Latvia welcomes careful Europeans...

Next month, Latvia assumes the Presidency of the European Council and, to introduce itself to the world, this really rather charming video has been released. So, if you don't know very much about Latvia, here, in less than three minutes, is a Latvian view of themselves...

Liberal Democrats and political philosophy - let's not be strangers, eh?

Perhaps it requires exposure to the brisk, clean air of a properly liberal country to get the old philosophical juices flowing but, finding myself in the Estonian countryside this afternoon, along with Ros and Cicero, talking about what is wrong with British politics, I find myself faintly perturbed by the relationship between political parties and political philosophies. Or, in the case of the United Kingdom, the evident lack of such a relationship.

The Labour Party has little in common with socialism these days, and Conservatives behave in a way which is anything but. And, it dawns on me, Liberal Democrats have a not wholly consistent relationship with liberalism. As a self-confessed liberal, that does rather trouble me.

"Ah yes,", I hear you say, "but what sort of liberalism do you mean - social or economic?". And I find myself thinking, why choose? For to choose either is to deny the benefits of the other, to determine that one is secondary to the other.

So, for example, we debate the level of private sector involvement in the delivery of public services. All very interesting, I'm sure, but shouldn't we be more worried about how the market works in reality - avoiding the creation of effective private sector monopolies and cartels, encouraging new providers and nurturing a spectrum of delivery vehicles for those services? Does Mrs Brown worry about the logo on the side of the bus that takes her to market on a Thursday, or is she more bothered about the fare and the quality of the service? Does choice trump quality or vice versa? By creating larger contracts in an attempt to create economies of scale, are we, as David Boyle so astutely notes, creating a chasm between the day to day needs of humans and the behaviour of big, impersonal institutions?

How can we empower people, so that they aren't enslaved by conformity, ignorance and poverty? How should we educate our people to allow them to think for themselves, to evaluate information in an ocean of data and place value upon it? What is the role of the State, what size should it be and why, where should power be exercised?

I have this uncomfortable feeling that Liberal Democrat thinking has developed an acceptance that change can only be delivered within the confines of our current political construct, that legislation is the first tool to be reached for in any given circumstance. In Parliament and at the heart of our Party, we have fallen into the trap of playing the game the way the big boys want it to be played, rather than exploring a new form of politics, one that reflects the rapidly-changing world in which we live.

And, worst of all, we seem to become ever more rigid in terms of the solutions we propose. There must, it seems, be an answer to everything which will, well, answer everything, leaving no room for doubt or uncertainty. Life is full of doubt and uncertainty, and our political response should face that slightly discomforting proposition.

So, perhaps the biggest challenge for the Party, regardless of the result in May, is to decide what Liberal Democrats are for, and how you create an effective campaigning vehicle to win those things. Sadly, I fear that we'll instead choose to wring our hands and allocate blame...

Sweden: another bite at the electoral cherry* for liberals

In August, Ros and I ran into members of Folkpartiet, campaigning in Sweden's General Election, and I later reported on the rather unstable minority coalition government that emerged. It indeed turned out to be unstable, when its first budget was defeated by the combined Opposition.

And so, another election will take place on 22 March, which may offer a window into what might happen here in the event of an inconclusive election on 7 May. Admittedly, with first past the post here, the chances of UKIP having the same sort of directly malevolent impact on the ability of other parties to form a coalition is somewhat slighter. However, given the stated enmities between the various UK parties, finding enough of the right dancing partners could, if current predictions turn out to be accurate, be rather challenging.

* By the way, does anyone know if biting an electoral cherry falls foul of our new porn laws?

International Relations Committee - some initial observations from a new kid (elect) on the block

So, I have attended my first meeting of my Party's International Relations Committee, having kindly been invited to attend in order to get a feel for it before I formally take up my role as a directly elected member on 1 January. How did it go, and what do I think?

Firstly, Robert Woodthorpe Browne is a very efficient committee chair - we ran pretty much to time, which is always good - and a old-fashioned political operator (that's a compliment, by the way). His experience, contacts and political awareness would be very hard to duplicate, and someone would be have to be very good to be a credible replacement.

The International Office, led by Iain Gill, is enthusiastic and keen to engage. They are aware of the need to be sensitive in how assistance is given to our sister parties across the globe, practical in how that help might be delivered, and pragmatic in achieving their goals whilst factoring in the needs of the wider party.

So far, so good. Is there a niche for me?

I find that most committees need a bureaucrat sometimes, but my engagement in the finances of ALDE via its Financial Advisory Committee already appears to be helpful and my party knowledge and desire for inclusivity may offer some ideas for future interaction with the wider Party.

This evening's meeting was interesting too, with talk of the Africa Liberal Network (expanding fast) and the Council of Asian Liberal Democrats, of study visits and the activities of Liberal Youth, the British Group of Liberal International and the Liberal Democrat European Group. Gathered around the table are a collection of highly informed, very experienced internationalists - former European Parliamentarians, academics and diplomats, with a leavening of enthusiasts - although a few more women would be good.

