Starvation as a Weapon of War
(2 days, 13 hours ago)
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Baroness Brown of Silvertown
To ask His Majesty’s Government what assessment they have made of the use of starvation as a weapon of war globally, and what steps they are taking to ensure that international humanitarian law is upheld in this regard.
Baroness Brown of Silvertown (Lab)
My Lords, I am incredibly grateful for this opportunity to raise an important issue that affects millions of people around the world. Today is World Food Day, and this year’s theme calls for global collaboration to create a peaceful, sustainable, prosperous and food-secure future. Yet we live with the devastating reality where last year, over 295 million people faced acute hunger. In armed conflicts, both intranational and international, hunger is increasingly used as a deliberate strategy of warfare and control.
Conflict-related food insecurity affects over 140 million people. Humanitarian aid is restricted, aid workers and journalists are killed, cities are blockaded and starved, agricultural land is destroyed and vital food infrastructure, like bakeries, is bombed. Starvation and malnutrition do not only kill people; they destroy the very fabric of societies, making it so much harder to achieve peace, and lock countries and communities in a never-ending cycle of conflict and insecurity.
The use of starvation as a weapon of war in international conflicts is recognised as a war crime in the Rome statute, including starvation through wilfully impeding relief supplies. An amendment in 2019, which the UK has not yet recognised—it would be very good to know where the Government currently stand on this—extends this recognition to non-international conflicts. The UN Security Council has also unanimously adopted Resolutions 2417 and 2573, which condemn the starving of civilians and the deprivation of objects indispensable to survival as methods of warfare.
Yet this abhorrent tactic is increasing in prevalence throughout the world. It is often undertaken with impunity, and we are seeing it across nations such as South Sudan, Afghanistan, Yemen, Ethiopia and Syria. Children are most at risk of death, whether from starvation itself or from preventable diseases that turn deadly because of the way malnutrition weakens our bodies. To quote a doctor,
“Basically, the body just”
shuts
“down … it pulls energy from other organs just to keep the brain going”.
If a child does not die from the conflict or from an infection, eventually, the heart gives out.
“It is a very cruel, slow death”.
The generals’ war against the people of Sudan is a blight on humanity. These generals use their forces to enact a brutal campaign of terror, using mass executions, sexual violence and starvation as inhumane tools of war, with devastating consequences. Over half the country—more than 24 million people—is now in acute food insecurity. Famine was confirmed in 2024 in North Darfur’s Zamzam region and is now present in 10 regions of the country. Some 3.2 million children under the age of five are expected to suffer from acute malnutrition this year.
There are grave concerns about the RSF siege of El Fasher, where 260,000 civilians have been trapped for more than 500 days. There have been indiscriminate attacks on civilians, and a blockade on aid is being used as an attempt to starve the city into submission. Diseases like cholera are increasingly prevalent as critical infrastructure is targeted and vital supplies diminish. Both the SAF and the RSF use starvation as a deliberate strategy to break the civilian population through hunger, fear and exhaustion. A doctor based in El Fasher said:
“The children of El Fasher are dying on a daily basis due a lack of food, lack of medicine. Unfortunately, the international community is just not watching”.
We cannot afford to let this crisis unfold: there needs to be a greater international effort to stop this brutal war. The UK is the UN penholder for Sudan. Is the Minister confident that we are using all our influence on the international stage and within the UN to build a coalition of the willing against those generals, and to protect the people of Sudan?
I very much welcome the doubling of UK aid to Sudan, but within Sudan there are many local actors and organisations that could be used to save lives and distribute humanitarian aid. They have an undaunted spirit, and a hope that a Sudan free from the generals and their catastrophic war is achievable. The recent report from the Independent Commission for Aid Impact has highlighted that the UK struggles to provide direct funding for these local organisations. Can the Minister assure me that the department can address this going forward?
Sudan is a hidden war in which the generals’ forces continue to act with impunity, but that has not been the case in Gaza. We have seen the conflict constantly play out on our TV screens and news feeds. We have followed the flotillas, and millions of us have marched throughout the country to campaign for an end to this war.
Aid has not been allowed into Gaza—except the pittance the Gaza Humanitarian Foundation was permitted to distribute—with often disastrous consequences. More than 12,000 children are acutely malnourished, and more than 150 have died as a result of starvation. A mother in Gaza city wept: “We fast for days, just to leave something for the children. Sometimes, there is nothing—only water. At night they cry, saying, ‘Mama, we’re hungry’. I hold them and say, ‘You’ll eat in heaven’, and then I cry when they fall asleep.”
Given the peace deal, we must now ensure that this truce turns into lasting peace and that humanitarian aid can flow unrestricted into the area. Deliberate starvation of civilians not only kills people; it undermines the very fabric of society, normalises these crimes for future conflicts and weakens the international legal order.
I close with a call for action. We need a united and urgent response to ensure the upholding of international legal norms, and we need accountability for those who have deliberately starved populations as a method of war and control. I hope that by next year’s World Food Day, we will have seen an end to this abhorrent use of hunger—I am not holding my breath—but for this to begin to happen, we need action now.
Baroness Helic (Con)
I thank the noble Baroness for securing this debate. In my own family’s memory lies Sarajevo and the siege, when starvation was wielded as a weapon and for more than 1,400 days, civilians were cut off from food, water, medicines and power. Some starved, surviving on nettles, grass and animal feed; others died as snipers and shells struck queues for bread and water. During that time, 11,500 civilians were killed, including more than 1,600 children.
The UN airlift later known as Operation Provide Promise flew 160,000 tonnes of aid into Sarajevo across more than 12,000 missions. It was far from perfect. Aid was often intercepted and spoiled by the besieging militias and forces, but it prevented famine and sent a message that the world would break the grip of siege designed to starve civilians into submission.
In Sarajevo today, you can see a monument shaped like a vast tin can and printed on it is the brand name ICAR, the canned food distributed to surviving civilians during the siege. It is a gritty reminder of indignity, but also of survival and international resolve. The monument stands not only for what was given but for what should never be withheld: the basic necessities of life. Sadly, the siege is not ancient history. The forced hunger and deprivation that we have seen in Syria, Myanmar, Ethiopia, Sudan and Gaza follow the same tactics. Civilians are reduced to begging for scraps or denied access to humanitarian relief convoys, even as they wait only a few hundred metres away—even as they can see them.
Sudan and Gaza are the most recent examples of this inhumanity. Gaza has been subject, on and off, to full or partial blockade since October 2023. Its civilians were starved, denied basic medical support and stripped of dignity and hope. A cruel collective punishment was inflicted on them, which resulted in a manmade famine. This lack of humanity spreads across countries and into our social media feeds. Only yesterday I was reading about Google’s recent facilitation of false advertising that starvation was taking place in Gaza. Today, it has said that it is not going to remove those posts from Instagram and so on. This week, the withdrawal of aid from Gaza was again used as a threat.
As has been mentioned, using hunger and starvation as tools of warfare is prohibited by international law: the Geneva conventions and additional protocols, the Rome statute and UN Security Council Resolutions 2047 and 2573. We have the legal framework. Yet, despite that legal framework and despite all the promises, outrage and condemnation, starvation is now used just as sexual violence is: not as a tragic by-product or a breakdown of discipline or an incident, but as a premeditated weapon designed to inflict pain and death. Blocked air corridors, denial of relief and seizure or destruction of supplies all contribute to catastrophic hunger and often amount to collective punishment, with consequences lasting generations. As we have heard, an often overlooked aspect is the dire impact that malnutrition has on the brains and bodies of young children. Those who survive never recover.
We do not lack legal means. What is missing is consistent enforcement, political courage and accountability. What we are missing is shame that this is happening on our watch. We in the United Kingdom should always be absolutely clear that there are no circumstances under which the withholding of food to a civilian population—no matter where they are, no matter the colour of their skin and no matter their religion—should ever be tolerated. It should never be allowed.
With this in mind, I ask the Minister to answer a few questions. First, how will His Majesty’s Government ensure that, wherever starvation is used as a method of war, it is systematically investigated and prosecuted? Secondly, with our foreign aid commitment set to fall to 0.3% by 2027—critically, programmes are already being closed in Sudan and elsewhere—will the Government consider ring-fencing resources for starvation prevention as a core humanitarian priority? Finally, what steps will the Government take to embed compliance with international humanitarian law not only in our Armed Forces’ training, but with partners trained here? Can the Minister confirm that proportional defence and military training is allocated under international humanitarian law compliance, so that the forces we train never become perpetrators of these crimes?
The legal tools and precedents exist; moral and political courage must follow. As the president of the ICRC has said:
“International humanitarian law is only as strong as leaders’ will to uphold it”.
I finish by reminding us all that our duty is not merely to condemn starvation as warfare; it is to ensure that starving civilians are protected, not as an afterthought, but as a legal, enforceable and moral imperative.
Lord Oates (LD)
My Lords, I declare my interest as the chief executive of United Against Malnutrition and Hunger. It is a huge privilege to follow that very powerful speech by the noble Baroness, Lady Helic. I thank the noble Baroness, Lady Brown of Silvertown, for securing this debate and for her eloquent words which laid bare the scale and devastating consequences of the increasing use of starvation as a weapon of war.
