House of Lords
Death of a Member: Lord Brittan of Spennithorne
The Lord Speaker (Baroness D’Souza)
My Lords, I regret to inform the House of the death of the noble Lord, Lord Brittan of Spennithorne, on 21 January. On behalf of the House, I extend our deep condolences to the noble Lord’s family and friends.
Specialist Printing Equipment and Materials (Offences) Bill
(9 years, 9 months ago)
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Baroness Berridge
That the Bill be read a second time.
Relevant document: 15th Report from the Delegated Powers Committee
Baroness Berridge (Con)
My Lords, this small Bill is an important step in tackling identity crime. It had swift conduct through the other place by the honourable Member for Southend West, Mr David Amess. I will address briefly the context, the mischief that the Bill aims to address and a couple of final matters of clarification.
First, on the context, obtaining false identity documents enables criminals at all levels, from opportunistic criminals to those involved in immigration offences, serious organised crime and terrorism, to hide their tracks and evade detection. Although your Lordships will be aware of the use of false identities to commit fraud, in 2013 the National Fraud Authority showed that almost a third of UK adults have been the victim of such crime at some point, with an average economic loss of £1,200 per person. In fact, crimes using false identities now account for half of all frauds in the UK. False documents might be used to obtain a bank account, which gives the first layer of a legitimate identity that could then enable illegal immigrants to merge into society and even to claim social security benefits to which they are not entitled.
However, there is a public safety aspect to false documents. If someone knows that they will fail a CRB check to work with children, they might seek false documents and a false identity to obtain the requisite permission. People might even try to obtain a firearms licence with them if they have a previous conviction. On a visit this week to the specialist Metropolitan Police unit, Project Genesius, named after the patron saint of printing, I was shown numerous recent examples of illegal document factories which it has uncovered. Merely by downloading the hard disks from specialist printing equipment that it has seized, it has compiled a database of 94,000 false identities that are in circulation.
Project Genesius is a great example of the retailers of specialist printing equipment working together with the police to protect the public and the reputation of their industry. There are around only 1,000 retailers of this equipment. I was pleased to learn that when PC World proposed selling this equipment, it followed the police service’s request not to do so as, unlike other retailers, its systems would not have allowed the identity of the purchaser to be obtained. In fact, the consultation on this Bill showed that more than 80% of respondents favoured the introduction of this specific offence. I pay tribute to the dedication and enthusiasm of DCI Andrew Gould, Mr Gary McManus and their team at Project Genesius, which is such that other countries are now sending their officers to visit our specialist unit.
People who operate these document factories are of course prosecuted but the Crown Prosecution Service has not been able to prosecute those who have supplied this specialist equipment to criminals, even when there was evidence that the equipment was to be used for such purposes. The mischief that the Bill seeks to address is a small but important gap in the criminal law armoury: of knowingly supplying specialist printing equipment for the purposes of criminal conduct. Clause 2 defines “specialist” to cover the manufacture of relevant documents, which include passports and immigration documents, travel documents such as driving licences and blue badges, security passes, national insurance number cards, currency, credit cards, and birth, death and marriage certificates. It even includes those who make rubber stamps, as a false passport without a false UK immigration stamp can be useless.
Finally, there are a few matters of clarification. The geographical extent of the Bill will be for England and Wales. However, the Home Office is working with the devolved Administrations in Northern Ireland and Scotland, and the Crown dependencies, on these measures. It has committed to keeping them informed of the progress of the Bill. It is also important to note that false document factories are a cross-border problem, so the Bill will apply to the supply for the purpose of criminal activity occurring in any jurisdiction. If a supplier in England and Wales sells equipment to an identity fraudster knowing that they will use it to manufacture false documents, the supplier will be prosecuted whether the manufacture happens in England, Scotland, France or even Timbuktu.
Many of these specialist printing firms will also service the equipment that they have sold but the offence will take place at the time of the supply or sale of the specialist printer. If the company or an employee later becomes aware that a crime is being committed as a result of a printer supplied by their company, they will be in the same position as any other citizen, in having a moral responsibility but no legal duty to report it. However, if the company or an employee then made a subsequent sale to that person, their knowledge would be a relevant factor. I note that under Clause 3 corporations and partnerships, as well as individuals, can be prosecuted for this offence.
Finally, and in fear of sounding like I am on the National Lottery results programme, this seems to be the first appearance of the word “connivance” in an English statute. The word is not defined in the Bill and will therefore have its dictionary definition,
“willingness to allow or be secretly involved in an immoral or illegal act”.
Essentially, this is to cover implicit rather than explicit consent and will, I hope, cover those officers of companies or partnerships whose systems of reporting are so dilatory or are designed so as to avoid them knowing the information obtained by their salespeople or delivery drivers. I beg to move.
Lord Cormack (Con)
My Lords, I shall speak briefly in the gap. It is a shame that there is no other Back-Bencher to support my noble friend’s admirable and exemplary Bill. It was introduced in the other place with his customary aplomb by Mr, and now Sir, David Amess MP, and we all congratulate him on his recent honour.
As I say, this is an exemplary Bill because it has a target and a specific purpose. If it is passed into law, every Member of your Lordships’ House will be a potential beneficiary. As my noble friend said, there can be few of us who have not been victims of identity fraud of one sort or another. I have had my credit cards used in America, and so has my son. Large sums were involved, but they were fully covered so they were not particular personal disasters, but the incidents bring it home to one just how prevalent such crimes are. If this Bill when it is enacted can strike at the root of these appalling criminal offences, we will owe a great debt of gratitude not only to my noble friend Lady Berridge, but also to Sir David Amess. I hope very much that we will be able to couple in that vote of thanks both the Opposition and the Government before this brief debate is over. I give my full support to the Bill.
Baroness Smith of Basildon (Lab)
My Lords, I add my congratulations to the noble Baroness, Lady Berridge, and to Sir David Amess on bringing forward this Bill. Perhaps the fact that there are not many speakers in your Lordships’ House is a mark of the support the Bill has. I do not see it as anything controversial, although it is interesting to note that because we are also debating the Counter-Terrorism and Security Bill, we can see the synergies where this Bill can feed into the work we are doing on that legislation. This important Bill has real and tangible benefits, and it has our full support.
I have a few comments and questions. The noble Lord, Lord Cormack, has just made a very important point. Most of us know someone who in one way or another has been subject to some kind of identity theft or fraud. I recall sitting at my desk as a Minister in Belfast and receiving a call from my bank asking, “Where are you?”. I replied that I was in Belfast and was told, “So you are not in China, then”, where my credit card had been used by someone who must have taken great delight in spending a lot of money. The noble Baroness mentioned the figures and the level of fraud, but these crimes also cause people personal distress.
Another area of concern has not been touched on. Some elderly friends of mine went into the local high-street branch of their reputable bank. Although they own a computer, they do not go online to surf the internet, they do not use online banking and they do not buy anything from websites. However, a bank representative convinced them that they should take out insurance protection against online identity theft at quite great expense. They were fearful because they had read in the papers about the problems people experienced with identity theft, so they were persuaded to take out an expensive insurance policy. This crime preys on people’s fears and causes other problems. This Bill gives us an opportunity to put a stop to it.
However, the Bill goes further because there are other instances to which the noble Baroness referred where obtaining a fake identity facilitates further serious crime. I have mentioned the counterterrorism Bill. It is interesting to note that before coming into your Lordships’ House this morning, I googled “fake passports” to see what came up. It was a legitimate inquiry and I was not trying to buy one; rather, I wanted to find an estimate of how many fake passports were in circulation and what other information there was about this issue. The very first link was to a website offering to sell me a fake passport. That is an indication of the seriousness of this crime. I hope that the Minister will be able to say something about the efforts being made to crack down on those kinds of websites because they encourage half the nation to find a link to buying a fake passport.
This is a serious matter. The introduction of e-passports to reduce the level of counterfeiting that goes on has been important, and we should educate people on the value of e-passports and encourage them to use them. Last year I came through Heathrow with a Conservative MP. We looked at the queues at passport control and we both headed for the e-passport channel. The MP did not know what the logo was on his passport to identify its e-status, but we both went through much quicker than anyone else. At that point he did admit that he had actually spoken against e-passports because he had thought that they were less secure, but afterwards he swallowed his words. We need to make it clear to people that we are bringing in e-passports to address the security issues around these documents.
The noble Baroness has done the House a service by giving us some examples of what specialist printing equipment can be used for. I do not think that I have a particularly criminal mindset, but I did my best to imagine what kinds of things could be printed. The more I thought about it, the more possibilities and their attendant dangers emerged, which reflects how serious this issue is. Perhaps the noble Baroness will be able to help me by explaining whether every kind of document that could be forged is covered by the legislation. I shall probe on one point to seek clarity. It cannot be safe to have security guards producing false qualification documents or to have people working on construction sites producing fake SKILLcards. The definitions of the documents are rightly very wide, but it would be helpful to know whether the Bill would include all documents. Further, whether or not those kinds of documents would be included in the legislation, the people who produce them may well be involved in other criminal activities, such as producing documents that would come under the scope of this Bill. I am thinking by way of example of cards to verify national insurance numbers.
Road safety is undermined if people have fake driving licences. Our security is undermined if people have fake travel documents. Fairness in society is undermined if people use fake blue badges to park in disabled spaces. Fairness in our immigration system is undermined if false documentation is used to obtain work here in the UK. What should concern us, but which has not been touched on in our short debate, is the fact that once someone has obtained a series of false identity documents they can then apply for genuine identity documents, thereby creating what appears to be a genuine identity for themselves. That route is open to criminals. I join the noble Baroness in paying tribute to the Metropolitan Police for the work that it is doing in this regard. The fact that it has clear information about more than 90,000 false identities should alarm us all, and illustrates the importance of the Bill in order to ensure that the police have the legal powers they need.
I seek clarification on one other point. Can the noble Lord or the noble Baroness give some more details on how, under the Bill, it can be proven that somebody “knows” that the equipment will be used for illegal purposes? Will it be enough to assert that the person supplying the equipment could only reasonably have come to the conclusion or will a higher level of proof be needed? In addition, it will be helpful if anything can be said about the likely costs and benefits of the Bill. The Minister in the other place said that the likely costs and benefits would be overwhelmingly positive, and I have no doubt that he was right, but it would be helpful if we could have any other information on that. The City of London Police, which has expertise in this area, believes that it,
“will not be overly onerous on legitimate businesses, but will allow police to take much needed action against those companies who seek to put their own profit above the country’s security and safety by selling this equipment with a complicit ‘no questions asked’ approach”.
My final point is that there is often a general view that forgery and dealing in fake goods is a benign offence. Many of us have been on holiday and seen the so-called Gucci handbags on sale in a market for the equivalent of £20. In Istanbul I was offered a “genuine fake”—not like the other fakes—Mulberry bag, which I must say was pretty impressive. I also recall being in China some years ago, when I took a trade mission from Northern Ireland when I was a Minister there, and the amount of fake “branded” goods on sale, semi-openly, was quite staggering. I did not take that terribly seriously—I was not going to get too upset about a handbag or a £1 Montblanc pen. However, officials told me that those things were linked to the same gangs who produced engineering parts—spare parts for aeroplanes and cars; there are obvious implications if those are fake—and documents. I do not know if that is always the case, but it illustrates how serious forgery is. What may seem benign and a bit of fun could be the thin end of the wedge that leads to very serious criminal activity and impacts on national security. This legislation is therefore clearly needed. I hope it will prove useful to the police in tackling a form of crime which in itself is bad but which may also lead to very many more serious and dangerous offences.
The Parliamentary Under-Secretary of State, Home Office (Lord Bates) (Con)
My Lords, I join other speakers in paying tribute to my noble friend Lady Berridge for the way in which she introduced the Bill. In the words of my noble friend Lord Cormack, this is an exemplary Bill. It is exemplary because it focuses clearly on a specific problem identified by the police. I join my noble friend and the noble Baroness, Lady Smith, in paying tribute to the Metropolitan Police and to Project Genesius. The project has done tremendous work in tackling fraud since it was formed in 2007, which shows that this has been a problem for some time. We have all had experiences of being victims—or alleged victims—of this type of fraud. I once had a panicked telephone call from someone at my bank who said, “We’ve had to stop your credit card—it’s been used six times in Albania”. I replied, “That’s because I’m in Albania. I’m walking there”. They said, “Don’t worry; you can just pop into the local branch where you are”. I said, “This is Albania. You don’t have branches in Albania”. They said, “Don’t worry, we’ve got branches everywhere. I’m sure you’ll find one”. But I did not.
Identity crime is a serious problem. It is rarely committed as a sole offence; it is usually the enabler for a broad range of serious crimes. For example, criminals use false documents to evade criminal record checks and gain access to children and vulnerable adults, to commit immigration and benefit fraud and to assist in terrorist activities. I therefore fully support my noble friend in her taking this important legislation forward and join other noble Lords in paying tribute to the work of Sir David Amess in the other place.
Prosecuting those who make and possess false documentation is a relatively straightforward process under the Identity Documents Act 2010. However, it is not specifically against the law to supply specialist equipment or materials to those who make those documents. That makes it difficult for police to prosecute those who “knowingly” supply specialist equipment to persons who intend to use it to commit a crime.
The Bill has strong support among the specialist printing industry, as noble Lords mentioned. Some 81% of respondents to the Government’s public consultation expressed support for the legislation, with 93% agreeing that it would act as a deterrent to specialist printing companies that might be tempted to collude or connive with identity fraudsters.
Just one individual colluding with identity fraudsters can lead to the production of thousands of false documents; and as the noble Baroness said, in the wider context of the counterterrorism legislation that we considered last night, this issue needs to be addressed. I also pay tribute to her for the assiduous way in which she was able last night not only to identify Twitter accounts belonging to the proscribed terrorist organisation under discussion but, today, to identify new sources of fake passports. I am grateful to her for her research. I am sure that the officials are listening in to this debate, and we will be sure to pass those details on to either the police or other prosecuting authorities.
Existing legislation is clearly insufficient as there is no targeted offence for “knowingly” supplying specialist printing equipment for criminal use. Currently, the police can prosecute using the conspiracy to defraud offence under the Fraud Act. However, conspiracy to defraud is not easy to prove, and the police have informed us that prosecuting under that offence requires a lot of time and resources to take it forward, often to no avail. The Bill will therefore strengthen the police’s powers in this area and send the message that the Government and this House take criminal behaviour very seriously.
The Home Office has also developed a wider programme of activity designed to tackle the manufacture and criminal use of false identities, including working closely with the City of London Police to address the wider issue of identity crime. This will reduce the harm and loss to the public and service providers caused by the criminal use of counterfeit documents, an offence which ultimately damages businesses and harms the economy, at a time when we are seeking to encourage economic growth.
Identity crime is clearly a serious crime, and it is clear that we must act now to prevent and disrupt criminal activity brought about by the supply of this highly specialist technology. The Private Member’s Bill before us today provides us with the opportunity to make this necessary change to strengthen police powers and to send a message to those who might collude with criminals. We must seize that opportunity. I hope that all Members of this House will support this much needed and exemplary Bill today. I commend the Bill to your Lordships’ House.
Baroness Berridge
My Lords, I am grateful to the noble Baroness, Lady Smith, and to the Minister for supporting the Bill. I shall deal with a couple of points that were raised.
First, on the scope, the Bill is aimed at identity documents; so while it would cover entry passes to premises and driving licences, faked examination results or qualifications would not be. Secondly, on mens rea, I made specific inquiries about why the wording is “knowingly supplying”. Making this a “recklessness” level offence had been considered but as there is a response to that, the mens rea remains “knowingly supplying”. Clause 3(1) states that the issue is whether the person who supplies the equipment “knows of the fact”. The lesser mens rea of “neglecting” or “consent and connivance” apply to the offices of a company. The Bill aims to ensure that officers cannot escape prosecution, leaving their front-desk staff, who have the knowledge, to be prosecuted alone. I hope that that clarifies the points raised.
I should cover one or two other minor matters. The craft shop sector was the only part of the industry where the police were concerned about a lack of awareness, because in order to fake a large number of documents, the forger needs hot foil which is obtainable in craft shops. Criminals go round buying up hot foil from many different shops, so the police are keen to raise awareness within the sector. I saw what these machines can do: they can print fake passports at a cost of just £300 each. I have checked and found out that, fortunately, none of the equipment seized so far has been used to try to forge parliamentary passes.
International Development (Official Development Assistance Target) Bill
(9 years, 9 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Purvis of Tweed
That the Bill be read a second time.
Relevant document: 15th Report from the Delegated Powers Committee
Lord Purvis of Tweed (LD)
My Lords, it is my privilege to be able to support my right honourable friend Michael Moore in bringing his Bill to this House for consideration. I am grateful to noble Lords for their attendance in the House today, and to those who will be taking part in the debate with their great knowledge and experience in this field over many years. In particular, I know that we are looking forward to the contribution of my noble friend Lord Fox, who will be making his maiden speech. I am also grateful to my noble friend Lady Suttie for her support leading up to today.
This Bill, founded upon a strong evidence base and backed by a wide cross-party political consensus, is supported strongly by non-political bodies, academics and charities and will play a major role in securing a long-term level of support for those in the world most in need, both directly through our bilateral aid and through multilateral support with our partners. The Bill also allows for UK leadership in the field of international development to be strengthened even further. Finally, it is in the long-term national interest of the United Kingdom itself.
The UK has been a major contributor to development assistance since the first moves to assess what level of support of official flows—loans at market or near-market rates and direct concessional flows through aid—would be needed for countries to develop their economies faster, in addition to private sector flows, in order for them to deliver improved social outcomes. From the initial work in the late 1950s and the subsequent analysis of the World Bank and the Pearson commission, the 0.7% target was formally recognised in October 1970, when the UN General Assembly adopted Resolution 2626, which included the goal:
“Each economically advanced country will progressively increase its official development assistance to the developing countries and will exert its best efforts to reach a minimum net amount of 0.7 per cent of its gross national product at market prices by the middle of the Decade”.
The decade in question was the 1970s. In many key respects, the UK finally meeting this target in 2013 also met the commitments of our Liberal manifesto, which stated:
“Greater freedom in international trade will assist the underdeveloped countries who need markets for their products. We support the principle that in accordance with the Pearson Report Britain and other countries should contribute 1 per cent of Gross National Product of official aid to developing countries as soon as possible”.
The manifesto in question was that for the 1970 general election.
It is with a deep sense of quiet pride, therefore, that, for the first time since the UN target was established, Liberal Democrats have served as a partner in the UK Government and the UK has met the UN target, making it the first G7 country to do so, and we are bringing a measure to Parliament to entrench this achievement for years to come. We have delivered this in close partnership with Conservative colleagues equally committed in recent years to securing this goal. We have built our joint work on the very strong foundations laid down by the Labour Party, which made considerable progress after its election in 1997, especially in the commitments given in the 2004 spending review and the 2009 White Paper. I therefore echo the tribute that Michael Moore made in the other place to those on different Benches and those beyond Parliament who for many years have worked hard together to increase our development assistance. There was unanimity in the major parties’ manifestos in the 2010 general election to reach the UN target and entrench this in law.
Perhaps I can borrow words from the OECD’s Development Assistance Committee peer review report of 2014 of the UK’s development aid effort:
“Development is a high priority for the UK government. Even in difficult economic times, it remains committed to honouring its commitments and leads by example … This shows that persistent political will, sustained by broad cross-party consensus, makes it possible to achieve ambitious objectives”.
This Bill delivers on this wide consensus.
Clause 1 places a duty on the Secretary of State to meet the UN target in 2015 and in each subsequent year. Clause 2 provides for a requirement on the Secretary of State to make a statement as to why the target has been missed, if it has been. Clause 3 states that the process of reporting is to Parliament only, while Clause 4 consequentially repeals an existing duty on the Secretary of State to report when the target would be met in future. Clause 5 was amended in Committee in the other place, where Michael Moore accepted a government amendment for a duty on the Secretary of State to make provision for the independent evaluation of aid spending rather than the establishment of a new, separate body to carry this out. Consequently, the Schedule to the Bill was removed.
The independent evaluation of the efficacy of aid spending is both important for us to deliver properly on our aid objectives and important for our own public to know that such a large amount of money is being spent properly. This is especially important at the time of budget pressure within the UK. The Independent Commission for Aid Impact, established by the coalition in 2011, is expected to carry out the duty under the Bill, but Clause 5 also places a duty on the Secretary of State to report to Parliament on how the Government carries out the evaluation. Finally, Clause 6 states that the Act is to commence on 1 June this year and extends to the whole of the UK.
I shall address some of the issues raised about the Bill that have been aired before turning to the real benefits that I believe it will bring. These issues fall into four main broad areas: questions about the merits of maintaining the 1970 target in the modern world; whether maintaining the target focuses too heavily on how much is spent rather than what it is spent on; whether meeting the 0.7% target each year has distorting aspects with unintended consequences; and whether the Bill can really bind successive Parliaments.
Recent evidence from development charities, with which I am confident noble Lords will be familiar, highlights the positive change in global development over the past decade—principally because of economic growth in China and India but also in African and Asian economies. The impressive report of the Commons International Development Committee last February highlighted the practice for middle-income countries to graduate from aid in a controlled manner, making more use of technical assistance and climate change for economic development, for example, and loans and support for NGOs.
Support is therefore directed more towards low-income countries, with more support for financing global public goods. In particular, this addresses disease alleviation, health support, nutrition, sanitation and child mortality. The committee’s strong conclusion addressed the second concern directly, saying:
“There has been huge progress in developing countries. The number of people living in extreme poverty since 1990 has halved, and the prospect of ending extreme poverty by 2030 is within reach. Aid is still of critical importance, especially for reaching the very poorest people in Low Income Countries and we believe that they should remain the priority for UK aid”.
The third issue is that there might be an inbuilt instability and an end-of-year rush to meet a binding target, especially if external factors on the calculation of GNI take place. Last week’s National Audit Office report, which I am sure noble Lords will have seen, is an important contribution. The requirement to hit, but not significantly exceed, 0.7% every calendar year means that DfID has to hit a fairly narrow target against a background of considerable uncertainty. However, the NAO’s conclusion was:
“The Department worked hard to manage this very substantial increase in its budget, completing preparatory work to strengthen many of its business processes, increasing the capacity of its workforce, and improving its focus on capturing the results of its spending”.
There is also now a considerable body of work from the Independent Commission for Aid Impact, with its growing reputation since it was formed, and its report to the sub-committee of the Commons International Development Committee also shows a clear reporting mechanism and accountability that is proving its worth.
The fourth major area of concern is whether the Bill is necessary at all, since future Parliaments may change course. The Bill not only entrenches the 0.7% target but entrenches a wide consensus. Repealing the measure effectively means repealing such consensus. Secondly, as the legislation becomes established in the coming years, it will become a core part of our arrangements with fellow countries and international organisations, which will give it extra strength. Both together mean that this law becomes an enduring law. The major benefit is that we move on from debating whether we reach the target to how we improve even more the effectiveness of our budgets.
We start, of course, from a good foundation. By 2013-14, DfID had made major progress towards its 2011-15 commitments, which demonstrate the sheer breadth and depth of British development aid around the world. On behalf of us all, it has helped 43 million people with access to clean water, better sanitation or improved hygiene conditions; supported more than 10 million children—half of them girls—to go to primary and lower secondary school; ensured that nearly 4 million births took place safely with the help of nurses, midwives or doctors; prevented 20 million children under five and pregnant women going hungry; reached more than 11 million people with emergency food assistance; and, as an investment for the long term, provided more than 54 million people—more than half of them women—with access to financial services to help them work their way out of poverty; and, in an area close to my heart, helped 86 million people to hold their authorities to account and have a say in their communities’ development. This is the UK acting as a global citizen, helping people to have citizens’ rights around the world. The Bill allows for this to be a starting point, not a culmination, and—this is of critical importance—allows us actively to shape the global development agenda post 2015.
