cameras to people. There has been what our excellent ambassador to the UN, Matthew Rycroft, described only last week as “an onslaught of cruelty” in Aleppo, which he said could not possibly be the work of the Syrian forces on their own.

The tragedy of Aleppo and Syria is that it is an entirely human construct devoid of any natural disaster component. It has happened in front of our eyes—eyes that have witnessed in my time as a Member Rwanda and Srebrenica too. It has happened with so many other memories of previous conflicts in our minds. It has happened because of, as much as despite of, international mechanisms such as the UN and the International Criminal Court—mechanisms that we have all hidden behind, to a certain extent, believing that they could find the answer, as we watched them being stripped of their authority, week by week, action by action in Syria, and actually reduced to ridicule. If international mechanisms cannot prevent an Aleppo, what actually can they now prevent?

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I am grateful to the right hon. Gentleman, who was one of the best Ministers in the Foreign Office over a long period, for bringing great knowledge to the House from what he did in the Foreign Office. Many Syrians in my constituency—I meet them regularly—say that they just want people to give them some help. He mentions some international organisations, but does he think that the UN is doing enough? If it is not doing enough, do we need to consider reforming that organisation, so that it can help in such crises?

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The point made by my right hon. Friend the Member for Sutton Coldfield and myself, and the point of the hon. Gentleman’s question, is that Syria demonstrates the failure of these international mechanisms now. If a veto is continually used on the UN Security Council, what can we do? My right hon. Friend rightly argued—this was recognised on both sides of the House—that the League of Nations was damaged by the stripping of its authority. That is the point that we have reached, and if we cannot rely on these mechanisms, what are we now going to do?

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Will my right hon. Friend give way?

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I shall give way very briefly, but I am being fair to Mr Speaker by trying to keep the intervention short.

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The veto in the Security Council by Russia will kill any plan stone dead. Perhaps this is a chance for the General Assembly to get some power and do something about it.

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There may be international mechanisms that involve talk, but perhaps there are other things that we can do, and I think that that will be the mood of the House.

A little bit of history will provide a pointer forward; we need not review it all. Assad knew exactly what he was doing when the revolt started in 2011. Syria was not beset by radical Islam, but he released prisoners from his prisons to join radical Islamic bands because he wanted to create the narrative of his providing stability against terrorism. The narrative has succeeded. It gave him the excuse to attack his own people. That reached a nadir in 2013, with chemical weapons attack on his people. That was a fundamental point. I am not going to rehearse what was said in the House—there are reasons for colleagues to make the decisions that they did—but by stepping back at that moment, the moment not to destroy Assad but to get him back to the negotiating table by convincing him that something would stand in his way was lost.

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Inaction has consequences, and the consequences of inaction in 2013 are seen in Aleppo today.

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They are; we learned that intervention has consequences, but so does non-intervention. We talk about non-intervention, but Syria has had intervention from Russia, from Hezbollah and from the Iranians. I remember briefings in the House, talking to colleagues and saying that, if the ultimate answer to Syria is a victory for Assad, for Russia, for Iran and for Hezbollah, and if we think that that will be in the United Kingdom’s best interests, I think we ought to think again. So we move on, and it is all very well to hear the history.

The involvement of Russia, which the hon. Member for Islington South and Finsbury bravely mentioned, is a crucial part. Russia needs to understand that savagery stokes terrorism; it does not end it. Russia is rightly concerned about the possibility of radicalism in Chechnya and all that, but its efforts to deal with it are failing. Part of this discussion is being very clear that what is happening and what Russia is doing will fuel the terrorism of the future and will do nothing to prevent it.

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Does the right hon. Gentleman agree that one of the reasons why some of us are so concerned about the Government’s approach to Russia is the evidence in Syria that Russia is not targeting ISIS? The number of air strikes by the Russian forces against ISIS has decreased by 10% in the past year alone, so it is clear that they have another agenda, and they should be called out on that, and rightly so, as soon as possible.

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I thank the hon. Lady for her intervention. Anyone who thought that Russia had any other agenda was fooling themselves. Russia’s agenda in the area is very mixed. First, it is to provide a bulwark against radical Islam in its own country. Secondly, it is to demonstrate to people in the region that it is now a power, as it has seen the United States retreat. Thirdly, it is to consolidate its own interests, which do indeed go very deep. But that vacuum is now being seized, so what do we do?

I turn to what my right hon. Friend the Member for Sutton Coldfield said towards the end of his remarks. This is about an effort of will. The fundamental failure in Syria in the past couple of years has been to give an impression that no one would stand up against the attacks on people in Syria because we have lost the will, not to advance an ideological agenda, but to defend and protect people. That is what R2P is about. The calculation is whether trying to enforce a no-fly zone, trying to protect the people on the ground, would be challenged by the powers of Syria and Russia, or whether that would be the point at which they would say, “No more killing,” and proceed on the way of negotiation and peace. That is actually the point that we have now reached.

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I am grateful to the right hon. Gentleman for giving way. Does he agree that the reason why we have not managed to secure no-fly zones is that people are understandably concerned that they would escalate tensions, and even conflict with Russia? However, the proposal is that the answer to any air attacks against civilians in no-fly zones would be carefully targeted strikes against the Assad regime’s military assets only. That could provide a real answer that would protect Syrian civilians and hopefully get the peace process back on track.

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I thank the hon. Lady for her intervention, because what she says is exactly right. Those who are killing civilians in Aleppo are relying on the fact that we fear escalation and we worry. People therefore do nothing. We did not know what the consequences of 2013 would be, and we worried about intervention. However, we know now, and accordingly, we know what will happen in Aleppo over the next few months if nothing is done. That is the point that we have reached. Ultimately, we are talking about an act of will. If a force determined to do the unspeakable is met with moral argument but little else, the determined force will win. We have reached the stage at which we have to declare—I look forward to the Foreign Secretary making this clear—that that is a point beyond which we are no longer prepared to go.

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Order. The hon. Member for Islington South and Finsbury (Emily Thornberry) made a succinct speech from the Front Bench; that is the length of speech that I know the Scottish National party spokesperson will seek to imitate.

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Thank you, Mr Speaker. I am aware that a lot of colleagues want to get in. I congratulate the right hon. Member for Sutton Coldfield (Mr Mitchell) on securing the debate, and thank you, Mr Speaker, for granting the House leave to hold it. It is an emergency debate in every sense of the word; it is urgent and necessary for us to have the debate, because the situation in Aleppo and across Syria has dramatically worsened from the already nearly catastrophic state that the conflict has brought about.

As others have said, the turning point in recent weeks seems to have been the bombing of the UN aid convoy on 19 September. If that and other atrocities are called out as being war crimes, they should be investigated, and the perpetrators must be brought to justice. That event ended the tentative ceasefire; hostilities, particularly by Russia, have increased since then. Some 275,000 people in eastern Aleppo, over 100,000 of whom are children, face daily bombing. The UN Secretary-General, Ban Ki-moon, described the situation as “worse than a slaughterhouse”, and others, including rebel groups inside the city, effectively see the enactment of a scorched earth policy by the Assad regime. Over 1 million people have been killed since the conflict began in 2011, so we should not be surprised at the comparisons with Rwanda and Srebrenica. It was absolutely right to make time for today’s debate.

I want to consider briefly responses so far from across the UK and the world, and the options available to the UK Government and the world community. The Scottish National party has consistently been opposed to military action, and has consistently called for a negotiated settlement and significant humanitarian intervention. When this House debated whether to join the bombing campaign, we warned that becoming a party to the conflict would reduce the UK’s ability to be an arbiter in any resolution, and so it has proved. We welcome the response, led by the Department for International Development, in terms of humanitarian support, but there is further to go. We have consistently said that what people in Syria need is bread, not bombs. If we have the technology to drop bombs, surely we have the technology to drop or deliver bread and aid.

The Scottish Government, with their limited power and resources in this area, have played as active a role as they could. In March 2013, they donated £100,000 to the Disasters Emergency Committee, and they later doubled that to £200,000. Earlier this year, the First Minister accepted an invitation from the UN special envoy for Syria, Staffan de Mistura, to host an international women’s summit in Edinburgh, focused on supporting Syrian women, so that they can engage in communication, negotiation, and post-conflict planning, and become a key part of the peace process.

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I am sure that all of us want a negotiated end to the problems in Syria, but does the hon. Gentleman not accept that the timid approach of America and other allied forces has led to the encouragement of the Russians, who have escalated their military involvement and its brutality?

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I will come on to the geopolitics and relations between the United States and Russia, but the answer has clearly not been for the UK to dive in and continue to add to the chaos and bombing.

The Scottish Government have continued to try to play a role. They announced in August 2015 that they would contribute up to £300,000 to the 1325 Fellowship programme facilitated by Beyond Borders Scotland—another initiative that trains women in prevention and resolution of conflict. It was set up in response to UN resolution 1325, which reaffirms the important role of women in the prevention and resolution of conflicts. We in Scotland and the Scottish Government have been keen to make a positive contribution wherever possible. Of course, many people across the country have joined in the efforts to welcome refugees, especially from Syria, who have come here seeking stability and peace.

Peace in Syria seems as far away as it was at the start of the conflict. Russia and the United States have completely different aims for the region, particularly as regards President Assad’s role, or otherwise, in the country’s future. There is a worrying risk of the situation becoming a proxy for broader tensions between the two countries, and indeed of further backsliding in international relations more generally. That is why the right hon. Member for Sutton Coldfield is right to question the stalemate’s impact on the role of the United Nations. It has never been more necessary for the UN to play a role, yet in this area at least, it seems that the impasse has never been more difficult to breach.

There have rightly been calls for the General Assembly to be more outspoken where the Security Council cannot reach agreement; that would be a start, but the GA still lacks the teeth of the Security Council. The UK’s seat on the Security Council is supposed to be one of the great defining assets of the Union, putting the great into Great Britain. While I welcome the strong words of the UK representative at recent meetings, strong words are increasingly not enough. It is for the United Nations and the International Syria Support Group to facilitate a peaceful settlement, and the United Kingdom Government should seek to make sure that the UN has the mandate and the support that it needs.