I will focus on two issues: first, how we ensure accountability and meaningful consequences for state and non-state actors that use starvation as a weapon of war; and, secondly, the role that malnutrition plays in destabilising societies and contributing to conflict.
Recent years have seen an explosion of conflict and of what the World Food Programme describes as the
“increasing ‘instrumentalisation’ of humanitarian aid”.
Humanitarian access is frequently denied. Humanitarian workers are targeted and often killed. Crops, livestock and food storage facilities are destroyed and, as the Mines Advisory Group notes, agricultural land is often rendered unusable as a result of mines or contamination with other ordnance. Action Against Hunger draws attention to how critical infrastructure, such as water systems, markets and transport routes, is frequently attacked, denying communities access to the resources that they require to survive.
Some years ago, I had the privilege to visit Sudan on several occasions, working with the civilian democratic parties before the outbreak of the war. I watched with horror as the fighting created one of the world’s greatest humanitarian catastrophes. Famine is now ongoing in at least five areas, and there is a risk of famine in 17 additional areas. Warring parties have imposed sieges and attacked food infrastructure, leaving over half the population facing acute food insecurity.
In Gaza, there has also been a deliberate policy to deny access to food, fuel and water, contrary to international humanitarian and criminal law. Before the recent ceasefire, which we hope will allow food to get in and alleviate the situation, 95% of the population was in acute food insecurity, 1 million were in emergency levels of food insecurity and famine conditions existed for 500,000 people. In both cases, ostensible allies of the United Kingdom are either imposing such policies directly or supporting armed groups that are. Despite the obligation of third parties to take all measures necessary to ensure that parties to conflicts respect the provisions of international humanitarian law, we and our international partners have done far too little to impose real consequences for these actions and to enforce accountability.
As Action Against Hunger and others have argued, the UK needs to ratify the amendment to Article 8 of the Rome statute, mentioned by the noble Baroness, Lady Brown, so that non-international conflicts are covered. We need to put UN Security Council Resolutions 2417, 2573 and 2730 at the heart of our diplomatic efforts to prevent starvation being used as a weapon of war and to protect humanitarian workers. Where these resolutions are violated, we should be willing to impose meaningful economic and other sanctions.
We need also to look at how we can best support efforts to prevent conflict in the first place. There is a good understanding of how conflict drives malnutrition, but much less well understood is the role that malnutrition plays in destabilising societies and giving rise to conflict. A research study carried out in north-eastern Nigeria by experts from the UN Food and Agriculture Organization, CGIAR and the International Center for Tropical Agriculture found strong links between malnutrition and conflict, and demonstrated that acute malnutrition is an early warning signal of social breakdown in fragile settings.
People who are not getting the food they need may increasingly be inclined to support, or be recruited by, armed groups to ensure food security, shelter and physical protection. This cycle will not be broken without tackling malnutrition, because nutrition is so foundational to individual, societal and economic development, and indeed to global prosperity. We need to look again at the false economy of the huge cuts that we have made to our development budget; there was a cut of more than 60% to the budget for combating malnutrition in 2020-21 alone.
The numbers impacted by deliberate policies to use food as a weapon of war in Afghanistan, DRC, Gaza, Sudan, Yemen and elsewhere are immense, but figures so large can numb us to the real meaning of these actions. That reality was brought home to me by a faded picture of a young boy that my colleague at United Against Malnutrition and Hunger, Roh Yacobi, carries with him always. It is of his younger brother, Mohammad. Roh says this:
“When I was a child, living under a brutal Taliban blockade, thousands starved to death, including my little brother Mohammad. I was the last person to see him alive. He was buried in a small grave in the village graveyard at dawn, and soon joined by more children”.
That is the brutal cost of what happens when parties to conflict use starvation as a weapon of war. Millions of people have been subject to similar blockades, with similar horrific consequences. Such actions will continue with increasing frequency and impunity unless we, with our international partners, are willing to impose meaningful consequences on perpetrators, whether they be our friends or our foes.
Lord Mohammed of Tinsley (LD)
My Lords, I thank the noble Baroness, Lady Brown of Silvertown, for securing this timely and profoundly important debate. I also support wholeheartedly the contributions from the noble Baroness, Lady Helic, and my noble friend Lord Oates, powerful as they were.
Today is World Food Day, when we commemorate the creation of the Food and Agriculture Organization of the United Nations in 1945, born out of the ashes of the Second World War. It stands as a reminder that access to food is not a privilege but a fundamental human right, one that the international community vowed to protect when it said “never again” to the suffering and cruelty of total war. Yet across the world, right now, rights are being violated and weaponised. Food, water and even humanitarian aid are being turned into instruments of war and tools of political coercion.
In Sudan, as we heard earlier, more than 24 million people face acute food insecurity. We also heard earlier about Gaza, where the United Nations has warned of famine, declaring that almost every child under five is suffering from nutrition. In both places, civilians have been deliberately deprived of food, medicine and clean water, not by accident but by design. This is not a tragic consequence of conflict; it is a method of war, and it is expressly prohibited under the Geneva conventions, the Rome statute of the International Criminal Court, and UN Security Council Resolutions 2417 and 2573, yet impunity reigns. The law exists but the will to enforce it has withered.
Food is not the only weapon. We are witnessing the growing weaponisation of water through the destruction of infrastructure, the blocking of access or the manipulation of rivers that sustain entire nations. Water is life itself, yet it too is being politicised and withheld. The recent decision by India to suspend co-operation under the Indus Water Treaty and divert flows from the northern rivers that feed Pakistan should concern us all. For decades, that treaty has stood as a model of cross-border co-operation, even in times of tension. To undermine it for political leverage is to risk regional instability, deepen food insecurity and erode a vital humanitarian norm: that access to water must never be used as a weapon.
This is where the United Kingdom must rediscover its voice. After the horrors of the Second World War it was the UK, with its allies, that helped to forge the rules-based international order: the United Nations, the Universal Declaration of Human Rights, the Geneva convention and the principle that the strong are bound by the same laws as the weak. These were not abstract ideas; they were the moral foundations of a world rebuilt from ruins. That legacy places upon us both a moral duty and a strategic obligation to defend those principles today, to uphold the rule of law when others abandon it and to lead by the strength of our example.
So, what should the Government do? First, the Government should ratify the 2019 amendment to the Rome statute, extending the prohibition of starvation as a weapon of war to all conflicts, whether international or internal. Secondly, the UK must deploy every diplomatic, legal and economic tool available to hold violators to account—whether state or non-state actors, allies or adversaries—including targeted sanctions, as we heard earlier, against those who obstruct humanitarian access or manipulate essential resources such as food and water.
Thirdly, as we heard earlier from the noble Lord, Lord Oates, we must restore our commitment to international development in nutrition, food security and climate resilience. The cuts to aid in recent years have not only cost lives but diminish our nation’s moral authority. Reinvestment in those programmes is not charity but a reaffirmation of who we are and what we stand for.
Finally, our voice must be consistent and principled. International law cannot be applied selectively. We cannot condemn war crimes in one region while turning a blind eye in another. Our credibility and our conscience demand that we speak with one standard, guided by law and humanity. Starvation and the denial of water are not tactics of war; they are crimes against humanity and an affront to the conscience of the world. The United Kingdom, as one of the architects of the post-war order, must not stand silent as these norms are eroded and these crimes repeated.
Let us, on this World Food Day, reaffirm that no person anywhere should ever be starved or denied water as a weapon of war. Let us stand for the principles our forebears fought to defend: for the rule of law, for human dignity, and for the belief that the measure of a nation is found not in its power but in its moral courage to uphold what is right.
Lord Browne of Ladyton (Lab)
My Lords, given the gravity of the events that are the subject of today’s proceedings, while it is not exactly a pleasure to contribute to this debate, I am pleased to follow the noble Lord, Lord Mohammed of Tinsley, and to thank him for his powerful contribution, and to have the opportunity to thank my noble friend Lady Brown of Silvertown for securing this debate and for a clear-eyed, informed, impressively analytical and forensic speech. I shall not repeat the appalling statistics and data that show the extent to which starvation as a weapon of war is deployed globally, but I will focus on a limited number of issues.
Like all noble Lords who are contributing to this debate, I received briefing notes from INGOs. They are, independently and collectively, both comprehensive and helpful. Helpfully, they include recommendations of questions to my noble friend Lord Collins of Highbury, whom I am delighted to see speaking from the Front Bench on this issue. I hope that he and his office have had the opportunity to review the briefing notes we all received.
I have in the past suggested that your Lordships’ House should find a way of publishing with the Hansard record the briefing notes that we receive to complement the debate. I am convinced that, if they are moderated before publication, such briefing notes will show the degree to which, in its deliberations, your Lordships’ House is engaged with and connected to the outside world and values the knowledge and experience of those who have expertise in particular policy areas. However, and sadly, publication in this case would have detrimental repercussions on the very authors of these notes because they require humanitarian access, and it would only get worse if they are known to have been doing this. So I will not press the issue in this debate but will focus on three issues.