The UK’s recent record was recognised by the OECD peer review report, which commented on our success in meeting the 0.7% target. It says:
“This commendable, well planned achievement adds weight to the UK’s internationally recognised leading role. Maintaining that level of support until 2015/16 and beyond will reinforce the UK’s legitimacy with respect to the global development agenda”.
The Bill helps us to bring about even more stable sources of funding and allows greater planning with our partners and recipients. This can be witnessed perhaps most clearly in the areas of aid where long-term support is key, such as education, supporting young women and medical research. Cures for the world’s preventable diseases are sitting in the world’s labs, waiting for long-term, secure and stable research funding, and then a secure means of distribution. We will be making a major contribution to shorten that wait. We will retain possibly the most respected humanitarian relief capacity in the world, able to respond quickly and methodically. In all this, we continue to tackle corruption and poor governance, too.
We also know that supporting people abroad is one of the best means of helping people at home. Reducing at source the threat of dreadful incidences of Ebola or other diseases, reducing radicalisation or preventing conflict helps us be safe and healthy at home in a shrinking world and an open, multicultural Britain. But we do what is right and potential benefits then flow—it should always be in that order, with that motive. We should make a contribution in an untied way, without condition, because at the very heart of this is simply: a girl who wants to have an education and to learn in a safe school; a mother who wants to feed, wash and nurture a child with good health, clean water and access to a hygienic hospital; a father who wants to work in an open, free-trade economy, free from slavery, danger or exploitation in the workplace; a woman who wants to be empowered to represent others or to lead in a corruption-free political system; and a boy who simply wants to play outside and have a childhood not in a war zone. We take all these things for granted at home; we must end the situation whereby others abroad think that they are a luxury. We must strive for them to be taken for granted everywhere in the world. Perhaps now, much more than in 1970, we can see the prospect of global development making seismic advances in the coming 15 years, ending extreme poverty and eradicating preventable disease.
I conclude by saying that the UK has less than 1% of the world’s population. Our global footprint is massively disproportionate to the size of our tiny islands. If the UK is a citizen of the world, what kind of citizen must we be? I say we are one that comes to the assistance of others who are in need, does not shrink from challenging those who abuse minorities, refuses to support those who prevent women accessing rights, and never turns a blind eye to those who disempower their own citizens. We establish our place and our identity as a citizen of the world if we uphold our obligations and encourage others to do likewise. This Bill is one major way in which we demonstrate our citizenship of the world. I beg to move.
Baroness Royall of Blaisdon (Lab)
My Lords, it is a real pleasure to wholeheartedly support this Bill on behalf of the Opposition. I congratulate the noble Lord, Lord Purvis of Tweed, but also his right honourable friend Michael Moore, who brought the Bill forward in the Commons, and who, together with my Labour colleagues, secured its safe passage, notwithstanding the fierce opposition of some on the Conservative Back Benches. I am delighted that the Government support the Bill and I hope—indeed, I believe—that while some in this House may express concerns, they will be few. It is, of course, right and proper that their arguments should be heard, although I believe that they are profoundly wrong. This measure is neither against the national interest nor the interests of poor countries and their people.
I warmly welcome the fact that there is strong cross-party consensus on the Bill but noble Lords will understand if I express particular pride in the enshrining of the commitment to spend 0.7% of our gross national income on development assistance. It was a Labour Government who first adopted this target in 1974, and it was a Labour Government who established the Department for International Development in 1997. We helped to lift 3 million people out of poverty every year and to get some 40 million children into schools, and that has been built on. We made huge progress towards achieving the 0.7% target, but I pay huge tribute to this Government for all that they have done. It is an area of policy in which achievements have been consolidated and built upon rather than torn apart for ideological reasons, and I celebrate that.
I also pay tribute to the exceptional work of the NGOs, including many faith-based organisations, and to the bravery and selflessness of those who often live in difficult and dangerous circumstances, saving and transforming lives. We should be proud of the work and reputation of DfID. I note that your Lordships’ Economic Affairs Committee was pleased to report that,
“expert opinion is virtually united in agreement that DFID enjoys an outstanding reputation internationally as an effective aid agent”.
I say, “Hear, hear” to that.
With cheap travel and extraordinary advances in technology, the world grows smaller by the day and we become increasingly interdependent. This should provide a huge opportunity for all, including those in developing countries who need freedoms to flourish, be educated, have access to healthcare, work, live with dignity and human rights, have a voice and the power to demand change through peaceful means. But the reality is not like that for far too many of our fellow human beings. The Oxfam report this week was shocking, demonstrating that global inequality is growing, making it more difficult to eradicate poverty and slowing much needed global growth. Inequality also makes the world a more dangerous place, not just in places of war and fragile states, but in the cosy corners of the developed world. That makes development assistance more vital than ever. Evidence shows that aid works and has succeeded in lifting people out of poverty, saving lives and enabling countries to take hold of their own development, helping people and countries to help themselves. The noble Lord cited many examples of where we have been at the forefront of this aid, and I know that many more examples will be given today. Aid really does transform lives, especially those of women and girls, and transforms communities and countries.
When young women are educated, they are more confident and less likely to be victims of domestic violence. They are able to take decisions about the size of their families and are less likely to die in childbirth. They are able to work, not just in the home, on the land or in sweatshops, but can become doctors, nurses, teachers, entrepreneurs and leaders. Sitting on the floor in a mud hut in India, talking with young girls about their aspirations, is awe inspiring. Not only did we enable their education, we ensured that they were able to go to school because there was adequate sanitation. But there is much more to be done. The latest UN statistics show that 58 million children of primary school age still do not go to school and are unable to fulfil this basic human right. The situation is, sadly, much worse for disabled children, who make up more than a third of the out-of-school population.
Of course, there is a moral case for development assistance, but it is also, as the noble Lord said, in our national interest, and not only in terms of trading with newly prosperous countries, although that is important, as the untapped potential of developing nations represents lost customers, lost trade and, ultimately, lost economic growth for the UK. However, such investment can help to make our people and our country safer. Our security and stability are assured not just by our Armed Forces but by training the police in Afghanistan, by building governance structures in the Middle East and by educating young people in Pakistan. Poverty, injustice and oppression go hand in hand with conflict and instability.
This Bill will make aid more effective by ensuring that it is predictable, allowing developing countries to plan and spend it effectively, with an impact on the long-term health and sustainability of their economies. It will allow our Government to make smart, long-term investments, ensuring that we get better value for money for every pound spent while measuring success by the change we make. With this Bill, our Parliament and our country will be showing global leadership, acting as a catalyst for the other countries in the G7.
It is fitting that the 0.7% target will be put on to the statute book in 2015, which has been called by the EU “the year of development”—a year in which the world will commit to a new set of global targets, the sustainable development goals, and a year in which we must all hope that there will be a historic agreement on climate change.
Aid alone will never eradicate poverty but development assistance empowers and enables. It is an investment in people, their health and education, in building prosperity and promoting good governance, and in tackling conflict, promoting human rights and supporting people to live a life of dignity. I end with the words of Nelson Mandela:
“Poverty is not an accident. Like slavery and apartheid, it is man-made and can be removed by the actions of human beings”.
By giving this very welcome Bill its Second Reading today, we are taking much needed action.
Baroness Chalker of Wallasey (Con)
My Lords, I welcome the opportunity to debate this Bill, albeit that I am able to make only a short contribution when there is so much to be said. I very much welcome the noble Lord, Lord Fox, who will be making his maiden speech today, and I hope that he will join in our debates on this subject a great deal in the future.
As colleagues will know, it is almost 18 years since I completed my nearly eight years as the Minister for Overseas Development—that was the title in those days. In the last of those years, our spending on overseas development reached just 0.26% of GNI. There are many in this House now, as there have been in the past, who heard my pleas that we could do so much more if we had a little more money. In those days, 0.7% was an aim but it was very far off the reality. We turned down far too many good projects because we had to cut our coat according to the then available cloth. We also discouraged too many people from becoming involved, which, to me, was almost a sin. We were unable to fulfil many deeply needed programmes across the world, but we did our best.
Following my role in government, I went on to do some part-time work for the World Bank as I set up my own consultancy. Africa Matters Ltd is not involved in the NGO sector, except in the donations that we make, but we are very involved in encouraging investment in worthwhile projects in Africa. That investment can be from anywhere, provided it is honest and open. There have been real improvements in the manner in which the richer countries of the world have worked with Governments to develop skills, institutions and democratic management, but there is still a long way to go, as many of the reports which will be referred to in this debate will undoubtedly mention. The millennium development goals have been a real spur to improvements, and most of the international and national bodies have raised their game. We can see the results, to which many have already referred.
It is in the light of the great changes that have taken place that I have thought long and hard about whether or not the UK Parliament should make the 0.7% target a legal requirement of public spending. Yes, most of the developing countries are gradually improving their economies and their business sectors. Some, such as India, will no longer have assistance, as they can afford to give aid to those parts of their country which lag far, far behind the good-news stories that we occasionally hear. It is quite clear that the UK is giving a higher proportion of its bilateral aid to low-income countries than most other bilateral DAC donors.
My daily work is telling me that there is much more to do, especially in the Commonwealth, to help to build up business and social institutions so that the money being raised is properly spent. I say this as a supporter of the African Corporate Governance Network and many other institutions, such as Transparency International, which, when I was a Minister all those years ago, I was proud to assist in getting started. However, there are areas such as education provision across the developing world that must have our help, even though the improvements contributed to by UK aid have seen in the last three years more than 10.2 million more children, including 4.9 million more girls, go to primary and lower secondary schools. Starting at the very bottom with education and healthcare makes an enormous difference 10, 15 or 20 years on to the ability of those young people to be involved in business and to create their own economic future. Therefore, it is in education, clean water, sanitation and healthcare improvements, as well in as institution building, that DfID is now so much more involved. I believe that the £11.6 million donation helped many organisations to get access to financial services, and this has been another of the critical steps forward which DfID has gradually been able to take in the last few years.
Time does not allow me to go into all of this. I have considered very carefully whether it is right to put this target into law. However, from all my work in corporate social guidance and other development areas of business, I know that there is a real feeling that Britain, which is leading the way, must have the money to do this. As the mover of the Second Reading, the noble Lord, Lord Purvis, said, it is critical that people know from year to year how they are going to be able to finance projects. One of our great nightmares was that we never knew how much we were going to have.
On balance, I welcome the Bill wholeheartedly and I hope that the House will give it a Second Reading.
Lord McConnell of Glenscorrodale (Lab)
My Lords, having in the past criticised the delay in bringing forward this legislation, I start by expressing my appreciation to the Government for making time both in another place and in your Lordships’ House to ensure that we can debate and, I hope before the end of this Parliament, agree this important legislation.
I congratulate the noble Lord, Lord Purvis, on his outstanding opening speech and on bringing forward the Bill in your Lordships’ House. It is a long time since I heard such a comprehensive and passionate but also evidence-based case for the cause that we are debating today. It was also a great pleasure to hear, with all their years of experience and dedicated commitment, the wise words of the noble Baroness, Lady Chalker, and my noble friend Lady Royall on our Front Bench, who stressed the important year in which we make this decision—2015. This is when we will go from the millennium development goals to the new sustainable development goals, which will, I hope, move international development on to a completely new level of quantity as well as quality.
It is with the issue of quantity versus quality that I want to start my contribution today. When we have previously debated in your Lordships’ House the issue that is in front of us today in this Bill, primarily two points have been made. The first is that an increase in spending was happening far too quickly. If that was a legitimate point then—and it was of course legitimate that we debated it—then I say to those who have made the point in the past that the time for that argument has passed. Not only do we now have a consensus among all the major parties in the United Kingdom but also the reality of 0.7% of GNI being the annual budget for international development co-operation.
The second point was about effectiveness, which is where the argument about quality versus quantity comes forward. We have been debating for 45 years—I repeat: 45 years—since UN Resolution 2626 was first carried. It is 40 years since it was meant to have been implemented and we have since then debated the quantity of international aid. Today, we have a chance to move on and to debate in the future only the quality of our international aid and no longer the quantity. I appeal to those who have made this argument in the past to consider that point and to join those of us who have supported 0.7% of GNI in moving forward in the years to come to a debate on the quality and effectiveness of our aid. This is important for many reasons.
The key issue of justice is at its heart. We are not rich because it was predetermined and they are not poor because it was predetermined. We are not smarter than the average African, south-east Asian or Caribbean person. Decades and centuries of exploitation, distortion of international trade, abuse of natural resources and bad governance have been encouraged by us, and not just by those who were in power in the underdeveloped world, the developing world, the Third World—or whatever it has been called from decade to decade. We helped to create that situation and we must now help to resolve it. Justice is absolutely key. That justice did not stop at the end of colonial times. We were quite happy to participate in a cold war in the 1970s and 1980s, in the first 20 years after the UN resolution was passed, when both sides propped up dictatorships and bad governance, and the exploitation of people in the developing world who still suffer today as a result.
Looking forward, there is also the issue of our self-interest. There are great fears in our country and across Europe today of migration, fears about the climate and fears about identity-based conflicts, which many people do not understand and do not know what to do about. Do we really imagine that migration, climate change and conflict will be improved by a reduction in or a halting of international aid? Surely the evidence shows us that if we invest in development co-operation, we can help to tackle those real fears of migration, conflict and climate change.
Finally, it is 45 years since the UN resolution was passed and 40 years since it should have been implemented. Can we just imagine what the world would be like today if 40 years ago the resolution had been implemented in the middle of that decade? What would our global education system have looked like? How many people would be smarter, better educated and better able to cope with the demands of the modern world? How many people would have been vaccinated and how many lives would have been saved? How many democracies would have been built? What great works of culture would have been created? How many scientific inventions might have been forthcoming? How many problems might have been solved? If we can imagine what might have been possible if the right decisions had been made back then, we can imagine what is possible in the 15 years to come when we could end extreme global poverty and build the better world that was imagined in 1970.
Lord Chidgey (LD)
My Lords, I add my congratulations to my noble friend Lord Purvis on the way in which he brought the Bill to this House. It is absolutely first-class. I echo his remarks on the quote from the National Audit Office on managing the ODA target. It states that DfID,
“worked hard to manage the substantial increase in its budget, completing preparatory work to strengthen … business processes, increasing the capacity of its workforce, and improving its”,
focus on capturing the results of its spending. Those words will be remembered for many months.
I remind noble Lords of what our ODA expenditure achieves and can achieve if this Bill is passed. UK aid saves lives around the world every day. It provides more than 40 million people with clean drinking water. It puts more than 10 million children in school. It delivers emergency food assistance to more than 11 million people. It provides 54 million people with access to financial services that helps them to work their own way out of poverty. UK aid has the potential to transform the lives of millions of people around the world. This Bill will enshrine that potential into law.
The facts and figures about world poverty and disease provided by NGOs such as Bond, Save the Children, UNICEF and RESULTS, which many Members will have received, make sobering reading. Nearly 14 million people die every year from poverty-related diseases, including TB, which we nearly eradicated some decades ago, and HIV/AIDS, which are each responsible for 1.5 million deaths every year. Globally, 35 million people live with HIV/AIDS.
Since 2002, the Global Fund has contributed hugely to the campaign to eradicate TB, funding the treatment of more than 12 million people. Since its inception in 2002, the Global Fund has helped to save nearly 9 million lives. DfID has pledged up to £1 billion pounds to the Global Fund over the next three years, which will save a life every three minutes and is an eloquent answer to those who might doubt the efficacy of DfID’s 0.7% of GNI budget being taken into law.
Since I entered your Lordships’ House in 2005, and particularly in this Parliament, I have been very fortunate to have had the opportunity, as a parliamentary representative, to see for myself the impact of some of the work that DfID is doing. For example, in Malawi, DfID wrestled with the tangle of local administrative practices that hindered the distribution of vaccines and dietary support for children. That has been overcome through a very tenacious approach to its task.
At the other end of the world, in Bihar state in northern India, with a population of more than 103 million, stunting and malnutrition are endemic. DfID is working with its Department of Agriculture. Although our aid programme is coming to an end, technical support continues. In that support DfID is helping the Department of Agriculture to develop crops with a higher nutrition content, expand crop diversity and access infrastructure to markets, cold storage and packaging and marketing skills, in an attempt to reduce the 40% of produce that is currently wasted.
In Ethiopia and Kenya, the story is even more upbeat, with DfID providing major support for Ethiopia’s land and agricultural reform programmes, which are aimed at unlocking the vast potential in the economy for developing an agricultural base. That is a precursor to an industrialised economy. In Kenya, DfID is supporting a small UK company that has invented a revolutionary and simple tank-fed system for regulating crop irrigation, which minimises water wastage in the process.
After these positives, one can only despair at the situation in Sudan and South Sudan, where millions have been displaced and thousands of children orphaned. The DfID teams work on, but some tragedies are difficult to deal with; for example, in Juba, seeing the plight of children as young as three and no older than eight attending an ad hoc playgroup run and supported by volunteers from UK NGOs. Talking to them through interpreters, we learnt that one little girl wanted to be a doctor. The dearest wish of another was to be adopted. The reality was that the children were found every morning wandering in the Juba markets, and brought in to be washed, fed and clothed. But in the evening, there was no alternative but to return them to the markets to find places to sleep. Their future was grim. The girls would be taken into one of the market brothels by the age of 11 and probably be dead by the age of 13. For the boys, the future was even grimmer.
Now, we have Ebola. In Sierra Leone, DfID, together with Save the Children, the British Army and NHS volunteers, has stepped up to the plate. They have prevented the Ebola outbreak turning into a pandemic, with potentially hundreds of thousands of victims. Dr David Nabarro, the UN Ebola special envoy, has described their effort as magnificent. I tracked him down in Davos to ask his views on the 0.7% of GNI for aid. He e-mailed me last night to say, in terms, that it gives the UK potential for significant impact and has massive benefit for poor countries. The UK and countries that commit to the target are more respected internationally and able to advocate more strongly for other donors to increase their development aid contributions. It is a very good thing.
From all these international debates and deliberations, one thing is abundantly clear. DfID has a formidable reputation among its peers around the world. It sets standards and achieves goals that are the envy of many. Adding legal force to a 0.7% commitment of GNI to the development aid budget can only reinforce the respect and leadership that DfID and the UK enjoy in the developing world.
Lord Williams of Oystermouth (CB)
My Lords, it would be all too easy to see this admirable and welcome Bill in terms simply of its financial implications. The truth is that its significance is a great deal broader. Many international voluntary agencies—I declare my interest as chair of the trustees of Christian Aid and patron of the Africa Prisons Project—are working, and will continue to work, not only to alleviate poverty and privation but actively to resist a culture of long-term dependency and structural dysfunctionality in developing economies. Our hope as aid agencies is to build up active, creative economies which are proper vehicles for people who need their dignity affirmed at least as much as they need their physical privations dealt with. Contrary to some people’s stereotypes, I can think of few, if any, aid agencies which would disagree with the definition offered by a leading local broadsheet earlier this week saying that aid works if it promotes self-sufficiency by laying the groundwork for investment, enterprise and growth.
We strive to tackle both the building of lasting capacity and to diagnose and campaign around the factors, global as well as local, that keep cycles of poverty and dependency alive. We are very grateful to those in government who have taken this on board in their response to the campaigns in recent years around, for example, tax transparency. When last year I visited some of our Christian Aid projects in South Sudan, what struck me most was the extraordinary resilience and vitality of small-scale co-operative projects, especially those run by women, whose education and empowerment is a major focus of our work. It was good to hear that flagged up by several previous speakers in the debate. The will and the ability, the strength of purpose and the sense of large responsibilities are all emphatically present in developing countries, and so often the real task is to work with the grain of this, listening hard to what local communities want and believe they can achieve. Once again, contrary to some stereotypes, it is simply not the case that there is an appetite for handouts in contexts such as this.
Yet South Sudan illustrates with painful clarity why this Bill matters. I am most grateful to the noble Lord, Lord Chidgey, for foregrounding the needs of South Sudan. We at Christian Aid are privileged to work with our own Government and others to sustain capacity at the grass roots. But collapsing or non-existent infrastructure, the lack of real nation building at a number of levels, endemic problems with the diversion of funds to elites, constant instability with sporadic outbreaks of murderous violence, all mean that grass- roots work is deeply vulnerable.
In Juba last July I was shown the empty and shattered cashbox which was all that was left of one small women’s co-operative’s savings after the murderous disorders of the winter of 2013-14. Without the wider and longer-term commitment of our Government to support not only grass-roots work but nation building and the creation of a responsible political culture, smaller-scale projects will always be at the mercy of political and social instabilities, which need more resources than any voluntary body can summon up. I applaud wholeheartedly the emphasis given in the excellent opening speech of the noble Lord, Lord Purvis, to this question of the long-term perspective, which we need to keep in mind, and what was said in support of that by the noble Baroness, Lady Chalker.
Intelligent and well directed government support is what saves many nations from becoming failed states. We hardly need reminding, in the light of the events of recent weeks, how readily instability leaks out from failed and failing states, with murderous effects elsewhere. The Bill offers the possibility of proper planning and consistent strategy. The commitment we are talking about today is a commitment to that task as well as the routine responses to crises and the building up of local self-sufficiency.
Another word for a commitment is a “treaty”. We have always regarded it as a matter of national honour to keep our treaty obligations. These are obligations of mutual defence and support. I believe that what we are being invited to do in taking the Bill forward is likewise a matter of our honour, our self-respect as a nation. We are making a treaty with those who inhabit a poorer and more risk-laden environment than ourselves, a treaty which recognises that what people need to be defended from is not just aggression from outside but chaos and need within. I am delighted to think that we are still a society willing to make and keep such commitments of honour. I believe, on the basis of the continuing generosity of so many supporters of our work at Christian Aid and that of other charities, that even in a time of financial stringency the people of the United Kingdom still care profoundly about behaving honourably towards their less fortunate neighbours.
Lord Fowler (Con)
My Lords, I very much agree with what the noble and right reverend Lord has just said.
Following the sad announcement made at the start of business by the Lord Speaker, perhaps I may preface my comments on the Bill by one or two remarks on Lord Brittan—Leon Brittan—and still be within the five-minute timescale.
You can sense the man by the tributes that have been made over the past 18 hours. They came from people like me who knew him well. I knew him in Cambridge where he was, without doubt, the outstanding undergraduate of our generation; I knew him in the Commons and in the Cabinet. One of the last conversations I had with him was about his ambition to play a bigger part in this House. Regrettably, that was not possible. He was the youngest Home Secretary since Churchill. He was moved from that post for, frankly, no sensible reason. He became Trade and Industry Secretary and was just re-establishing his career when Westland intervened. Anyone who thinks he woke one morning and thought, “I am going to leak the Solicitor-General’s memo” is gravely mistaken: it was a very different story from that. However, what is certain is that he was left to carry the can. Happily, the effect was that he went to Europe and made an indelible contribution there.
The man himself was kind, with a gift for friendship; he was wise, and people went to him for advice. Perhaps above all, in the light of some of the comments today, he was a man of honesty and integrity. That is what I remember and recall. It is a vast tragedy that his very last months should have been scarred by innuendo and gossip. It is inconceivable that he would have taken part in any kind of cover-up. Indeed, Geoffrey Dickens, I understand, wrote to him, thanking him for the way in which the Home Office had dealt with his letters—letters, not a dossier. Now that he is dead, I hope that people will not use the release from libel to attack his reputation; he certainly does not deserve that.
I have lost a lifelong friend, but this is as nothing compared to the loss of Diana, the great love of his life, and of Catherine and Victoria. To them we send our heartfelt commiserations and the small comfort that their sense of loss is very widely shared by a vast number of people in this country.
Turning briefly to the Bill, I support it very strongly and I will tell noble Lords why. Over the last two years I have been researching a book on HIV and AIDS. I went to look at the position on the ground in a number of countries. I saw a hospital in east Africa that had not had a budget increase for a decade; where a visit to the hospital took a day in travelling to and fro; where they did their best to meet the demand, but, frankly, many births were far away from the hospital on concrete floors, under a single blanket. In another country I saw a so-called model treatment centre, where drug users queued for long periods; while in another African country where they were treating TB, the queues started forming at 5 am and patients waited hours to be seen.