In the meantime, there must be more that the Government can do, either independently or with allies. I have already said that if we have the technology to drop bombs, surely we have the technology to drop aid, but we also need the ability, stability and permission to provide aid, especially to areas controlled by the Assad regime. Negotiating a safe space for that ought to be part of the UK’s diplomatic efforts. If that means that a no-fly zone could help, then that should be explored, but it needs to be properly enforced.

Getting aid—medical, food and non-food relief—into the country, and into Aleppo in particular, should be the No. 1 priority for humanitarian agencies in the country. If the big and multilateral agencies are having difficulty with that, more support should be given to local actors, especially those coming from faith-based or community-based organisations. I join in the tributes paid to the White Helmets, who are thoroughly deserving of their Nobel prize nomination. If there are practical ways that the UK Government, through partners, can support that work on the ground, they should be acted on.

Support also has to be provided in the refugee camps, both in Syria and in the surrounding areas. I was visited last week by a former constituent, Tony Collins, who now lives in Lebanon, where he assists the aid effort on the ground—in the camps. He describes the situation as no longer an emergency, but endemic, and as having a major impact, as we have heard from Members, on the future of Lebanon. UK humanitarian support has to provide emergency relief, but also look at long-term economic development, and the impact that these profound movements of people are having.

The Minister of State, Department for International Development, the hon. Member for Penrith and The Border (Rory Stewart) is still here; the Secretary of State for International Development has left. I sound notes of caution about DFID’s role and response. I have said many times that while conflating some aspects of security and aid spending may be permitted under OECD rules, it is not what people expect to happen when the Government say that they are meeting the target of giving 2% of gross national income to NATO and the 0.7% target for aid spending. These targets should be met and accounted for separately; the situation in Syria in particular shows why that is necessary.

DFID also needs to think about the longer-term impacts of its policies, and consequential effects that might not be seen at the time. The withdrawal of programme partnership arrangement funding from many organisations is leading them to withdraw from areas, or wind up altogether, and that has a long-term impact that might not be seen at present, yet need is vastly increasing. Of course, support for refugees here needs to increase as well. The UK is committed to taking 20,000 over five years, but that is nowhere near our fair share.

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While the UK Government are right to focus their efforts on providing aid in the region, the refugees we have agreed to take, particularly under the community sponsorship scheme, include only 2% of Christian refugees from Syria, despite the fact that religious minorities constitute up to 12% of the Syrian population. Does the hon. Gentleman agree that we need to make more effort to reach out to frightened religious minorities in Syria?

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Yes, absolutely, I agree that persecuted minorities need to be given special attention. The House as a whole has given the Government a mandate to act on the genocide of the Yazidi community. The support provided for refugees needs to go beyond simply meeting physical requirements. I have constituents who are traumatised by their experiences in Syria and elsewhere, and mental health support will be increasingly important.

I am conscious of time. The Government say that they are leading the humanitarian response, but that does not mean that they cannot go further. They must rethink their military objectives. We were told in December last year that UK air strikes would cut off the head of the snake, but the chaos has only increased, and the people of Aleppo are paying the price. The UK urgently needs to rethink its military strategy, and it needs to commit to working across borders and interests to find a sustainable and lasting peace. While that goes on, the aid effort must be stepped up for the sake of people in Aleppo, Syria, the region and, indeed, around the world.

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It is a pleasure to follow the hon. Member for Glasgow North (Patrick Grady). I shall keep my speech brief, but I want to begin by congratulating my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) on securing the debate and commending him for the way in which he made the case yesterday and brought the matter to the attention of the House. It was a powerful, passionate speech that was also practical, and I trust that Ministers listened to every word and will consider the recommendations and suggestions he made. He was exactly right yesterday to describe the situation in Aleppo as an “unfolding humanitarian catastrophe”.

I share the deep, deep concern that my right hon. Friend expressed, and I believe that the House should send the strongest possible signal at this time, both to our own Government and to other Governments, that the present suffering of innocent civilians in Aleppo is unacceptable; that the criminal acts of the Syrian and Russian forces are unacceptable, not least the bombing of hospitals, schools and humanitarian supplies; and that the seeming impotence of the international community in the face of such acts must not, and cannot, be allowed to continue.

As the debate on the statement by my right hon. Friend the Secretary of State for Exiting the European Union demonstrated, the attention of the House in the coming months will be consumed, overwhelmingly and necessarily, by issues relating to our withdrawal from the European Union. We will debate and argue about how best we protect our national interest in the Brexit process and how we give our nation the best chance of future prosperity to protect the quality of our lives and those of our children. We will even have debates about debates.

Today’s debate, however, demonstrates that the House remembers its duty to look outwards and have regard for that part of humanity that does not live within our borders. With you in the Chair, Mr Speaker, I am confident that the House will always make time available for us to speak with clarity and unity when confronted with suffering on the scale that we have witnessed in Syria in recent days. We should not underestimate the interest of the outside world in what is said in the House. A number of us have received emails today from groups within Syria who are watching the debate, and who want that clarity and unity expressed by hon. Members.

I pay tribute to the clarity of voice that our Foreign Secretary has brought to bear on the international stage on the subject of the Syrian conflict. He was one of the very first to describe the attacks on the Red Crescent aid convoy three weeks ago as a war crime—that was exactly what they were—and directly to implicate Russian forces. However, in commending the Foreign Secretary may I ask him to update the House on his most recent discussions with Foreign Minister Lavrov about the events in Aleppo and what further representations he plans to make? Will he leave us in no doubt whatsoever of his determination to ensure that the Russians know that we will keep up the pressure in the wake of their illegal acts in Syria, and that as the days slip by our anger and disgust at the acts for which they are responsible will not subside?

As has been said, President Hollande of France has stated in the past 24 hours that there should be a role for the International Criminal Court in holding Moscow to account for its actions. What consideration has my right hon. Friend the Foreign Secretary given to that suggestion and any other processes, including at the UN, for upholding international law on Syria?

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On the International Criminal Court, I am worried that any action would be hamstrung by Russia in the Security Council, which in some way controls the ICC. I speak as someone who has given evidence in five trials there.

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My hon. Friend is right to express those concerns. The ICC has not proved itself effective in many respects in upholding international law, but we have a new opportunity. As my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) said, a lot of this boils down to an effort of will on the part of the international community. I shall come on to address that point.

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Does the right hon. Gentleman accept that one problem with the ICC is that not enough countries, including some influential ones, are members. Perhaps an international lead from some of our larger friends would be of great assistance.

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The Opposition spokeswoman makes an important point. Far too many countries have not signed up to the ICC, and a job for our diplomacy in the months and years ahead is to encourage buy-in to the court. Will my right hon. Friend the Foreign Secretary update us on any discussions that he has had with his French counterpart before the scheduled visit by President Putin to France next week, and on the need to ensure that there is a united stance by international allies when discussing the latest events in Syria?

I welcome the business-like tone struck by the Prime Minister when she met President Putin at the beginning of September at the G20. It is right that our initial posture should be one of reaching out and seeking improved relations with Moscow, but one can be forgiven for thinking that Putin is taking the west, including us, for fools, in the belief that the distraction of a US presidential election and Brexit means that there is neither international interest nor resolve to try to stop the brutal and so far effective power play that he has undertaken in Syria.

Aleppo is a litmus test of whether Russia wants to play a constructive role in the region and whether it is willing to work in collaboration with the international coalition to bring peace to Syria, acknowledging that its interests may be different in key respects. Unfortunately, the events of recent weeks demonstrate that it has failed that test and that its behaviour is not consistent with that of a responsible actor. It behaves instead like a thuggish gangster regime flouting international law at will.

We can be business-like in our relations with Russia, but that does not mean business as usual when Russia behaves shamelessly in attacks on innocent civilians in Aleppo and then defeating attempts at the UN to secure some respite from the hostilities. The bombing campaign in Aleppo amounts to a war against children. Almost half of the casualties since the current attack began have been children, as bombs and mortars have landed on hospitals and broken through underground bunkers that sometimes also serve as schools. Last week, newspapers carried photographs of children playing in water-filled craters in the ground created by bombs and mortars—images, I suppose, of innocence amidst the conflict. The images that we should hold before us are others that we have seen in the past fortnight: the lifeless, dusty, broken-limbed bodies of children being removed—exhumed—from bombed-out buildings and piles of rubble. This is indeed a war against children.

In conclusion, the point has been made several times this afternoon that there are no easy solutions. Indeed, my right hon. Friend the Member for Sutton Coldfield described in some detail the complexity of the challenge before us. My right hon. Friend the Member for North East Bedfordshire made a really powerful point when he discussed the effort of will needed from the international community, with leadership from us, to show that there is a resolve to make progress and to hold Russia in particular to account for its actions, given its responsibilities as the key player at this moment in time in achieving respite from the bombings to secure an enforced ceasefire, including safe passage for humanitarian supplies while allowing room for a diplomatic process that might possibly stand a chance of achieving some lasting peace.

We have heard practical suggestions this afternoon, such as having a no-fly zone and discussion of economic sanctions as a way of bringing more pressure to bear on Russia. I will be particularly interested to hear the Foreign Secretary’s response to those two suggestions, and on what more the Government can do to show leadership and increase the international resolve and will.

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Much has been written about Syria and Aleppo in recent months. Parliament has not been sitting, so some of us have been left to tweet our continuing concern about the events unfolding in that country day after day. One of the best articles on Syria that I have read recently was in The Guardian on Saturday, under the headline “We are watching the destruction of Aleppo. Where is the rage?” It was written by Natalie Nougayrède. It was very poignant, and I suggest that other Members look at it.

That is the question: where is the rage? Where are the demonstrations that we have seen on so many previous occasions—I have taken part in them myself—for example on Iraq, East Timor and Cambodia. Where are those demonstrations now? I want to see—I challenge the people listening to this debate—2 million, 3 million or 4 million people outside the Russian embassy day after day. Let us show them what we think of their actions in Syria and their refusal to bring peace to that country. Russia used carpet bombing tactics in Grozny, and we all know what happened there. The west cannot stay silent, because we know how this could end.

The current UN special envoy to Syria, Staffan de Mistura, is an old friend of mine; in the past we worked together on Iraq. He has warned that rebel-held eastern Aleppo could face total destruction by Christmas and that thousands of Syrian civilians—not terrorists—could die if the current assault on the city by Russian and Syrian forces is not stopped. He has called for the shelling of the city to stop immediately and for the UN to be allowed to take aid supplies into rebel-held areas. Eastern Aleppo has received no humanitarian assistance for the past three months, and food and medical supplies are running at dangerously low levels.