First, on the Rome statute amendment, the UK has long prided itself on being a global leader in upholding international humanitarian law, yet it remains one of the few countries not to have ratified the 2019 amendment to the Rome statute. This amendment criminalises the deliberate starvation of civilians in non-international armed conflicts, closing a critical loophole in international law. It puts the legal framework in place for the ICC to pursue investigations and prosecutions of starvation crimes when they occur. By ratifying it, the UK would send a clear signal that starvation—whether in Gaza, Sudan or elsewhere—can never be an acceptable tactic of war. Ratification would cost us nothing but would show that we mean what we say about accountability and the protection of civilians. It is time for the Government to take that simple but powerful step. Will the Government commit to ratifying the 2019 Rome statute amendment and ensure that the necessary co-operation and enforcement mechanisms are in place so that this vital legal reform has real effect?
On ODA spending and conflict prevention, we cannot separate famine prevention from conflict prevention. Yet, as my Government have reduced UK ODA to 0.3% of GNI, they have also drastically cut spending on peacebuilding and conflict resolution—the very areas that prevent conflict and humanitarian crises before they start.
If the UK wants to help to break the cycle of conflict-driven hunger, it must reinvest in its tools of diplomacy, mediation and early warning. Restoring ODA levels is part of that, but so too is ensuring that our remaining aid is directed towards reducing violence and protecting civilians, not simply responding after catastrophe strikes. Can my noble friend, whom I greatly admire and who has the ear of your Lordships’ House, confirm what proportion of UK ODA is currently allocated to conflict prevention and resolution, how this compares to previous years and what rationale underpinned those reductions?
Finally, on Israel and the use of starvation as a weapon of war, in Gaza today almost the entire population faces acute food insecurity and more than half a million people are in catastrophic conditions. It is a famine in all but name. Access to food, fuel and water is being systematically restricted in direct violation of international humanitarian law. The Government must be clear that the deliberate deprivation of food as a method of warfare is prohibited under international law. We must press Israel continuously to comply with those obligations and ensure that humanitarian access is immediately and unconditionally restored. The UK cannot champion international law abroad if it applies it selectively. What representations have the UK Government made to Israel regarding the use of starvation and the obstruction of humanitarian access and what response has been received from the Israeli authorities? In the words of Justa Hopma, research fellow at the University of Sheffield, writing in the Conversation:
“Famine doesn’t just ‘happen’ - and those who cause it must be held to account”.
Lord Bruce of Bennachie (LD)
My Lords, I am grateful to the noble Baroness, Lady Brown of Silverton, for this debate and I am grateful for all the powerful speeches that have been made, all from perspectives of people who know, care and are involved in this issue. Each one of them has added a different aspect of the dimension, which we should all appreciate.
As people will know, I spent 10 years as chair of the International Development Committee watching what the UK could and did do in humanitarian aid and I am appalled that we are no longer able to do that. There is a really important point here. Not only did we do stuff, but we were witnesses to what was going on. The plea that has come from every speech about ensuring that consequences flow from imposing starvation as a weapon of war means something. If there is nobody there to see it happening, it is surely much harder to promote successful prosecutions, so the absence of aid workers is an issue. It is probably the reason why so many aid workers are killed by protagonists—325 last year, as the World Food Programme has identified.
Of course, it is odd to have rules for war. War is a terrible thing and terrible things happen, but we have created rules. Many players in the past have attempted to take account of them, but the actors who are playing now are not interested in the rules; they have total disregard for the rules. They are state and non-state players and they think that there is no accountability. That is the problem. The message from everybody seems to be, “What are we going to do about it?”
On Article 8, first, it should be ratified, but, secondly, we need to clarify what the intention is. Nearly all the speeches identified situations where it should not be difficult to prove the intention—that starvation and deprivation of water and food was a deliberate act to intimidate people, put them into a desperate situation and subjugate them. The noble Baroness, Lady Brown, is right that Sudan is the worst situation and is on an almost unprecedented scale. Hopefully, the situation in Gaza is about to become better, but let us not hold our breath. Other places, such as Mali and Haiti, are in pretty desperate straits. There is no doubt at all that hunger is increasing. Not all of it is caused by conflict, but more of it is conflict-related than anything else and more of it is being deliberately perpetrated rather than being just an incidental consequence of the conflict.
I want to make a suggestion that may not be appreciated by everyone. We have a very real concern in this country about migration—desperate migration—but what drives this migration is exactly this. If you are in a situation where you are trapped, then of course you cannot get out, but if you are in a situation where there is no food or water, your family are threatened and you are under attack, what are you going to do? You get as far away as possible if you have half a chance.
A point that many of us made about why the aid cuts were such a mistake is that one of the things that aid did was help to reduce and remove some of the pressures of migration for desperate people. I therefore make no apology for saying that in my view the Government got it badly wrong. They can do it differently, and that is fine. The noble Lord, Lord Browne, said the cuts brought the aid budget down to 0.3% but, when you take out the handling of refugees in the UK and the consequence of that, it is about 0.1%. In other words, it has gone—it hardly exists. I genuinely think that Ministers such as the noble Lord, Lord Collins, and the noble Baroness, Lady Chapman, care about this and I regret that they have to perpetrate a government policy about which I am sure they are as appalled privately as I am. I hope that they will use their voices inside to make clear how strongly people feel about this and how it is connected to the domestic agenda.
One of the reasons why it was possible to rip up the aid budget was that the consensus broke down and opportunist politicians started to denigrate its achievement: “Oh, it was just charity. It was a waste of space. It wasn’t effective”. I know how effective it was because I saw it. Most of that was misrepresentation and untruth, but the consequence was that politicians took the view that, “These are faraway places of which we know little and the British public are much more concerned about domestic issues”— of course that is true—“and they’re concerned about migration”. We fail to point out to them that if we do not support these communities and these people in situ, that adds to our problems. It creates a situation in this country that we have to deal with.
I argue that, from a moral point of view, this timely debate is absolutely right. My final plea to the Minister—I know that I am knocking at an open door—is that he will use whatever means he can to ensure that the UK Government take genuine, consistent leadership to condemn this, but also to do everything they can at every opportunity to make it clear to those protagonists that there will be consequences. When people see that there are consequences, that will not stop it but it might reduce it. And please have a rethink about our aid policy, because it is not serving our national interest.
Lord Callanan (Con)
My Lords, this has been an excellent, albeit brief, debate. I, too, thank the noble Baroness, Lady Brown of Silvertown, for securing the debate and for her extremely powerful opening remarks. It is worth putting on record my party’s deep-felt relief that a ceasefire has now, hopefully, been reached in Gaza, that the remaining hostages have been released and that the war that has caused so much death and destruction over the past two years now appears to be over, although, while I join the noble Lord, Lord Bruce, in very much hoping that it is at an end, there is still an awful long way to go.
As the noble Lord, Lord Browne, observed, it is hardly a pleasure to contribute to this debate on such a tragic subject. It is a worry that reports of starvation being used as a weapon of war are still in abundance and, frankly, getting worse across the world. The noble Baroness, Lady Brown, and others have drawn attention to the situation in Sudan. It remains a wonder to me that, while we have seen thousands marching on our streets regarding Gaza, we have seen virtually no one marching regarding the much worse situation in Sudan and it makes me wonder about the motivations of some of the protesters.
The reports that we have seen include, from Sudan, an estimate by the UN of 25 million people being deliberately starved; 4.5 million in Somalia; and accusations of a covert, and sometimes overt, starvation operation by Russian forces in Ukraine, among others. Sadly, none of those has yet led to any prosecutions, which speaks to the difficulty of verifying the use of starvation as a weapon of war in general, let alone in some of the active war zones. That point is driven home by the fact that there has never been an international prosecution of this as a war crime on its own. It is for that very reason that it is hard to verify cases of weaponised starvation. If they are, punishment must be executed in a timely fashion so that justice may be seen to be done. It is not something, as other speakers have observed, that can be solely delegated to judges in The Hague; the UK and our allies must continue to commission and support the gathering of evidence and press for those cases to be brought to court.
I sympathise with Ministers; Ministers in my Government also spent much time on this matter. But producing change of course requires more than paying it lip service; it means interacting with international partners, including those currently at war. We in the previous Government secured commitments from the Israeli Government, by working and collaborating with them, to open specific pathways for aid, such as the Erez crossing and the port of Ashdod. We extended aid hours and ensured that more aid trucks were promised entry.
I thank all noble Lords who have spoken in this debate. We should all benefit from hearing from the Minister about the steps the Government are taking to ensure that starvation is not used as a weapon of war. We are proud signatories of the Rome statute, and we should be doing our utmost to take practical actions to uphold it.
Lord in Waiting/Government Whip (Lord Collins of Highbury) (Lab)
My Lords, I start by expressing my gratitude to my noble friend for securing this debate. I am also grateful to all noble Lords for their contributions. The simple fact is that millions of people today are dangerously malnourished because of conflict, and too often this malnourishment has devastating consequences, in particular for children. It has severe and often irreversible impacts on their physical growth, cognitive development and immune system, perpetuating a cycle of poverty and ill health, as the noble Lord, Lord Oates, highlighted.