I am not overdramatising the position—that is the trouble. There are far worse examples. It is the way of life and death in vast parts of the world. The recent outbreak of Ebola is closely connected to the lack of medical support. In Sierra Leone, there are 134 doctors for a population of 6 million.
I often feel that there is a lack of imagination about the health provision for millions upon millions of people in other parts of the world. Worse, I think that sometimes there is an optimistic belief that private giving and philanthropy can solve all the problems. Valuable as voluntary giving is—it is invaluable—it is never going to meet the gigantic demand around the world, so I support entirely the amount of aid that is going to fight these diseases. I support the 0.7% target. Without that international aid, the world would be facing a catastrophe.
I also support the leading part that this Government are taking in making help available. I also reject some of the headline reports we have seen over the past week which allege that the decision in 2013 to meet the target of 0.7% of national income was rushed and last minute. The decision on £500 million going to the Global Fund was about the best-trailed announcement that I can remember.
I regret the time imperative of this debate. Suffice it to say that I entirely back the emphasis that this Government have given to international aid. It is what I would expect from a civilised and outward-looking country that recognises it has responsibilities to try to help the poorest people in other parts of the world.
Lord Lipsey (Lab)
My Lords, as the first dissident to speak in this debate, I start by saying that I agree with north of 90% of what has been said so far, particularly the moving remarks of the noble Lord, Lord Fowler, about the impact of the aid programme. I am unambiguously for aid, and I am unambiguously in favour of a highish level of public expenditure on aid; the sole question is whether we assist effective aid by setting this 0.7% target. Last time I spoke on this, I had hardly got to my feet before somebody popped up and said, “Do you not realise that 0.7% is party policy?”. I know, but in this House I do not think we should put party policy first. We put first our own assessment of what is in the interests of, in this case, not only our country but people in poorer countries whom the aid programme is designed to assist.
The House’s Economic Affairs Committee, chaired then by the noble Lord, Lord MacGregor, looked into the development aid target in its 2012 report. I must say that the noble Lord, Lord MacGregor, is profoundly upset that he is unable to be here today. He hopes to participate in later stages of the Bill. If he were here, he would outline better by far than I the arguments that persuaded the committee—every member, left, right and centre—that the 0.7% target fails the test of helping poor countries and is bad for our country. I will not go over the arguments in the report today, but simply ask that noble Lords read it. It is in the revised Library brief circulated last night.
I shall add two points that have emerged since the committee studied this subject. The first is quite general. The evidence accumulates that singling out particular items of public expenditure for special treatment has disastrous results. Modern government cannot help itself: we say that health expenditure must remain the same in real terms at least, and education; we ring-fence this, we hypothecate that—anything to please the voters, anything to please the pressure groups. This is making the management of public finances almost impossible.
I will take a salient concrete example. Health spending is protected but social care spending is not, so we have people going to hospitals in droves because services are available there while we are slashing community services, which are where those people could most economically and best be treated. The Institute for Fiscal Studies recently drew out the implications of this. Because of all the protected programmes, we are going to see cuts of 30% or 40% in the unprotected programmes. We will be looking very hard around the streets to find a policeman if the government cuts go through. This is a mad way to run public finances, and this Bill seeks to add another item to the protected pile.
Secondly, we no longer have to gaze into the crystal to see the damaging effects of the Bill; we can read the book. Last week, the authoritative National Audit Office—I know that the noble Lord, Lord Fowler, with all his experience disagrees with it—published a report on aid. It was a very judicious report and showed how the ODI, in a desperate attempt to get past 0.7%, rushed out money in the last two months of the year as if it grew on Whitehall trees. That is taxpayers’ money and much of it is going straight into the pockets of the elites in developing countries. That is the trouble you get when you have a target. People do stupid things in order to meet those targets. Margaret Hodge said that Parliament is going to have to look at this; we are going to have to look at that every year, because it is going to happen every year.
I hope that the House will not divide on the Bill today. The right course is to consider it in Committee with sensible ameliorative amendments. If we do not make such amendments, the Bill will go down in history as a piece of gesture politics whose adverse effects will be felt. Development aid in principle has my strong support, as it does the support of every Member of this House, bar only a few—but this Bill in practice will aid only those who want to discredit aid.
Lord Shipley (LD)
I, too, was a member of the Economic Affairs Committee when it conducted a lengthy inquiry into the economic impact and effectiveness of development aid two years ago. I spoke in the debate in your Lordships’ House and said then that it was morally right for rich countries to give aid. It can help to make the world a safer place by spreading wealth and opportunity.
This Bill enshrines in law that figure of 0.7% and, as I said in that debate, that figure exists as a statement of the responsibility of richer countries to support poorer ones, and I subscribe to it. This Bill means that we can move the debate on from whether to spend aid to ensuring that we spend it most effectively. However, it should not be paid in such a way that it enables or encourages fraud, corruption, capital flight or the purchase of arms, and it should always be properly audited to give confidence to UK taxpayers who fund it. That is why Clause 5 is so important. It requires an independent evaluation of the extent to which development aid reaches its target and gives value for money. For this to be achieved, it will be important for proper systems of audit to operate in each country on the ground, not just in capital cities.
Spending 0.7% cannot be an end in itself. Rather, it should be the consequence of what we do project by project and programme by programme. It is on that that we now need to focus. In our debate two years ago, I expressed some doubts about the speed of the increase in spending—some 37% to 2015—and queried whether DfID had the resources to do it successfully. Evidence was given to us that there had been a serious loss of experienced staff in DfID. I hope the Minister when she replies will be able to say something about DfID’s current staffing levels.
In fully supporting the Bill, I emphasise that the development aid we give must be in a form that can be audited for its outcomes. Budgetary support to other Governments is not fully auditable, and it would be interesting to know how much of our aid is still in that form. We heard, for example, evidence from Professor Jeffrey Sachs of Columbia University advising strongly against budgetary assistance. He said that handing over money to central Governments and expecting it to reach the local level was “a hope too far”. He urged well targeted and well defined programmes that accomplished a specific purpose, such as vaccines or bed nets, which can be properly audited. That seems sound advice.
It is good that this country has achieved the 0.7% UN target. However, we should note the NAO report last week, which pointed out that £3.7 billion out of the £11.4 billion budget in 2013 was spent in the last two months of 2013, raising questions about target-driven spending. We will no doubt learn more about this in due course, but my own reaction is similar to that of my noble friend Lord Fowler, in that spending it as humanitarian aid seems absolutely appropriate in the circumstances.
The Bill is important, and Clause 5 is particularly important because it will build public confidence that their money is being well spent. The Bill as a whole gives a certainty to future planning of overseas development aid. We should welcome that.
The Lord Bishop of Derby
My Lords, I, too, congratulate the Government and the leaders of all the major parties on, at a time of amazing austerity and financial challenge, this bold commitment to a generous settlement in our public finances for the support of those in developing countries, especially the poorest of the poor. As we have heard, the 0.7% is an international target and therefore a very important sign that we play our part in an international community in a responsible way. Many activists, and church members in particular, are concerned for us to make that witness to global citizenship, and see this as an important issue. We have heard that it is important for us to be able to plan and be efficient and effective in the deployment of these resources. We have also heard that it creates more stable and peaceful societies, and gives us better communities with which to trade.
Some of your Lordships were in a debate in December about soft power. This is a very important sign to the world of a narrative of a generous country that has high values. We need that narrative in an age when our young people are being radicalised by other, more violent and narrow-minded narratives. This is very important sign not only to our own society but across the world, especially to young people, about generosity and commitment to others. Some of us, too, were involved in the legislation proposed for slavery. I met a young man who, when he was six, was sold by his family into slavery in the fishing trade in Africa because they were so poor. I met a young woman who, when she was 12, was sold into sex slavery in Nigeria because her family were poor. This kind of policy and this kind of committed, regular and properly audited investment in building societies across the world joins up with other concerns we have, such as the slavery issue, and the fact that it is not just an issue here but across the globe.
Like my colleague, the noble and right reverend Lord, Lord Williams, I am privileged to be a trustee of Christian Aid. The noble Lord, Lord Purvis, gave some statistics, and we are proud to be involved in the provision of clean water, schools and financial services, and in working with women and girls. They all provide stability and capacity for local societies to be healthy, peaceful and forward-looking. The OECD estimates that for every pound spent on some of these enterprises, developing countries gain an additional £350 in increased revenue, which shows how effective targeted and planned investment can be. Christian Aid is proud to work with DfID in programmes such as those to eradicate malaria; to give priority to women and girls, as the noble Baroness, Lady Royall, said; and to provide mobile technology to help health services develop appropriately in rural areas. All those things need consistent and planned investment, as does the response to climate change. There are more and more signs of flooding in El Salvador, for example, and more and more problems relating to a lack of water supply in Kenya as the climate changes. Christian Aid is proud to work with DfID and others to be proactive in being able to plan to tackle those issues and to invest in them properly.
I say thank you to the noble Lord, Lord McConnell, for his inspiring words and say to the noble Lord, Lord Lipsey, that it is not just a matter of neat systems. This is a moment for giving a sign, to our own people and across the globe, about our commitment to generosity, the development of others and a mutual world that works through partnership—a narrative that is radical in the proper way.
Lord Tugendhat (Con)
My Lords, like my noble friend Lord Fowler, I begin today by saying a word or two about my dear friend Leon Brittan. A lifelong friend, I met him in our first week at Cambridge in 1957. He was a man of outstanding ability—generous, loyal, wise and of the utmost integrity—who gave great service to this country. I mourn him deeply and pay tribute to his character, life and achievements. I want, from this Chamber today, to send my condolences to his wife Diana and to my former colleague, Sam Brittan, with whom I was once on the Financial Times. It is a very, very sad day for me.
Like the noble Lords, Lord Lipsey and Lord Shipley, I, too, was on the Economic Affairs Committee under the leadership of my noble friend Lord MacGregor, who very much regrets that he cannot be here today. I repeat the point that they made: it issued a unanimous report that was against coming down in favour of the 0.7% target, with Conservatives, Liberal Democrats, Labour and Cross-Benchers, all of whom had seen the same evidence, reaching the same conclusion. I stress that this does not mean that we were against development aid. We all want poor countries, and especially poor people in poor countries, to escape from poverty and we all agree that British aid has an important and continuing role to play. In that connection, we were very pleased to hear that DfID is widely regarded as one of the most effective and efficient operators in the field—a point made by the noble Baroness, Lady Royall, and by the noble Lord, Lord Chidgey.
However, to set an expenditure target that must be met, come what may, as a legal obligation, is never a good idea. It will deprive government of flexibility to respond to changing circumstances, whether here or in the recipient countries. It is also bound to lead to distortions and misallocations, as administrators strive to spend given percentage amounts, on an annual basis, of what are bound to be multi-year programmes, instead of in accordance with the practical needs and rhythms of those programmes. In my view, the noble and right reverend Lord, Lord Williams of Oystermouth, made exactly the wrong point when he talked about the target helping good administration, while the noble Lords, Lord Lipsey and Lord Shipley, made exactly the right point.
I do not oppose the target just because it is set in this field—far from it. I would oppose it in any area of expenditure and believe that in setting it in one, we are establishing a very bad precedent which is likely to be followed in others. I very much hope that the Minister will give an assurance, as far as she is able, that the Government do not regard this as a precedent. If the Government do not regard it as a precedent, why do they think it is such a good idea on this occasion?
In this particular case, there is an additional problem that we need to consider. The Government are rightly shifting the emphasis of the aid programme to the more fragile and needy states, but those, by definition, are often the states where Administrations are weakest and the temptations to corruption greatest, and where the pressures of the powerful elites, to which the noble and right reverend Lord, Lord Williams, referred, can also be very considerable indeed. I am afraid that the provisions of Clause 5 are very unlikely to put up a substantial barrier to the difficulties that are going to arise.
I would also like to draw attention to the extent to which the landscape of international development has changed in recent years—a point made by the noble Lord, Lord Purvis. Aid used to be a major element in the flow of capital to developing countries. Now, although it has increased greatly since the 1970s, when the 0.7% target was set, it is dwarfed by private flows by about nine to one. The major elements in the private flows are not just investment—foreign direct investment and portfolio investment, very important as they are—but the remittances from citizens of developing countries working abroad also play a major role and are, indeed, very much more substantial these days than aid itself. If we want to be more helpful, we should be encouraging still further the investment by corporations—private and foreign direct—as well as finding ways to help those who have migrated to developed countries such as ours to send remittances home. That would be something practical that we could do.
Finally, I ask the House to remember that development aid is no longer something that flows only from western countries to developing countries. Important new players in the game—China, India and Brazil—have joined Japan as substantial providers of aid. We should welcome this, particularly this week, when so much attention is being given to the proportion of the world’s wealth in the hands of the top 1%. Oxfam, I read in the Guardian, claims that the 85 richest people on earth have the same wealth as the 3.5 billion poorest. As we all know, a significant number of those 85 are to be found in India, China and Latin America. They, among others, should be doing much more to help relieve the poverty in their countries and elsewhere in the developing world.
Lord Cashman (Lab)
My Lords, I congratulate the noble Lord, Lord Purvis of Tweed, on his excellent introduction to this discussion. I welcome this Bill from the other place and applaud its author. While we are congratulating, I also congratulate the Government on their commitment to 0.7% of GNI as ODA, and successive Labour Governments on their unbroken commitment. This promise to place in law 0.7% of GNI as ODA is long overdue and we should work to ensure that it becomes a reality before the election of May 2015.
Some have argued that they do not believe in this target or that it will create an overflow of funding that will be washed out through the doors of Whitehall. I believe that argument has already been dealt with, but I will return to it later. The fact is that over recent years, since the global economic crisis, programmes have been shortened or cut by other EU countries. Indeed, there have been attempts to recalibrate funding by creating the dubious concept in development terms of “middle-income countries”, where instead of looking at poverty and inequality indicators, the overall GDP of a country is used as a crude basis for funding decisions, often undoing the good that has already been done. As I said in a previous debate, the UK Government are actively pursuing this approach, and it has detrimental effects.
Reductions of programmes and funding hit those in need the hardest—South Africa, a country I know well, springs to mind. But let me repeat a few statistics—oh, how we repeat and use statistics on different sides of the argument. In its 2013-14 programme, DfID provided 43.1 million people with access to clean water—something we take for granted—better sanitation and improved hygiene; supported more than 10 million children, half of them girls, to go to primary and lower secondary school; ensured that 3.6 million births took place safely with the help of nurses, midwives or doctors—something that we take for granted; prevented 19.3 million children under five and pregnant women from going hungry; and reached 11.4 million people with emergency food assistance. The multilateral organisations that DfID supported provided food assistance to more than 80 million people in 75 countries, immunised 48 million children against preventable diseases and detected and treated 1.5 million cases of tuberculosis—I could go on and on with these statistics.
Why do I repeat these statistics? Because some people say that ODA does not work and that to do more would be to throw money away. I say: tell those millions that ODA is not necessary and that ODA does not give value for money; tell the child whose life is saved and whose mother survives childbirth; tell the girl who goes into education and the child soldier given a future; tell the farmer now able to grow and sustain; tell the pregnant mother now able to prevent the transmission of the HIV virus to her unborn child; tell the person whose life is saved by access to medicines and antiretroviral drugs; tell it to the AIDS orphans who now have a future where before there was none; tell it to LGBTI communities and individuals given hope and support in the face of hatred; tell the neediest and the poorest that theirs is not our case—and let civilised societies and individuals give their judgment.
What happens elsewhere in the world does affect us and does matter. It makes sense—as my mum would say, good old common sense—to continue our investment in developing countries. It affects us and protects us, whether our borders, immigration, trafficking, anti-terrorism policies or sense of decency. I will repeat this again and again, as I did in the European Parliament: we are not committing a sum of money; it is a percentage of our gross national income, and if our income goes down, so does the amount of ODA. Therefore, let us do the decent thing and pass this Bill swiftly and with pride.
Baroness Manzoor (LD)
My Lords, I am delighted that Michael Moore MP instigated this Private Member’s Bill in the other place—otherwise, it would not be before us today—and that my noble friend Lord Purvis is seeing its passage through this House. I concur with everything he said in his excellent opening speech. I start by accepting that there are competing demands on all Governments and that most noble Lords are committed to some form of humanitarian aid. After all, what differentiates us as humans is what we do for humanity.
In 2013, the UK was the first G8 country to achieve the 0.7% GNI target and, in doing so, met the 1970 UN resolution. We are one of the richest countries in the world and, like the rest of the western world, have faced hardships resulting from problems in our economy. However, these hardships are relative to the huge poverty, misery, pain, and death seen by millions in many parts of the developing world.
In 2010 the World Bank estimated that 1.2 billion people across the world were living in extreme poverty, on just under £1—around 83p—a day. There are also estimates that between 2008 and 2012, 143 million people were displaced because of disasters and 33 million people were displaced within their countries as a result of war and conflict. Some 870 million people suffer from under-nutrition and around 3 million children die each year as a result. Under-nutrition falls the hardest on the very poor, mainly women and children, and pushes them even further into a continuous cycle of infections such as TB and further poverty. Nearly 22 million children from the poorest families and the most marginalised groups do not have even basic vaccines. It is estimated that only 5% of the world’s children receive all 11 of the vaccines recommended by the World Health Organization. This is a disgrace.
Aid, used wisely, creates the right conditions for economic growth, because the most powerful tool to take people out of poverty is to give them the means to look after themselves. I was part of the delegation with my noble friend the Minister that visited India last year. We saw at first hand the excellent work being undertaken by DfID; for example, community-led infrastructure projects such as building classrooms, improving sanitation and providing vaccines to eradicate polio. We also witnessed the emphasis that DfID was placing in its work on educating girls. As has already been said, it is well known that getting girls into schools begins a chain of further benefits. Educated women have better maternal health, fewer and healthier children and increased economic opportunities, thus improving the quality of life for their families and lifting their communities out of poverty.
As has already been said, and I make no apology for repeating it, in 2013-14 alone DfID supported 4.9 million girls to go to primary and lower secondary schools, ensured that 3.6 million births took place safely, and provided 26.9 million women with access to financial services to help them work their way out of poverty. We saw an example of this during our visit to India, where local women with seedling money started tiny fish farms. The women took great pleasure in telling us that, previously, the banks would not lend them any money but that now the men were borrowing from them.
Enshrining the 0.7% of GNI in law shows how serious our commitment to humanity is. It demonstrates our leadership in this vital area to the world. It will enable proper planning and resourcing of the valuable and excellent work that DfID and other organisations do on our behalf.
We must not forget that some of our most important trading partners are countries on which we have spent development aid previously—countries such as India and China. In today’s turbulent world, when it seems that a day does not go by where some heinous crime is not committed, one thinks of the words of Nelson Mandela, who said that the greatest threat to peace was international poverty. Clearly, where there is little or no hope, there is no future. Tackling global issues such as economic development, supporting conflict, supporting fragile countries and communities, ensuring effective governance and working together in areas of climate change are in all our interests. I support this Bill wholeheartedly.
Lord Anderson of Swansea (Lab)
My Lords, I was Leon Brittan’s pair and I wholeheartedly endorse every word in the tributes paid by the noble Lords, Lord Fowler and Lord Tugendhat, and share with them the sadness and the willingness to be with Diana at this very sad time.
I support the Bill so ably moved by the noble Lord, Lord Purvis, but accept that it is largely symbolic. Since this is a consensus Bill, no party in the future would dare to move away from or fall below the 0.7% of GNI target. I support the Bill on moral grounds, not passing by on the other side, but also because I believe that it is in our national interest broadly defined. I have had the good fortune to travel widely and see at first hand the work of DfID—I join in the chorus of approval for it—but also the work of non-governmental organisations and wonderful individuals from the UK.
That said, we do no service to developing countries or to our own taxpayers if we abandon our proper scrutiny, value-for-money criteria and accountability. Those are points raised in the Select Committee’s report published in March 2012 and in Clause 5 of the Bill.
I shall make a few random observations. We must be willing in a positive spirit to ask hard questions—heart, yes, but head also. Why, for example, has South Korea pulled itself up so remarkably when so many other countries, particularly in Africa, remain dependent on aid? It is not a question of natural resources. Is it bad governance? Is it tribalism? Is it culture? Is it corruption? Is it armed conflict? Or is it failures in the education system?
We must also be prepared to challenge political correctness; for example, in confronting problems of long-term population increase. This is not only a question of women’s reproductive health; it is not only a question of education of women in family spacing, for example; but it is clear that population explosion may negate the effects of aid. For example, who dares point out that the recent turmoil in Kenya is due not just to tribalism but to competition for land from the booming population; that the population of the Philippines has doubled in the recent past; and that the population of Gaza was in 1948 250,000 and is now 1.8 million on that small territory?
My main point, however, relates to the definition of aid, the remit of DfID, the need for “Whitehallism” and market share, and co-operation with other countries and international organisations to maximise the beneficial effects of aid. Failure to include such considerations will only give ammunition to the populist press. Purists strongly oppose any proposal to weaken or dilute the definition of what should be within the 0.7% target. They may often fall into the trap of concentrating on the amount rather than on quality or effectiveness.
The budget of DfID is ring-fenced; the budgets of the FCO and MoD are not and under increasing strain. Surely we should recognise the contribution of these departments to our national aid effort. I have in mind particularly—and the noble Baroness, Lady Chalker, will recognise it, too—the work done by the British Council in education in South Africa in the past. Even the most “pure” aid specialists would surely agree that the MoD’s work to combat Ebola in west Africa should be reimbursed from our aid budget, as it has been. We should at least consider taking that precedent further on the grounds that there can be no development without security and possibly include our contribution to international peacekeeping, even perhaps seeking to look again at the OECD definition of official aid, which I concede is wide in part, including support for civilian nuclear energy.
The independent appraisal proposed under Clause 5 should be given adequate resources and expertise. It should look at the precedents of co-ordination in Whitehall, for example, in the Balkans in the 1990s and more recently in Afghanistan.
The NAO report has been mentioned. This only underlines the case for an independent evaluation and the need for accountability and transparency, which is overwhelming. Any evaluation should include not only the value added from co-ordination within Whitehall, but also from co-ordination with international organisations and bilaterally. There is a good precedent here over co-operation on Ebola, for example—Liberia to the USA, Guinea to France and Sierra Leone to the UK. I recall Robin Cook’s excellent initiative after 1997 in building co-operation with France in west Africa. Whatever became of that?
With these few observations, I end not in a spirit of negative criticism but by welcoming the commitment of the Bill. Once we accept that principle in legislation, as I am confident we shall do, we should be ready to ask hard questions about effectiveness and value for money. Therefore, Clause 5 is an essential element of this important Bill.
Baroness Falkner of Margravine (LD)
My Lords, I had the privilege nearly five years ago of being the first Liberal Democrat to speak from Government Benches in seconding the Queen’s Speech when the coalition was formed. One of the most significant things in that Queen’s Speech was the commitment to legislating for 0.7% of GDI being given in overseas development aid. I am sorry that it has taken nearly five years to get there but immensely proud of this Government for delivering on that significant and early promise. I also pay tribute to Labour: that promise was committed to by a Labour Government and the enabling departments and structural factors were very much theirs and bear their signature.
At a time of singular apathy towards voting as we face another general election and with a view that there is very little that engages the public, listening to the debate in the House of Lords and seeing noble Lords across the Chamber coming together with such singular purpose to support this noble objective is heart-warming. If there is anything that the public should be proud about, this debate bears testament to Britain’s internationalism.