Staffan de Mistura has also offered to go to the besieged area of the city and personally escort al-Qaeda-linked fighters out of the city, in an appeal to stop the current bombing campaign. At least 250,000 people are thought to be trapped in eastern Aleppo, where rebel supply lines were cut off by President Bashar al-Assad’s troops in July. According to the UN, a renewed aerial and ground campaign to retake opposition-held areas has left hundreds of civilians dead and damaged hospitals, water plants and bakeries. Médecins sans Frontières has reported 23 attacks on medical facilities in eastern Aleppo since July, and all of us have seen on “Newsnight” and other programmes the bravery of the doctors and nurses in those hospitals—there is probably only one hospital remaining—saving lives by video link. We are particularly grateful to the British doctor who has been doing that.

A psychologist on the ground has said that 75% of children in Aleppo have post-traumatic stress disorder, and that 50% of those between the ages of nine and 13 are incontinent as a result. More than 100 children were killed only last week. The US Secretary of State, John Kerry, has said that the bombing campaign is a targeted strategy to terrorise civilians and kill anybody and everybody who is in the way of Syrian and Russian military objectives. The UN Secretary-General, Ban Ki-moon, has called eastern Aleppo “worse than a slaughterhouse”. Syria, backed by Russia, says that it is targeting militants in the city who use civilians as human shields. However, as Staffan de Mistura has pointed out, the presence of about 900 former or current Jabhat al-Nusra—it now calls itself Jabhat Fatah al-Sham—fighters cannot justify the destruction wrought on the city in the past two weeks, following the collapse of a US-Russian-brokered ceasefire.

Staffan de Mistura has also said:

“There is only one thing we are not ready to do: be passive, resign ourselves to another Srebrenica, another Rwanda, which we are sadly ready to recognise written on that wall in front of us, unless something takes place.”

He warned that history would judge decision makers in Damascus and Moscow for the misery imposed on eastern Aleppo citizens through the fighting. Our own Foreign Secretary—he is sitting on the Front Bench—along with the US Secretary of State, has accused Russia of war crimes and said that the country should be held accountable for allegedly bombing aid convoys in Syria.

We do not have to wait for the International Criminal Court. Indict, an organisation that I chaired, collected evidence on Iraqi war crimes years before they were heard. That can be done again, for example through the Foreign Office. The testimony that we collected from hundreds of people about Saddam’s regime was subsequently used in the trials in Baghdad. I sat there myself to hear some of the people accused of those dreadful war crimes being judged, so it can be done.

US attempts to establish a long-lasting ceasefire and further talks have been thwarted, with the US finally breaking off talks with Russia, citing Moscow’s unacceptable backing of Assad’s Aleppo campaign. An attempt made only this weekend to pass a Franco-Spanish-sponsored UN Security Council resolution, which called for an end to the bombing of the city by Syrian and Russian jets, was vetoed by Russia, which argued that the distorted resolution would provide cover to terrorists. During heated exchanges in the Security Council on Saturday, the UK ambassador to the UN, Matthew Rycroft—I also worked with him on Iraq over a period of time—said:

“This council cannot stand by while such misery is meted out on the people of Aleppo. And yet, thanks to you, Mr President,”—

the Russian President—

“that is exactly what we are doing. Thanks to your actions today, Syrians will continue to lose their lives in Aleppo and beyond to Russian and Syrian bombing. Please stop now.”

What is the international community going to do? We have heard several suggestions this morning. How are we going to prevent another Rwanda? If Russia will not end its military aggression in Syria in support of President Assad, and there is no sign that it will do so any time soon, with the Russian Parliament having voted recently to give Putin authority to keep war planes in Syria indefinitely—and with the Russian military obliquely warning that it would use anti-aircraft missiles to attack any US jet that tried to strike the Syrian regime—are we doomed to watch this unfolding tragedy, this genocide in the making? Will we continue to feel utterly impotent?

I would like quickly to suggest a few things that have been advanced from a number of quarters today. We must better protect civilians now and in future, because in the middle of this appalling conflict civilian protection has to be prioritised. First, we have to get assistance to Syrian civilians in eastern Aleppo and other besieged areas fast. It is now over four months since the International Syria Support Group set a deadline of 1 June for airdrops and airlifts to communities under siege—a proposal the UK took credit for. In those four months, there has not been one single airdrop or airlift to territory under siege by the Assad regime. As of 5 October, there have been 131 UN airdrops to regime-held Deir Ezzor, which is under siege by ISIS, and 104 airlifts to the regime-held al-Qamishli airport. There have also been airdrops by regime aircraft to the besieged regime towns of Foua and Kefraya. However, despite the large number of UN airdrops and airlifts to regime-held territory, the Assad regime will not grant the UN permission to drop aid to the areas the regime is besieging. As well as alleviating human suffering in the short term, airdrops to those areas could play an important part in alleviating human suffering in the longer term by breaking the Assad regime’s stranglehold over aid.

The UK Government should therefore now ensure that their own proposal can be implemented. The UK has the experience and the capacity to airdrop food and medical aid to besieged communities from its bases in Cyprus. It has the military might to deter attacks on its aircraft. Suitable partners on the ground are available—through local councils, medical care and relief organisations, and others—to co-ordinate drop zones and aid distribution. Putin is already carrying out airdrops every day to help those he protects. The UK military and its allies delivering airdrops and airlifts should be understood not as a logistical second-best option for delivering aid but as a means of pressing for proper ground access for humanitarian organisations.

Secondly, the international community should and could institute a no-fly zone for Syrian helicopters. It is Syrian helicopters that drop the illegal barrel bombs full of napalm, chemical weapons and high explosives. It is estimated that such a no-fly zone could reduce civilian deaths by roughly 90%. In that respect, I shall always be grateful to John Major. When I was shadow International Development Secretary, I went to Kurdistan. People there asked me whether I could ask the Prime Minister to institute no-fly zones. He asked to see me, and I went to see him. Within a week, those no-fly zones were in place. It can be done—it has been done, and it could be done again.

Thirdly, we must ensure that Russians and Syrians responsible for this cruel and constant bombing are ultimately held to account. The UK and others should track Russian and Assad regime aircraft and publish regular timely reports on which aircraft, from which base, are responsible for each potential war crime. The UK has military assets in the region that could make the difference. An aircraft-tracking system that named and shamed Russian and Syrian aircraft bombing hospitals might encourage Putin to stop this slaughter. UK AWACS aircraft and Type 45 destroyers already based just off the coast of Syria could monitor and police such a system. That would establish that evidence was being collected for future prosecutions and that all those responsible in the chain of command risked being implicated. Although Russia would be able to use its Security Council veto to block any attempt to refer it or the Bashar al-Assad regime to the International Criminal Court, other avenues to obtain justice should be explored. Earlier this week, the United Nations Commission on Human Rights called for countries to be stripped of their veto powers if they blocked war crimes investigations. The vast majority of countries around the world support the idea of denying the possibility of a veto in situations of mass atrocities.

Finally, in the light of the UN Security Council’s current intransigence, the UN General Assembly should hold an emergency meeting, demand an end to unlawful attacks on civilians in Aleppo, and explore avenues for accountability. We have to make it crystal clear to the Syrian and Russian Governments that their actions are deplorable. We need to speak up for and on behalf of our common humanity. I therefore call once again on everyone who cares about the plight of Syrian civilians to picket the Russian embassy in London and its embassies in capitals around the world from today. Two million, 3 million, 4 million people—it can be done, and it has been done in the past. That should carry on until the bombing campaign stops and all the relevant players are forced to get around the table to end this horrible war.

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It is a pleasure to follow my right hon. Friend the Member for Cynon Valley (Ann Clwyd), who has been such a powerful, consistent and long-standing voice on these issues in the House. I pay tribute to the right hon. Member for Sutton Coldfield (Mr Mitchell) and to my hon. Friend the Member for Wirral South (Alison McGovern) for securing this important debate.

The situation in Syria is truly horrendous, and I want to focus on the humanitarian catastrophe. In Aleppo and the Idlib governorate, 2 million people are living without water or electricity, and there are attacks on health facilities. Across Syria as a whole, there are 470,000 people who have lost their lives, 8 million people who are internally displaced and more than 4 million refugees.

We can rightly be proud of our role in providing aid in the region, and I welcome the Under-Secretary of State for International Development to his place. We have seen £1.35 billion in UK aid to the region since 2012—money well spent. However, concern has been raised by a range of humanitarian, civil society and human rights organisations that the Assad regime is controlling deliveries of aid to the detriment of rebel-held areas. That raises serious questions for the United Nations—questions I would like the Government to raise with it.

May I echo what the right hon. Gentleman said about the heroic efforts of Jordan, Lebanon and Turkey in coping with the massive numbers of refugees coming to their countries? The International Development Committee recognised that in its report in January on the Syrian refugee crisis. We also said in that report that we would welcome a decision by the Government to resettle 3,000 unaccompanied children. I would like an update today from the Government on what progress they are making on the former Prime Minister’s pledge to take 20,000 vulnerable people through a resettlement scheme, on the pledge to take 3,000 vulnerable children from the region and on the pledge to take children from Greece, Italy and France. I raised that yesterday with the Home Secretary, who said that around 50 children have been accepted so far. I would like to see that accelerated, because we have a duty to act here, in the same way that we have a duty to act there.

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My hon. Friend is making an extraordinarily powerful point. However, the resettlement programme is absolutely stuck in the mud. In Greater Manchester, agreement cannot be reached between the city authorities and the Government because the Government refuse to pay the money that is required to get these children and other Syrian refugees to Manchester, where we are willing to accept them. Does my hon. Friend agree?

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I do agree with my hon. Friend. The people of Liverpool have made a similar pledge, as have the city council and the mayor of Liverpool. The National Audit Office published a report last month on this very issue, in which it praised the progress made by local government in the last year but pointed to some of the issues my hon. Friend has highlighted—not least that it is not clear what funding will be available to support local authorities beyond the first-year costs.