It also impacts on the very thing we want to achieve: economic development. Growth, jobs and education are the key elements for changing this disastrous situation. The noble Lord, Lord Oates, is absolutely right about malnutrition: addressing nutrition is the foundation for real change. The Government of course acknowledge that the deliberate deprivation of food, water and other essentials for civilian survival is a growing and persistent threat.
Let me address the questions from my noble friend Lord Browne and other noble Lords on ODA and the current situation. The Prime Minister has made it absolutely clear that for us to achieve a safer and more prosperous world, we need to address aggression, particularly the prevention of conflict, which is a priority. Certainly, the difficult decisions we have made have been in response to the aggression committed by the Russian Federation. But I stress what noble Lords have heard me say before: ODA is not our only tool in ensuring peace, prevention and development. We need to use every tool in our toolkit to ensure that we can focus. A key element of that is supporting those conditions to ensure investment and increase trade. We are absolutely focused on that.
Promoting compliance with international humanitarian law is at the heart of our foreign policy. Our debate has underscored a sobering truth: as many as 70% of major food crises are directly linked to conflict and insecurity, according to the World Food Programme. We have seen patterns of sieges, blockades and denial of access in multiple contexts, so ably evidenced by the noble Baroness, Lady Helic, whose personal experience is true evidence of this terrible situation. In too many cases, these patterns are not collateral consequences of war; they are being used deliberately to weaken, punish and displace civilian populations.
It was against this backdrop that, as the Minister covering Africa and human rights, I attended the launch event in May this year for the Government’s legal handbook on conflict, hunger and international humanitarian law. To reassure the noble Baroness, Lady Helic, this handbook is not only a guide for our diplomats, lawyers and Armed Forces but a very important advocacy tool, setting out clearly what the law requires of all parties to conflict, including non-state armed groups. This is important because famines are significantly less likely to occur if all warring parties, including non-state armed groups, comply with international law.
The handbook also firmly backs UN Security Resolution 2417, as my noble friend set out, which helped the United Kingdom in 2018 when we joined the consensus on the amendment on the intentional use of starvation as a method of warfare in non-international armed conflicts—which was adopted, as she rightly pointed out, by the ICC Assembly of States Parties in 2019. Our position on ratification remains under review. The simple fact is that we need to ensure a very strong coalition for action, as she pointed out.
Many noble Lords also referred to Gaza, where we are witnessing a catastrophic man-made famine. As the Prime Minister said, the welcome ceasefire agreement must be implemented in full, without delay, accompanied by the lifting of all restrictions on life-saving humanitarian aid to Gaza. To respond to my noble friend Lord Browne, the Foreign Secretary delivered a very strong message at the UN Security Council on 23 September. We also led joint statements with over 30 partners, pressing Israel to allow food, medical supplies and fuel to reach those in most desperate need. The ceasefire is that opportunity to get desperately needed humanitarian aid in there, fast.
We are also funding a £74 million aid package this financial year for Palestine and Palestinians across the region. Alongside our diplomatic efforts to increase humanitarian access, this is contributing to providing food, shelter and support for over two million people. There is no doubt that this is saving lives.
Many noble Lords, but my noble friend Lady Brown in particular, along with the noble Lord, Lord, Oates, highlighted Sudan. We are deeply alarmed by the UN fact-finding mission’s findings that starvation has been deliberately used there as a method of warfare. No one could have failed to be moved by this morning’s BBC “Today” programme, which had first-hand evidence of the impact of that starvation on not only the civilian population in general but children in particular, and its absolutely horrific consequences. As my noble friend and other noble Lords have said, almost 25 million people are acutely food insecure, and almost 9 million are on the brink of starvation. This is absolutely abhorrent. I congratulate the BBC for reporting on that, but we are not getting sufficient focus on Sudan, and we need to do more.
As the third largest humanitarian donor in Sudan, we have already provided aid to over 2.5 million people since the conflict started. To reassure noble Lords, we are using our position at the UN Security Council and Human Rights Council to call out violations and demand rapid, unimpeded humanitarian access. At last year’s UNGA, I also led a meeting where we brought in first-hand evidence from the victims of sexual violence and from those who were suffering as a consequence of food deprivation. In October, we led efforts to renew the UN fact-finding mission’s mandate for a third year, securing the strongest council support and reinforcing the independent mechanism investigating human rights abuses across Sudan.
I will briefly mention Ukraine. We are fully committed to holding Russia to account for its illegal and barbaric actions, and we have welcomed the agreement between Ukraine and the Council of Europe to have a special tribunal for the crime of aggression. It is a good example of how we can hold people to account. We are absolutely strong supporters of the ICC, and we are determined to hold those responsible for serious violations of IHL to account. To address the point made by the noble Baroness, Lady Helic, we are also supporting Ukraine and the training of its troops in international humanitarian law. It is a good idea to see how that works in practice, and how we can spread that good practice.
It has been a great, important debate, focusing on issues that are often too silent. We must ensure that starvation must never be a weapon of war. We must never be silent when it is used as one, because protecting civilians is not optional; it is both a legal obligation and a moral imperative.
Music and Dance Schools: Affordable Access
Lord Blackwell
To ask His Majesty’s Government whether they are committed to maintaining affordable access to specialist music and dance schools for talented children of all social backgrounds.
Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)
My Lords, just before the noble Lord, Lord Blackwell, starts, I emphasise that the timings on this debate are very tight. Most speakers have two minutes, so can noble Lords please stick within that, so that everybody can be heard and the Minister can have adequate time to respond.
Lord Blackwell (Con)
My Lords, my purpose in raising this question is to highlight the vital role of MDS, the music and dance scheme, which provides means-tested support to enable exceptionally talented young children from all backgrounds to attend specialist music and dance schools. I should draw attention to my interest as governor of the Yehudi Menuhin School and the Royal Academy of Music, both of which have students who participate in this scheme.
There are a handful of specialist music and dance schools in the UK that take exceptionally talented and highly committed youngsters and provide them with the advanced tuition they need to achieve their potential. The children who attend are at the very top of their peer group, and most go on to make careers as acknowledged leaders in the music and dance professions. To fulfil their mission, these schools aim to take the highest-potential children regardless of their social background and financial means. The intense specialist education that these schools provide, mostly within a boarding environment, is expensive and beyond the means of all but a few parents. The boarding fees at the Menuhin school, for example, are almost £50,000 a year—and that does not cover the full cost. Musical talent is not restricted to wealthy families, and the music and dance scheme provides the financial support that is essential to enable talented children from any background to attend. Therefore, while these schools are classed as independent schools, they are not the preserve of rich, privileged kids.
At the Menuhin school, for example, only a handful—under 10%—pay the full fees, and they have to earn their place on ability just like every other pupil. The other 90% can benefit from this special environment only because of the financial support they receive from MDS, together with the bursaries funded by charitable donations. Without MDS funding, some of these schools would no longer be financially viable. Unlike many private schools, with such a limited number of full-fee payers, they cannot simply expand the number of pupils paying full fees and raise enough money to subsidise scholarships to those from poor families. Further, any lowering of standards to accept wealthy children who do not have the talent or commitment to reach the top of their profession would not be fair to those children, putting them in an environment where they were unlikely to succeed. Nor is it realistic to make up any shortfall through more charitable donations. Every one of these schools is already struggling to raise enough funds to fill the hole in their finances, and they do not have massive endowments.
After several years of zero or limited increases in the MDS funding, we are now approaching a crisis point. Over the past 10 years, the real value of fees funded by MDS has fallen by more than 15%. On top of general inflation, in the last year these schools have been hit with the additional costs from the loss of business rates relief, higher national insurance contributions and VAT on fees. Responding to an Oral Question in June, the Minister, the noble Baroness, Lady Smith of Malvern, made clear her personal commitment to the long-running MDS scheme, and I welcome her success in securing this year’s MDS funding in last year’s settlement. However, whereas historically, schools received a three-year settlement, there has been no assurance that the funding will continue beyond this year. The absence of a firm commitment to future funding at a level that makes these schools financially viable is putting them, and the parents of their children, in an impossible position, with no certainty for some of them about whether they will be able to continue.
To lose these schools would be a tragedy not just for the exceptional youngsters from all backgrounds who benefit from their unique support, but for the artistic calibre of the country in the years ahead. The Government have declared that creative industries will be at the heart of their industrial strategy, and their sector plan set out a commitment to back the next generation of British talent. The Government’s support for music hubs to broaden access to music education is welcome, but it does not replace the role of the MDS. As with sports, we need to support excellence in every field of artistic endeavour not just for those individuals but for the leadership and aspiration that they transmit in raising standards across the board. The outreach programmes of these schools are also very important and complementary in delivering this.
I understand the constraints around budget decisions, particularly in the current environment. However, the cost of this vital support—some £36 million a year, including the cost of the advanced training centres—is small change in the budget ledgers. In responding to this debate, I hope that the noble Baroness, Lady Blake, will put on record the Government’s commitment to maintain the MDS at a level of funding that will ensure the future of these small but precious schools, and that we see that reflected in next month’s Budget announcements. I thank other noble Lords for their interest in this debate and look forward to hearing the Government’s response.