I turn directly to the argument of the noble Lord, Lord Lipsey, about hypothecation. I am sorry that the noble Lord is not in his place—oh, I see he is now sitting in another place. I am very glad to see him here. His argument was very valid when it comes to the broad thrust of this. When you hypothecate too many different departments you leave all the rest to take the brunt of cuts. Of course that cannot be right. However, I take the example he used: the NHS. There is no comparison here. The NHS spends something like £100 billion a year. In having achieved 0.72% of GDI, we are talking of expenditure of something in the region of £11.5 billion. Were you in this case to rob Peter to pay Paul, you would make a fractional difference in terms of the NHS. I point out to him that the recent report by an eminent body, the Academy of Medical Royal Colleges, found some £2 billion being wasted in NHS treatments and drugs. Frankly, that wastage is the equivalent of almost 20% of what we spend on humanitarian assistance. While hypothecation overall can be difficult, there are exceptions where it is absolutely necessary. It has taken 40-something years to get here. If this legislation is not necessary, I do not know what is.
In the brief time I have, I turn to how appalling it is that the five most powerful countries of the world—that is, the five permanent members of the United Nations Security Council—have such a poor record in this area. As I said, we in the UK can be proud that we give 0.72% of GNI. However, France gives 0.4%. The US—one of the richest countries in the world—gives 0.2%. Russia, with the benefits of the extractive industries of oil and its mineral wealth, gives a mere 0.3% and, charged with securing international peace and security, is actually a catalyst for increasing international instability rather than helping to solve the problems. China, the fifth member of the United Nations Security Council, does not even recognise OECD methodology in terms of assistance. It is completely untransparent in what it gives, but from what experts can determine most of its funding is through state-owned enterprises and banks, and is spent on extractive industries and infrastructure in developing countries. Most of that is conditional or tied. Estimates are that, at best, it gives about 0.3%—like Russia.
We have a situation where the five countries charged with upholding international peace and security—in this area, security should have a wide meaning and encompass disease, food security and environmental degradation as well as conflict—give appalling amounts in terms of discharging their responsibilities. This is an important Bill. If we legislate for this in the UK, we serve as an example to other rich and developed countries that they, too, should move in the same direction. In that alone, we will have achieved a significant step forward.
The Earl of Sandwich (CB)
My Lords, this is an historic occasion which should make us all proud of belonging to an outward-looking United Kingdom. It was a pleasure to hear the noble Lord, Lord Purvis, lead this debate. The Bill provides us with an opportunity to re-emphasise the importance of maintaining our aid programme at its present level. We are not the first country to reach 0.7%—far from it—but we are recognised as among the foremost of OECD countries in delivering an effective programme.
I have spent most of my working life working with aid agencies, especially Christian Aid and Save the Children. However, I am not an uncritical supporter of aid. I listened to the forceful contribution of the noble Lord, Lord Tugendhat, with particular interest. We must acknowledge that there are failures in both official and voluntary sectors, and I know aid is wasted or diverted, especially during emergencies. Yet I strongly support the size of our aid programme and I have seen enough to be convinced of the potential long-term value of both humanitarian and development aid, especially as a catalyst to stability and stronger local initiative and participation.
No one can deny the necessity of humanitarian aid and there are many competing demands for it. I was with the noble Lord, Lord Chidgey, as he described those demands. Among them are the girls in South Sudan, the Syrian refugee camps, the vast Somali camps in Kenya and the victims of Ebola in Sierra Leone. Our voluntary aid agencies have an outstanding record alongside UNHCR, ever since the Indo-China emergency, bringing emergency relief and providing jobs and education—the two essentials that refugees dream of but can scarcely reach.
Long-term development is a more difficult concept to explain to the public. For some, it implies interference in another state’s internal affairs and the distortion of a national economy, as has certainly occurred for good or ill in countries such as Iraq and Afghanistan. However, to most people, development is the basis of economic survival and sustainability. It means immunisation, reproductive health, the reduction of infant mortality and the halving of under-five mortality since 1990. These are the pillars of successful aid. Capacity and institution-building are equally important.
As has been mentioned several times, one of the best reports on our development aid programme was carried out in 2012 by our own Economic Affairs Committee. The report generally commended DfID but made criticisms as well, notably that there was insufficient evidence of aid’s contribution to economic growth, that aid could undermine local economies and that there were considerable risks of corruption. All these still apply to aid today but this Government have set up an impressive watchdog in the form of the Independent Commission for Aid Impact, reporting to the International Development Select Committee. I did not agree with the committee that the 0.7% target should not be enshrined in legislation. Its argument was, broadly, that any ring-fenced target would place an undue emphasis on quantity. I understand the point but it is much exaggerated. International targets are now widely used and there is a strong moral case for a minimum percentage of national wealth. That does not mean that aid money will be wasted as end-of-year surpluses accumulate in most businesses and must be properly managed. However, that lays a greater responsibility on the ICAI, the IDC and our own EU Select Committee.
An essential element of the Bill is the duty to lay a Statement before Parliament if the target is not met. It is inevitable that that will happen before the end of a year. As the National Audit Office pointed out, there should be no rush to make up lost ground unnecessarily. In fact, the NAO recommended a two-year target to avoid that happening. I am sure that the Minister will comment on that.
I, too, was pleased to see in Clause 5 the need for the Secretary of State to commission an independent evaluation to show value for money. That complements the present arrangement introduced by the coalition. We must recognise, however, that there is a proportion of the public, perhaps as high as one in three, who believe that the 0.7% figure is too high. That suggests to me that the aid lobby is not doing enough to explain the purposes of aid and what it can achieve. We must make more of the argument of self-interest. For example, we need to find ways to stem the flow of migration. One of those is to reduce conflict and support local economies. Our own economy benefits from rising standards in developing countries, which can bring us jobs through aid, trade and investment. It is imperative to fight the scourge of Ebola, not just for humanitarian reasons but because it could easily affect this country. Development education and global awareness is another area in which we as a country benefit from our outreach to the poorest parts of the world.
Finally, I agree with the noble Baroness, Lady Falkner, that the Bill sends an important signal to other countries that they, too, must meet their aid targets. That is particularly important as we look towards the future financing of international development and the post-2015 sustainable development goals.
Viscount Astor (Con)
My Lords, it is surprising, when one has heard that the Bill has all-party support and was a manifesto commitment, that it is not a government Bill but has been left for the noble Lord, Lord Purvis, to introduce as a Private Member’s Bill at what might only be described as the very end of the parliamentary Session.
I fully support the Government’s intention to keep the aid budget at 0.7%. I would be delighted if economic and financial circumstances in this country allowed that percentage to increase in future, but I am concerned by the way the Bill enshrines the percentage in legislation. Surely that should be a matter of policy rather than law. Future Governments might feel constrained not to increase the percentage because it would require legislation. Equally, in severe economic times, they might be discouraged from lowering it if that was necessary in one particular year. I am nervous of enshrining any percentage of expenditure in legislation. This seems to be one Parliament binding the next, something that we have so far always avoided in legislation. Why the exception in this case? If the aid budget, why not the health service or defence spending? They are all just as important.
The argument has been put forward that we want to encourage other countries to follow suit. That is a laudable aim, but I am not sure that domestic legislation is the right way forward. We should be putting pressure on other members of the EU through the Commission, and other countries through the UN, to increase their development spending.
Then we have the problem of defining exactly what aid is. Is it just money spent by DfID? What about the sums that we send to the EU that is spent by the Commission in its aid budget? Should not that contribution be taken into account? Can the Minister tell us how much we send and how much is spent by the Commission?
Then we have to consider the MoD. It is currently manning hospitals in Sierra Leone, treating Ebola patients. It is vital work; is it not also a form of foreign aid? We should all be very proud of the work that our Armed Forces and health workers are doing in that country, which is not without risk.
If we added all that together—together with the work of the British Council, which the noble Lord, Lord Anderson, mentioned—would that not increase the amount of money that we are spending? We should be championing that.
Then we have the issue that the NAO report raised about year-end spending. We know that the department spent £1 billion in eight weeks to hit the target. Anyone who has spent time in a government department has seen that when that department suddenly finds an underspend, there is always an ugly rush to spend the money. It cannot be given back or rolled over. Projects that have been rejected are revived, or brought out of mothballs. One way that that could be solved for DfID is if it was allowed to roll over spending from one year to another, rather than go through what looks like a panic to spend money before the year’s end. Would that be allowed under Clause 3(3)?
Another issue is that the department’s year end is March, but the OECD year end is calendar. The National Audit Office report says:
“This difference is likely to represent more than an accounting difficulty because of the need to hit a target with little or no flexibility, causing significant decisions to be made late in the year and at short notice”.
The report recommends a three-year rolling average when specifying spending targets. Perhaps the Minister will respond to that suggestion.
In Committee in another place, the Minister, Desmond Swayne, answered that question with the following words:
“I come finally to the question about the difference between the calendar year in which we report overseas development aid and the financial year in which we do all our other business. I confess that that has caused me some angst over recent weeks as it has crossed my desk again and again. If you will excuse my French, Mr Crausby, it is a bugger”.—[Official Report, Commons, International Development (Official Development Assistance Target) Bill Committee, 4/11/14; cols. 26-7.]
I hope that the Minister will today be able to give a less colourful but more explicit answer to that question.
I fully support our aid budget. It helps to control economic migration, it helps countries to develop their infrastructure, it promotes self-sufficiency and, above all, it helps those in dire need. It saves lives. However, I have questions that I hope that the Minister will answer. Anyone listening to the debate today will wonder whether it is just a debate about the benefits of the money we send to countries in need. There is no question about that, but I respectfully suggest that we ought also to consider the detail of the Bill to see whether it achieves its laudable aims.
Lord Watson of Invergowrie (Lab)
My Lords, occasionally, when a Private Member’s Bill arrives in your Lordships’ House from another place, the noble Lord who picks it up here appears to do so on a rather fitful basis. The very opposite was demonstrated today by the noble Lord, Lord Purvis, who exhibited passion and commitment to the cause in what was a first-rate speech.
It was hugely significant when, in 2013, this country met the ODA target for the first time. Even prior to that, British aid was a success story, and I believe that the Bill offers the chance to ensure that it continues to change the lives of millions for the better. We should remember that that aid is delivered through the Department for International Development. I take this opportunity to pay due credit to my former colleague in another place, Clare Short, who, when she shadowed the noble Baroness, Lady Chalker, prior to the 1997 election, ensured that the Labour Party included in its manifesto the establishment of a separate department, and then, famously and commendably, went on to serve with distinction for six years as its first Secretary of State. It was Clare Short who insisted that British aid should target those countries where people are most in need of it and where it can have the greatest impact. That is exemplified by the fact that 30% of our ODA is directed towards fragile and conflict-affected countries or regions, a policy that I very much hope will continue.
There are high returns to be had from what have been termed smart investments: the channelling of aid to projects where there will be real, sustainable outcomes. That involves investment in family planning and sexual and reproductive health and rights. As a member of the All-Party Parliamentary Group on Population, Development and Reproductive Health, that is the subject on which I want to concentrate my remarks.
The millennium development goal that has lagged behind the most in the current international development agenda is MDG 5 on maternal health. Women’s and girls’ health must be at the forefront of the post-2015 development goal agenda. The greatest proportion of ill health among women and infants is concentrated in places where health systems are weak and provision is unavailable or inadequate. Statistics for 2014 show that sexual and reproductive health services still fall well short of needs in developing regions. An estimated 225 million women who want to avoid a pregnancy are not using an effective method of contraception. Increases in contraceptive use have barely kept up with growing populations. According to the World Health Organization, of the 125 million women who give birth each year, 54 million make fewer than the minimum of four antenatal visits recommended by the WHO; 43 million do not deliver their babies in a health facility; 21 million need, but do not receive, care for major obstetric complications; 33 million have newborns who need, but again do not receive, care for postnatal health complications; and 1.5 million are living with HIV, more than one-third of whom are not receiving the antiretroviral care they need to prevent transmission of the virus to their newborns and to protect their own health.
If all women who want to avoid a pregnancy used modern contraceptives and all pregnant women and their newborns received care at the standards recommended by the WHO, the results would be dramatic, not least in terms of the transmission of HIV from mothers to newborns, which would be nearly eliminated, achieving a 93% reduction to fewer than 10,000 cases annually. According to the United Nations Population Fund, fully meeting the need for modern contraceptive services would cost $9.4 billion a year, while treating the major curable sexually transmitted infections for all women of reproductive age would cost $1.7 billion.
These investments, if made together, would bring the total cost of sexual and reproductive healthcare to something like $40 billion annually. That figure represents more than a doubling of the current cost of those services, yet it amounts to only $25 per woman of reproductive age annually, or $7 per person in the developing world. Not only would the additional investments have major health benefits, they would be cost-effective because helping women to choose the number and timing of their pregnancies makes healthcare more affordable overall. With far fewer unintended pregnancies, the cost of improving pregnancy and newborn care and preventing mother-to-child transmission of HIV becomes much lower than it would otherwise be.
Investments in sexual and reproductive health are critical for saving lives and reducing ill health among women and their children. Spending $1 for contraceptive services reduces the cost of pregnancy-related care, including care for women living with HIV, by $1.47, so over years there are real savings to be made, although the health dividends are multiplied when taking into account the wider long-term benefits for women, their partners, their families and their communities. These include increases in women’s education and earnings, increases in household savings and assets, increases in children’s schooling, increases in GDP growth and a reduction in just one thing—poverty.
I welcome the fact that all the main parties are committed to allocating the resources needed to improve the lives of people in the developing world. The Bill will perform a vital role in that task and I congratulate Mr Moore and the noble Lord, Lord Purvis, on their determination to make that happen.
Lord Steel of Aikwood (LD)
My Lords, I am proud of the fact that both the authors of the Bill, in the other place and here, are my constituency successors—Michael Moore in the House of Commons and my noble friend Lord Purvis in the Scottish Parliament. Perhaps there is something about the air in the Scottish Borders that conveys a sense of proportion. I am proud because during all the time when I was the MP there, particularly during the three elections that I was party leader, I emphasised the target of 0.7% and insisted that it went into the party manifesto. However, I simply articulated it, whereas my colleagues have had the satisfaction of not only seeing it happen but now entrenching it in legislation, and I fully support that.
A few weeks ago, I was asked to speak at a dinner in south-east London to raise money for the Ebola crisis. It was a very successful event that raised £30,000. It was in the hall of a mosque. The proceedings began with an imam reading some verses from the Koran, which of course I did not understand. However, when someone got up and gave a translation of it, I was very struck by the similarity between that passage from the Koran and the passage with which we are all familiar from St Matthew’s Gospel, which I was brought up on as a son of the manse, particularly during my father’s time in Kenya. We remember how people asked:
“Lord, when saw we thee an hungred, and fed thee? or thirsty, and gave thee drink? When saw we thee a stranger, and took thee in? or naked, and clothed thee? Or when saw we thee sick, or in prison, and came unto thee?”,
and received the answer:
“Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me”.
The point that I want to make at the start of the Bill is that there is a moral imperative that we are fulfilling today. The verses from the Koran that were read on that occasion were chapter 76, verses 9 and 10:
“And they feed, for love of Him, the poor, the orphan, and the prisoner, Saying, ‘We feed you for Allah’s pleasure only’”.
It is astonishing that, in a world where there is so much conflict between Christian and Muslim in different areas, these passages are the same in the holy books of both religions.
I stress again that there is a moral imperative, but there is also the imperative of enlightened self-interest. It cannot be right that so many people are fleeing from poverty and conflict in different parts of the world to Europe, and we must try to put that right. There is therefore self-interest in ensuring that this target is reached. A year or so ago my noble friend Lord Chidgey and I were in Malawi, working with the DfID representatives there, and we were full of admiration for what they were doing. I know that those same people will be dealing with the flood crisis that has hit that poor country so dramatically in this past week.
Yet, in some places, I have to say that DfID is sometimes accused of being interested only in rather grandiose projects—I have written to the Minister on the subject before. I was very struck by the invention of the community cooker in the Kibera slum in Nairobi; it is not photogenic but it is a wonderful community project that deserves support, yet it has not been given support by DfID. I was delighted to get an e-mail from Nairobi only yesterday saying that, where DfID had failed, the Prince’s Trust had moved in to support a project that involves the burning of rubbish and the provision of hot water and cooking facilities in the shanty towns of that great city.
We all have our own recollections and experience of seeing people working on the ground in poor countries. My own abiding memory is of talking with a woman doctor who was alone in a very poorly equipped hospital in the north of Malawi some years ago. We came to a young boy lying in a cot with a very swollen head, and she said to me, “I’m going to have to operate on this boy tomorrow, and I’ve never done anything like it”. I said, “How do you manage?”. She said, “I phoned a colleague at home who’s a specialist and they told me what I should be doing, but I’m just hoping it will go all right”. The great thing about the Bill is that it sends a message of support and comfort to all those people who work so diligently in most parts of the world, and that is another reason why I think we should support it.
Baroness Tonge (Ind LD)
My Lords, I note with amusement that I am the first of a very long list of a positive feast of noble Baronesses who are going to speak to your Lordships next in this debate; I feel very proud of that, and I hope that you enjoy us.
I warmly welcome the Bill. The Pearson commission set this target in 1968 and it has taken us a long time to get there. I am pleased to say that it was official Liberal Democrat policy and in our manifesto from 1992, five years before I became international development spokesperson for my party in the other place. For me, as for my noble friend Lord Steel, it is the right and moral thing to do. It will increase the GNP of poorer counties, if we want to be hard-headed about it, and provide more markets for our trade. Eventually it will mean that we need to give less aid and, dare I say it, reduce the need for migration by people fleeing war and poverty in their own country for a better life here. That is what I would do if that were my family—UKIP, please note.
There are three main reasons for giving aid. We can all tell stories about the need for it. We know, too, of the success of our Government’s initiative, which I must highlight, on sexual and reproductive health and rights, beginning with the family planning summit in 2012. The very welcome extra pledges there have already seen 8.4 million more women and their spouses able to plan their families and have fewer and healthier children—the first step towards a country’s rise in prosperity, as more women and girls receive education and enter the workforce. There are endless examples of good outcomes.
Despite my enthusiasm, though, I worry about the delivery of aid and the accountability of those responsible for spending our money, and I hope that the Minister will give us some reassurances today. To illustrate this, I must say, as other noble Lords have said, that I am very concerned about the failure of Sierra Leone to cope with the Ebola epidemic. We intervened and stopped that war in 2001-02. Aid projects there have expanded and I know that, in the initial years after that war, DfID was not responsible for many health projects there, as it was mainly about security and nation-building. But according to DfID’s Operational Plan 2011-2015, we are going to be doing a lot of health projects. Those finish this year, so I want to know: have they been blown off course by Ebola, and what happened before that? What sort of things were we working on? Why were no health systems set up which would have given Sierra Leone a way of coping with the epidemic, as happened in other affected west African countries? Will the Minister please tell us whether we can learn from Sierra Leone?
I have also been concerned about the short-termism of various projects which then fail when our commitment ends and we pull out. I have heard this from Governments and NGOs all over the world. We must somehow address this problem.
I am sorry to tell the Minister that it is all questions from now on. Can she tell us about the forthcoming third international conference on financing for development, to be held in Addis Ababa in July? I had a Written Answer to my recent question but I am not going to read it out because I do not want to embarrass the civil servants, as it was complete gobbledegook. I would like the Minister to tell us about what will happen at that conference.
Can we guarantee that our aid money will go where it is needed and not be diverted to middle-income countries, as happens with a lot of EU aid? I know that Clause 5 is there to give us accountability and audit. But how are we to deal with corruption in the future? This delivery of aid and the proper expenditure of money are so important if we are to keep people on side. Having mentioned the EU, we have a lot of money going into multilateral aid with the European Union. That always seems to be very slow and cumbersome, and not to be as accountable as our own aid. Perhaps the Minister could address this now or in a letter.
Despite all these questions, I am delighted that this Bill has been introduced—let me crow—thanks to the influence of Liberal Democrats in this Government. That is a rare compliment from me.
Baroness Jenkin of Kennington (Con)
My Lords, we have a long debate today, with many well informed speakers—as we so often do in this Chamber—most of whom will be saying similar things, and things that we have said in previous debates; so the temptation is simply to say, “I support the Bill. Britain and DfID lead the world, and we hope that where we lead, others will follow”, and sit down. But I must, of course, make the case.
As one of the founders and the current co-chair of the Conservative Friends of International Development, it will come as no surprise that I support the Bill. I am proud of that group’s reach and activities, including events at conference in partnership with a number of NGOs. We have had meetings with, among others, Bill Gates, Bob Geldof and, more recently, Mariella Frostrup—who, with Bill Cash, so successfully steered the International Development (Gender Equality) Act through the Commons. Like the noble Baroness, I am also proud of this Government’s approach to the issue and successes in this Parliament, building as they have on the previous Government’s achievements.
DfID has not only led the way in reaching the target but is widely regarded as a world leader. As other noble Lords have said, this year and last year have been—or will be—critical years. I pay tribute to Andrew Mitchell, the first Conservative Secretary of State for International Development in this Parliament, and to Justine Greening, the current one, as well as to their teams. I was pleased to see the Minister of State on the steps earlier. I pay tribute to these Ministers in particular for their continuing focus on women and girls, especially in term of education, as well as for the inspirational Girl Summit last year. I am grateful to them also for recognising one of my own priorities—which the noble Baroness, Lady Tonge, and the noble Lord, Lord Watson, have also mentioned—which is the importance of sexual and reproductive health and the UK’s support for women in this area so that they can space their families, which in turn leads to education, more economic activity and lifting individuals and countries out of poverty.
Despite substantial inequalities within countries, and of course globally, we should celebrate the fact that the planet is increasingly prosperous and richer than ever before. We know the results and what our aid achieves. As we have heard, our aid budget saves millions of lives every year. Our support for immunisation saves a child’s life every two minutes, and we can vaccinate children against some killer diseases for less than the cost of a cup of coffee. We have helped 10.2 million children to go to school and provided 43 million with access to clean water, better sanitation and improved hygiene. Every time we turn on the tap, flush the loo or have a shower we should remember the billions of people who still do not have access to these things.
We also lead the way in responding to humanitarian emergencies. I take this opportunity to recognise the courage and dedication not only of the department’s staff in the field but of the many NGOs which are so committed and caring. They put themselves in danger every day, and I declare my interest as a proud board member of UNICEF UK. As a patron of Restless Development I also pay tribute to the 1,700 young volunteers in Sierra Leone who have been mobilised to spread the relevant health messages about Ebola to around 3 million people, saving lives while putting their own health at risk.
Like many others I support the Bill, but not without some reservation and some concerns. I am particularly tempted by the idea of a sunset clause. However, I know that passing the Bill unamended provides our only opportunity to deliver the promise which all three parties made to the British people in their manifestos at the last general election, as well as our promise to the millions of people around the world whose lives are improved by our support. Many of the changes made in recent years to improve transparency, governance and value for money have been for the better and dramatically improved how aid money is spent. Other noble Lords have already referred to Clause 5 and explained how it will help ensure that this continues.
When we talk about taxpayers’ money, how much are we actually talking about? How much does 0.7% represent for the average taxpayer? The ONE campaign—I am delighted to see that a number of its representatives are present in the Gallery—has calculated that a person on an income of £25,000 pays £5,465 in tax, of which a little more than £50 a year goes to the aid budget. The annual contribution made by someone on average earnings is around £58 a year. Is that really so unreasonable? The developing countries of today will one day be the economic powerhouses of the world. They will remember that the aid which helped their children to go to school and was invested in their communities was delivered under the British flag. When travelling in poor countries, it always lifts my heart to see the flag declaring our support for one project or another. As a trading nation, let us enthusiastically support countries across the world develop their economies and their entrepreneurial flair so that in the not too distant future, we will be in a position to do business in places that would astonish our parents and grandparents.
In the words of the OECD:
“The UK is a recognised leader in development. This is the result of clear vision, consistent political leadership … the UK is seen as a model by other donors”.
The passing of this Bill will consolidate that position, and I urge noble Lords to resist the temptation to amend it.