Will the Foreign Secretary address another aspect of the current crisis? Some 70,000 Syrian refugees are currently in what is known as the “berm”, which is a demilitarised zone between Syria and Jordan. Those 70,000 people are, effectively, being prevented from going to the safe space of Jordan. Our former colleague, Stephen O’Brien, who is now the head of the United Nations Office for the Coordination of Humanitarian Affairs, has described conditions at the berm as truly dire. My understanding is that a plan to deal with the crisis has been agreed by the United Nations but not yet by Jordan. Will the Foreign Secretary use his good offices to pursue this as a matter of urgency with the Jordanian Government?

Earlier this year the right hon. Member for Sutton Coldfield and another former International Development Secretary, Clare Short, brought to the International Development Committee’s attention the issue of the unintended consequences of counter-terrorism legislation for the delivery of aid. Several non-governmental organisations have been in touch with the Committee in recent weeks to raise that question and, in particular, two areas that require action from the Government.

The first area is the need to ease the concerns of banks. My understanding is that even when NGOs are fully compliant with counter-terrorism legislation, banks are sometimes nervous about lending, leading to delays in processing payments and the aid not getting delivered. The second is the need to use our good offices with Turkey. My understanding is that it is not always easy for NGOs to function on the Turkish side of the border region between Syria and Turkey. For example, Syria Relief UK has told us that it has been waiting for its application to establish an office in southern Turkey to be processed, and that the Turkish authorities can be overly restrictive about the means by which they allow funds to be transferred to Syria. I realise these are rather technical points, but they are about how aid can most effectively be delivered, and I would be grateful to Ministers if they addressed those points during this debate.

The scale of the challenge is truly enormous. The heartbreaking scenes mentioned by colleagues on both sides of the House, particularly those in Aleppo, touch us all. They touch our constituents and they touch people in all parts of this country. I am pleased that several speakers have reaffirmed the important principle of the responsibility to protect, which arose from what happened in the 1990s in Rwanda and the Balkans. In the meantime, we need urgent action to secure the safe delivery of aid to all parts of Syria.

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There have been suggestions that the International Development Secretary is disinclined to allow officials to shovel money out of the door towards the year end to meet a 0.7% target if those projects are not up to scratch. She is quite right to say so, but does the hon. Gentleman agree that, given the state of need, there is no shortage of very effective ways of spending that money?

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I entirely echo what the right hon. Gentleman the former Minister says. I entirely agree. The scale of need in Syria, but also, frankly in other parts of the world, including Africa, should mean that we can both deliver the 0.7% target and do so with true efficiency and value for money.

The safe delivery of aid is clearly urgent, but as others have said, we need to move forward to some kind of political process, with a return to the ceasefire. We need to explore every option: no-fly and no-bombing zones; airdrops; and we need to look at the role that Russia is playing.

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My hon. Friend is making a very powerful case for helping the people in the region. Ultimately, however, what will help them is to end the civil war in Syria. Some are saying we should wait until the presidential elections are over, but we know that the people in Aleppo do not have the luxury of waiting. Does he agree that there is absolutely a role for sanctions to get Russia back to the table and to start the process again?

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I absolutely concur with what my hon. Friend says about sanctions against Russia. I support the description of Russia’s role given by the right hon. Member for Sutton Coldfield in his opening speech. The Russians should hang their heads in shame for the role they are playing in Syria, and we should use every available means we have, including further sanctions, to put pressure on President Putin. This is a colossal failure of the international system. It is a stain on our humanity, and all of us must do all we can to redouble our efforts to bring peace to the people of Syria.

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Thank you, Mr Speaker, for granting time for this debate. Until today, we had not debated the atrocities in Syria substantively since June, so it is thanks to the work of brave journalists at “Channel 4 News” and elsewhere, and to fearless humanitarians in Syria, that the killing and maiming of Syrian people has not passed unseen in this country despite our recess. In this House, we can make sure that the call for help from the Syrian people does not go unanswered.

Let me thank the right hon. Member for Sutton Coldfield (Mr Mitchell). I am privileged to work with him as the co-chair of the all-party friends of Syria group. I also thank my hon. Friend the Member for Barrow and Furness (John Woodcock) and the other officers and members of the all-party group for their work. I was a member of the International Development Committee when the right hon. Gentleman was the Secretary of State, and I am not ashamed to say that I took pleasure in trying to find questions he could not answer. However, today I stand united with him. He is a relentless champion for human rights and international law, and I pay tribute to him. I also thank the Foreign Secretary for attending today’s debate, alongside the International Development Secretary, who was in the Chamber earlier.

Just a few weeks ago, the fragile ceasefire in Syria was shattered in a disgraceful attack on a UN aid convoy carrying desperately needed humanitarian aid to the people of Aleppo. The brave drivers and volunteers in that convoy risked everything to help the people who need it most, and they represent the best of humanity. It is an outrage that they have paid for their decency with their lives. The peace in Syria had lasted barely a week. At the time, the ceasefire was very welcome, arising shortly after the publication of a transition plan from the opposition Syrian high negotiations committee just a few weeks earlier in London. However, through the callous targeting of civilian aid—let us be very clear that that is a war crime if it is shown to be deliberate—the Syrian regime has shown it is interested not in peace, but only in suffering. This is not the only war crime committed by Bashar al-Assad and his allies.

These are the facts. More than 400,000 people are dead. Millions have fled for their lives. Hospitals, which are supposedly protected by international law, are now attacked as a matter of routine. Some 600,000 people are still besieged in eastern Aleppo, under constant bombardment from the regime and the Russians. As we have heard, Aleppo, which is under bombardment today, is just one of about 17 besieged cities, and many neighbourhoods and entire towns have been razed to the ground. One report suggests that three quarters of children in Aleppo now suffer from post-traumatic stress disorder. Anas, a little boy there, spelled out what it is like to grow up in Syria today:

“All the days are similar to each other; the only new thing is what time the shelling comes…the shelling is the thing which scares us a lot and it is not possible to get used to it.”

No child should have to live like that.

It is a fact, as a recent report from Human Rights Watch revealed, that incendiary weapons similar to napalm have been dropped on civilians in the opposition-held areas of Aleppo and Idlib. Napalm, a weapon all of us might once have thought had been consigned to the worst chapters of history, is being dropped on civilians in the 21st century.

It is also a fact, as established by the UN joint investigative mechanism in August, that the regime is using chlorine gas as a weapon by dropping barrels of it on densely populated civilian areas. This gas, when dropped in barrels from helicopters, disperses quickly and fills the lungs of people who inhale it with fluid until they choke. Such gas attacks are taking us back to the worst times of the first world war. As a result, experts are warning of the risk of normalising chemical weapons after decades of sustained international effort to keep them beyond the pale. Meanwhile, Syrians on the ground talk of hearing the sound of helicopters and praying that they are carrying just explosives and nothing worse.

It is important to be clear not just about what is happening in Syria, but about who is to blame. Clarity is necessary because confusion results in equivocation, indecision and inaction. When the Serbs were slaughtering thousands in Bosnia, international action was delayed by false claims that Bosnian Government forces had staged attacks against civilians to try to provoke an international response against Karadzic. The result was that the Major Government—to their shame, I am afraid—opposed arms sales to the Bosnians and at first resisted a no-fly zone.

The same campaign of misinformation and propaganda is being waged today. We have seen the denials and the lies about what is happening and who is to blame before, and they cannot stand. The truth is that British airstrikes are targeted at Daesh and are hundreds of miles from Aleppo, where the worst suffering is occurring. The truth is that the vast and overwhelming majority of civilian casualties in Syria are the victims of Assad’s aggression against his own people, sparked by the democratic uprising of the Arab spring.

I recognise the concerns of many about how we must think through the consequences of our actions. However, as others have said, let us be clear that it is not just when we choose to act that the consequences of our action must be accounted for, but when we have the capacity to act and choose not to. When we choose to look away, that has consequences, too.

Of course, it is natural to feel powerless in the face of such horror, but our knowledge of horror must drive us to action, not transfix us with despair. So what can be done? First, with bombs raining down on the people of eastern Aleppo as we speak, it is urgent that the ceasefire be salvaged, if at all possible. If it is not possible, there are still actions that the UK can take. We should volunteer to take the lead in tracking aircraft over Syria, using our assets based in the region. There must be absolute clarity about who is responsible for these crimes, not just in the hope that the aggressors will change their tactics, but to keep alive the possibility of prosecutions. We have Type 45 destroyers and monitoring aircraft off the coast that could do that job and make a difference.

Speaking of accountability, I hope that there is now consensus in this House that we can support the French initiative to send Syria and Russia to the International Criminal Court, and the strongest possible sanctions against Russia to show that there are consequences for what it is doing. The Foreign Secretary has said this before and I agree with him: we have to be at the forefront of applying sanctions.

In the longer term, the protection of civilians from aerial bombardment, along with the destruction of chemical weapons stockpiles, must be the aim. There is a legal precedent in Kosovo for the establishment of a no-fly zone without Security Council backing. My view is that that must not be off the table if it can be shown to be the most effective way of protecting civilians.

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We must be absolutely clear as a House precisely what we mean by this demand for a no-fly zone. The right hon. Member for Cynon Valley (Ann Clwyd) pointed out how that worked in Iraq, where we had to take down Iraqi planes. This would require the will to take down Russian planes. Perhaps that is the right answer, but we must be aware of what we are contemplating.

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I thank the right hon. Gentleman for his intervention. He anticipates the very point I am about to make.

Given that barrel bombs and chemical weapons are mainly delivered by helicopter, experts have calculated that a no-fly zone just for helicopters could reduce civilian casualties by up to 90%. Even failing that, there are things that we could do. We can push for bigger windows to get humanitarian aid into the worst-hit areas and look at using other assets to drop aid into besieged areas. We can also get more support to the heroic White Helmets, the Syrian volunteers who risk their lives to save as many people as they can from the death raining down on them. Many people will have seen the White Helmets in the news in recent weeks because of their nomination for the Nobel peace prize. These heroes risk it all every day to save lives, often running towards the sound of the shelling and risking being caught in second strikes. They need our support. Even if the only result of this debate is that all those people watching make a donation, it will have been worth it.

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Will my hon. Friend be clear about what support she is seeking for the White Helmets? Are we talking about greater access to technical help and advice from doctors over the internet during surgery, increased donations or sending medical equipment—I am unclear?

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All of the above.