Baroness Warwick of Undercliffe (Lab)
My Lords, clarity on the future of the music and dance scheme to ensure access to specialist music and dance education for students, regardless of their background, is urgently needed. As a supporter of the National Youth Orchestra, I wholeheartedly support the points from the noble Lord, Lord Blackwell, but I put in a plea to ensure that all our youngsters have a high-quality creative arts education in primary school and on through secondary school.
Music education is in a parlous state in many mainstream schools. Many commentators have pointed to the absence of the arts from the English baccalaureate as a key reason for the decline in these subjects in our schools. Secondary schools are measured on the number of pupils who take GCSEs in these core subjects. Another measure, Progress 8, introduced in 2016, adds further pressure to prioritise EBacc subjects. Neither the EBacc nor Progress 8 specifies music, dance or drama in their assessments. Since 2010—the year that the EBacc was introduced—there has been a 42% drop in overall arts subjects and GCSE entries in music in England have fallen 25%. Music A-level entries to England fell for the third consecutive year.
The EBacc has made art subjects an add-on with which schools can dispense, yet teachers tell me that music is often now the only subject where an entire classroom of 30 students work together as one, building collaborative skills and social confidence. Music develops creative intelligence; our creative industries start in the classroom.
Will the Minister assure us that creative subjects will be properly recognised in the anticipated curriculum and assessment review? The recent £88 million “Building Creative Futures” package is encouraging, but to ensure that every child has access to a high-quality music and arts education in school requires concrete action, not just good intentions. Will my noble friend the Minister start by putting the arts back into the EBacc?
Baroness Bull (CB)
My Lords, I speak in this short debate as someone who owes her career to a predecessor of today’s music and dance scheme. I will focus my time on what it takes to achieve that success in the highly specialised field of dance. Without that understanding, it is easy to underestimate the importance of the MDS.
Elite performance—and I use that word as we do for athletes—is performance at the limits of human potential, characterised by extreme flexibility, accuracy and speed. It is achieved only through 10 years of intense daily practice under expert tuition in specialist facilities; those 10 years have to start before puberty sets in if a dancer is going to compete in a global market. It is not just about physical prowess; it is about training the brain to send precise movement commands and issue corrections faster than the human eye can see. When you watch an expert dancer, you are seeing the cerebellum at its most extraordinary.
This intensity of training is impossible to achieve within the state school system, which does not have the teachers, the spaces or the hours in the day. And it is expensive; without government support, it is beyond the reach of many talented children. Over 50 years, Governments have recognised this through the music and dance scheme, which allows specialist schools to trawl wide and offer places on talent alone, blind to financial or social circumstances.
The Prime Minister has often said, “Talent is everywhere, opportunity is not”. The MDS schools offer that opportunity but 12 years of funding freezes mean that it is a system under strain. I therefore ask the Minister to press the Treasury to deliver the £4 million the schools need and restore the three-year settlements so that the schools can plan efficiently and children can be confident of completing the training they begin.
Without this investment, the scheme is at risk. This risks not only the talent pipeline that underpins the UK’s global creative success but a return to a world in which only the most advantaged can access the opportunities their talent deserves. I feel sure that the Minister does not want this to be the legacy of her party’s years in power.
Baroness Bottomley of Nettlestone (Con)
I send my warmest congratulations to my noble friend Lord Blackwell and my appreciation of his dedicated service at the Yehudi Menuhin School. It is always a privilege to follow the noble Baroness, Lady Bull, who was principal dancer at the Royal Opera House when I was Secretary of State in the mid-1990s. She is a wonderful advocate for dance; it is always so important to remember that dance matters quite as much as music.
It was a privilege to be Secretary of State for Culture, Media and Sport, but I am aware that whereas on the sport side there was a real commitment to investing in creating international excellence and successful Olympiads, on the music, dance and arts side, much went into restoring our wonderful institutions, doing what Sir Ernest Hall called creating the “national treasure houses”. As he said, the National Lottery did for the arts and culture what the Medicis did for the cultural treasure houses in Florence. We did not focus on the pipeline, however, and that is the critical issue now.
Talent is everywhere; regrettably, opportunity is not. The 2024 Sutton Trust report on social mobility and the creative industries is a call to action. Privately educated students represent more than half the students at the most prestigious conservatoires. At Oxford, Cambridge, King’s College and Bath, more than half the creative students came from upper middle-class backgrounds. At Hull, where I had the joy of being chancellor for 17 years and which has a top 10 music school and a very impressive dance school, it was better but not good enough. Among under-35s, there are four times as many individuals from middle-class backgrounds in the creative industries. We have to do better to extend opportunity. The Sutton Trust calls for an arts premium to fund arts opportunities. I ask the Government: what is their practical action?
Malcolm Gladwell refers in Outliers: The Story of Success to the 10,000 hour rule: to become an expert, an elite performer requires 10,000 hours of practice. How can the Government help us to ensure that for the young people of the future?
Baroness Royall of Blaisdon (Lab)
My Lords, I have worked to ensure access to excellent education for talented children from all social backgrounds, and specialist music and dance schools are no different. As a society, we have a duty to break down barriers that prevent young people from underrepresented backgrounds—working-class kids—achieving their potential in the subjects in which they have exceptional talent. Education transforms lives, enables social mobility and is a great way of investing in our economy and future growth. My friend Natasha Kaplinsky, chair of the Royal Ballet School, brought this issue to my attention. The school is a shining example of excellence and accessibility. However, it has great financial challenges.
I particularly like the title of the MDS paper, Supporting Potential Before Privilege. It is clear that we have to do this both to ensure fulfilment and success for the students themselves, and to safeguard the domestic talent pipeline for the creative sector, which contributes such a vast amount of money to the Exchequer, as well as providing thousands of jobs.
To sustain the success of our creative industries, we must nurture talent and develop skills. The UK’s status as a global creative superpower, of which I am hugely proud, is only as good as the talent that underpins it. The education that students receive in the music and dance schools simply cannot be provided in mainstream schools, and it must be protected. Financial support is critical to ensure that talented children and young people from all backgrounds can become the stellar performers of the future. It is also vital to enhance the resilience of the schools. I therefore strongly support calls on the Treasury to provide an uplift of £4 million to the current MDS settlement, and I support restoring three-year MDS grant agreements from the DfE. It would be a tragedy if not only was access limited but schools themselves had to close.
Lord Vaizey of Didcot (Con)
My Lords, there were comments last week about Canterbury Cathedral posting graffiti in the great cathedral as part of an exhibition to attract young people. Many people saw as it as an act of great vandalism. I rather saw it as quite avant-garde, experimental and exciting, but that is an aside.
I hope that by securing the music and dance scheme, we ensure that we do not commit an act of vandalism against one of the great music traditions in this country, which is, of course, English choral music. I can use the opportunity of this very brief speech to praise the Church of England for its support of English music. We have more than 2,000 choristers and more than 207 cathedral choirs. When I was in the other place, I was lucky enough to represent a constituency that had chalk streams in it, a unique geographical feature of England and northern France, and we fought hard to preserve them. We must not inadvertently lose one of the most important music traditions in this country.
In many respects, this debate is a metaphor for all Governments’ approaches to the arts. Nobody is suggesting that the music and dance scheme is under fundamental threat. It is part of the Government’s national music plan. It is ably supported by £34 million of funding. The message that goes out today from this debate, as it should for the arts in general, is: please may we have long-term funding rather than just one-year grants, which are impossible to manage? Three-year grants are not too much of an ask. Please, can we stop nickel-and-diming the arts budget? It is a pinprick on the Government’s budget. The budget for the music and dance scheme is a pinprick on their budget but the rewards are almost limitless.
The Earl of Clancarty (CB)
My Lords, at this moment in the Government’s lifetime it feels important to make, or at least re-emphasise, some basic points. The arts, as opposed to the wider creative industries, are themselves an engine of growth. The more financial support there is from the Government, the more jobs are created and the greater the financial rewards, many times over, for the Treasury. This is aside from the democratic necessity of both the arts and arts education, which are part of the same ecology. I say this now because of the very worrying signs that this message about the importance of the arts to the industrial strategy is simply not getting through.
The signs include the hugely disappointing cuts to DCMS funding, which, as has been said, are drops in the ocean in relation to overall Treasury funding; the decision to stop state funding of the international baccalaureate, which is so important for the arts and critical thinking; and the complete axing of ITT bursaries for all arts subjects, including music, which the Independent Society of Musicians described as a damaging decision just before the final report of the curriculum review. These savings are false savings; they save very little money but are potentially devastating for the arts. With the eight music and dance schools in England, we are talking about the achievement of excellence in the arts alongside an inherent commitment to social mobility, a double whammy in a good way, and a no-brainer, surely, for the £4 million funding required to enable these schools just to survive. This is yet another test case of how much this Government are willing to make that commitment to invest in the arts that the Prime Minister himself promised for both the arts and arts education 18 months ago.
Lord Liddle (Lab)
My Lords, first, I must say how much we miss Lord Lipsey in this debate as he was totally committed to the cause that we are discussing today. I support those who have spoken eloquently in favour of the future of the music and dance scheme and scholarships. My wife was for several years managing director of the English National Ballet and then went on to serve on its board for many years, and I know Caroline believes very strongly in the case for specialist schools.