Baroness Kinnock of Holyhead (Lab)
My Lords, at the outset I pay tribute to the noble Lord, Lord Purvis, and to my noble friend Lady Royall for their introduction to this debate. I also recognise, as others have done, the commitment shown by DfID to the principles raised in the debate today and, indeed, the role played by successive Labour Governments.
The reality is that we are living in an age of unprecedented human development, and we celebrate the fact that millions of people are leading a better, more fulfilled and healthy life than their parents did. On every continent, children’s lives are being saved. More are surviving infancy and are being vaccinated against deadly diseases. More are going to school and, as UNICEF and Save the Children confirm, child well-being generally has made real progress. Those who claim that “aid doesn’t work” should, to take just one of countless instances, try saying that to a mother in Africa whose children sleep safely under anti-malarial bed nets directly provided by aid. Aid does work and, as others have said, it is the smart thing to do. Hundreds of children’s lives are saved every day by these nets, paid for by aid. With that reality in mind, the argument has to be that we should do more and do better so that we succeed in underpinning what all noble Lords in this Chamber ultimately seek, which is shared prosperity and security.
The tendency has been to focus too much on income levels instead of key indicators such as health, education and the general provision of basic services. Of course we should recognise that progress has been patchy, but we must also assert that countries such as Congo and Zimbabwe are not the norm. Generally, there has been substantial progress. We must emphasise that people’s lives are longer and better because aid has enabled them to have access to income, education, social protection and better government.
For many years, the UK has been recognised as one of the world’s best and most effective donors, but we know that there is a steep hill to climb if we are to meet the MDG goals which were agreed in 2000. The achievement of full and productive employment with decent work for all, and the ambition to halve the proportion of people who suffer from hunger, has eluded us. More children are in school, but millions are not. The majority of the 58 million children not in school are girls. Gender inequality remains a major propellant of poverty and women’s marginalisation, and a basic cause of under-development.
In 1970, the UK Government committed to spending 0.7% of GNI on development, but it took 43 years for that promise to be delivered. The Bill we are debating today has not been rushed. It is simply a reflection of the generation-old commitment made by one of the world’s richest countries to the world’s poorest people.
The Bill is vital because it is the final opportunity to deliver the 2010 manifesto promises of our three parties, as well as the coalition agreement. In addition, it sends a signal to other developed countries that they, too, must meet their aid targets. Demonstrating our commitment by legislating is a wise, timely and excellent initiative. It will serve to protect the aid budget and increase predictability and accountability. It will also confirm our support for the 97.5% of MPs who were elected on manifestos that supported legislation or have adopted the policy in this Parliament.
Honouring our pledges is the right thing to do because we share an interest in joining together in a world that is stable and secure, with an educated and healthy population. We should applaud the cross-party commitment to keeping our promises to the world’s poorest people. If we take steps to pass the Bill in the remaining time of this Parliament, it will send a strong signal in 2015, which is such an important year for development. All three parties made a commitment in 2010 to enshrine the aid level of 0.7% of GNI, but it has taken five years to put that consensus into practice. It is now time to show that we can and will work together for the greater good.
Baroness Williams of Crosby (LD)
My Lords, I echo the words of the noble Baroness, Lady Kinnock, in paying tribute to all three parties for what they have done about aid. In particular, I add one name: that of the noble Baroness, Lady Chalker, who I believe persuaded the Conservative Party to become a great champion of aid and changed a great many attitudes by the work she did. She deserves our tribute for that.
I will deal with just two issues, because obviously time is short. The first is the issue of partnership, which was raised by the noble Viscount, Lord Astor, and my noble friend Lady Falkner. One of the ways in which we can most effectively use the Bill is by recognising that there should be in middle-income countries a commitment of partnership towards what is sometimes called in churches, “the option for the poor”. I am thinking about a country such as India, which has now moved statistically into the middle-income group, but which, as many of us know, has huge inequalities and vast areas of poverty, as is also true of China. We need to mobilise, perhaps through the Commonwealth, the concept of joint responsibility; of more partnership between the countries that receive aid for their fellow citizens and those like us who contribute it.
I will give as an example one instance with which I happen to be associated, and which I declare as an interest: namely, the huge efforts being made for continuing and lasting assistance through economic development, for example in northern India. I have in mind a charity called Seva Mandir, which attracted very large sums of money from wealthy and middle-income Indian groups for the sustaining of the concept of rebuilding the old Rajasthan forest, including huge efforts to reforest and to involve children at school in looking after saplings that are handed out to them, which they then become responsible for—the tree almost becoming a kind of pet.
That means that whole communities become committed to rebuilding their own economies, and do so by involving children and young people—and not least, by the by, do so by exchanges of young people from this country and elsewhere, who work alongside their Indian colleagues for months at a time in that effort. The concept of using the growing knowledge of our own schoolchildren and university students in taking part in the physical rebuilding of many of the poorest communities is one which will help to give us a lasting international sense.
The second thing I will mention quickly was raised by the noble and right reverend Lord, Lord Williams of Oystermouth, which is the huge and growing challenge of anarchy in certain parts of the world. We need to recognise that bodies such as ISIL build upon a sense of hopelessness among young people. Again, the Commonwealth could do much more here to associate attempts to rebuild economies that are in desperate plight, and sometimes states that have broken down, by associating us together in a constructive—one might almost say a Marshall plan—approach in some of those desperate countries. South Sudan is one example; tragically, Nigeria is increasingly becoming another.
I have long felt that we do not use the resources we have in the Commonwealth to present good alternatives to some of the areas under the greatest pressure of all. That pressure reminds one, sadly, of the famous lines from the great Irish poet Mr Yeats, who said, as noble Lords may remember:
“The best lack all conviction, while the worst
Are full of passionate intensity”.
The noble and right reverend Lord, Lord Williams of Oystermouth, was absolutely right in saying that we need to work much more widely between departments —and I include in that the FCO, the Ministry of Defence and others—in offering constructive alternatives to the terrible spread of anarchy in our world, and that we should address that as part of our objective of building up the link between ourselves and these other countries.
Finally, it is very important that we recognise that countries which are themselves poor often have an amazing amount to contribute, and we do not recognise that contribution if we are too patriarchal and imperial in our approaches. Therefore, let us say, here and now, that we will use aid not only to credit ourselves for acts of generosity and imagination but to elicit from other countries, including poor countries, the huge contribution they themselves can make once there is a sense of hope for them to build on.
Baroness Flather (CB)
My Lords, this is an unusual debate, because a lot of the speeches have filled me with a warm glow—we do not get that very often. I thank the noble Lord, Lord Purvis of Tweed. He made a wonderful speech, which made clear what we were aiming for. I felt proud, and many noble Lords have already said that they felt proud today. It is a cause for pride that we are the only country among the G8 countries that has accepted this 0.7% target for aid, and the only one that has met it. I think that we need to be proud.
There has been some talk about tying ourselves up, but surely every Act of Parliament ties Parliament up in some way—and, if we do not like it, another time we can change it. I thought that that was normal practice. It does not mean that you do not do something because you are tying the future of the country; you are not tying the country's future because, if it is not working and if we get very poor, no doubt we will come here again and say, “We can’t do it”. So let us not go down that route at all.
I shall say a very few things. First, people have said that aid should be spent properly. Well, naturally it should be spent properly—and, if it is not spent properly, we should change the people who are in charge. This is almost not necessary to say, that aid should be properly directed and targeted and spent. That goes without saying.
Quite a lot of things are being said about India, which is my country of origin. I go there every year and I see what is going on. Yes, things have improved for some people. Even those who are not now starving are really not in a very good place. People who have, say, a salary of 10,000 or 12,000 rupees a month find it very difficult to keep a family because of inflation. So let us not get carried away and say that a huge number of people are doing very well. In fact, half of India is on the poverty line—and I do not know where people draw the poverty line, but in India it is pretty low.
When Christine Lagarde gave her Richard Dimbleby lecture, she said that Indian billionaires could wipe out India’s poverty just like that, if they wanted to. One of the most upsetting and hurtful things to me is that they do not give. India has now passed a law that 2% of net profits of a company must be put into corporate social responsibility. What is going to happen? A lot of Indian companies will create something, and then it will disappear or be for their own benefit. This has been going on for a long time. For tax reasons, they have created foundations from which they redraw the money for themselves. It is really appalling.
We have mentioned corruption—well, corruption is endemic in India and Africa. One of the biggest problems that they face is corruption, because nothing can get done if three-quarters or more of the people—everybody who has the opportunity—take something out. That is something to be watched. Something else that needs to be watched is the Commonwealth. We talk about it as if it was some kind of a dream, because it is not real. The two things that are most important are having no corruption and having rule of law. No country can have democracy or do well without the rule of law, and almost every country now has judges who are under the control of the Government. That is an extremely serious and worrying aspect and, if we can do anything about it, we should do it.
Quite a lot has been said about women, yet not enough. Women are half of the world’s population and they are certainly the poorest of the poor. Why? It is because men hold all that is going—they have control of money and over the bodies and lives of women. It is not as though the women are individual human beings, as we imagine. They are not; they are part of a man’s chattel. That has not changed, and we need to do far more than we are doing for women. And we need to do far more for that elephant in the room—I know that that is a cliché but it fits in this case—family planning. The world is drowning under the increase in population. However much aid we give, however is it going to meet the needs of the increasing population? Unless we do something about it, we are not going to reach any targets.
My Nigerian friend says that, since men are so lazy, if it had been only a little more difficult to create a baby, they would not have done it. But, unfortunately, it is ever so easy. They will have children and they are proud of it. They say, “I am father of 10 children”. “Do you ever feed them?” No, they do not feed them —they just create them.
Baroness Hodgson of Abinger (Con)
My Lords, we have heard many excellent contributions, starting with the wonderfully comprehensive introduction by the noble Lord, Lord Purvis, which was followed by many other outstanding contributions. I, too, am delighted to speak today and am proud of our Government’s commitment to deliver 0.7% of our gross national income as official development assistance—the first G8 country to do so. As a DfID spokeswoman said:
“Investing in overseas development is creating a world that is healthier, more stable and increasingly prosperous. This is something Britain can be proud of”.
Tackling poverty overseas means tackling the root causes of numerous global challenges, such as disease, drugs, migration, terrorism and climate change, which are ultimately interconnected with us in Britain and the developed world. Aid assists with long-term economic growth and stability, helping to build new economies and potential trading partners for the future. Through working in fragile and post-conflict states, UK aid is also helping to protect the national security of our country. Many of these points have already been made, but, when visiting countries, I have seen the difference that our aid can make in so many ways.
We have heard the relevant figures for what DfID aid has achieved in giving people access to clean water and better sanitation, supporting children to go to school, ensuring safe births and reaching people with emergency food assistance. Where humanitarian disasters occur, the UK is a world leader, whether responding to Ebola in Sierra Leone, the people of Iraq fleeing from ISIL, the humanitarian crisis in Syria or those affected by the typhoon in the Philippines. These are truly impressive achievements and mean the difference between life and death for so many.
While a few may question the necessity for this Bill, legislating to oblige this country to maintain the current level of investment will ensure that we continue to build on this progress. There is no doubt that some people resent public money being diverted overseas, especially in times of austerity when cuts have had to be made at home. However, as the Prime Minister said:
“We are the kind of people who believe in doing what is right. We accept the moral case for keeping our promises to the world’s poorest—even when we face challenges at home”.
As we have heard, we should not forget that the commitment to spend 0.7% is an international agreement, originally set by the United Nations, and that we are one of five countries that have achieved this.
As has been highlighted, our Government have a responsibility to British taxpayers to make sure that we get the best value for every pound that we spend. During the past five years, tough steps have had to be taken, cutting the number of countries that receive aid, tightening financial controls, cutting administrative costs and focusing on value for money. Transparency is key to building and maintaining public support. DfID was ranked the top bilateral donor in the 2014 Aid Transparency Index, with the department’s online development tracker allowing users to trace the delivery of aid from donor to beneficiary. By driving value for money and improved transparency, it ensures that UK aid goes where it is most needed and where it will deliver the very best results for taxpayers’ money.
Across the developing world, women and girls continue to bear a disproportionate burden of poverty and, as we have heard, are the poorest of the poor. By putting them at the heart of development through working to help girls get through secondary school and tackling violence against women and girls, DfID enables them to have greater choice in their lives. The Girl Summit last July demonstrated the UK’s commitment to eliminating FGM and early and forced marriage for ever. The UK’s ending sexual violence in conflict initiative has led the way to force the world to take notice of this crime, with 155 nations having signed the declaration at the UN.
This is a very significant year for development. The UK has led the global debate on what should replace the millennium development goals when they expire. Although the number of people living in extreme poverty has halved since 1990, globally 1 billion people still struggle to survive on less than $1.25 a day. Therefore, this Bill is crucial. It sends a signal to those in developing countries that we are committed to keeping our promise to them and to other developed countries that they, too, must keep their promises and follow our lead. I am pleased to support the Bill.
Lord Davies of Stamford (Lab)
My Lords, I endorse the very fine tributes given by the noble Lords, Lord Fowler and Lord Tugendhat, to Leon Brittan. Being from a slightly different generation, I was not as close to him as they were, but I always regarded him as a friend and I have, and will always have, the greatest affection and admiration for him.
The last thing that I want to do today is to make a party-political point. However, and I put it no more strongly than this, I am genuinely mystified that this measure—the Government support it, I believe, with complete sincerity—was not only in their manifesto, as it was in all our manifestos, but in their first Queen’s Speech and they have done nothing about it at all until the last few months of the Parliament. Even then, it came forward not as a government measure but as a Private Member’s Bill, with all the constraints that that entails. I am just mystified to know why that has happened and, when the Minister sums up, I would love her to explain to us why we find ourselves in that position today.
I pay tribute to my noble friend Lord Lipsey and to the noble Lord, Lord Tugendhat, for having had the courage to go somewhat against the current this morning in arguing against the Bill. There is no question at all but that it presents some remarkable anomalies and some problematic aspects and I think that we would be failing in our duty if we did not engage with them thoroughly.
It is not normal practice to decide arbitrarily to spend a certain amount of money in a certain area without knowing what you are going to purchase. That is not the way that budgeting or financial governance is taught in any business school or, indeed, in any graduate school of public administration. As has been said, there is a real danger of distortion when you hypothecate certain elements in public spending. I might add to that a point that has already been made this morning: if you do that often enough, it becomes impossible to pursue any stabilisation policy. If the economy grows above trend, you suddenly find that, because GDP goes up, you are required to increase government spending and may be adding to overheating in the economy. That would be very perverse.
What worries me most about the Bill is almost the inevitability that if you place on a bureaucracy and on a Minister the obligation to spend a certain amount of money by a certain deadline, you will induce the operation of the law of diminishing returns and the productivity of that spending will fall. That worries me considerably.
However, unlike my noble friend Lord Lipsey and the noble Lord, Lord Tugendhat, and despite all those reservations and very genuine concerns, I support the Bill. It is essential to do something. First and foremost is the need to make a contribution to relieve the appalling human suffering that exists in the third world today. Some of the examples given by the noble Lord, Lord Chidgey, were deeply moving. Secondly, as an earnest of our sincerity, we need to do something about the worrying levels of inequality in the world today. Thirdly, as a subsidiary consideration, we need to take action for the sake of the credibility of the British political system. If all three major parties have committed themselves to doing something and they do not do it by the end of the Parliament, that will undermine public credibility in our whole system. Therefore, I support the Bill, despite all the reservations that I have set out.
However, I want to propose three safeguards. First, we must strengthen the audit controls that we have in place, particularly because there will almost certainly be a greater degree of mis-spending than in the past. I have no confidence at all—indeed, I think that the Economic Affairs Committee had no confidence at all; it said as much—in the DfID statement that in the last year for which it had figures, which I think was 2011-12, only £1 million of its budget was mis-spent or wasted, having been subject to fraud, corruption or what have you. That is completely non-credible and I think that DfID is deceiving itself. Whether by strengthening Clause 5, if we have the opportunity to do that, or by some other means, we need greatly to improve our financial controls.
Secondly, I am concerned about budget support. It inevitably increases the power and influence of the existing Government and bureaucracy in the country that receives it. Where you have a democratic, incorrupt Government and state pursuing rational economic policies, budgetary support is a thoroughly good thing—the Government are part of the solution, not part of the problem. All too often, however, as noble Lords know, that is not the case. We should make it a principle that we will not provide budget support to states that are single-party dictatorships. We are supplying budget support to Vietnam, which is a colossal mistake, and we should not be doing that. There are other examples that we should look at carefully. I should like a much more critical view to be taken of the candidates eligible in this world for budgetary support.
Thirdly, if we are to enhance the productivity of our spending on aid and to secure the achievement of the aims that we all hold so dear in spending this money in what is admittedly a very anomalous way—a salient exception to our normal way of doing things—it is essential to have regular audit review meetings with the recipients of the aid under budget support, those who are taking the decisions in the country concerned as to the allocation of funds in the sector that we are supporting.
No decision-takers in any bureaucracy in the world have the time to get involved in detailed discussions of that kind with 10, 12 or 15 separate people. In practice, they can at best manage with three. The three who will be chosen will be the EU, the biggest provider of aid in the world, USAID and the World Bank. If we are to have any influence we need to remain fully committed to the EU programmes and, even when we have national programmes in addition to the EU programme, to concert with our EU partners in having those review meetings. Otherwise, we shall not have the leverage and influence that we need and shall need increasingly as the sums that the British taxpayer expends on this thoroughly worthwhile cause increase.
Lord Fox (LD) (Maiden Speech)
My Lords, time constraints have spared noble Lords from the lengthy maiden speech of my imagination. First, I thank your Lordships for the warm and inclusive welcome that I have been given, which I will work hard to justify. I would highlight my noble friends Lord McNally and Lady Northover who kindly acted as my supporters, alongside Black Rod and Garter King of Arms, and their teams, who helped to make my introduction so enjoyable and smooth. I thank them for that. Finally, I thank the doorkeepers who continue to tolerate my transgressions.
I grew up in an agricultural environment in and around Leominster in Herefordshire. After graduating from Imperial College, London, the majority of my career has been spent working in international engineering and manufacturing, latterly with several UK-based global businesses. It is through the prism of that experience that I hope to engage with your Lordships’ House. I declare my interest as an employee of GKN plc and a shareholder of Smiths Group plc, both of which derive a small proportion of their sales income from developing countries.
Noble Lords will be aware that the lifeblood of engineering and manufacturing is a long-term commitment to investment. In my business experience, project cycles vary from a matter of years to decades. Often, products come on stream well after the people initiating the project have moved on and ever see the results. The projects of today are built on the decisions of the predecessors, which is what we are considering today.
I know that the international development world often shrinks from business comparison but for development aims to be met and for the aims to be firmly embedded, the principle is very similar. Project commitment needs to be long term. We have heard many speeches that made that point. The noble Baroness, Lady Chalker, eloquently described the need for a long-term approach. This Bill helps to make that long-termism possible. My colleague from another place, Michael Moore MP, is to be congratulated on shepherding the Bill to this stage. My noble friend Lord Purvis of Tweed also should be congratulated on the eloquent way in which he introduced it here.
Clause 5 mandates independent evaluation and reporting. We have heard many speeches setting out its importance, which I endorse. For international development to have a public writ, its work needs to be seen to be effective, as well as being effective. I agree with my noble friend Lord Shipley that auditing is vital. For audits to be possible, we have to be clear about the purpose of each of the projects, and what we are seeking to achieve. We have work to do on that.
As we have heard, well managed engagement helps to create a healthier and more stable world—a world where target communities are increasingly plugged in internationally and where individuals are more able to live life to the full. As the noble Baroness, Lady Royall, set out, raising living standards may one day raise the capacity of individuals to become consumers of UK products—and there is no shame in us wishing for and acknowledging that. Yet we have also heard that the stakes are much higher, and today the signs of those stakes could not be clearer. The evidence of what happens in political and moral vacuums is obvious to millions of people whose lives are being made a misery by those vacuums. Meanwhile, the threat of an international medical pandemic is also clear and obvious to all of us. These are reasons enough for promoting a long-term commitment to engage in development work.
We often hear that Britain punches above her weight. I would question the sporting wisdom of doing that for too long, but I interpret it as an aspiration that the UK should maintain its international significance. I share that aspiration. Inconsistently, many of those who urge us to keep punching are also seeking to slim down the international development budget and to shrink from many elements of internationalism and global co-operation. I suggest that they are seeking to create a Britain with less weight. If successful, this would reduce our significance. On the other hand, a well planned programme of sustained international development adds to our national gravity, communicates our values, internally and externally, and makes us stronger. I support the Bill.
Baroness Hooper (Con)
My Lords, it is a great pleasure to voice the congratulations and welcome of the whole House on the excellent maiden speech of my noble friend Lord Fox. His background and successful career in industry—and in communications in particular —mean that his contributions to our debates will be practical, well informed and persuasive, as was his speech today. We look forward to hearing from him on many occasions in the future.
I also wish to associate myself with the tribute paid by my noble friend Lord Fowler to the late Lord Brittan, whom, I, too have known as a contemporary since university days.
I support all that has been said concerning the purpose of the Bill and the need to embed the spending target in law to ensure that the commitment that has been made by this Government will be continued into the long-term future, as my noble friend Lady Chalker explained. I am proud that we are one of the few countries to have complied with the target, and I certainly feel the warm glow that was referred to by the noble Baroness, Lady Flather.
Much has already been said about the importance of development assistance, and examples of projects and success stories in many parts of the world have been quoted. I congratulate the noble Lord, Lord Purvis of Tweed, on his lead and on his splendidly comprehensive introduction. I do not need, therefore, to underline the importance of clean water, emergency food assistance, education, access to financial services or the health benefits brought by this funding and the work of NGOs in the field, save only to highlight the example of the fight against malaria. Deaths of young children in Africa have more than halved since 2000. This work must be sustained.
The economic development and the welfare of developing countries are of prime importance in today’s world of interdependence. Ethical and humanitarian considerations apart, it is plain common sense to try to help people and countries to avoid catastrophe and to build themselves up to be economically, as well as politically, independent.
Of course I acknowledge the need for precautions voiced by my noble friend Lord Tugendhat in particular. Of course there must be good, clear and transparent administration of any fund, but the problem of economic refugees taking dangerous means to transport themselves to developed countries has to be averted. If all European Union countries met the 0.7% target, that would make a huge difference to the countries of, for example, sub-Saharan Africa, and prevent some of the tragedies and loss of life resulting from the attempts made by the poorest of people to reach European shores in order to find jobs and security.
I recognise that the part of the world with which I am most involved—Latin America—is outside the overseas development funding criteria. Most countries are now considered to be middle-income or high-income countries. The noble Lord, Lord Cashman, made some important points about this. I assume that it was as a result of the peer review process. I also recognise that some funding to that region may get through on a multilateral basis via the European Union, the IMF and other agencies.
However, there are still pockets of poverty—others have mentioned this—even in the middle-income and high-income countries. There is an issue over the waste and hardship caused when existing country programmes are terminated—or were terminated in the case of Latin American countries—abruptly. Will the Minister tell us whether any direct funding still goes to any Latin American country? Is any thought being given to creating a smoother transitional arrangement for projects in countries that are deemed no longer to require official development assistance?
In general, I hope that the United Kingdom will continue to give a lead in this area and work to persuade other countries in the European Union and, indeed, in the Commonwealth—I think of Canada, Australia, New Zealand and India—to reach the targets. My noble friend Lady Williams of Crosby made some very interesting suggestions in this respect which merit further exploration. The passing of this Bill and the arguments and ideas put forward in today’s debate will, I hope, help to ensure this, and I feel confident that it will have a safe and successful passage through your Lordships’ House.
Lord Judd (Lab)
My Lords, I declare an interest as someone who has worked most of my life outside the confines of Westminster in the spheres which we are discussing today. In particular, I should mention that I am a former director of Oxfam and am currently a trustee of Saferworld. I learnt a great deal from that, and I have very many vivid memories. As I listened to the very significant speech by the noble and right reverend Lord, Lord Williams, I recalled once standing in the middle of a refugee camp in the middle of Mozambique’s terrible civil war. It was only possible to reach it by air because the fighting was too serious all round it. People were coming into that camp having walked for days. I remember one family which days previously had seen their child chopped to death and thrown into their house to be burnt with the house. The indelible memory that I brought from that experience was that they were not asking just for blankets or food. Very early in their time in that centre they were asking for spades, watering cans and the implements necessary to grow their own food.