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I just want to make sure that the record is absolutely accurate. The difficulty with taking Syria or Russia to the ICC, as things stand, is that they are not members. The French initiative is to try to get an International Criminal Court prosecutor to set up a way of prosecuting. That we certainly support.

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I thank my Front-Bench colleague for that clarity.

Finally, we can certainly offer support to the credible, inclusive plans the Syrian opposition are putting forward.

I cannot help noting that, in serving as co-chair of the friends of Syria group, I am taking up the role of my friend, Jo Cox. She would have been here and she would have known what was needed. Most of all, I think she would have said that we should help refugees fleeing Syria—not just 20,000 by 2020, but many more and much more quickly.

On London’s south bank, there is a memorial dedicated to the international brigades—those who fought for democracy in the Spanish civil war. On one side of the sculpture, there is an inscription that reads:

“They went because their open eyes could see no other way”.

In Syria today, the world is confronted by unspeakable evil and unimaginable suffering. Some of us might have hoped that the advent of social media and new means of technology would have opened eyes even more so than in the 1930s, but the pictures we see make us want to close our eyes and turn away from the horror. But we cannot unsee what we have seen and we must not turn our backs on the greatest crime of our century. The people of Syria are suffering; let us do everything we can to bring them relief.

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I thank the hon. Lady for her speech. There have been some exceptionally powerful speeches in the debate already.

As I am keen to accommodate everybody and for everybody to have the chance to make a decent length speech, and in anticipation of us all wanting to hear the Foreign Secretary respond comprehensively to others’ speeches, I appeal to colleagues to try to stick to seven minutes each. I call Mr Gavin Robinson.

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You caught me slightly unawares, Mr Speaker, but I appreciate being called at this juncture.

It was right that the comments of the right hon. Member for Sutton Coldfield (Mr Mitchell) moved towards geopolitics and the constraints we have in finding a positive resolution, and also the willingness to do so. Although he, like many other Members, has not had as much time as he would have liked to focus on the compassionate reasons why he is motivated by this case, those reasons are well grounded. In paying tribute to him and all colleagues who serve on the friends of Syria APPG, it is important that we always remember the rationale for engaging in this discussion and those people who are suffering continually in Aleppo and beyond.

I have been encouraged by a great number of the contributions that have been made this afternoon, save one. When I listened to the shadow Foreign Secretary, I despaired. I despaired for the people of Syria and I despaired of the paucity of positive policy proposals she had to make. I am glad that that has not been reflected by Back-Bench Members. What we heard can be summed up like this: more statesmanship and less brinkmanship—platitudes. Withdrawal was mentioned—withdrawal from every other country that we associate ourselves with and that we are allied with to do a good job, leaving the Syrian people by themselves. It is appeasement: allowing the jihadists safe passage out of Aleppo in the hope that—these were her words—we will get “lasting peace” by December. That would let the jihadists live to fight another day—to be parasitical and go and find another host community in which they can do their evil deeds. I think it is appalling.

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Has the hon. Gentleman seen what happened in Homs when it was being besieged? The proposed action I have put before the House today in relation to Aleppo worked in Homs, and lives were saved as a result. Does he not think that we should look at that?

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Where did those people go and what did they do? I will take no lectures from Labour Front Benchers about the appeasement of terrorists, whether it is in Northern Ireland or Aleppo. I am glad that what has been shared from the Labour Front Bench has not been reflected in what has been said by the honest, decent and caring individuals who sit behind it. We recognise how serious this matter is.

The Foreign Secretary and the Defence Secretary have a big job to do in considering how we, as a country, can appropriately and responsibly deal with Russia. It is an age-old saying that, “Mine enemy’s enemy is my friend.” Here, that is turned on its head, because in the case of Russia, mine enemy’s enemy is my enemy. It is as stark as that. Russia is moving nuclear weapons to Kaliningrad. It has sorties day after day, whether in the Baltic sea, the Black sea or the North sea, in contravention of NATO. Having shot down a Russian jet a number of months ago, Turkey, a NATO ally, signed a deal with Russia just yesterday. What is the NATO view of that? How will Turkey’s future engagement be affected when our ally is signing a trade deal for gas and a deal for military intelligence with Russia?

Those are huge questions, yet the immediate consideration must be the people of Aleppo. The ICC has been mentioned, and there is concern about whether Russia is a member. My understanding is that Russia has signed, but has not ratified membership of the ICC. I am keen to hear from the Foreign Secretary whether that is an impediment to progress. Last night the BBC was suggesting that, given the nature of previous prosecutions focused on African states, there is the ability to pursue the French option to pursue the Russian state, but there is no will to do so.

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Given that Russia is a key part of this conflict and the problems faced by the people in Aleppo, it has been suggested today that we impose trade sanctions, take people to the ICC and impose no-fly zones. Does my hon. Friend accept that that will need huge political will, as we will be taking action against a country that thinks that it can do what it wants?

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I do entirely—it will. Reports at the weekend have suggested that Russia is succeeding in the electromagnetic war. It is succeeding in jamming signals and removing the cover and support for Syrian rebel fighters, meaning that it can attack them. It is succeeding in drone strikes, and is operating those strikes in a way that we do not. Russia is succeeding comprehensively. Is a no-fly zone an easy option? No, it is not, but if it is the right option for the people of Syria and the wider region, this party will not be found wanting; it never has been when it comes to support for the security of the Province and this country, or internationally.

I hope that the Foreign Secretary can give us some reassurances. The task ahead is not an easy one, but I hope he understands from the tenor of debate in this Chamber and from all the positive contributions he has heard that the resolve is there, that there is the will to do the right thing and that, as a country and as individual representatives, we need to be counted.

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It has been a privilege to be in the House today for some of the best—although I also have to say some of the worst—traditions of where our democracy is at the moment. I will say briefly that there is no one better to seek to step into the shoes of our dearly missed friend, Jo Cox, than my hon. Friend the Member for Wirral South (Alison McGovern). We will all do our best.

I want to dwell for a little longer on what happened on 19 September. It is no mean feat to put together a cross-line convoy. Some 31 lorries had been assembled by various nations under the clear banner of the UN High Commissioner for Refugees. I will read from a couple of eye witnesses. One said:

“The bombardment was continuous, continuous.”

Someone else said:

“I saw the bodies of men on the ground…I was told they were truck drivers and volunteers who had been unloading...medicine, food and other desperately needed items”—

desperately needed by the people of Aleppo.

That bombing went on for more than two hours. It came from helicopters and land forces, and started immediately after a Russian drone that had been directly overhead disappeared. There is no doubt as to who was the perpetrator of this grotesque war crime. It was President Putin of Russia. He was sticking two fingers up to the United Nations and the international community of which he still has the audacity to claim he is a working part.

I have to say this: shame on anyone, from the UN official report to Members of this House to members of my party, who fails to acknowledge that grotesque war crime. I hear the platitudes about bread, not bombs, but the bombs are destroying the bread, and when the people who are making the platitudes are obstructing the possibility of any peace in the region I say that they are directly complicit in what is happening. It is time for us to choose—as individuals in this Parliament and as a country—which side we are on. Do we want to act or to stand by?

Last week I was in Istanbul, where I met the leadership of the Syrian opposition coalition in its headquarters. Those people are of course exiled from their country, where they still have families. Members of their communities live in fear of their lives there and their lives are taken every day. I met the president and the secretary-general, a man called Abdulelah Fahed. He does not speak English, so spoke to me through an interpreter. He looked at me with cold and cynical fury in his eyes, and said, “We are grateful for the sugar that is sent to us from the international community and is bombed by the Russians. We hope you send more sugar that will be bombed. But actually this is not primarily a problem of a lack of aid being sent. It is that the aid is being bombed by the regime and by Russia, and until you help us with tackling that at source no amount of goodwill and humanitarian handwringing is going to help to solve this situation.”

There are different interpretations of what a no-fly zone or a no-bombing zone would mean. I recognise the grave danger of escalation in saying that we would be prepared to shoot down a Russian plane. I will say two things. My sense—and I would like to hear the Foreign Secretary’s initial views on this—is that a no-bombing zone could work. We could say that every time the Assad regime and Russia committed one of these atrocities in the full of view of the international community, the coalition that is currently fighting Daesh would respond, primarily with naval assets, by targeting part of the regime’s infrastructure. No one would be bombing Russia or taking down Russian planes, but we would target that infrastructure every time they committed an atrocity. Each time they killed civilians we would respond, targeting only the military.

The Foreign Secretary knows his history. We could also say that he knows a thing or two about bullies. President Putin is a classic bully. Over the past few years, and in fact beyond that, the international community has cowered every time he has advanced. When you do that with bullies, they go further and further. I say to the people who say every time that we must not do something because we will enrage Russia and we do not want another world war, that their cowardice is making conflict more likely—both the continuation of conflict in Syria and the possibility of further conflict in Europe. The only thing to do with bullies is stand up to them.

We are going to have to do that, sooner or later. I absolutely agree with my hon. Friend the Member for Walthamstow (Stella Creasy). The people of Syria do not have three months to see how the presidential handover goes and what the new president is like; they are being killed in their hundreds every single day.

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Will my hon. Friend give way?

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Okay, really quickly—we are getting frowned at by Mr Speaker.

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I will be very quick. Does my hon. Friend agree that the suggestion from the Labour Front-Bench spokesperson that we go through a different process, which involves engaging with the Syrians at various levels, will not work, because we have no time whatever, as Aleppo will have disappeared by Christmas?

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Who are we kidding? There is no process, because no one is standing up to the Russian regime’s bombs. People understand that, but they do not want to get involved. The question is ultimately for the Foreign Secretary and the Government, because my party is making itself more and more of an irrelevance with every pronouncement from the Front Bench. Are we prepared, as the right hon. Member for Sutton Coldfield (Mr Mitchell) said at the beginning, to oversee another Guernica or a collapse of the UN, like the League of Nations before it? Are we going to be a latter-day generation of Neville Chamberlains, or are we going to take courage and act in the manner of the great Winston Churchill, which the Foreign Secretary knows very well from his time as his biographer?