I have two points to make. First, I agree with the noble Lord, Lord Vaizey, about the importance of cathedrals, particularly in church music. My own cathedral, Carlisle Cathedral, set up the school that I went to some time in the seventh century, allegedly with St Cuthbert. It has a very long but fragile tradition, and it needs support. It needs a new partnership between the state and the church in this area of music education.
My second point is that, yes, we need more scholarships at specialist schools, but we also need a broader base of encouraging experts in the arts throughout our education system. This is where changes in the curriculum are so important. Before the election, the Prime Minister said:
“Seriously, in what world does learning to act, dance, sing or paint count less than learning a language from more than a thousand years ago?”
He went on to say:
“We’re going to update the Progress 8 performance measure and use it to help all kids study a creative arts subject or sport until they’re 16”.
Does the Minister believe that the Government are going to deliver on the pledge that Keir Starmer made?
Lord Black of Brentwood (Con)
My Lords, I declare my interest as chair of the Royal College of Music, one of our leading conservatoires, ranked number one in the world QS rankings for performing arts. That we are able to be a global leader in this way, a huge source of soft power for UK plc, is because of the health of our music ecosystem. That ecosystem, the so-called pipeline, is in danger as never before. If it fails then the threat to the future of music in our country is, without exaggeration, existential. It is a delicate organism, depending on many interlocking actions, from primary school teaching right through to the conservatoires and universities where tomorrow’s musicians are trained.
Central to that fragile but vital system are the music and dance scheme schools, the seedbed from which so many of tomorrow’s talented music graduates grow. The future of our conservatoires, in turn, is absolutely predicated on their success. Last year 123 applications for the BMus course at the RSM came from the MDS schools, resulting in 73 offers being made. That is a significant proportion of those coming to study and providing the greatest talents. If the MDS schools failed, with their rigour and training, it would have enormous consequences for all conservatoires. For a tiny amount of money—a rounding error, frankly, for the Treasury—the return is incredible. It is difficult to think of a more important investment in the future of our creative industries, and one on which we should in fact double down.
The future of music in this country hangs in the balance as we wait for action from the Government on so many fronts—on copyright protection, the school curriculum, the future of the Arts Council and the future of the hubs, which exist from hand to mouth because they have no guarantees of funding. I understand that those are all complex issues that can take time, but here we have one that is really simple and which could immediately both help to secure the future of the ecosystem and, at the same time, signal the Government’s commitment to the music. The MDS is a huge success, it is integral to the ecosystem and it pays for itself many times over. Let us show our confidence in it by uplifting its current settlement and restoring three-year grant agreements.
Lord Hall of Birkenhead (CB)
I shall speak in favour of another part of the MDS scheme: the role played by the centres of advanced training, the CATs. These provide specialist training in music or dance for talented 10 to 18 year-olds, while allowing them to stay at home and attend their regular schools. When I chaired the Music and Dance Advisory Board in the noughties, a long time ago, this was a scheme that we all wanted to cherish. What could be better than finding talent wherever it might be, supporting it, nurturing it and giving financial support to those who otherwise would never conceive of having a life in music or dance? That is what these centres—the CATs—do.
However, for that to work, you need long-term commitment. It is difficult to run anything involving people’s lives as this does—young lives—when you are living from year to year not knowing where the money is going to come from. The support that they need to grow is measured over years, not the short-term cycles that we all work on. I also think that commitment should include—and indeed increase—going out there, working in schools and looking for talented children. I myself have seen the inspiration that can come from a dancer or a musician working up close with children in schools.
This morning I had an inspiring chat with an alumnus of a CAT about just that. Reece McMahon grew up in York in a single-parent household on a council estate with no car. For him, it was the Northern School of Contemporary Dance coming into the classroom in his secondary school that lit the spark. As he said to me:
“That visit genuinely opened up the rest of my life”
and
“It gave me confidence”.
That is why CATs cannot be passive, waiting for people to come to them. They have to create those transformative moments and be funded to do so. Reece, by the way, now runs Chisenhale Dance Space. I think he is the youngest dance leader in the UK. He is passionate about giving opportunities to others, opening up doors, however difficult the funding landscape is. As he and I were agreeing, it is not that we lack evidence—we know this works. Over more than two decades it has been finding and producing some really talented people. Let us keep on opening those doors.
Baroness Fraser of Craigmaddie (Con)
My Lords, I stand before you as an alumnus of Tring Park, one of the MDS schools. Dance is, I believe, the “Cinderella” of the arts. The noble Baroness, Lady Bull, talked about the years of training but there is little chance of making money. The UK is blessed: we have world-class ballet companies and schools, but there is a danger that they are filled only with those who can pay and talented foreign dancers.
The Government recognise dancers as critical to economic growth, as they are included in the list of priority professions for visas, but without sustained public funding we will not have homegrown talent—no more Billy Elliots, no more Reese McMahons, no more like the noble Baroness, Lady Bull. Ninette de Valois recognised the need to nurture homegrown talent in 1926 when she created a school before she founded a company.
Professional dance training is expensive. There are audition fees, even for the associate programmes, requirements to travel—sometimes for many hours—around the country to access training hubs, and, even with MDS contributions, fees are more expensive now with VAT. MDS support does not cover exam fees, registration fees, music supplies, physio, insurance, uniform or shoes—and yes, ballet dancers get through a heck of a lot of shoes. This is all before we consider the impact on the rest of the family. You need either really dedicated parents to take you to all these classes, summer schools, intensives and exams, or to be able to afford to board. Neither option can be said to be truly affordable for many families.
Ballet is a global market. We have an incredible British heritage but if there is to be a future for British dancers within our great schools and companies, then truly affordable access to specialist training, through the MDS and CAT schemes, must be maintained for the longer term.
Baroness Keeley (Lab)
My Lords, the music and dance scheme or MDS is a vital gateway for talented children from disadvantaged backgrounds to access world-class training. It is a success story that we must protect to ensure the future pipeline of talented musicians and dancers in the UK.
Schools such as Chetham’s School of Music in Manchester—technically independent but primarily funded through MDS—are in financial distress. Rising costs and the introduction of VAT on fees have compounded issues which were caused because government grants have been frozen or increased below inflation since 2011. Chetham’s actually made efficiencies to manage within budget, and says it would be breaking even this year without the increase in national insurance and the teachers’ pay rise.
At the Hammond School in Chester, students come from Liverpool, Wigan and St Helens but every parent relies on financial support—whether from MDS, dance and drama awards, bursaries or charities. That school absorbed the VAT on fees, as it felt it could not pass it on to families. Now it is operating at a deficit and fears becoming financially unviable within two years. Chetham’s and the Hammond are vital to ensuring specialist training for children in the north of England. These are not typical fee-paying institutions. They are grant-funded centres of excellence in music and dance, serving children whose families cannot afford fees.
I had the privilege on Sunday of speaking to Carlos Acosta, at an event where he was honoured for his outstanding contribution to British theatre. He came from a poor family—as one of 11 children—and received dance training at a state-funded school in Cuba, training that was crucial to his development. Carlos’s vision for Birmingham Royal Ballet centres on the development of future talent. He was therefore disturbed to hear of the financial pressures facing our dance schools. The music and dance scheme is not just a funding mechanism; it is a lifeline. It is the difference between a child from a low-income household accessing world-class training and never discovering their potential at all.
Lord Lingfield (Con)
My Lords, I remind the Committee of my registered interest as chairman of the English Schools’ Orchestra. I pay tribute to my noble friend Lord Blackwell for his long-term championship of the music and dance scheme. The almost one thousand hugely talented students who are supported by the scheme are this country’s soloists, orchestral players and, of course, the corps de ballet of the future. They are among those at the apex of the UK’s cadre of young musicians and it is vital that their funding is not jeopardised. The students are chosen, of course, from a pool of the most musically accomplished children in the country, but, alas, that pool is growing smaller as musical opportunities in state schools diminish.
Many of your Lordships had the good fortune, as I did, to attend schools where music was very much part of daily life. School assemblies, celebration and open days, and parents’ evenings all had musical accompaniment, and of course there were many concerts and other musical entertainments. Alas, this is too often no longer so. There are too many schools where little or no classical music is heard by children, and, where music-making is available, instead of being part of school life it is often off-site at a music hub. Only about 15% of state schools have school orchestras, compared with about 85% of independent schools, so instrumental tuition and playing are too often a solitary activity for the young, with limited chances of taking part with other players in ensembles and orchestras. How wonderful, therefore, that we have the MDS schools, such as Wells Cathedral School and the others, with such high standards of music-making, to which other schools should aspire. It is imperative that they remain as a vital national resource.
Lord Freyberg (CB)
My Lords, Britain’s reputation as a global creative powerhouse rests on the strength of its education system, yet while other nations expand investment in creative learning, we appear to be retreating from it. The recent decision to remove bursaries for music and art teachers, at a time when recruitment for secondary music trainees meets barely 40% of the Government’s own target, illustrates starkly this contradiction.