The thing that we should all remember is that we are not talking about us fulfilling our responsibilities to the world, or what we can give to the world; we are talking about participating to the degree that we should be in the privilege of working with people who, in the face of such adversity, show so much courage and so much determination to build their own lives. It really is a privilege for this nation to be able to support such people, and if the Bill is going to help in that respect it deserves the support of us all.
I have been impressed by the quality of the speeches. The speech by the noble Lord, Lord Purvis, introducing the Bill was outstanding—I think that the noble Lord, Lord Purvis, is a good thing in this House. I would also like to say how glad I was to hear the maiden speech by the noble Lord, Lord Fox, which augurs well for his contributions in future. One of the things that has come out of the debate is that we are concerned not just about quantity but about quality and effectiveness. I was glad to hear my noble friend Lady Royall again give a very committed and—as I always find—effective speech, making it absolutely plain that our support on this side of the House for the Bill and all that it talks about is not rhetorical. It is real.
One of the things which I take great joy from is the very serious work that I know has been going on in the leadership and in many other quarters of my own party as to how we should approach this in office. I am glad that we are committed, among our priorities, to reduce inequality, to push action to tackle climate change—which is disproportionately affecting the poor of the world—to support the introduction of universal healthcare across the world, to improve working conditions throughout the world, and to crack down on tax evasion and help developing countries build their own tax collection infrastructure. I would add only that education and building human resources are crucial, so that we can have good-quality public administration based on good education and integrity.
We also want security sector reform, so that security systems in the countries concerned do not alienate people but win their confidence and support so that, together, stability is being built. We also need to put some muscle into our frequent oral commitments to the rule of law and justice across the world, which has been referred to. The rule of law and justice do not come cheaply: if we want to see the rule of law and justice, we have to be prepared to pay for them. That means making sure that the lawyers are there, that the judges are of the necessary integrity—the noble Baroness, Lady Flather, referred to this—and that the facilities for courts to work effectively are there. If not, we just deceive ourselves and frustrate people across the world, and they just see it as a sort of refrain on our part that we must have the rule of law.
The other thing I believe is that we need to strengthen still further the control of the arms trade. This, I think, is crucial, because if I take away one overriding memory of the frustration in my time as director of Oxfam—going back a number of years in my life now—it is that we wanted to get on with sustained, long-term development but, all the time, were being frustrated by conflict. The irresponsible, easy availability of arms across the world is still a disaster.
Baroness Suttie (LD)
My Lords, I, too, congratulate my noble friend Lord Purvis on his truly exemplary speech. I agree with the noble Lord, Lord Judd, that he is indeed a very good thing. I also congratulate my noble friend Lord Fox on his wonderful maiden speech and I look forward very much to working with him in future.
It is a genuine pleasure to speak in a debate in which there has been so much consensus. The journey to this point has been made possible because of the support of all the mainstream parties—the previous Government as well as the current coalition. The NGOs have played an absolutely vital role, as have charities and religious organisations. To have achieved the internationally agreed target of 0.7% is a cause for celebration. As many have also already said, it is a chance for Britain to demonstrate real leadership on the world stage—to fight against poverty, ignorance and disease across our increasingly interconnected world.
However, we cannot be complacent. Our country has a proud history of supporting aid but the case for aid has to be constantly made and refreshed for each new generation, especially at times of economic crisis and global insecurity, when there is a tendency to retreat inwards towards nationalism and insularity. We constantly need to restate the case that helping a nation and a people to help themselves, and assisting in the prevention of economic or environmental disasters before they develop into global crises, make sense for all concerned, donor and recipient alike. This is particularly true when it comes to health and disease prevention. In our increasingly globalised world, disease can travel extremely quickly, as we have seen most recently with Ebola but is also the case with less publicised infectious diseases such as TB, particularly multidrug-resistant TB.
Last February, I had the privilege to go in a cross-party delegation to Cambodia with Results UK to look at several projects where British aid has made a significant impact. One particular visit stands out for me: we visited a child vaccination project in a hospital in the outskirts of Phnom Penh, where we saw mothers and grandmothers proudly queuing up with their vaccination passbooks for their children and grandchildren. One grandmother we spoke to said that it was such incredible progress to see several previously fatal infectious diseases—childhood killers—being eradicated from her country.
According to the World Bank, Cambodia has exceeded the millennium development goal poverty target and is now one of the best performers in poverty reduction worldwide. In many ways, Cambodia is a success story for international aid. The country has benefited from assistance from many countries and is now much more self-sufficient. Although the UK bilateral aid programme has now ended, UK funding is still incredibly important through the big global “basket funds” for vaccinations, AIDS, TB and other programmes.
One area where particularly good progress has been made is in the vaccination rate: 10 years ago only 60% of children were being reached by vaccinations in Cambodia; today the coverage has gone up to 95%. The immunisation programme is an example of effective pooling of funds in a global pot. The Global Alliance for Vaccines and Immunization—GAVI—supports the poorest countries with the cost of vaccines. As the economies of the recipient countries improve, they will gradually pay an increasing percentage themselves. The coalition Government are a major supporter of GAVI: DfID has been the largest global contributor during the past five years and I am delighted that this is to be continued for the next five years.
I conclude by restating the case for the Bill. First, it will make aid predictable for recipient countries and so improve the capacity to make intelligent long-term investments. Increasing the predictability of aid will greatly help service providers plan their projects more effectively in both the short and long term. This will allow for effective prioritisation and significantly improve the quality of UK aid. As the noble Lord, Lord McConnell, said so powerfully, the Bill will also help shift the debate from the quantity to the quality of development aid. The focus can therefore shift to the quality of aid investment and how best to get value from it. This should help address a key concern of the public, who ultimately want to see the best value for UK aid.
By passing this Bill, we are a step closer to ensuring that developing countries can reach their full potential and achieve self-reliance in the long term. When Bill Gates made his excellent speech to us at the end of last year, he stressed that the ultimate aim of aid had to be the successful transition from recipient status to self-sufficiency. He said that we should aim for a world where nations and individuals are able to chart their own course and attain their own destiny, unburdened by disease or extreme poverty. I believe that this Bill, with strong UK leadership to encourage other nations to follow suit, will help us to achieve this objective.
Baroness Uddin (Non-Afl)
My Lords, I congratulate the noble Lord, Lord Fox, and welcome him to the House. In doing so, perhaps I may take the liberty of expressing my long-standing admiration for the noble Lord, Lord Judd. He, too, has been a very good thing for the House.
I congratulate the noble Lord, Lord Purvis of Tweed, on his impassioned introduction and my noble friend Lady Royall on setting out our historic track record in international development work. I have little to add to the expertise of the noble Lord except to say that I support the Bill becoming law. Legislating will bind the cross-party consensus and set an international benchmark for others to consider.
Whatever the political context of their relationship with the British Government, many developing countries have understood and valued the work of DfID, which has trailblazed in progressing and championing maternal health, reproductive rights, education, clean water, post-conflict reconstruction and increasing women’s economic independence. Of course, that success comes from well established partnerships.
Notwithstanding today’s ever growing uncertainties, British aid has been ever present across the globe, developing with NGOs and Governments alike a vision of a healthy and equitable society. I believe that our persistence has inspired and encouraged other donors. The statistics for success are staggering in many parts of the world. Some excellent examples of DfID’s work are cited in the report produced by the Africa All-Party Parliamentary Group, Democracy Soup. I was able to make a small contribution alongside other notable Members of this House to the evidence-gathering and to several round-table discussions with parliamentarians and experts working in the field in Africa. I also had the privilege of working with DfID alongside the NGO sector post-Cyclone Sidr in Bangladesh, where hundreds of thousands of people lost everything to nature. DfID responded to the humanitarian catastrophe, working alongside Save the Children, Christian Aid, Oxfam, Islamic Relief and Muslim Aid. In both those instances, the respect with which the presence of DfID is held in developing countries was evident.
I draw your Lordships’ attention to two specific aspects of DfID’s work: first, the continued commitment of the British Government to the people of Palestine through DfID, which has exceeded £350 million during the past five years, must be commended. It remains one of the largest donors in support of Gaza—as mothers and children begin their journey towards survival—since the brutal assault by the Israeli forces last summer. Here, DfID alone cannot begin to compensate for the loss of livelihood and damage inflicted to infrastructure. I hope that our ongoing financial commitments and expertise will encourage other donors speedily to give attention to this critical situation.
Secondly, I agree with other noble Lords that surely the best work of DfID is its commitment to the advancement of the economic independence of women—I refer in particular to preventing sexual violence across the globe. Such commitment is rooted as an integral part of its value. It has been ongoing over decades, ably picked up and led by the former Foreign Secretary. The Minister will be aware of my long-standing campaign for justice for women in Bangladesh who were raped as a weapon of war in the war of independence. Survivors have since languished over decades, neglected by all parts of society, including their families. However, due to the campaign of the NGOs, the leadership of our Foreign Secretary and the work of some British Bangladeshi women campaigners, the remaining survivors have finally been given national recognition and the status of freedom fighters. This is massively significant, not least for the women survivors, many of whom have endured decades of punishment for crimes that others perpetrated on their bodies and well-being. Will the Minister take this opportunity to congratulate the women campaigners and the Bangladeshi Government on not only being one of the 130 signatories but also issuing directives to provide monthly allowances for all remaining survivors throughout their lives? Does she agree that this is a model of good practice for other countries to follow if we are to begin reparations for those women who survive rape in conflict?
Today’s historic step in legislating our financial commitment has strong roots, emanating from the noble Baronesses, Lady Chalker and Lady Amos, Clare Short and Andrew Mitchell. It is now in the capable hands of Justine Greening. I salute their work and that of the DfID teams across the world in supporting this Bill.
Baroness Barker (LD)
My Lords, to be speaker No. 33 on a day such as this, when we have had the privilege of listening to so many outstanding speeches, is a tough call. It would be invidious to highlight too many individual speeches, but I pay tribute to my noble friend Lord Purvis of Tweed for the way in which he introduced the debate and to my noble friend Lord Fox. Making a maiden speech in a Chamber full of noble Lords as knowledgeable as your Lordships is never easy and I thought he carried that off with great aplomb.
I return to the one speech from today that really went to the heart of our debate: the speech of the noble Lord, Lord Lipsey. It will horrify the noble Lord that, not for the first time, he and I have been thinking upon the same lines. He posed the question, “Why put this target into law?”, and drew the analogy with our domestic commitments to health and social care in spending on the NHS. I had been thinking upon exactly the same lines. He is right in his analogy. If one goes back and looks at the debates held in another place, some of those speeches might seem slightly reckless. They were full of the rather populist statement, “Why should we put international aid spending into law? Why not put a percentage into defence spending?”. It is exactly the same argument.
International aid is a very difficult and complex subject to explain domestically. It deals with issues that are largely endemic and have often been considered intractable in countries that are far away, issues which often disproportionately affect those parts of the population most demonised and marginalised. The mechanisms for resolving those issues are really complex. It is a Sun headline-writer’s dream. That is the very reason we should be bold and say we are willing to make this commitment today. We know and understand that the issues with which we are dealing are international issues.
As noble Lords know, I come from a health background. Public health is now an international matter. Tackling HIV and AIDS, malaria and resistance to TB and antibiotics can no longer be done on a country-by-country basis. The noble Lord, Lord Fowler, and I attended a dinner a few weeks ago where a British research scientist, whose work is underpinned by international aid, sat and told us without any hesitation whatever that we will not conquer these diseases unless we do research in those countries abroad. The funding for that research will not come entirely from the private sector. It will come from partnerships between Governments, international funds and the private sector. We have a record in the past 10 to 15 years of driving the efficiency and effectiveness of those bodies in furthering that research—a record of which we should be proud, but for which we get very little recognition.
Another point has been made which has not yet been answered. It has been asked whether we will tie the hands of future Governments. No, we will not, but we will require of a future Government that, if they wish to overturn this legislation, they will have to make their case in a manifesto and come to Parliament to explain it, just as we have been putting forward our case today. I think that that would be no bad thing. As other speakers have alluded to, in times of austerity it is extremely easy to become very narrowly focused and to make very cheap and obvious points. This is a hard sell for an investment which is difficult and may take many years to come to fruition, but it is an investment which matters as much to the generation of people whom I care about in this country—the young people whom I know and meet every day—as it does to those most marginalised people in some of the poorest countries on earth.
What we are doing today is not popular—it is certainly not populist—but it is the wise and right thing to do, and we should do it without delay.
Lord Collins of Highbury (Lab)
My Lords, I, too, congratulate the noble Lord, Lord Purvis, on bringing forward the Bill, and Michael Moore on introducing it in the other place. It is vital that we debate these issues and have a full and frank exchange of opinions. As the noble Baroness, Lady Jenkin, and my noble friends said, it is worth remembering that the provisions of the Bill featured in all three party manifestos and in the coalition agreement. All sides of this House passionately support the legislation. I also welcome the noble Lord, Lord Fox, to the House and congratulate him on his excellent maiden speech, which made the points that are at the heart of the matter.
For many here today, the Bill marks a point in a journey that can be traced back through the establishment of the Department for International Development by the incoming Labour government in 1997 and the adoption of the target by the Government back in 1974. It is a long journey, as many noble Lords have pointed out. I congratulate my noble friend Lord Judd on being on that journey all the way. He has been a fantastic advocate for the past 45 years.
As we have heard, the Bill will be a catalyst to action by other countries as, this year, the world agrees the sustainable development goals and how we can end global poverty over the next 15 years. For me, development is about tackling the imbalance of power—politically, economically and socially. Labour’s vision for development tackles that imbalance by expanding freedoms as well as signing cheques, measuring success by the change that we make, not the cash that we put in.
Too often, people say that there is a choice between the interests of rich countries and of those in the developing world, but improving tax fairness benefits both the developed and the developing world. All of us, rich or poor, will be affected by climate change. It might seem that the powerful and the powerless live in different worlds, but it is one planet and we need to change how it is run. Our global contract with the developing countries needs to reflect that.
As many noble Lords have said in this debate, passing the Bill means that the question becomes less about how much we spend and more about how we spend it. As the noble Lord, Lord Shipley, highlighted, it is right to ask whether a larger development budget can be delivered by an ever smaller department. There are real worries that, in a bid to cut costs, the department has kept the bureaucracy but is losing some expertise and, with that, the ability to lead.
Your Lordships’ Economic Affairs Committee questioned the effectiveness of the target, saying that,
“the speed of the planned increase risks reducing the quality, value for money and accountability of the aid programme”,
as we have heard in this debate. I do not see the primary point of DfID as simply distributing aid; rather, it is to help to change the world by redistributing power, as my noble friend Lord Judd said. As the aid budget rises, so must our ability to control it. That is why Labour strongly supports the Independent Commission for Aid Impact. Value for money should mean maximising the impact that we make. When a budget as important as this is ring-fenced, there is a fiscal responsibility and a moral duty to deliver as much change as possible for the money that we invest, and the sort of value for money is crucial.
As my noble friend Lady Kinnock said, aid and development work; development changes and saves lives. Life expectancy is rising while preventable deaths are falling. More children are in school while fewer mothers die in childbirth. Literacy is storming ahead while polio is mostly in retreat. This is all in part because of aid and international development efforts across the world.
As, again, we have heard in this debate, development is also in Britain’s best interests. Britain invests in development to prevent extreme poverty, climate change and conflict. Retreating from that responsibility one way or another will still carry a cost, as the noble Lord, Lord Steel, said. The way to eliminate that cost is to tackle it at source. The UK would be immeasurably better off growing and trading with a strong global economy, with a sustainable climate, supportive Governments and secure borders. That is what British development helps to achieve. Tackling the big global issues can save us billions in the future.
I strongly agree with the sentiments of the noble Baroness, Lady Jenkin: I do not believe that this House should impede the progress of the Bill by further amendment. There is an opportunity for us to put this on the statute book, and we should not miss it. This is a very small Bill on just a few sheets of paper. It will save hundreds of thousands of lives of people that we will never meet and whose names we will never know. In years to come, we will look back with a real sense of pride on what we are achieving together today.
The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD)
My Lords, on behalf of DfID and the Government, I am delighted to speak in support of the Private Member’s Bill sponsored by my noble friend Lord Purvis. As the noble Lord, Lord McColl, put it, he introduced it with a passionate, comprehensive and evidence-based speech. I pay tribute to my right honourable friend Michael Moore for having the vision, grasp and commitment to introduce and then pilot this vital Bill through the other place. I also pay tribute to all those who have supported the Bill there and here, and for the cross-party agreement here.
I pay tribute to those who have helped to develop the UK’s outstanding record in development, including the right honourable Clare Short and my noble friend Lady Chalker, whose speech showed her long and deep commitment to this area and her understanding of how underpinning economic growth brings the relief of poverty. I thank the noble Lord, Lord Collins, and the noble Baroness, Lady Royall, for pledging the Opposition’s support for the Bill, which is exceedingly welcome.
As other noble Lords have, I pay tribute to the NGOs for doing all that they have to explain, from their own work, why the Bill and the commitment of better-off countries is so important. It is transformational to those in extreme poverty and at the very margins of life around the world. I also pay tribute to DfID staff working in-country—for example, those on rolling shifts in Sierra Leone and those currently locked down in the DRC—and to others from the United Kingdom whose work in humanitarian crises or in longer-term development is so important.
To hear praise from my noble friend Lady Tonge as she crows, as she put it, particularly warms my heart as we do not always please her. I also note the pride expressed by the noble Baroness, Lady Flather, and she is right.
I am delighted to be part of the United Kingdom Government who have, for the first time, met the 0.7% target of GNI going to support worldwide development. I thank noble Lords for their tributes to that and, from the Government Front Bench, I make it crystal clear that we support the Bill, which will enshrine this commitment in legislation. This was in the coalition agreement and I am delighted that we are so close to ensuring that the legislation is agreed.
Lord Davies of Stamford
Is the Minister going to be able, in the course of her remarks, to respond to my question: why did the Government, who are so evidently in support of this measure, do nothing about it for nearly five years? Even now, it has not been brought forward as a government Bill although the Government appear to be in the process of taking credit for it.
Baroness Northover
I have in my notes an answer to the noble Lord, which was slightly lower down in what I was seeking to address. He said that he was mystified as to why we were dealing with this now. What occurred to me was that I was somewhat mystified that the previous Government had not legislated for this, despite their commitment. What we should welcome—and that is true across this House—is that we have finally ensured that we have met that 0.7% commitment, and that we are now seeking to legislate. That is the important thing and I welcome the cross-party support for it.
The House of Commons has passed the Bill overwhelmingly and handed it to us. It is now our responsibility to help ensure that my noble friend Lord Purvis is able to carry this through and into law. We have heard outstanding and compelling speeches and even those who feel that this is not the right move—
Lord Tugendhat
I take the Minister’s point about the responsibility to carry it forward into law, if that is what the majority want. However, I hope she will agree that this is an amending and revising House, and that there is a duty to seek to amend and improve Bills, regardless of where they are. I think back to the debate we had some months ago on the referendum Bill where many noble Lords opposite, whom I supported, argued that just because such a Bill had a majority in the Commons that was no reason not to try to improve it in the Lords. The same applies on this occasion.
Baroness Northover
I will be coming on to that in a while. Perhaps the noble Lord will be satisfied to wait a little for that.
As I have said, we have heard outstanding and compelling speeches which have recognised that aid is transformational. It is also interesting to note that even those who do not feel that this is the right move are committed in terms of aid, which of course is important. The noble Lord, Lord Lipsey, is an economist and not one to misuse statistics, but he expressed more than 90% agreement to what we are doing in terms of aid. I for one will bank that. I knew that we would have a powerful debate on this Bill, that noble Lords would speak from huge experience, and that we would take a far-reaching international perspective.
We know only too well that no man is an island—I might feminise that. As my noble friend Lord Purvis made clear, the first point to make is the moral case, and many noble Lords have made that case. Indeed, it was made with particular power by the right reverend Prelate the Bishop of Derby and—not least through his presence here—the former Archbishop of Canterbury the noble and right reverend Lord, Lord Williams of Oystermouth. I welcome his engagement, and we are pleased to see them involved today. My noble friend Lord Steel quoted strong passages from two global religions as to why we must do this. We heard my noble friend Lord Chidgey’s moving account from Juba, as well as those from the noble Lord, Lord Judd, and others. They all made the moral case exceptionally clear.
As noble Lords also laid out, we recognise our interests and how we are all interlinked. We can see that a weak health system in Sierra Leone, seemingly a distant place, results in an epidemic taking hold on an unprecedented scale. Even in Britain we have felt the effects of that. International development is not an optional extra or an afterthought; it is vital. Investing now to help the poorest can and will prevent some of the terrible situations we see today from happening tomorrow and affecting us. I was especially struck by the powerful speech of the noble Lord, Lord McConnell, about what might have happened had this measure been implemented 40 or 45 years ago. The noble Baroness, Lady Royall, quoted Nelson Mandela saying that:
“Poverty is not an accident”,
while my noble friend Lady Manzoor talked about tackling poverty.
The 2004 report of the UN High-Level Panel on Threats, Challenges and Change, of which our colleague the noble Lord, Lord Hannay, was a leading member, noted the interconnectedness of our world. That was a very important conclusion for the panel to come to. I shall quote from the report:
“Development and security are inextricably linked. A more secure world is only possible if poor countries are given a real chance to develop. Extreme poverty and infectious diseases threaten many people directly, but they also provide a fertile breeding-ground for other threats, including civil conflict. Even people in rich countries will be more secure if their Governments help poor countries to defeat poverty and disease by meeting the Millennium Development Goals”.
Quite so, and that underpins the powerful speech of my noble friend Lady Falkner about what other countries should be doing. It is excellent that at least we are taking the lead in this.
One of the most important principles of effective development is to ensure continuity. It is no use moving into a development programme one year and abandoning it the next. Continuity and certainty of programmes over a number of years are essential to securing good development outcomes. That is why we have committed to budgets over four years and why a Bill such as this, which commits us to spending 0.7% of our national income, is so important. There is otherwise the risk that the international development budget will fluctuate and fail to provide our partners with certainty when they need to make critical investments in health and education. I can recall, as no doubt can other noble Lords, when Ireland was delighted to make the commitment that it would reach an aid budget of 0.7% by 2007. I remember that that happened after an internal struggle. I also recall, with great disappointment, how quickly it moved away from that—and it is not yet achieved. Neither, prior to 2013, did we in the United Kingdom achieve it.
There is voter pressure in the United Kingdom for other budgets; for example, for the Department of Health, the Department for Education, and the DWP. Their budgets are very large, as my noble friend Lady Barker pointed out, and they are, largely, predictable. That has never been the case for overseas aid. The pressures are very clear as regards that budget, yet we seek to support similar projects: for example, getting girls into and through schools, and establishing and maintaining clinics, as the noble Baroness, Lady Tonge, rightly demanded of us.
I hope that the noble Lord, Lord Tugendhat, recognises that need for predictability. I am sure that he supports our long-term financial commitment to the EU—would it not be easy to push that budget back and forth?—yet we grant to the EU according to our legal obligation, and we are right to do so. The EU can then plan and budget. This is no different. The conflict across borders—
Lord Tugendhat
It is totally different. The problem that I—and I think other members of the committee—have is that while we are fully supportive of aid and made that quite clear, we also made it clear that we are worried, as are others, about the way in which money is spent. We are dealing with multiyear programmes. With such programmes, you will run into a lot of trouble if you have to spend on what is called—since the noble Baroness invokes Europe—the douzième provisoire: that is, if you have to spend one-12th on an annual basis instead of spreading it over the commitment. In the case of the EU, there is a formula by which the member states are assessed, and we pay according to that formula. However, it is not linked to projects. The problem here is that you have a multiyear project and you are saying that a given amount has to be spent each year. The Minister may or may not agree with me, but she is invoking a false parallel.