I have a few things I want to work on over the coming year, and I get the sense that, as long as I work collaboratively, there is the possibility of changing a few things that might make a difference. So, we'll see how it goes...

Sadomasochism and the public finances - a Freudian slip from Mr Cameron?

I couldn't really describe myself as an optimist when it comes to the public finances - I suppose that as a fiscal conservative who is more than a little debt averse, the notion of a budget deficit at 5% of GDP is still a bit unnerving. And so, it should not come as a surprise when I look upon the Autumn Statement with something less than a sense of triumphalism.

Amidst the announcements of investment in this, additional money for that and changing in the taxation of the other, the iceberg of the structural deficit - still not eliminated, lest we forget - looms worryingly large, let alone the deficit as a whole.

Of course, it isn't as simple as just cutting spending and dealing with the consequences - and only a fool would suggest that. Nevertheless, some serious thought needs to be given to how we get from here to a balanced budget. Indeed, we need to consider exactly how urgent it is to balance the budget anyway. After all, if the economy is growing faster than the national debt, you are actually reducing the debt in real terms, a first step towards stabilising our finances.

But what worries me is that further cuts in public spending have been, to a great extent, soft-pedalled. If tax rises are ruled out by the Conservatives, that suggests some pretty serious cuts in budgets that have already suffered grievously and a possible withdrawal of the public sector from what some might consider to be vital services.

Any post-2015 administration is going to have to address this, whether they like it, the sadism of having to make cuts, the masochism of self-denial when it comes to largesse (a particular problem for most of the political parties, I might suggest, but especially for Labour). And I suspect, as Vince Cable does, that nobody will want to in the run-up to a General Election.

We have, in this country, been rather guilty of offering the public Scandinavian levels of public services and, at the same time, American levels of taxation, something that they have swallowed only too happily. At some point, someone will have to explain why that can't work, and what the price will be. I'm not holding my breath...

@BaronessRos in the Lords - Hospitals: Voluntary Sector and Emergency Readmissions

The House of Lords does choose to do things with almost glacial slowness sometimes, and then, having chosen to move, does so so quickly that members are unable to keep up. And so it was in this instance, as Ros notes in her opening paragraph...

Baroness Scott of Needham Market

To ask Her Majesty’s Government what assessment they have made of the role of the voluntary sector in reducing emergency re-admissions to hospital.

Baroness Scott of Needham Market (LD):

My Lords, it is about a year since I first tabled this Question for Short Debate. I was inspired to do so by reports from the Royal Voluntary Service which described the impact of its Home from Hospital schemes. I regret that, having waited all this time, the Motion was in the end tabled at very short notice, which prevented many Members who would have liked to participate doing so. Given that it appeared on the Order Paper only on Wednesday and that the speakers list was closed on Friday, that comes as no surprise. I am particularly grateful to both Front Benchers and my noble friend Lady Thomas, who will speak in the gap. For the record, I give an assurance that the modest speakers list does not reflect the level of interest in this matter.

I am not one of the usual contributors to debate on health matters, so I thought long and hard before venturing into this area, but I do know about the voluntary sector, and here I declare an interest as chair of the National Volunteering Forum, and it occurred to me that I should table the Motion precisely because I do not come at this from a health expert’s perspective. We have all agreed that the time for silos is over.

It seems a long time ago now, but in 2010, the Secretary of State for Health took measures to manage emergency readmissions, which had risen, in part at least, because hospitals were reducing the length of stay. Despite this, about 19% of emergency readmissions—about 190,000—occurred in 2012-13. The evidence shows that people from lower socio-economic and vulnerable persons groups are at a higher risk of avoidable emergency readmission.

The Government and the NHS have made a good start on getting to grips with this problem by creating individualised discharge plans and ensuring that hospital-led discharge teams provide continuity of care. Of course, the better the integration of primary, secondary and social care, the better the contribution by prevention, early diagnosis and self-treatment. However, as Simon Stevens noted in the NHS Five Year Forward View,

“voluntary organisations often have an impact well beyond what statutory services alone can achieve”.

Last week’s report on patient-centred care from the Royal College of General Practitioners makes specific reference to the role played by community groups and the voluntary sector in achieving self-management of health conditions. Also last week, the NHS published Stephen Bubbs’s report into the commissioning framework for people with learning disabilities and autism, in which he, too, notes the role played by the voluntary sector in the sort of community-based support which reduces both initial admissions and readmissions. It is an area that I am beginning to know well as a fairly new patron of ACE Anglia, which provides just that kind of advocacy and support to people with learning disabilities and autism living in my area. Of course, they are all right. Voluntary organisations can help with early intervention by spotting problems early on and by helping to join up fragmented services. They often bring specialised and local knowledge and, precisely because they are not from the statutory sector, they tend to be trusted.

Provision of hospital-to-home services in a range of contexts can often give patients the time and space they need to make a recovery and avoid readmission to hospital, with all the trauma that that entails. The British Red Cross gave an example of Mrs Jones, a widow in her mid-80s suffering from dementia. Discharged from hospital but needing treatment for a urinary tract infection, staff referred her to the BRC, which arranged for a volunteer to meet her in hospital and then visit her at home to make sure that she completed her course of medication. It ensured that the social services team was aware of her needs, and that she felt supported. She not only recovered well at home but, because of the ongoing support and encouragement she received, her quality of life actually improved on a long-term basis.