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I, too, commend the right hon. Member for Sutton Coldfield (Mr Mitchell) for securing the debate. May I appeal to Members to bear in mind the subject under discussion, and the subject on which you have agreed to a debate, Mr Speaker? The debate is about a humanitarian catastrophe. It has been caused by the breakdown of political processes, crimes against humanity, acts of terrorism and lots of things, but first and foremost we are talking about an imminent mortal threat to 100,000 children. Every one of those children lives every second of their life not knowing whether they will see the next second. Surely that must be a priority. Establishing a peaceful, democratic and legitimate Government in Syria is important, as is stopping the Russian war machine and neutralising forever the threat from Daesh. All of those things are important, but right now, 100,000 children—our brothers and sisters—are in immediate danger of death. Addressing that must be the top priority.

I sometimes think that it is like four different fire engines turning up to a fire and spending time arguing about whose fault the fire is, while in the building the children are screaming for somebody, anybody, for God’s sake to put out the fire. When the emergency services turn out to a suspicious fire, the priorities are to get people out, extinguish the fire and then investigate whether it was caused by a criminal act, and then, if necessary and appropriate, to take action against those responsible. A lot of matters that have been raised in the debate are important, but we can never lose sight of the fact that, if we spend another three weeks looking for a negotiated settlement, it will be another three weeks of children being killed in the raids, starving to death or dying from basic simple illnesses because they cannot get the treatment they so desperately need and absolutely deserve.

There are probably 35 doctors left in Aleppo. They cannot possibly cope with the demands being placed on them. Each and every one of them risks their life every day. We know they are being targeted. I cannot imagine a situation where being a doctor or a nurse meant risking life every day to go to work. That is what those people are doing—heroes each and every one of them. We know that the largest hospital in the city was hit seven times in a single morning. That was not an accident or a navigational error; it was a deliberate war crime. When the time comes, it should be treated as such. Just to make the point, they went back and bombed it again the next day. It is a deliberate tactic by the Syrians and the Russians to attack civilian targets on one day, wait for the emergency services to respond, and then go in and target them again.

We also need to re-evaluate the part the UK is playing. We need to go back to the reasons why the United Kingdom got involved in military action and reassess whether it is still appropriate. The former Prime Minister, in arguing in favour of military action, described the Brimstone missile as a “unique” asset

“that no other coalition ally can contribute”.—[Official Report, 26 September 2016; Vol. 585, c. 1262.]

That unique asset was deployed by the United Kingdom nine times in the seven months between February and August. It was used more than that in January and December last year, but it does not seem to me like a compelling argument for continued military action.

We were also told that there were likely to be 70,000 moderate troops ready to join in the struggle against Daesh—one requirement for a just war is a reasonable chance of success. I hope the Foreign Secretary can tell us where those 70,000 moderate troops are and whether they still exist. If they do not, how many are there?

The former Prime Minister expected and hoped that, if we supported military action, we would have a transitional Government in Syria in about six months. Those six months passed in June. Will the Foreign Secretary tell us how far away we are now? Are we within six months or, as my hon. Friend the Member for Glasgow North (Patrick Grady) said, are we further from a peaceful solution than we have ever been? We must face up to those difficult questions. On this occasion, I am asking not because I want to trip up those on the Government Benches. I am asking from the heart. Please can we look to ensure that the part we are playing, whether through military action or anything else, contributes to the solution rather than makes the problem so much more worse?

Can any of us really imagine what 12 million refugees look like? A great many are refugees in their own country, and millions of them are scattered across the globe. I for one would welcome many more if only we were allowed to do so. Nine million of those refugees are women and children who have played no part in any war or any crime. They are utterly innocent. Thirteen thousand children have lost their lives. Are we going to allow that to get to 14,000, 15,000 and 16,000, or are we going to accept, ultimately, that the first priority is to save the lives of those who are left to prevent those appalling statistics from getting any worse?

I am a great fan of the Scots-Australian singer-songwriter Eric Bogle. I did not get his permission to quote his song, but I hope he will not mind the breach of copyright. Many years ago, in response to another conflict, he wrote:

“And have you seen the madmen who strut the world’s stage

Threatening our destruction as they prance and preen and rage?

Rattling nuclear sabres as humanity holds its breath

Feeding on fear and bigotry as the children starve to death”.

The children are starving to death today. Our first priority must be to feed the children by whatever means needed, and then we can deal with the rest of the mess that the Russians, the Syrians and Daesh have created.

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Perhaps I am one of those men who prance and preen in the way the hon. Member for Glenrothes (Peter Grant) described, but I regret strongly the fact that when the House had the opportunity three years ago to leave open the option of military action it chose not to do so. I felt that leaving the option open was the appropriate thing to do at the time, but a majority of Members of the House felt that it was not.

I am pleased that we have the debate today—I congratulate the right hon. Member for Sutton Coldfield (Mr Mitchell) on securing it—because it enables the Government to give us the quarterly update on Syria. Notwithstanding what is happening on the other side of the channel with Brexit, the House wants regular updates from the Government on progress in Syria. I look forward therefore to the Foreign Secretary giving greater clarity on what discussions the UK Government have had with the other players in the peace process, and on what role we have been playing to try to promote peace in Syria.

I welcome the role the UK Government have played in sanctions on Russia and hope that it will continue when the UK leaves the EU—the UK has played a prominent role in the EU in relation to Ukraine. In passing, I hope the Government look more carefully at sanctions in relation to Magnitsky and the Russians’ responsibility for that.

The Foreign Secretary drew attention to his view that the Russians may have committed war crimes and spoke specifically of the double tap manoeuvre, which I understand to mean that a strike takes place, there is a gap to allow the emergency services to turn up, and the site is hit again. I hope he sets out precisely what evidence he has for that, because it is clearly a very serious allegation. I want to draw his attention to the fact that, in Yemen, the Saudis are alleged to have used the same double tap manoeuvre. If rightly he expresses concerns about war crimes committed by Russia in Syria, I hope he will consider whether the Saudis’ use of that manoeuvre in Yemen also amounts to a war crime.

A lot of Members have contributed positively on the issue of recording information about where Russian planes and Assad’s helicopters have been active. I hope that that information is being recorded, because we will want evidence if there are war crimes prosecutions at some point in the future. I hope that when the Foreign Secretary responds he will be able to say something about whether the UK is considering using our universal jurisdiction to bring the Russians to account if there are no other means for doing so. Given that the Russians are engaging in a propaganda war—we have seen the activities of some of its news outlets here in the UK—I wonder whether there is no military reason why we could not put online 24/7 the flight paths of every Russian plane, with an identifier on it, so that people can go online and make a clear connection between that flight and a bomb. I put that suggestion to him and I hope the Government will consider it.

We are in favour of transparency. The Foreign Secretary will be aware of the joint policy for the military coalition to investigate civilian casualties. I do not think that that has yet reported. I hope it will come forward, so we can see that we are dealing effectively with any casualties that might have been caused by the coalition.

On air drops, I quoted the parliamentary answer from the Minister of State, Department for International Development, the hon. Member for Penrith and The Border (Rory Stewart), and I will do so again:

“The use of air drops to deliver aid is high risk and should only be considered as a last resort when all other means have failed”.

It seems to me that all other means have failed. The first half of that has been satisfied. The second half is that airdrops require certain conditions to be met for a successful delivery. It may be on that basis that that is being rejected, but the possibility of air drops must be actively pursued by the Government.

On the reporting of what is happening in Syria, I draw Members’ attention to the case of Zaina Erhaim, an award-winning Syrian journalist who had her passport removed by the British Government when she arrived in the UK. Apparently, the Syrians reported that her passport had been stolen. Given that we think Syria is a pariah state committing crimes against humanity, the fact that we would act on a request from it to seize someone’s passport is bizarre. I hope the Foreign Secretary can explain why that action was taken.

The international community and the UK Parliament failed Syria three years ago. Today, we must give the Government the strongest steer possible that they must act to stop the murderous activities of Russia and Syria. If we are back here in three years debating Syria again, it will be to pick over the skeleton of a country destroyed, flattened and obliterated, with its people scattered to all four corners of the world.

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I congratulate the right hon. Member for Sutton Coldfield (Mr Mitchell) on securing this important debate. My party, Plaid Cymru, like others believes that the perpetrators of repeated attacks—the bombing of civilians, hospitals and the aid convoy on 19 September—should be brought before the International Criminal Court. I will be brief and limit my remarks to this one specific point. In his response, I ask the Foreign Secretary to inform the House of the Government’s stance on this matter.

Others have been quite clear. On Sunday, the Socialist President of France, François Hollande, said that

“these...are the victims of war crimes. Those that commit these acts will have to face up to their responsibility, including in the ICC”.

On Monday, France’s Foreign Minister, Jean-Marc Ayrault, called on the International Criminal Court to investigate Russia for possible war crimes in Syria. He told French radio:

“France intends to get in touch with the prosecutor to find out how the probe can be launched.”

That was referred to earlier in this debate. This followed calls on Friday by the US Secretary of State John Kerry for Russia and Syria to face a war crimes investigation for their attacks on civilians. The case against them is clear and is backed up by firm evidence. I do not need to elaborate on that today.

My party opposed the bombing of Syria by the UK. We were told that such bombing would be carefully controlled to exclude danger to civilians. Russia and Assad’s Syrian regime take no such precautions. Indeed, the evidence is that they target civilians. They should answer for that before the International Criminal Court. I realise that there are substantial difficulties. The Rome Statute, which established the Court, has been ratified by 123 countries. The United States, Russia and Syria have not done so. I understand, however, that a case could be made to the ICC through a UN referral. I think that that is what the French Government have in mind.

The Security Council has been deadlocked over Syria. Russia vetoed a French resolution in May 2014 to refer the situation in Syria to the ICC. On Saturday, Russia again vetoed a UN resolution, drafted by France, demanding an immediate end to the bombing campaign. A rival measure put forward by Russia, which called for a ceasefire, made no mention of a halt to airstrikes. This was also rejected, blocked by the United Kingdom and the United States.

The UN Special Envoy for Syria, Staffan de Mistura, had said prior to the meeting of the UN Security Council that if urgent action is not taken to address the situation, thousands of Syrians would be killed and towns, such as eastern Aleppo, could be totally destroyed by the end of the year. The need for action, therefore, is pressing and the UK has the power and the influence to act. We believe the Government should use that power and influence ever more effectively, as others do, to put even more pressure on Russia in particular. It was confirmed this morning that President Putin will not visit Paris next week, after declining to meet François Hollande for talks on Syria.