Baroness Northover
Having been a Minister in the Department for International Development, I know that there is obviously flexibility in the department, because humanitarian conflicts will arise, which you have to put money into, while you also sustain support for various other projects. The noble Lord might read the NAO report; one of the things that struck me when I read it was that every department in government has to budget, and they know more or less what their budgets will be. There may be contingencies, and they may have a contingency fund, but they have to plan. It is not just left to what they may decide to do after six months or so.
The situation is no different in DfID. I assure the noble Lord that if he reads the NAO report very carefully he will see that it concludes that business was properly stress-tested and assessed. I think I should proceed, because I am now on 14 minutes, and I will come on to some of these other points. I will also be happy to meet the noble Lord after this debate, if that would help, so that we can explore some of those issues.
Noble Lords will be fully aware of the kind of projects that DfID is involved in; during this debate noble Lords have very helpfully outlined a number of these areas. A number of noble Lords emphasised in particular our support for women and girls and how right this is, including my noble friends Lady Hodgson, Lady Jenkin, Lady Manzoor, and the noble Baronesses, Lady Kinnock and Lady Flather. We fully recognise the importance of supporting women and girls and thank noble Lords for supporting us in doing that. In addition, as part of that, the emphasis on maternal health and family planning was mentioned by the noble Lord, Lord Watson, as well as by the noble Baronesses, Lady Tonge and Lady Flather.
Mention was made of women giving birth on a concrete slab. Today is my eldest son’s birthday. This morning I found myself thinking that, had I given birth in a developing country, he would have died and so would I. Noble Lords who think about it will probably recognise that either they or their close family might very well have been in that situation. As has been said, poverty is not an accident. It is not something that certain groups need to suffer from or should suffer from.
Noble Lords have made mention of our commitment of 0.7%, and some have suggested that the increase has not improved the quality of that spend. I assure them that the Development Assistance Committee of the OECD concluded recently in its formal peer review of DfID on the effectiveness of the way in which we have scaled up our spending in recent years, planning carefully to meet the target—and I have seen that this is very much the case—while at the same time increasing the quality of our spend. As noble Lords were speaking, I found myself thinking about the commitment that we have been able to make, for example, on so-called neglected tropical diseases. We hope that they are no longer neglected, so we can combat blindness, which is totally avoidable—something that we were able to do because of the increase in the budget.
In response to the noble Baroness, Lady Tonge, of course there are many lessons to learn from Sierra Leone. This was an unprecedented crisis. We have done a huge amount, as was noted during the debate, to ensure that it did not become a pandemic. She will know the details of our support there.
Baroness Tonge
Could the Minister perhaps expand a little bit on that matter? We would learn a lot if there was a proper inquiry into what happened in Sierra Leone in the years running up to the epidemic.
Baroness Northover
I am really running out of time, and I think that we have another Question down on that matter. We can certainly discuss it, and we will learn a lot of lessons from what has happened.
Noble Lords are very concerned that what we do is carefully audited. That is where Clause 5 is very important, and the independent evaluation that we put in place in 2010 from ICAI is extremely helpful. Of course, we will keep that under close watch to make sure that aid is effectively spent.
The noble Lords, Lord Lipsey and Lord Tugendhat, mentioned the House of Lords Select Committee on Economic Affairs report of 2012, which the noble Lord, Lord Lipsey, urged noble Lords to read. I also urge them to read the debate in your Lordships’ House on 22 October 2012 on that report and, in particular, the outstanding contribution by another economist, the noble Lord, Lord Stern, professor of economics and government at the LSE. He made an extremely cogent case.
My noble friend Lord Astor asked about the calendar year versus the financial year. We are monitored internationally on the calendar year, not the financial year, and we wish to be consistent with international best practice, which is why we will continue to report in that way.
The noble Lord, Lord Tugendhat, rightly encouraged us to place more investment in developing countries. We recognise the important role that the private sector plays in development, but he will recognise that it is not necessarily targeted at countries that most need it. It is true that that and remittances are playing a very important part, and that kind of investment is clearly key in lifting China and India out of poverty. However, that still leaves many people in poverty, which is why we are involved with so many multilateral organisations. For example, my noble friend Lady Hooper mentioned Latin America and the noble Lord, Lord Cashman, mentioned South Africa. Our involvement with the Global Fund and the World Bank helps to address poverty in those countries. We have to try to ensure that we have a more equitable society globally. Relying on foreign direct investment and remittances does not necessarily achieve that.
My noble friend Lord Astor wondered whether this was just about DfID’s spending. It is not; it is about official development assistance. Most of it is spent by DfID but other departments, such as the Foreign Office, the MoD and the Department of Energy and Climate Change rightly also have ODA budgets. I say to my noble friend Lord Shipley that ODA restraints mean that you cannot spend the money on arms. He is quite right: that would not be an acceptable route to go down. I can write to my noble colleague Lady Tonge about Addis.
I have mentioned the National Audit Office report. I suggest that noble Lords take a very close look at that. As regards those who are concerned about the money that was spent at the end of 2013, I point out that we had the Syrian crisis, with many more displaced people facing a winter in Syria. There was a lot of pressure from your Lordships that we should commit spending to that. We also had Typhoon Haiyan, which cannot be put down to DfID suddenly deciding to do something, and my noble friend Lord Fowler rightly chivvied me endlessly to support the Global Fund, which he and the noble Lord, Lord Chidgey, emphasised the significance of in terms of dealing with AIDS, TB and malaria. All departments work to a budget. DfID knew that its budget was increasing and, fortunately, we were able to increase our commitment in some very important areas.
My noble friend Lady Williams rightly emphasised the involvement of young people. As my noble friend Lady Jenkin said, it is fantastic that people involved in the ONE Campaign are present in the Gallery. I pay tribute to my noble friend Lord Fox. I obviously did the right thing in supporting him when he was introduced in the House and look forward to his further contributions.
As noble Lords have said, and as my noble friends Lord Purvis and Lady Suttie emphasised, passing this Bill means that we can move on from the debate on whether we do this to how we do it, and ensuring the quality, predictability and effectiveness of our absolutely vital aid. I hope that noble Lords will give the Bill a Second Reading. Given that this is a simple and effective Bill, which has been carefully scrutinised and amended in the Commons, I hope that it will proceed through all its stages formally and by acclamation. However, if that is not the case, I am sure that noble Lords will engage fully in scrutinising the Bill and, most importantly, making sure that we pass it for all the reasons that they have laid out.
Lord Purvis of Tweed
My Lords, I am most grateful to all those who have taken part in the debate for their exceptionally well informed, constructive and, at times, moving contributions. I am delighted to receive the support of my noble friend the Minister in this House. The Minister of State, who was present in the House, has offered support in another place. This debate lacked the flowery language that he used in Committee in the Commons. Nevertheless, this is an important debate and I would like briefly to pull together some of the broad areas where I think there has been genuine consensus.
The noble Baroness, Lady Royall of Blaisdon, rightly established the framework for the debate in citing the EU’s designation of 2015 as a year for development, and by recognising that, given that we have reached the target in the United Kingdom, our efforts are now focused on what we do with our partners going forward.
I know it is the practice to reserve the term “noble friend” for those on our own side of the House. However, my noble friend Lord McConnell of Glenscorrodale made a very important remark when he said that this is about not just commitment but also scale because you make a difference by having the scale and the ability. I pay tribute to the work that he did as First Minister of Scotland in bringing this agenda, and particularly support for Malawi, on to the radar of the Scottish Parliament.
I think that most of us—if I may be bold enough to speak for colleagues at this stage—were touched by the contribution of the noble Baroness, Lady Chalker of Wallasey. She reflected on both her frustration and perhaps her regret at having to turn down opportunities because there was no clarity surrounding the future budget. That illustrated more than anything else in this debate why this approach is justified.
My noble friend Lord Chidgey, supported by the noble Baroness, Lady Kinnock, and others, highlighted that many of these areas are difficult because of the circumstances in which we provide this support. They are often in conflict areas and in areas where there is either local corruption or poor governance. That was reinforced most strongly by the noble and right reverend Lord, Lord Williams of Oystermouth, who highlighted that best governance standards are the foundation upon which support can deliver improvements. I agree strongly with the noble Lord, Lord Watson of Invergowrie, and the noble Baroness, Lady Jenkin, in their support for DfID staff. It is worth highlighting that many of them are in East Kilbride. We come down from Scotland each week but a lot of the staff are there. Of course, they are not only in East Kilbride; many, as the Minister said, work in the field.
The noble Lords, Lord Lipsey and Lord Tugendhat, the noble Viscount, Lord Astor, and, to a certain extent, the noble Lord, Lord Davies, highlighted some of the issues that formed a substantive part of the debate. The noble Earl, Lord Sandwich, addressed these points clearly. The noble Lord, Lord Anderson of Swansea, my noble friend Lord Shipley and the noble Baronesses, Lady Flather and Lady Hodgson, all highlighted the fact that significant progress has been made since the EAC report of 2012. There is now much clearer and more consistent reporting and evaluation by DfID, by the Treasury in relation to clarity over budget practice and by the ONS in relation to classifying GNI, with better co-operation between the three.
Michael Moore and I see the Bill not as denying that there are complexities in the budgeting but as an opportunity. If we can resolve these complexities through best practice—we are starting to see that now, as the Minister said and as the National Audit Office has recognised—that will be an opportunity for us to show other major economies with complex budgets how this can be achieved. If we say that we cannot achieve it, what signal will we be sending to those other major G7 economies? We will be saying that it is impossible to do. A stronger signal would be to pass the Bill unamended and to work with DfID, the ONS and others through the aegis of the International Development Committee in another place, informed by ICAI, which is now starting to do globally respected work. I am not simply asking noble Lords to take my word for it as the sponsor of the Bill. The peer review by the OECD looked at all these aspects. It showed areas where it would like to see progress but it also recognised that we have the right model.
I am conscious of the time. Everyone has said what needs to be said. My noble friend Lady Williams highlighted one important area. She asked whether we have developed partnership working, encouraging other countries to become allies, thus adding to the strength of our work.
My noble friend Lord Steel of Aikwood said that there must be something in the Borders air, with Michael Moore and I being associated with this Bill. Perhaps the political air has been infused with his principles and standards over the past 50 years in this area. We are proud to be associated not only with the Bill but with his work.
I am conscious that I have not mentioned all noble Lords who have taken part in the debate—in particular, my noble friend Lord Fox, who made his maiden speech. We were not spared his imagination, nor his commitment to this area. He highlighted that economic and social development are not mutually exclusive, and that the practices of both can secure great success. I am also grateful for the support of my noble friend Lady Suttie. However, as a relatively new Member and a relative baby in this House, I suspect that the support given by the noble Lord, Lord Judd, and my noble friend Lady Suttie has damned me with faint praise.
I am 40 years old. The target for the 0.7% set by the UN in 1970 was for it to be reached in the year in which I was born. We have now reached it. We should never go back to the debate about whether we will reach it but should now focus our minds on how best we spend our support for those in the world who most need it. I therefore hope that the House will give the Bill a Second Reading.
Medical Innovation Bill [HL]
(9 years, 9 months ago)
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Lord Winston
Lord Winston (Lab)
My Lords, I shall not detain the House for great length. The amendment in my name and that of the noble Lord, Lord Saatchi, addresses patient safety, an issue which is dear to this Government. One of the concerns expressed again and again throughout the Second Reading and Committee stages of this Bill, and subsequently, has been that some patients might in desperation, for various reasons, seek treatment which is innovative but not properly regulated or properly justified. Particularly in the private sector, patients might be tempted to go into treatments which seem attractive but perhaps are overadvertised as sensible. In the end, they may be more futile than more recognised treatments that may carry known side-effects or perhaps be more frightening. I think that that is the case for cancer in particular.
This amendment is designed to make sure that any treatment given under this Bill would get broad support from responsible medical practitioners. There would be an onus, not only on the person doing the treatment, but on the person responsible for advising that the treatment was reasonable to the operator, the medical practitioner concerned. This would fall within that area. Essentially, there would be a legal onus, a responsibility, for that adviser to give advice which was regarded as serious and acceptable to a broad body of medical opinion in that field. That is the essence of this amendment, which we have discussed.
I am delighted that the noble Lord, Lord Saatchi, has agreed to put his name to this amendment. It is helpful. I hope that it will not prevent people participating in trials, particularly in cancer medicine. I also hope that it will make sure that private medicine is carried out responsibly. We all have reservations about this Bill but it covers most of the issues about which we have been concerned. I am concerned about reproductive medicine because I fear that that is now in a burgeoning private area. It worries me still that quite a lot of reproductive medicine done in the private sector is not properly validated and that patients are paying very heavily for it. Beyond that, broadly speaking, this is the amendment that I would like to see on the statute book. I therefore beg to move.
Baroness Gardner of Parkes (Con)
My Lords, I am slightly concerned about the wording of the amendment because I would not want it to become a way of dragging things on forever. How do you decide what is,
“a representative body of responsible medical opinion”?
To lay people such as myself, there seem to be heaps of medical bodies and I wonder how that would be determined. I would be interested to be satisfied on those points. The speech of the noble Lord, Lord Winston, was clear that he does not intend the amendment to represent any of those matters, but I would like someone who is more of an expert on the wording of these things to assure me that it would not be only a preventative technique.
Baroness Masham of Ilton (CB)
My Lords, having tabled an amendment to the Bill on patient safety, I am happy to support the amendment.
Lord Kakkar (CB)
My Lords, I declare my interest as professor of surgery at University College London and as a member of the General Medical Council, although I do not speak for the council in this Chamber.
I thank the noble Lords, Lord Winston and Lord Saatchi, for having tabled this important amendment. It goes to the heart of good medical practice, of course, always to innovate—but always to innovate, first and foremost, with absolute regard to patient safety. The fact that the amendment will now appear in the Bill will provide absolute clarity on what is required to discharge that patient safety responsibility with regard to innovation, as described in the Bill, which is vitally important. I strongly support the amendment. Once again I thank the noble Lord, Lord Winston, for his contributions in the passage of the Bill and, in particular, for tabling this important amendment.
Lord Pannick (CB)
My Lords, I, too, welcome the amendment. It will further emphasise that, in order to be lawful, medical innovation must be responsible. The criterion of responsibility has been the essence of the law on this subject since the judgment of Mr Justice McNair in the Bolam case in 1957, when he said that a doctor,
“is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art”.
That may provide some reassurance to the noble Baroness, Lady Gardner of Parkes, that the courts will easily understand what is involved in the amendment.
The amendment will reassure many of those concerned about patient safety. The words will further confirm what I understood to be the Minister’s statement in Committee that the Bill is not intended to alter the substance of the Bolam test but to provide a practical means by which innovative doctors can take steps in advance of carrying out the treatment.
Like the noble Lord, Lord Winston, I am less confident than the noble Lord, Lord Saatchi, that this Bill will have much, if any, beneficial effect. I am doubtful that the fear of litigation deters responsible innovation, but I have been reassured by the amendments that the Bill will certainly do no harm. I thank the noble Lord, Lord Saatchi, for the responsible manner in which he has responded to concerns about the Bill by welcoming amendments of this sort. I also thank Mr Daniel Greenberg, a former parliamentary draftsman, now an expert consultant, for the assistance that he has provided to many noble Lords, including myself, on the issues raised.
Lord Dykes (LD)
I hope my memory is not at fault when I recall that I have attended all the previous stages of this Bill but deliberately not spoken because I preferred as a lay man to listen to what the medical experts were saying. We have had considerable testimony from them in the previous stages which has helped us make progress. I thank the noble Lord, Lord Saatchi, again. I know it has been done before but it is important to record our thanks for his introduction of this extremely interesting legislation, which will be very useful and important to humanity in the future—although it is difficult at this early stage to tell exactly how it will develop and the noble Lord, Lord Pannick, is right in expressing certain reservations about it.
We all have experience of the sufferings of friends and families in cancer cases and the Bill, not only in a moving way but in a scientifically respectable way, makes progress in widening the ability of medical experts, operating under the strict safeguards that have been agreed in the previous stages, to make sure that people can be helped more than the already marvellous help that doctors give within the existing framework. I am glad to support the amendment.
Lord Hunt of Kings Heath (Lab)
My Lords, I, too, welcome the amendment and thank my noble friend for his efforts. I also thank the noble Lord, Lord Saatchi, for the way in which he has been prepared to listen and to support amendments which we see as improving the Bill. This amendment goes a long way to meeting some of the concerns expressed by medical bodies about what might be described as unintended consequences arising from the Bill.
I do not agree with the noble Baroness, Lady Gardner, that this amendment could be seen as delaying action. I think it is rather the reverse. Having this provision and the need to act within it would give confidence to doctors. I think the definition of,
“a representative body of respectable medical opinion”,
is a question of you know what it is when you see it. I would have thought that doctors would have no doubts about to which responsible body they should turn.
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)
My Lords, my interpretation of the amendment moved by the noble Lord, Lord Winston, is that it aims to ensure that in obtaining the views of one or more appropriately qualified doctors, a doctor is carrying out a test equivalent to the Bolam test. I recognise that these words are carefully chosen, and I listened closely to what the noble Lord, Lord Winston, said. However, I do not believe that the language of the amendment accurately reflects the requirement of the Bolam test.
To go a bit further, I am concerned that the amendment would create more confusion than clarity for both doctors and the courts. In particular, how would a court determine what is meant by the phrase “command the respect of”? It certainly does not mean agreement. If Noble Lords want an illustration of the difference, I deeply respect the noble Lord, Lord Winston, but, as in this case, I do not always agree with him.
Like my noble friend Lady Gardner, I question what might count as,
“a representative body of responsible medical opinion”.
Again, this wording is not in the Bolam test. The Bolam test sets out that a doctor is not negligent if their decision is accepted as proper by a responsible body of medical opinion. Bolam accepts that a doctor is not negligent merely because there is a body that would take a contrary view. Therefore, the courts recognise that there is not necessarily a representative body of medical opinion. The wording of the amendment would be open to interpretation by the courts.
I recognise that the noble Lord’s aim in tabling this amendment is thoroughly worthy and is to ensure the protection of patients. I assure him that the existing provisions in the Bill seek to achieve that same aim. Therefore, the Government do not consider the amendment moved by the noble Lord, Lord Winston, necessary. The Bill’s provisions boil down to one key test: a test of responsibility. Clause 1(2) states:
“It is not negligent for a doctor to depart from the existing range of accepted medical treatments for a condition if the decision to do so is taken responsibly”.
This objective test of responsibility ensures that the decision about whether a doctor has been negligent is based on the same premise as the existing Bolam test: has this doctor acted responsibly? Patient safety is an integral part of this test. Clause 1(3) makes clear that the risks of any innovative treatment must be considered, so if the treatment was likely to compromise patient safety unacceptably, it is highly unlikely that it would be considered a responsible decision when later judged in court. Furthermore, the Bill does not require doctors simply to obtain the views of experts in the field; it requires a doctor to take full account of those views in a responsible way. As such, a doctor could not simply listen to, or note, the views of colleagues and then proceed to disregard those with which he or she disagrees. A doctor can fully expect a court to scrutinise closely how they have taken account of those views and consider whether they had acted on the views in a responsible way.
It is that requirement which ensures that the Bill is the nearest equivalent to that of the Bolam test. I fear that the amendment of the noble Lord, Lord Winston, despite its best intentions, would not add to the operative provisions of the Bill but would only risk creating confusion as to the language of the existing Bolam test. It is not just that the Government consider this amendment unnecessary—which we do—but that we also have serious concerns about whether the language of the amendment will create confusion for doctors and, indeed, the courts.
Lord Saatchi (Con)
I thank noble Lords who have addressed this amendment. I happily added my name to the amendment of the noble Lord, Lord Winston, because I believe that it provides helpful additional clarity for Peers and those outside the House about the intention and effect of the Bill.
Your Lordships will be aware that on a number of occasions I have tried to stress that the intention and effect of Clauses 1(3)(a) and (b) are not, as my noble friend was just saying, that a doctor can just ignore the views of anyone who disagrees with the proposed treatment or that he or she can choose to consult only those who are known to agree. I agree with my noble friend that Clause 1(3)(a) and (b) contain a legal duty to obtain views and take proper account of them, and that that is a serious and effective threshold. However, I wonder whether I may encourage my noble friend to share with me the observation that a number of noble Lords, including the noble Lords, Lord Winston and Lord Turnberg, were anxious to see this set out more expressly in the Bill in language that at least resembles, if not copies completely, the wording of the Bolam test, as described by the noble Lord, Lord Pannick. I believe that the amendment of the noble Lord, Lord Winston, does that in a manner that will not change the substantive policy of the Bill, as already agreed by your Lordships, but will perhaps give greater clarity about the intention for those Peers and others who want to see this language expressed in the Bill in the closest approximation possible to the existing Bolam test, which is what we are all trying to preserve.
As your Lordships know, the Bill is all about giving greater clarity and certainty to patients and doctors at the point of treatment, and not forcing them to wait for the unpredictable outcome of possible litigation or disciplinary proceedings. I can only welcome any amendment designed to enhance clarity and certainty about the effect of the Bill itself. I am therefore very happy to support it.
Lord Winston
My Lords, as this is probably the last opportunity I will have during the passage of the Bill, I thank the noble Lord, Lord Saatchi, who has behaved with extreme courtesy throughout the debate on this Bill. We do not entirely agree, but I think we have come to respect each other’s point of view and we are in total agreement about this issue.
I was surprised that the noble Baroness, Lady Gardner, raised this concern, because a representative body of medical opinion is exactly what courts ask me to give and to be mindful of. I am very grateful to the noble Lord, Lord Pannick, for his quotation, which is of course now on record, because on the number of times that I have been an expert witness in court, that is exactly what my Silk, in taking evidence from me, has required me to recognise—whether I am doing something that is recognised by a responsible body of medical opinion. That is a phrase which is firmly in our minds and was therefore firmly in my mind when I set this amendment down.
I therefore really am disappointed with the response from the noble Earl, Lord Howe, on behalf of the Government. If the Government really want to protect patient safety—I have no doubt about their absolute commitment to that—this would be a very good way of doing that. It seems to me that there is a risk of mavericks operating without that control. This is a very shocking issue. We do have desperate patients seeking all sorts of treatments, sometimes at the end of life but often perhaps because they are infertile— which is hardly at the end of life—and they will go through anything that they think might be of benefit, even though it is not proven. That is innovative treatment and sometimes it is possible that for various reasons that innovative treatment might work; sometimes, purely biology works and random effects happen. The amendment is designed to deal with that issue.
I do not think it would be appropriate to divide the House. I am grateful to see so many of your Lordships here late on a Friday afternoon, which is a great credit to this House and something we should be proud of. I am sure that the noble Lord, Lord Saatchi, is grateful as well. However, I feel that this is something that will need to be teased out. If the Bill now proceeds to another place, I very much hope that some consideration will be given to the patient safety aspect. Of course, it is really in the Government’s interests, particularly at the moment, when we are increasingly concerned, understandably, about our health service, which we all want to see survive and prosper. For the moment, I will withdraw the amendment.
Lord Hunt of Kings Heath
“comply with any professional requirements as to registration of the treatment under the provisions of this Act with a scheme for capturing the results of innovative treatment (including positive and negative results and information about small-scale treatments and patients’ experiences),”
Lord Hunt of Kings Heath
My Lords, throughout the passage of the Bill the noble Lord, Lord Saatchi, has been enormously helpful to the House in responding to concerns and in his willingness to accept constructive changes to the Bill. I am most grateful to him for adding his name to my amendment.