AGE UK Cornwall carried out a pilot scheme where volunteers worked closely with patients to identify their needs and offer support. It acted as a key link with the NHS and social services. Under that scheme, emergency readmissions were reduced by 25%. The Midhurst Macmillan Service is a specialist palliative care service covering a 400 square mile area of rural England across three counties. By offering a host of roles from shopping and gardening to emotional support for the patient and their family and liaison with the NHS, the scheme is aimed at reducing the number of hospital admissions. Although they are not strictly emergency readmissions, nevertheless, its work is very successful: 73% of its patients died at home or in a hospice rather than having to be admitted to hospital.

In its recent report, Going Home Alone, the Royal Voluntary Service highlighted its own scheme in Leicestershire which showed that a package of support reduced emergency readmissions by half, from 15% being readmitted in 60 days to 7.5%. It was not rocket science. Contact was made with patients before they left hospital, and someone went home with them and made sure that the house was warm and lit, and that some food was available. They offered support to collect prescriptions, make follow-on medical appointments and liaise with the statutory services. Many of these actions are so simple, but make so much difference. However, like many simple things, they are not always easy.

Like most other services, voluntary organisations have had to deal with funding cuts. In many cases, when they wish to bid to provide services, they are disadvantaged against the private sector because they want to provide decent terms and conditions for their staff and are not going to go down the zero-hours contract route. In some cases, these organisations simply lack the capacity to engage in complex and expensive tendering processes.

The reorganisation of health and social care at a local level has meant that new relationships between the sector and the commissioners have had to be developed. Some health and social care providers are simply not aware of the range and extent of the work of the voluntary sector in their area and so patients miss out on the support they can offer. Then there is the vexed question of substitution. Volunteers do not want simply to replace public services which have been cut, but want to add value.

What we are now calling austerity looks likely to be the new norm. It is hard to take that on board, but we should be planning for it. Government spending should be much less reactive and give some priority to preventive spending, which involves a genuine forward look at the likely impacts of spending decisions made now on outcomes in a decade hence. Policy and funding changes which push costs off into the future are no different from borrowing, and the sooner we understand that, the better.

I am looking forward to hearing from other Members about how we can better harness the collective strengths of the statutory services and the voluntary sector. The old dividing lines have become blurred and the picture has become more complex as a result, but the need has never been greater.

Good news from Moldova. Probably...

Moldova - EU neighbour, but friend?

Yesterday's election in Moldova looks like returning another pro-European coalition to power - good news for those who support building a bigger, more inclusive Europe, bad for Russia, not great for UKIP supporters and possibly a headache for the European Union.

The elections saw allegations of Russian interference - the new Patria party was disqualified three days before polling day amidst accusations, probably well-founded, that the party was funded by Russia. The fact that its leader promptly fled to Moscow might imply guilt, although the OSCE rather wisely raised its concerns that the timing of the disqualification might have been, how might one put it, convenient.

The impact of the disqualification appears to have been that Patria supporters reverted to the pro-Russia Socialist Party, who want Moldova to reject its recently signed Association Agreement with the European Union in favour of a Eurasian Union with Russia and others. With what appears to be the largest share of the vote (21.1%), they will doubtless be seen as the big winners. The two members of the ruling pro-Europe coalition, the Liberal Democrats - somewhat confusingly associated with the European People's Party - and the Democratic Party, came second (19.6%) and fourth (15.8%) respectively, whilst the Communists came third with 17.9%.

Of rather more interest to liberals is the performance of the Liberal Party, who are observer members of ALDE, and who resigned from the ruling coalition last year. Their vote is slightly down on 2010 (9.5% compared to 10%), but as seats in Parliament are proportionately allocated to all parties who reach the required minimum share of the vote (6% but with some interesting provision for electoral pacts), they may well end up with an extra seat in the 101-seat Parliament.

Their support, presumed but not guaranteed, for the Liberal Democrats and the Democratic Party, would ensure that the pro-EU forces would have a working majority.

The result is probably bad for Russia, as their widely presumed interference in Moldovan politics may well have backfired, and Moldova is likely to move on its bid for EU membership as early as 2017.

UKIP supporters will probably not be too keen on the fact that Moldovans now have visa-free access to the European Union. Luckily, there are only 3.5 million people in Moldova...

But the headache for the European Union is that it brings into sharp focus the 'frozen conflict' of Transdniestria, which is currently something of a rogue state, having declared itself independent of Moldova and which has applied for annexation by Russia. With 1,000 Russian soldiers in its territory who show no signs of leaving, and rather a lot of weaponry still lying about the place, Federica Mogherini and her team will almost certainly have to add it to the list of issues to be raised when dealing with Vladimir Putin and his charming cohorts.

But, regardless of what the future may bring, congratulations to Mihai Ghimpu and his colleagues, and we look forward to congratulating them on their success if they are able to join ALDE Council delegates in Oslo in May.