The Department for Education claims that music teacher recruitment has risen by 53%, which is very welcome, but this represents recovery from an exceptionally low base and not success. Meanwhile, 42% of state schools had no students entered for GCSE music in 2022-23, up from 28% in 2016. Against this backdrop, the removal of support for training new teachers seems a puzzling way to rebuild capacity. As the noble Earl, Lord Clancarty, said, the disconnect between rhetoric and reality undermines confidence. Ministers speak of restoring creative education, yet their departments steadily dismantle the infrastructure needed to deliver it. It is as though the ghost of former Minister Nick Gibb still haunts the department’s corridors, his philosophy lingering in policies that reward STEM while quietly trimming the arts.
I ask the Minister who in the department is driving these decisions. How do they align with the Government’s stated commitment to creative education? The music and dance scheme embodies what is at stake—eight specialist schools nurturing 940 gifted young people, many from low-income families—yet its funding has been frozen since 2011, losing a third of its value in real terms. A modest £4 million uplift and multiyear funding would secure these pathways and show that the Government’s cultural ambitions are more than words.
Baroness Ramsey of Wall Heath (Lab)
My Lords, according to research by the Sutton Trust, 43% of classical musicians went to private school, compared with 7% of the population as a whole. More than half of all students at the Royal College of Music and the Royal Academy of Music did so. Since you are 10 times more likely to go to private school if your parents are in the top 10% of earners, rather than average earners, it is obvious that many young people are being denied the opportunity to shine in the creative industries simply because they were not born into a wealthy family. That is unfair to them and, of course, to all of us. How many amazing performances are audiences missing out on because stars in the making had to drop out through lack of funding?
Taxpayers lose out too. Some £11 billion a year is an already amazing economic contribution from music and the performing and visual arts, but just imagine how much more it could be if talented youngsters were not being turned away through lack of funds. The fact is that specialist music and dance training is expensive, which is why government help for those who would really benefit if they could only afford it is so important.
I should perhaps declare a maternal interest at this point: I have a daughter at the BRIT School, the first and leading state school for performing and creative arts in the UK, with Adele and Tom Holland among its alumni. The BRIT School is a model of diversity, with nearly half of students coming from lower-income families. To be clear, it is not part of the music and dance scheme, which is why I declared a maternal rather than a financial interest. The Committee will not be surprised to hear that, having had the opportunity to see for myself the power of top-quality specialist creative education, I am grateful that the noble Lord, Lord Blackwell, secured this debate on the importance of affordable specialist music and dance schools.
I anticipate support across the Committee, not least given the welcome Labour manifesto commitment that
“the arts and music will no longer be the preserve of a privileged few”,
followed by the Government’s recently published plan to significantly increase direct funding for the creative industries sector. Confirming the future of the music and dance scheme would be an excellent contribution to this plan, providing the opportunity for more talented youngsters without wealthy parents to attend the very best specialist schools and colleges.
Lord Kirkham (Con)
My Lords, the Government’s clear manifesto commitment was that
“the arts and music will no longer be the preserve of a privileged few”.
Nothing is more crucial to the fulfilment of this pledge than ensuring continued access to our world-class specialist music and dance schools on the basis of talent, not parental wealth, yet here we are, starving these national treasures of resources and giving them no certainty on future funding.
The principal of the Purcell School, the oldest specialist music school, puts a precise number on the shortfall in the MDS scheme this year: £4 million. Coincidentally, that is the sum that the Government have added to MDS funding to compensate lower-income parents for the VAT added to their fees. How simple it would be to bring joy to our specialist music and dance schools, and to secure their futures, by allowing them to retain that money, rather than having it recycled back into the Treasury.
The other fundamental that our specialist schools need is certainty. The Government must revert to the historic norm of funding the MDS on a three-year basis, allowing schools to plan their budgets and resources. If they do not do this, the Purcell School believes that the majority of MDS schools will be forced to close down within the next two years.
If we want to ensure the future of our world-class orchestras, dance companies, theatres and rock bands, we must cherish the fantastic resources in our specialist schools, particularly if we wish to ensure the continued diversity of players and performers and provide a career path for the gifted, regardless of family financial status. Surely this must be exactly what the present Government desire. If they will the end, they must provide the means.
Lord Addington (LD)
My Lords, from listening to this debate it is quite clear that one theme has come through: please give us certainty. With a one-year scheme, nobody would encourage a child to go into this. In dance, you are more certain to break your leg than you are in professional rugby—okay, maybe it is an even draw. You are asking a child to go into something risky, with no guarantees, so at least let them finish their training with a degree of certainty. I have to disagree: three years is not long enough. It should go on through their entire training. There has to be certainty.
If the Government do not like the MDS, they should change it and bring in something else that guarantees opportunity. That is something that is coming out here today. The economic case has been made—here and on many occasions—that you get a very good bang for your buck if you produce good artists.
I could not agree more with the noble Baroness, Lady Warwick. We need to make sure that we have an identification process for getting people into this, by encouraging the schools to at least have an introduction that might allow children to go on to this. You will cut out many people from the state school sector if you do not have some familiarisation package that means that they are ready for specialist training. The two go together, and there has to be an ongoing commitment to ensure that they are both working together.
If the Government do not like the MDS or the CAT scheme, they should come up with something new. If they do like them, they should guarantee them for as long as the Labour Party is in power. That is not too much to ask, and the economic benefits are clear.
The Earl of Effingham (Con)
My Lords, I thank my noble friend Lord Blackwell and all noble Lords for their valuable contributions, which are clearly united in their support. Access to high-level music and dance training should be an opportunity for every individual with shining talent. The music and dancing scheme exists to ensure that talent, wherever it is found, has a route to success. For over 2,000 students from low-income backgrounds, it has been exactly that—a lifeline, as was so well put by the noble Baroness, Lady Keeley.
That lifeline, however, is now under threat. There are serious and growing concerns about the future of the music and dance scheme. The Government have yet to confirm whether the scheme will continue beyond the current academic year, leaving students, parents and the schools themselves in a state of prolonged uncertainty.
In the spring, we were told that a decision on the scheme’s future would follow the conclusion of the spending review. That review has now passed but there is still no announcement on funding. No one likes uncertainty but the Government are helping to create uncertainty for families, schools and those very children with the talent and ability to achieve their dreams of performing at the highest levels. Surely, they deserve better than vague timelines and delayed decisions.
One had only to look at the front page of a major newspaper yesterday to see that the Government are spending £260 million on centres for deportation, which provide illegal migrants with “art classes”, including skills such as “sketching, crafts and … painting”. Can the Minister explain how, on the one hand, the Government seriously continue to provide arts funding of this nature but, on the other, will not commit to just £36 million per year for the music and dance scheme? The noble Lord, Lord Black, is entirely correct: it is a rounding error. The noble Lord, Lord Vaizey, is spot on: it is a pinprick in a Treasury spreadsheet. His Majesty’s loyal Opposition urge the Government to end this uncertainty and publicly commit to the continuation and stability of the music and dance scheme. Surely our future young musicians of the year and dancers are worth it.
Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)
My Lords, I start with an enormous thank you to the noble Lord, Lord Blackwell, for bringing forward this important debate. The number of people taking part demonstrates the strength of feeling in this House and, clearly, beyond. I thank all noble Lords who have spoken, who have considerable experience in this area. It is always an enormous privilege to hear them.
I mentioned before my personal interest from my role as the leader of Leeds City Council, when I took on its cultural portfolio. Like the noble Baroness, Lady Fraser, who talked about ballet shoes, and my noble friend Lady Ramsey, who spoke of her personal experience, I have personal experience from a granddaughter who is very involved in this area, and thank goodness—it is wonderful to see, as we have heard from all who contributed.
I make clear from the outset that access to specialist music and dance education must not be the preserve of the privileged few. This is the Government’s clear view. In emphasising the point made by the noble Baroness, Lady Bottomley, we have to stress this throughout, despite the difficult times through which we are living. As part of our opportunity mission, we want to widen access to the arts, so that young people can develop their creativity and find their expression and voice. This is important in its own right—subjects such as music and dance are a critical part of a rich education—but it also supports young people with the dedication to excel in the performing arts.
In closing this debate, I underline this Government’s commitment to maintaining affordable access to specialist music and dance education so that, regardless of their background, high-achieving young people can access specialist training. As we have heard through the debate, the Government continue to provide generous support to help students access specialist music and dance education and training. We committed £36.5 million to the music and dance scheme this academic year, as we have heard.
I will pick up on the comments of the noble Baroness, Lady Bottomley, and the noble Lord, Lord Addington, about the contribution that the sector makes to the richness of our economy. We know that growth is the Government’s number one mission and that the new industrial strategy is central to that. This is a sector in which the UK excels today and will propel us forward tomorrow.
The creative industries have been announced as one of the eight growth-driving sectors in the industrial strategy, which has been published following the multi-year spending review. The creative industries sector plan has been designed in collaboration with business and devolved Governments and the regions. It is critical that we provide a workforce with the right skills and capabilities, as we will go on to discuss. I am looking forward very much to the Government’s work on skills and where this sits within it.