I do not need to say that the situation is desperate, but both the Assad regime and Russia are accused, rightly, of perpetrating war crimes. We uphold international law. There are mechanisms for bringing perpetrators of war crimes before the ICC. On what possible basis might we not do this? Rather, we should do as our European partners do as well as fulfilling our duties as a permanent member of the Security Council. We believe that bringing such a case before the ICC would only increase its credibility. The ICC has been seen as weak, and strong countries are not signed up to it. It has been criticised, particularly by the African Union, for its focus on Africa—it has brought charges only against black Africans. We believe the ICC’s credibility can only be enhanced by such a case.

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I apologise to the House for my lateness in attending the debate; I was chairing the Environmental Audit Committee.

I congratulate the right hon. Member for Sutton Coldfield (Mr Mitchell) on securing the debate and my hon. Friend the Member for Wirral South (Alison McGovern) on her passionate and heartfelt speech. I echo her sentiments about how much we miss the good sense and the good will of our lost friend, the late Member for Batley and Spen.

I visited Lebanon last September as Labour’s shadow International Development Secretary and saw at first-hand the scale of the appalling humanitarian crisis spilling out from Syria and across the middle east. I stood in a sandstorm on the Beka’a valley on the road to Damascus, just 12 miles from Assad’s presidential palace. I certainly felt very close to everything that was happening. A charity worker from Islamic Relief said to me that just six miles away there were Jihadi fighters. I had been live tweeting a lot of photos from the camps and at that point I thought it best to turn off the geo-location from the Twitter account and not do any tweeting until we got back to our safe haven of Beirut. I must admit that I felt like a bit of a coward doing that.

What we know about Syria is that 400,000 people have been killed in this humanitarian catastrophe, 5 million Syrian refugees have fled their country and 8 million more are displaced within its own borders. They are fleeing the terror of Assad, ISIL and now Russia. I met a woman called Hadia who told me how her husband was killed in Homs while working as a Red Cross volunteer. The UN had offered to take her and her children to Germany, but she declined because her mother was unable to accompany them. Four of her adult children are still trapped in Homs. Cases like Hadia’s demonstrate the terrible choices refugees face: you lose your husband, you bring your mother with you and then you are forced to leave your mother behind in order to seek safety for your children.

I also met a man who had a pacemaker fitted in Damascus and who, upon his return to Lebanon, was deregistered as a refugee because he had left freely and returned. This left him and his wife destitute. He was 65 years old and unable to work. He was destitute, lying on his back in a camp.

The vulnerability of those refugees in the Beka’a valley and elsewhere in Lebanon is growing, as we heard in the speech from my hon. Friend the Member for Liverpool, West Derby (Stephen Twigg). Their food allocation has been cut. They are on pretty much starvation rations, capped at five family members. I met 10-year-old girls labouring for seven hours a day in the fields, earning $4 a day and working one hour a day just to pay the rent for their family to pitch a little ragged tent on a disused onion factory. Those children’s childhoods have been stolen. Eight million people have been displaced internally in Syria, having suffered attacks from cluster munitions and chemical weapons, and the collective punishment of siege warfare.

At the last meeting of the all-party group on Syria that I attended with the then hon. Member for Batley and Spen, Jo Cox, we heard about 60,000 people disappearing and their families paying extortionate sums of money for news of their loved ones or just to receive their bodies for burial. We are seeing Assad carry out the extermination of his people. He has destroyed his country. He has destroyed one of the oldest civilisations in the world. He has destroyed the economy and destroyed all good will in that country. It is now a wartime economy, based on looting, corruption, arms and people smuggling. People are living under siege, their access to basic services denied. Eleven per cent of Syria’s population—2 million people—have been wounded or injured, and we have seen the terrible suffering of Syria’s children.

In August 2013, this House voted against military action in Syria. I shared the regret of many on our side of the House and of the right hon. Member for Carshalton and Wallington (Tom Brake) at our cowardice on that occasion. We are now living with the consequences of that inaction. That vote was prompted by a sarin gas attack on civilians in eastern Damascus that killed 1,400 people, 426 of whom were children. The UN doctrine of the responsibility to protect allows military intervention to protect civilians from genocide and war crimes by their state and provides a valid legal basis for intervention. That responsibility to protect weighs upon us as heavily today as it did on that August day in 2013, when, after the vote, we went home, turned on our televisions and saw that Assad had carried out a napalm attack on a school. Using chemical weapons on sleeping children is a war crime. We know all the reasons for that vote, but we now know that we have to protect civilians from Assad and, now, from Russian intervention as well.

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Does the hon. Lady agree that what the Russians are doing now to Aleppo is exactly what they did to Grozny? We need to learn the lessons from that.

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Absolutely. The Russian war crimes in Grozny were bravely documented by Anna Politkovskaya and another woman journalist whose name escapes me, both of whom were assassinated by the Russian regime. Of course, truth is the first casualty of war, but we do not have the fog of war to hide behind in this case. People in Aleppo are tweeting their situation and their circumstances.

We heard from the Secretary of State for Defence yesterday about how Daesh have used the conflict in Syria to recruit jihadi fighters from all over the world and to spread their terror across to Iraq. We know that the airstrikes that we are carrying out against them in Iraq and Syria, backed by a coalition of 67 countries, are slowly pushing them back in Iraq, but they will never be defeated in Syria until this conflict is sorted.

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The hon. Lady is making some very powerful points. This is a fight not only for the people and the children of Aleppo—a point made so powerfully by my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell)—but very much for ourselves: the international order we all rely on, the migrant crisis we all see and the expansion of Russia we all feel. NATO, the west and the UK demand action.

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I agree totally with the hon. Gentleman. Russia’s positioning of nuclear-capable warheads in Kaliningrad is another example of its aggression towards NATO countries.

A war that we wished was none of our business is our business. Syrian children have drowned in our seas and millions of Syrians have turned up in our continent seeking shelter. I am pleased that Wakefield has offered to take 100 Syrian refugees. We are a city of sanctuary and we look forward to welcoming them among us. These are people like us. They had cars, apartments, solar panels and satellite TV, but were forced to flee bombs, napalm, sarin gas and cluster munitions from a Government who target schools and hospitals—a Government who are aided and abetted by Russia, whose sole aim is to preserve access to the Mediterranean through its port at Tartus in Syria. Russia attacked the first humanitarian aid convoy to enter Aleppo for weeks, destroying lorries filled with baby milk and anti-lice medication.

I want to hear more from the Foreign Secretary about what plans he has for further sanctions against Russia, but we cannot claim ignorance or hide behind the fog of war. Washing our hands like Pontius Pilate and choosing not to act is no strategy at all. I was too scared to tweet from the Syrian border, but brave people in Syria are tweeting their lives and filming the deaths of others as they happen. Omar Ibrahim is a neurosurgeon, removing bomb fragments from the brains of children on the floor of a destroyed hospital, and one of 30 doctors left in eastern Aleppo. Bana Alabed, a seven-year-old girl from eastern Aleppo, tweeted last week. She wanted to live like the children of London: “No bombing!” It is not too late for us to save Omar and Bana. They are relying on us. We need to do what we should have done in 2013. We need a no-fly zone over the city of Aleppo and the skies of Syria. Omar and Bana are watching. We must not let them down again.

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May I thank you, Mr Speaker, for granting the time for the debate this afternoon? May I also join colleagues from across the House in congratulating the right hon. Member for Sutton Coldfield (Mr Mitchell) on securing today’s debate?

There is, as we have heard, an unimaginable humanitarian disaster happening right now across Syria, and nowhere more than in the largest city, Aleppo. As we have heard, 400,000 people have already been killed, 15,000 of them children, with in excess of 1 million people wounded since the onset of the war in 2011. As a result of the war, 5 million Syrians have been displaced and have had to flee the country. Five million people is equivalent to the entire population of Scotland, displaced, homeless and impoverished.

If I may, I would like to pay tribute to the people of my constituency of Argyll and Bute, who, with the full support of Argyll and Bute Council, the Scottish Government and the Argyll community housing association, have responded magnificently and have warmly welcomed 15 Syrian families to the gorgeous island of Bute, with more scheduled to arrive in the not-too-distant future. I have met the Syrian families and enjoyed their kind hospitality. I am delighted to report that they are settling in well and are being supported by a thoughtful and generous local community. I am sure this House would like to put on record its appreciation for the welcome shown by the people of Bute to the innocent men, women and children of Syria in their hour of greatest need.

Like the hon. Member for Wirral South (Alison McGovern), Bute has shown what we can do. I sincerely hope that we in the United Kingdom can accommodate far more Syrian families—not just in Argyll and Bute or in Scotland, but across the UK. However, those few families on Bute are the very lucky ones, because they managed to escape the hell on earth that their country has become. Although many of the people I met were born and bred in Aleppo, I doubt very much whether they would recognise it today, as just last week the UN envoy to Syria said that he feared that the eastern part of the city could be totally destroyed within two months.

This claim follows on from the bombing of Syria’s largest hospital, which was hit by seven airstrikes on the morning of 1 October. Then, as the repairs started, it was hit again the following day. As we have heard, in a shocking attack—undoubtedly a war crime—a UN aid convoy was deliberately targeted, killing 20 people. The World Health Organisation said that in the week to 30 September, at least 338 Aleppo residents, including 106 children, were killed.

There is overwhelming evidence that the Assad regime and his Russian allies are now deliberately targeting civilians, hospitals and the emergency medical teams and first responders. As the right hon. Member for Carshalton and Wallington (Tom Brake) said, the regime, with its allies, stands accused of using a method known as two-tap strikes, in which they bomb an area, circle round, giving sufficient time for medical responders to attend, and then return to bomb the rescuers. If that is true, it is a despicably cynical tactic that, even amid the horror of this conflict, leaves one speechless at its depravity.

Today, in eastern Aleppo, a city officially under siege, there are only 35 doctors to care for a quarter of a million residents. It is the biggest besieged area by far. People still ask, “What can we do, when there is so much chaos on the ground and in the skies above Syria?”. I would say to the Government that, as protagonists in the conflict, it is absolutely incumbent on the United Kingdom to be part of the solution. The Government must produce a coherent plan and a sensible strategy immediately to halt the airstrike campaign in which the UK is involved. The Foreign Secretary said on 19 August:

“It is only when the fighting and bombing stops that we can hope to deliver the political solution”.