We had a useful discussion in Committee and on Report about the establishment of a register that could record uses of the Act. This would be immensely helpful to clinicians, regulators and doctors—and, indeed, patients. It would reassure those who have concerns about the implications of the Act. It would enable use of the Act to be tracked. I argue that it would also help spread good practice. It would inform legislators about further changes to the law that might be required in the light of practical uses of the Act.
On Report, I received considerable support around the House. The noble Lord, Lord Kakkar, is here today. He probably will not mind me quoting from what he said—that,
“the register needs to be obligatory, in which all innovation and the outcome of that innovation is properly reported. It would do much to ensure the development of an enhanced culture of innovation, but also, fundamentally, to provide very important protections”.
On Report, the noble Baroness, Lady Jolly, opposed the amendment on four grounds. First, she argued:
“Requiring doctors to record the results of innovative treatments in order to demonstrate that they have not been negligent … would impose requirements … additional to those in the existing law”,
and,
“may risk deterring doctors from innovating”.
Secondly, she argued that my amendment,
“would widen the scope of the Bill to cover all innovation. This Private Member’s Bill is not the right vehicle to make provision that would relate to all innovation”.
Thirdly—and quite remarkably—she said that,
“the act of putting something into legislation does not guarantee that doctors will adhere to it”.
Fourthly, she said that she would support a voluntary register,
“but it should be such that doctors would not dream of not recording on the register”.—[Official Report, 12/12/14; cols. 2062-63.]
My response is simply: let us put it beyond doubt by making registration mandatory.
On the question of the amendment going wider than the Bill, I have changed my amendment to make it clear that it relates only to this Bill—or Act, as it will become. On whether having to comply with this provision would dissuade doctors from innovating, I simply do not accept that. I would worry about doctors who were dissuaded because of the need to record an innovation in the register. I would have thought it created the conditions in which doctors would feel more confident in taking innovative action. On the suggestion that doctors will not adhere to the legislation, I simply do not accept that and ask what possible evidence there can be of it.
I do not think it is unreasonable to say that every use of the Act should be captured and available, to check on patient safety from the point of view of regulation but also for the purposes of research. I beg to move.
Baroness Masham of Ilton (CB)
My Lords, I am very pleased to support this amendment, to which I have added my name. Within the rare disease community, there is significant unmet medical need, and research and innovation are seen as the means through which new therapies for currently untreatable conditions will be developed. For this to make a difference to patients, the barriers to medical research and the adaption and integration of research and innovation into the NHS need to be addressed. Therefore, it is vital to ensure that registries are created to enable the collection and exploitation of real-world patient data and to promote the sharing of research findings and best practice.
The Royal College of Pathologists says that, unfortunately, this Bill, allowing the results of new tests and treatments to go unrecorded, will hinder its work and medical science more widely. Without the mandatory recording of results of such treatments, unexpected adverse outcomes and irresponsible activity will be harder to detect and prevent.
All results of innovative treatments should be centrally recorded, reported and publicly accessible. This must include both positive and negative outcomes and feedback from patients. Without the mandatory recording of results, the public benefits of medical innovation will not be achieved and the advantages to future patients will be lost.
I am pleased that the noble Lord, Lord Saatchi, is supporting this amendment. I hope that the Government will, too. I would like to ask whether patients from both the NHS and the private sector are covered by the Bill. In my view, all patients who wish it should be able to benefit from innovation as long as it is fully explained to them and is felt to be as safe as possible.
There are many splendid trusts which support medical research. I hope that if this Bill becomes an Act they may find it possible to help fund the register.
Lord Kakkar
My Lords, I remind noble Lords of my interests, stated earlier, as professor of surgery at University College and as a member of the GMC, but I do not speak for the council in this Chamber.
I thank the noble Lord, Lord Hunt of Kings Heath, for once again bringing this issue to your Lordships’ House. It is critically important, and probably one of its most vital elements is that there is the opportunity for registration of innovative interventions and therapies.
Clearly, providing transparency and the opportunity for sharing the outcomes of such innovations rapidly and broadly across clinical communities in this country and internationally is of so much importance. It will allow colleagues to understand what has been achieved and not achieved; it will allow those with other ideas to build on knowledge gained from experience to date; and it will ensure that through transparency we have the best opportunity to ensure the greatest patient protection. I am very grateful to the noble Lord, Lord Saatchi, for having considered this issue carefully and having come to the place where he has put his name to the amendment and supports it. I hope that Her Majesty’s Government will be able to consider this issue. The measure enjoys substantial support and will be a vital contribution to this long journey with regard to innovation, ensuring that we can do the best for patients as rapidly as possible without undermining the very best practice and the ability to share knowledge, and ultimately ensuring that this Bill enhances patient safety.
Lord Giddens (Lab)
My Lords, I strongly support this amendment and hope the Government will take it seriously because we are talking here about not innovation but scientific innovation. Science is a collective enterprise. It depends on the accumulation of evidence. It is crucial that that be recognised formally somewhere in the Bill, with this embodied as part of the advancement of scientific progress more generally.
Baroness Gardner of Parkes
My Lords, I support this amendment. I was surprised that the Government took a line similar to my own on the previous amendment because I was greatly reassured by what noble Lords said on that point. In this case, and right from the start of the passage of the Bill, we have all believed it essential to fully record what happens. The whole aim of this has been not only to give hope to people via an innovative treatment but also to have research that will benefit other people in future. No one has for a minute queried the need for recording the cases and results. I would be amazed and shocked if the Government denied that today.
Lord Ribeiro (Con)
My Lords, many noble Lords will remember the disasters that occasioned the introduction of laparoscopic cholecystectomy in the 1990s. Quite a few patients suffered as a result of the innovation of our surgeons playing with a new instrument, new tools and a new operation. At the time, I was secretary of the Association of Surgeons of Great Britain and Ireland. In recognising the problems, we introduced a voluntary register of all surgeons undertaking the procedure and got a very good response. Admittedly, it was not compulsory and not every surgeon introduced their data to it, but the net effect was that when we analysed our data we were able to identify where many of the problems lay. That led to further research and proper control trials in the procedure. We were able to turn to that from an innovation used by a succession of surgeons as and when they felt necessary, without any good evidence on how best to use it. On that basis, and mindful of the benefits that we saw in the 1990s, I would very much support some form of register to ensure that, if an innovation is introduced, we have the information, can go back and refer to it again, learn from the mistakes and improve the outcome.
Lord Winston
My Lords, briefly, I support the amendment of my noble friend Lord Hunt of Kings Heath as well. I was reminded by the noble Lord, Lord Ribeiro, of laparoscopic surgery. Of course, we gynaecologists were doing that 20 years before the noble Lord was and we did not have as many deaths. Having said that, what the surgeons did with laparoscopic surgery and recording those events was really important in bringing down the complication rate and the haemorrhages that occurred. That is a very good example and the noble Lord is to be thanked for bringing it to the House. It is exactly what would be covered here.
I would be astonished if the Government seriously opposed this amendment. I was very unconvinced by the noble Baroness, Lady Jolly, in the previous stages of the Bill. She did not seem to take on board exactly what we were trying to say about the need for keeping proper records, which is important in all sorts of ways. If you keep a record and it is done under this Bill then you are effectively legally protected. For that reason if no other that would be important, but in any case we have to build up the knowledge of our experience. We do that automatically in the laboratory. Every single thing we do in the laboratory, whether negative or positive, we record in our laboratory books. If we do not, we are not doing good science or science useful to the public. Here in innovative medicine, we are—whether we like it or not—doing a form of science because we are exploring our knowledge about what a treatment means. That is what science means. I urge the Government to support the amendment. I feel very strongly about this. If the Government were reluctant to support it and my noble friend Lord Hunt were to divide the House, I would certainly join him.
Earl Howe
Perhaps I may deal briefly with the question posed by the noble Baroness, Lady Masham, who asked whether the Bill would apply to patients receiving private treatment. The answer is yes. Any departure from the accepted range of medical treatments for a condition, whether that patient be receiving NHS or private treatment, would be covered under the Bill.
The amendment of the noble Lord, Lord Hunt, would change the test of negligence under the Bill. If accepted—and assuming that the appropriate professional requirements were created—the amendment would require a doctor to comply with any professional requirements as to registration of the treatment; that is, to register the treatment with a scheme for the purposes of taking a responsible decision to depart from the existing range of accepted medical treatments for a condition. In other words, registering details and results of an innovative treatment on a data-capturing scheme would form part of the steps that a doctor has to take under the Bill.
Lord Woolf (CB)
I hope the Minister will forgive me for saying that I do not think he is right in saying that the amendment would in any way change the standard. It is only adding a requirement to keep records. That does not change the standard of care which is required. It puts on the doctor an obligation to do something in addition, but I suggest with respect that it does not change the standard.
Earl Howe
I am grateful to the noble and learned Lord. Obviously, I must take account of his expert view, but the fear that I was about to articulate is that if you require a doctor to register the details and results of whatever innovative treatment he or she may have administered on some kind of data-capturing scheme in the way suggested by the noble Lord, Lord Hunt, that would constitute part of the requirement for the doctor to demonstrate that he or she has acted responsibly, and thus not negligently. Therefore, if the amendment were accepted, the result could be that a failure to record would be part of the picture when deciding whether a doctor had acted negligently.
If that point is accepted—I expect the noble Lord, Lord Pannick, to take me to task on it—my submission is that that would be a disproportionate requirement.
Lord Pannick
I understand the noble Earl’s concern that if there is an obligation to report the results, that might have an effect on the common law Bolam test, but surely it would not, because of the contents of Clause 2(1), which states:
“Nothing in section 1 … affects any rule of the common law to the effect that a departure from the existing range of accepted medical treatments for a condition is not negligent if supported by a responsible body of medical opinion”.
I therefore understand that under the Bill—the noble Earl can tell me whether I am right or wrong—the doctor has two means of defending himself or herself. One is the Bolam test at common law; the other is to take advantage of the procedures of the Bill. If one of the procedures of the Bill is a duty to report, that does not affect the general Bolam test under Clause 2(1).
Earl Howe
My Lords, I take the point made by the noble Lord, Lord Pannick. My point was not that the amendment would alter the effect of Clause 2(1). It would not have an effect on the common law, but it would create a more burdensome test under the Bill. That is troublesome to me, because to do that would in itself impose requirements which go beyond the current Bolam test of negligence. It would mean that the test of clinical negligence was more burdensome under the Bill than under the common law.
Lord Woolf
There are provisions as to machinery and provisions that deal with standards of care. I think that this is a machinery requirement. You could not sue the doctor because he had not reported something. It is something that the law requires but I do not think it is intended that this should be enforced by criminal sanctions. There is certainly no specific provision of that sort.
However, it would exclude the ability to take advantage of Clause 1. You have to do Clause 1 in a way that complies with the Act, and the requirement that is now being inserted says that if you are going to do so, you have to do this. The implication is that if you do not do it, you will not get the benefit of Clause 1. This does not mean that the doctor is going to be liable for negligence just because he has not signed the register. As the noble Lord, Lord Pannick, has made clear and those who have taken part in the debate so far have emphasised, the common-law position remains the same. This is an additional mechanism to allow innovation. I therefore suggest that a machinery provision does not do anything else than act on a requirement that you have to go through if you want to take advantage of the Bill.
Earl Howe
My Lords, I have been in the House long enough to know that when the noble and learned Lord, Lord Woolf, opines on something, it is a matter that all noble Lords would do well to listen to, and I am grateful to him. I agree that the amendment does not change the standard of care, we are agreed on that, but our concern is that a court might look at the requirements under the Act—and this is one of the requirements—as part of the picture that it would form as to whether or not the doctor had acted responsibly. It is merely part of the picture.
If we are agreed on that, and I hope that we are, it does not seem sensible to me that we should impose requirements in the Bill additional to those under the existing law, as that could risk deterring doctors from innovating under the Bill. Let us not forget that a doctor does not have to follow the Bill if he or she does not want to; they can simply rely on the Bolam test later on if they are challenged. Do we want to deter doctors in the form of a test or requirement that obliges them to go further than they would otherwise go? If they were deterred by that, it would defeat the whole object of the Bill and result in less benefit to patients, so I worry about that.
The amendment from the noble Lord, Lord Hunt, specifies that the use of a scheme be enforced through professional requirements. We have sought advice from the GMC about whether professional requirements in the form of guidance might be a suitable route to enforce the sharing of learning from innovation. The GMC has been clear that it is very happy to consider anything it can do to be helpful. However, from those initial conversations, it seems that this may not in fact be an effective route. The GMC’s statutory power is to provide advice. Doctors must be prepared to justify their decisions and actions against the standards set out in its guidance.
Serious or persistent failure to follow the guidance would put a doctor’s registration at risk. So on the one hand, were we to go down this route, a doctor who failed only once to use a data registry might not face any consequences; that would be okay for the doctor. However, this would not address noble Lords’ concerns that the results of each and every innovative treatment, whether or not successful, should be recorded. On the other hand, if a doctor persistently failed to use the data registry, this could result in fitness to practise proceedings being brought against him or her for not having recorded information on an online database designed to foster the sharing of learning from innovation. Should a doctor’s fitness to practise be called in question simply on those grounds, that really does not seem a proportionate response.
For the reasons that I have outlined today—namely, the difficulty of relying on professional requirements and the link, which I hope noble Lords will accept, to the test of clinical negligence—the Government would not be able to support this amendment.
Lord Giddens
I am not a medical specialist but I have followed this all the way through. What kind of structure would the Minister envisage being put in place if there is not a formal requirement of this sort? If you do not have some kind of system of dealing with the data produced, the whole thing becomes an erratic exercise and therefore does not contribute to the overall fund of medical knowledge.
Earl Howe
I would not disagree with the noble Lord at all. I was about to say that on Report, my noble friend Lady Jolly suggested that there should be a registry and made a commitment to that effect. I would like to clarify that the Government are committed to exploring what may be useful in the data registry. The key here is to establish what could be workable and beneficial. The Government have heard a range of views on the topic of a data registry from those who argue, as many of your Lordships do, that this is essential to the Bill to others, including eminent clinicians, who argue that informal methods of sharing learning are more effective and that a compulsory registry would be overly burdensome.
With thanks to the contribution of your Lordships, the Government have started this conversation and are committed to continued engagement with relevant bodies. Any method of learning that should develop from the Bill must surely work for doctors to be of benefit to patients and the wider medical community. That is no simple task. It is crucial that any mechanism to encourage learning should be developed with a sufficiently light touch so that clinicians see it as facilitative of good practice, rather than burdensome and bureaucratic. It is also important to consider the costs of a method of learning and how this can be encouraged in the most cost-effective way. While I do not take issue with the end-point which noble Lords want to reach, I really believe that it is wise for us to remain open to all possibilities, rather than committing in legislation to an approach which may discourage doctors from innovating under the Bill and therefore not be of benefit to patients in the longer term.
This is a beguiling amendment and I understand the motivation behind it but I hope that noble Lords will join me in questioning the wisdom of having such an amendment in the Bill and accept instead our preferred approach: to continue to discuss this issue with relevant parties as the Bill progresses and, should the Bill pass, to engage with the medical community as to the best way to ensure that innovation can be translated into learning.
Baroness Masham of Ilton
Before the Minister sits down, to do research surely one needs data to see what benefits patients because these are new procedures that we are talking about.
Earl Howe
I would just say that the Bill is not to do with research but with innovative treatment, which is rather different. There is no question of the noble Lord, Lord Saatchi, promoting another form of clinical trial so while I accept the principle that the gathering of data is a very good idea, we must be clear that this is not for clinical research.
Baroness Gardner of Parkes
Before the noble Earl sits down, from the outset we have been very clear that this was to be recorded. Everyone has wanted someone reputable to come forward and say that they were going to record it. To see that this will possibly now not happen is just unbelievable because what is the benefit, unless people in the future can benefit from it and it is accurately recorded? I am sorry to say that I cannot accept the view that this amendment should not be accepted by the Government.
Lord Woolf
My Lords, before the noble Earl sits down for the last time, I am very conscious of the kind things said by the Minister about my interventions, and I can assure him that I hold his approach to all matters of this sort in equally high esteem, if not higher. He is a lesson to us all in the care with which he approaches these matters.
Just before we leave the subject, I want to draw attention to the words,
“comply with any professional requirements as to registration”.
That is a very important limitation in the amendment because—as I understand it; I did not have anything to do with the drafting—it presupposes that there should be professional requirements. Surely we can rely on the medical profession to put in sensible requirements.
Lord Winston
Before the noble Earl sits down—although I do notice that he has managed to take his seat on the Front Bench—I would argue that of course it is not research; we accept that completely. But it is science within the meaning of the Latin word, which has the notion of knowledge, and of course it is wrong for us to exclude knowledge being dispersed and promulgated. Of course, the Medical Innovation Bill hopes to do this, and that is the point of supporting it. Otherwise, I fear that the Bill when enacted will be almost useless. This has been an issue of great concern and was the cause of correspondence this week from many different medical sources. I hope that the Government will consider that very carefully.
Earl Howe
Of course the Government will consider this carefully. Let me make it clear that I do not want to sound negative about the idea of data gathering. I am the first to recognise that that could be a major advantage of the procedures that my noble friend Lord Saatchi is encouraging within the scope of the Bill. I would not dispute that for a moment. My concern is that to build a further requirement into the test of negligence would be the wrong course to take, because that is how this amendment is framed.
Also, what would be the benefit if we do not engage fully with the medical community to make sure that doctors are able to use any registry that might be created easily and simply? If it does not work for doctors, there will be no benefit—so I think that we need to take longer over this. It is not a case of kicking it into the long grass, but in the time available we have not been able to come up with a precise solution, despite our best endeavours in our discussions with the GMC.
Lord Brown of Eaton-under-Heywood (CB)
My Lords, before the Minister finally sits down, does he agree that it would be desirable that any professional requirements of registration should deal not only with innovation,
“under the provisions of this Act”,
but also with innovation that may well be outside the provisions of this Bill but are covered by Bolam and expressly contemplated in Clause 2(1): namely,
“a departure from the existing range of accepted medical treatments”.
That, too, needs to be recorded and registered because it may point the way ahead. As matters stand, that is not within the compass of the proposed amendment to Clause 1.
Perhaps I may further ask the Minister whether he agrees with me that the real purpose of this Bill is to carry Bolam a stage further. Bolam applies if a proposed innovation is,
“a departure from the existing range of accepted medical treatments”,
and is,
“supported by a responsible body of medical opinion”.
Clause 1 of the Bill, as was made plain by the first proposed amendment, deals with a situation where,
“a departure from the existing range of accepted medical treatments”,
may not actually be supported by, but has the respect of,
“a responsible body of medical opinion”.
In other words, the,
“responsible body of medical opinion”,
may not support it, but, taking that into account and having regard to patient safety, none the less respects it and therefore implicitly allows it to go forward as a responsible treatment. That is outside Bolam but within the compass of the Bill.
Earl Howe
I will reply very briefly, with apologies to noble Lords for speaking so often. I have been troubled by the fact that if we were to build this amendment into the Bill, it would apply to those innovative treatments covered by my noble friend’s process and not to other innovative treatments. It would seem inherently odd if we did not have a database that captured all innovative treatments—so, again, we need to consider that, and the noble Lord, Lord Hunt, referred to that issue himself.
On the second point made by the noble and learned Lord, my concern is that—going back to the previous amendment we were discussing—there was a mismatch of wording that does not quite conform to the Bolam test. However, I will consider what he said carefully and come back to him, if I may.
Lord Saatchi
My Lords, I am so grateful to all noble Lords who have spoken on this amendment. I will not in any way detain your Lordships by reciting again what has been brilliantly and articulately expressed by other noble Lords. I will say only one thing about this amendment, which is to pay tribute to Oxford University, whose original concept it was—I refer to Professors Alastair Buchan and Stephen Kennedy at Oxford—that a database should be created to record the results, positive and negative, of innovation under the Bill. The reasons were, as expressed by noble Lords today, to advance scientific knowledge, as the noble Lords, Lord Giddens and Lord Winston, said, and to protect patients with full disclosure and full transparency.
A number of individuals and organisations have told me that any doubts that they had about the utility of the Bill would be removed by the emergence from it of this new and exciting initiative in data collection and sharing. This database will, I hope, be a significant—perhaps enormously significant—development in the field of medical practice. I am confident that my noble friend and the officials in the Department of Health will be able to devise a suitable system, in collaboration with the medical profession and the regulatory bodies, which will achieve what is wanted here.
I will end by saying that I do not remember ever seeing your Lordships’ House in full agreement, on all sides of the House, on one amendment. We have not just had that once, on Report, but have had an exhibition of exactly the same unanimity and strength of feeling again. I very much hope that my noble friend the Minister will not consider voting against the amendment should it be put, but will, as he said, take forward the Government’s commitment to ensure that the register happens and is put in place, and that he will be able to encourage the noble Lord, Lord Hunt, and all the rest of us here that that will happen.
Lord Hunt of Kings Heath
My Lords, it has been a very good debate; I am sorry that it has happened so late in the day. I, too, echo the words of the noble and learned Lord, Lord Woolf, in paying tribute to the noble Earl, who has been extremely helpful during the passage of the Bill. Of course, I am well aware that Sir Bruce Keogh, medical director of the NHS, has himself been extremely helpful in assisting with the drafting of some of the clauses in the Bill.
I will make three or four points. First, the noble Lord, Lord Ribeiro, was very helpful in giving us a practical example of why a register was necessary. The register that he referred to was a voluntary one and was used by most surgeons, but of course not by all. My contention is that, in the specific circumstances of the use of the Bill, we need greater reassurance by having a mandatory register. The noble Lord was concerned in essence that a mandatory register would be a disproportionate requirement, and that in so being it would discourage doctors from using the provisions in the Bill. I disagree with that. All of us have received, at every stage of the Bill, extensive letters from just about all the medical bodies you could think of, all of which have expressed some concerns about the provisions of the Bill. They recognise that the noble Lord has moved a very long way and in a very helpful way, but they remain concerned. My view is that the kind of amendments being proposed today would go a very long way to reassuring those bodies. In the end, the more that those bodies are reassured, the more likely it is that they would provide the advice that would allow their members to consider use of the provisions in this Bill.
We have had a very interesting debate, with contributions from the noble and learned Lords, Lord Woolf and Lord Brown, and the noble Lord, Lord Pannick, on the provisions of the Bill and their relationship to the Bolam test. I make it clear that my amendment refers only to the provisions of this Bill. At Report, my amendment was criticised by the Government because they thought that in its wording it might go wider than the Bill, which is why I have rewritten the amendment to make it clear that it provides only for the Bill. It may well be that, as the noble and learned Lord, Lord Brown, suggested, we should discuss the use of a register in relation to all innovation. However, that is not today’s argument. I believe that we are justified in seeking a specific requirement in relation to the use of this Bill because of its special provisions and, in particular, because of concerns raised by many responsible medical bodies.
On the question of the GMC, I agree with the noble Lord, Lord Saatchi, that it is not beyond the bounds of possibility that the Department of Health and the GMC can come to a sensible outcome within the confines of my amendment. In the end, it may well be that, in the circumstances to which my noble friend Lord Winston has referred, whereby rogue doctors use this legislation inappropriately, it should fall to a fitness to practise committee.
In the end, as the Minister said, we need to engage with the medical community. Many of us have been engaged with it for a long time and we have come under great criticism for seeking to help the Bill. Most of the letters that we received from very responsible medical bodies have asked your Lordships’ House to make sure that the Bill does not proceed. We have tried to be as fair to them as to the noble Lord, Lord Saatchi, and it is through these kinds of amendments that the Bill can go to the other place considerably enhanced. For that reason, I move the amendment.
Lord Saatchi
My Lords, I shall not delay the House, as it is late, but I want to express my enormous gratitude to my noble friend the Minister and to his team at the Department of Health, who have been unfailingly courteous and professional in the most admirable way. One hears that this is a scrutinising House and that it is its particular skill to look in detail, line by line, at legislation in a careful way. I do not know of a case in which that has been better demonstrated than in this Bill, and I take my hat off to your Lordships’ House. I beg to move.