I say to the Foreign Secretary that that means everyone’s bombs, including our own.

Andy Baker of Oxfam has said:

“It’s not only Russia, it is other nations, too, Britain among them, that have fuelled the fire of this conflict, continuing to support one side or another and failing to deliver peace.”

The Foreign Secretary and Oxfam are right: adding UK jets and bombs to this prolonged and agonising war has not and will not bring about a lasting peace.

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Is the hon. Gentleman suggesting that the UK should unilaterally stop its actions in Syria? If so, how does he think Russia and Assad would react to such a withdrawal?

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The United Kingdom unilaterally joined this fight in December last year, promising that it would be a pivotal turning-point in the campaign. It has singularly failed to do so, so we have to take a different tack. We must have the bravery and the courage to stand up and say that we were wrong to do what we did last year. As I say, we have to take a different tack.

Almost exactly a year ago, we asked the Government a series of questions, none of which was answered in the headlong rush to join this conflict, so I ask again: how, when more than a dozen different countries are engaged in military action, have UK airstrikes brought peace and stability closer to Syria? Where is the UK Government’s detailed plan for winning and securing the peace? Where is the money for the reconstruction of Syria going to come from when the bombing ends?

We need to act, and act decisively with our allies and friends. As the French Foreign Minister, Jean-Marc Ayrault, said last week,

“If we don’t do something, Aleppo will soon just be in ruins and will remain in history as a town in which the inhabitants were abandoned to their executioners.”

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I, too, thank the right hon. Member for Sutton Coldfield (Mr Mitchell) for bringing forward this debate, and I thank you, Mr Speaker, for granting it. As I rise to speak today, I am mindful that it is little under a year since the vote on whether the UK should join the US-led coalition airstrikes against Daesh in Syria. SNP Members did not support the military action, and any case for airstrikes that the Government believed to exist has now completely fallen apart.

There is a very clear need for a revised military strategy. It is needed urgently, and it must not ignore the extreme humanitarian situation in the country. When the former Prime Minister addressed the House on 26 November last year, he said:

“All these elements—counter-terrorism, political and diplomatic, military and humanitarian—need to happen together to achieve a long-term solution in Syria”—[Official Report, 26 November 2015; Vol. 602, c. 1492.]

Regrettably, it very much appears that these words have not been followed up with any coherent strategy that would have them realised. The humanitarian element is seemingly discarded when at the expense of a military agenda. I know that the response from the Government will be to inform us of how many billions of pounds have been spent, and will be spent on rebuilding Syria after the war. The great problem is that these words are presently meaningless to Syria’s suffering civilians.

According to the Syria Campaign, more than 100,000 children are being bombed in Aleppo, while figures from the Syrian Observatory for Human Rights place the total number of children killed in the conflict at over 13,000. Since the ceasefire collapsed fewer than three weeks ago, more than 100 children have been killed out of a total of around 600 civilians. Please stop to think about that—it is the equivalent of a primary school class being slaughtered every five days.

The humanitarian crisis in Syria just continues to get worse. More than 400,000 people have already been killed since 2011. The UN estimates that more than half the country’s pre-war population of 23 million is in urgent need of humanitarian aid. Millions of people have been displaced: 4 million are living as refugees outside Syria, and at least 8 million more are displaced inside the country. Amnesty International estimates that for every hour of the conflict, 50 families have been uprooted from their homes in Syria. Humanitarian aid is being blocked by the Assad regime from getting to those who need it. Hospitals are being systematically targeted by Assad and Russia, while an estimated 382 medical facilities have been destroyed.

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The hon. Lady is understandably painting a heart-rending picture of what is happening in Syria. It seems to me, having listened to two speeches, that the SNP’s position is to equate our military intervention with that of Vladimir Putin, and to argue that we should step aside from this carnage and hope that a unilateral act of disarmament on our part will somehow instil in Bashar al-Assad a spirit of generosity towards his own people that he has not yet shown. Does the hon. Lady not realise how absurd the SNP’s position is? Does she not recognise that it is only through both military engagement and humanitarian work that we will be able to bring relief to the suffering people of that country?

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That is the gravamen of the point, for which we are grateful.

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The right hon. Gentleman misses the fact that we are not denying that the brutality inflicted by Assad and Russian forces is beyond comprehension. However, the role that we can and should play is a humanitarian and diplomatic one. That, I believe, should be our role.

In an utterly shocking attack—one that possibly amounts to a war crime—a UN aid convoy was struck in an airstrike, which killed at least 20 people. The reality is that there is utter chaos on the ground and in the skies over Syria. Just last month, the MOD confirmed that the UK was involved in airstrikes that killed at least 62 Syrian Government troops. We have become part of the chaos.

Other Members have mentioned the work of the White Helmets, which I want to mention, too. They have saved thousands of lives, and continue to do so on a daily basis. They were recently nominated for the Nobel peace prize. As the bombs rain down, the White Helmets do not stop. They rush in to save civilians. They are the heroes in this conflict.

The UK Government need immediately to halt their airstrikes in Syria, and present Parliament with an alternative coherent plan. We need a sensible strategy—one that actually ensures that the humanitarian situation is not cast aside. We can make a difference in this conflict. We can play some part, no matter how small, in minimising the human suffering in this horrific war. However, it is time for the Government to admit that doing so will require a complete change of strategy.

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I congratulate my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) on securing this valuable debate and commend him for the power of his speech. I also thank you, Mr Speaker, for granting the debate. We have heard speeches or interventions from 43 right hon. and hon. Members, and I think that every one has made clear the horror of the House at the suffering being endured by the people of Aleppo, where rebel-held districts have come under furious attack from the Assad regime and from Russia, with the help of Iranian-backed militias.

Let me spell out some of the consequences. At this moment, the 275,000 inhabitants of eastern Aleppo are under siege. They are isolated from the outside world, subjected to constant bombardment, and prevented from receiving humanitarian aid. Their power and water supplies have been cut off in what has become a signature tactic of the Assad killing machine: the besieging of civilian populations. What we are now seeing in eastern Aleppo is the biggest and, potentially, the deadliest siege since the outbreak of Syria’s civil war more than five years ago.

Last week the United Nations special envoy for Syria, Staffan de Mistura, warned that eastern Aleppo might be “totally destroyed” by the end of the year. In the past two weeks, at least 376 people—half of them children—have been killed, and another 1,266 have been injured. Every hospital in eastern Aleppo is believed to have been bombed, some more than once, and several have been put out of action. Hospitals have been targeted with such frequency and precision that it is difficult to avoid the conclusion that this must be deliberate policy. As the House will know, intentionally attacking a hospital amounts to a war crime.

It is time, I think, for all these incidents to be properly and fully investigated with a view to assembling the necessary evidence and ensuring that justice is done—and, yes, I say in answer to questions that have been raised by several Members today that we do think that there could be advantage in the procedures of the International Criminal Court. I remind the House that in recent history, war criminals have been successfully prosecuted decades after their offences.

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Does my right hon. Friend agree that this catastrophe represents a terrible failure of the security order that protects our very civilisation, and that if these prosecutions are not made, a terrible, terrible failure will be laid at our door?

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I certainly agree with my right hon. Friend that we are all judged in the House by our actions and our resolve. I think it was my right hon. Friend the Member for Sutton Coldfield who spoke of the will of the House. I am afraid that that was absent three years ago when, as several Members pointed out, we took an historic decision not to intervene. I hope that we will show a different measure of resolve this afternoon. Those who are conducting this bombing and who are, in my view, culpable of these crimes should realise that the mills of justice grind slowly, but they grind small.

The same penalties should apply to those involved in deliberate attacks on humanitarian convoys. As many Members have pointed out, on 19 September a UN aid convoy was destroyed near Aleppo and at least 20 people were killed. The vehicles were clearly marked, and the convoy had official permission from the Assad regime to deliver those desperately needed supplies. Satellite photographs that are in the public domain leave no doubt that the convoy was struck from the air. The incident took place after dark; by Russia’s own account, the war planes of Syria’s regime cannot strike targets after dark, and—also by Russia's own account—its aircraft were in the vicinity at the time. All the available evidence therefore points to Russian responsibility for the atrocity.

I trust that the UN board of inquiry will establish exactly what happened, and we in the United Kingdom Government stand ready to help. I emphasise that it is the UK which, week after week, is taking the lead—together with our allies in America and France, and all like-minded nations—in highlighting what is happening in Syria to a world in which, I fear, the wells of outrage are becoming exhausted.

I listened to the passionate speeches from the right hon. Member for Cynon Valley (Ann Clwyd) and the hon. Member for Wirral South (Alison McGovern), the co-chair of the all-party friends of Syria group, who is carrying on the tradition of Jo Cox, whom we mourn. I listened to all the speeches that made the point that there is no commensurate horror among some of the anti-war protest groups, and I agree with the right hon. Member for Cynon Valley: I would certainly like to see demonstrations outside the Russian embassy. Where is the Stop the War coalition at the moment?

It is up to us in the Government to show a lead, and week after week in the UN we are indeed doing what we can to point out what the Russians are up to and to build an international understanding of what is going on in Syria. I believe that we are having some effect. As Members have pointed out, the Russians have now been driven to mount a veto in the Security Council to protect their own position five times. This is not some anti-Russian campaign; we are not doing this out of any particular hostility towards Russia. Indeed, the US Secretary of State, John Kerry, did his utmost to negotiate an agreement with his Russian counterpart, Sergei Lavrov, that would at least have reduced the killing. Anyone who has studied the Lavrov-Kerry talks will know that John Kerry threw himself into that task in a Herculean way. However, on 3 October, he was driven to abandon his efforts by the attack on the aid convoy and the pounding of Aleppo, which destroyed all hopes of a ceasefire. The US Secretary of State has concluded, I think rightly, that Russia was determined to help Assad’s onslaught against the women, children and families of Aleppo regardless of any agreement.

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Will the Foreign Secretary take this opportunity to tell the House whether he supports the French proposal that, in the case of war crimes and crimes against humanity, the five permanent members of the UN Security Council should voluntarily undertake to give up their veto in order to enable the Security Council to take action when these heinous crimes are being committed, as is clearly the case in Aleppo at the moment?

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