I emphasise that the scheme provides income-assessed bursaries and grants to enable high-achieving children and young people in music and dance to benefit from world-class specialist training, regardless of their personal and financial circumstances. The scheme supports students to attend eight independent schools and 20 centres for advanced training, the latter providing places at weekends and evenings and in the school holidays. Bursaries support more than 2,000 pupils a year, with around 900 pupils attending schools. I emphasise that all families earning below the average relevant income of £45,000 per annum and making parental contributions will continue to receive additional financial support this academic year, so they will be unaffected financially by the VAT change in January 2025.
The music and dance scheme is a long-term commitment and the Government will continue to look at it. We know that there is enormous gratitude for the additional £4 million covering the issue of VAT. I want to give reassurance that due consideration will be given to the cost of providing specialist education, including consideration of the points made today by the noble Baroness, Lady Bull, my noble friend Lady Royall, and the noble Lords, Lord Vaizey, Lord Black and Lord Hall. They all made important points about long-term funding, and the noble Earl, Lord Effingham, emphasised them.
I have to say, however, that we have been, in the main, in this space for more than two decades. This is not something new that has been brought in. The current scheme was established in, I think, 2002 under the previous Labour Government. We need to be clear about where we are going forward. We know that we have had to make tough decisions to get our finances back under control—the noble Lord, Lord Hall, referred to this—including some additional non-bursary funding and some music and dance scheme centres. The main bursary funding itself has, however, been protected. All eligible students from the last academic year have continued to receive MDS bursaries, and new eligible students will have commenced at the beginning of this term.
The Government will also ensure that high-quality arts education, including in music and dance, is available across all state-funded schools. To achieve this, additional support for our schools and teachers is needed. We acknowledge this. I want to pick up on the comments of my noble friend Lady Warwick on the impact of EBacc and recognising the need for pupils to be prepared and ready for training as the noble Lord, Lord Addington said. We want every child, regardless of background, to have a rich, broad, inclusive and innovative curriculum.
I am sure all noble Lords will be aware that we are still awaiting the launch of the independent review of curriculum assessment, chaired by Professor Becky Francis. She is looking at all subjects. She is looking at music and seeks to deliver a curriculum that readies young people for life and work, including in creative subjects and skills. It is being informed by evidence and data, and in close consultation with education professionals and other experts. Parents, children, young people and other stakeholders, such as employers, have been involved in that work.
The final report is very close to being published but I cannot pre-empt the outcome of that review, as I am sure noble Lords will be aware, despite requests for me to do so. We will of course consider associated implications for accountability measures, such as EBacc and Progress 8, alongside this. It is fundamental that we take this incredibly seriously. I hope noble Lords understand that the Government are emphasising these points, as my noble friend Lord Liddle highlighted.
On additional support, again, that is why we announced in March our intention to launch the new National Centre for Arts and Music Education as we go forward. We believe that the new centre will help us to meet our ambitions for improved and equitable arts education. The centre will support schools in teaching music and dance, as well as art and design and drama. It will also be the national delivery partner for the music hubs network, with the 43 hub partnerships central to supporting schools. Our intention is to appoint a delivery partner for the centre through an open, competitive procurement. We have been engaging with sector stakeholders, including the music hubs network, to refine the details of the centre. The invitation to tender is due to be issued soon.
Again, in recognising how important this is, the music hubs grant funding of £76 million has been secured for the full academic year of 2025-26 and to the end of August 2026. Following the outcome of the spending review, longer-term funding will be confirmed in due course. The Government continue to invest £25 million in capital funding to widen access to musical instruments and technology to the end of this year.
I am taking a bit of licence here in what I pick up, with the permission of the Whip, because we have until 3 pm.
Baroness Bull (CB)
Can the Minister help me to understand where dance will sit within the new centre that she describes? The centre is dedicated to music and the arts but, as we know, in schools dance sits within the PE curriculum. Is there going to be some sort of tension in how the centre can support dance within schools, when in fact it is not viewed as an art but as a physical education subject?
Baroness Blake of Leeds (Lab)
I have had the great pleasure of having this discussion with the noble Baroness on a number of occasions. I cannot go further than we have before on the curriculum review, but there is an acknowledgement of the position of dance and its relationship to PE. In all of the wider picture, that voice is very loud and it has been heard.
I want to emphasise the issue of teacher training, on which an important point has been raised. It is true that the £10,000 tax-free bursary for music will be removed in 2026-27 but this is due to improved teacher retention and higher ITT recruitment. That is the basis for that announcement on 11 October. I also emphasise the importance of choir schools, referred to by my noble friend Lord Liddle. As part of the scheme, the department provides a grant of £210,000 to the Choir Schools Association. This offers means-tested support to choristers attending CSA member schools, including cathedral and collegiate choir schools in England, to help those with exceptional talent who are unable to afford the fees.
This has been a rich debate and I am conscious that I have not been able to give all the points that have been made their due notice. I know that we will have more discussion across the House but we are at a critical point, as the noble Earl, Lord Clancarty, mentioned, given the timing of the Budget that is coming up. I understand why so many noble Lords have brought these matters to the attention of the House through this important debate.
In closing, I underline this Government’s commitment to ensuring that all children can access and engage with high-quality music and dance education. Access to the arts is a vital part of a rich education and must not be the preserve of the privileged few.
The Earl of Clancarty (CB)
Before the Minister sits down, since we have a couple of minutes, I have a point of clarification. The figure of £4 million has been repeated a number of times in the debate. I would clarify for people watching that the £4 million the Government have given is to offset VAT, but the music and dance schools are asking for an entirely separate £4 million. I just wanted to put that on record.
Baroness Blake of Leeds (Lab)
Thank you. I acknowledge that and we will obviously take away some of the more detailed comments made. I have just had a note to tell me that the new PE and sport partnerships will support dance as well as sport in schools, if that is helpful.
Shanghai Cooperation Organisation
(2 days, 13 hours ago)
Grand CommitteeRead Hansard Text Read Debate Ministerial Extracts
Baroness Stuart of Edgbaston
To ask His Majesty’s Government what assessment they have made of the challenges presented to the international order by the Shanghai Cooperation Organisation following the recent summit held in Tianjin.
Baroness Stuart of Edgbaston (CB)
My Lords, there are moments which stick in your mind because they tell you that “something has changed”. Sometimes it is obvious, such as when the Brandenburg Gate was opened and the Berlin Wall fell, but at other times it takes a bit longer before it becomes clear just what has happened. I had one of those “Is this history being made?” feelings when I watched the footage of the 2025 China Victory Day parade in the first week in September. It was not just the parade but the parade combined with the summit of the Shanghai Cooperation Organisation, hosted by China in Tianjin between 31 August and 1 September, which made me reflect.
The Shanghai Cooperation Organisation is an intergovernmental organisation which brings together 10 countries, including China, Russia and India. Its members represent 42% of the world’s population and account for 23% of global GDP, and the official languages are Russian and Chinese. A feature of this particular summit was the attendance of the Prime Minister of India, Narendra Modi. This was his first visit to China in seven years. Two days later, on 3 September, in Tiananmen Square, the 2025 China Victory Day Parade in Beijing celebrated the 80th anniversary of the end of the second Sino-Japanese War and the Second World War. Over 12,000 troops of the People’s Liberation Army participated in the parade. For anybody who saw this, it was absolutely awesome, strategic and precise. It almost made me think, “Is this real?” President Xi showcased China’s new weapons and demonstrated the modernisation of the PLA, with hypersonic missiles, stealth drones, underwater drones and long-range, nuclear-capable missiles. He was joined by 25 foreign Heads of State and Government. They came from Asia, Africa, Latin America and eastern Europe. Western nations were hardly represented.
However, there were two high-profile guests. President Xi was flanked by the Russian President, Vladimir Putin, and the leader of North Korea. Traditionally, there is little brotherly love lost between Russia, China and North Korea, and the three leaders had not appeared together in public before they did so in Beijing. Bilateral meetings between China and Korea and North Korea had not been uncommon. Similarly, Russia and China have regular contact. But Putin’s first foreign trip in his new presidential term was a state visit to Beijing, and they had met in the margins of the SCO at the 2024 summit in Astana in Kazakhstan. What made this different was that it was the first time that the three leaders had appeared together in public. In less than a week, China, Russia, North Korea and India had come together. Arguably this was the moment which demonstrated that Russia had accepted China’s dominance and a challenge to the hegemony of the United States of America. In Xi Jinping’s words, his country’s rise is “unstoppable”, or, to quote the Chinese Foreign Minister’s words after the summit,
“the monopoly of global governance by a few countries must not continue”.
We are used to talking about threats and how we will meet them, but I want to take a completely different stance and to reflect on how the world is changing, how western democracies have to respond, and how the multilateral institutions which we have created and developed since 1945 are out of step with what is happening around the globe. The Berlin Wall fell in 1989; in 1991, the Soviet Union formally dissolved; in 1992, Francis Fukuyama predicted the “end of history” and the “last man”. Going back to the deep European traditions of Hegel, he reasoned that history is linear and that, ultimately, it will culminate in a rational free society—if we only allow things to develop, everywhere will become a liberal democracy.
There was a period when it looked a bit like this. In 1997, the British Government set up DfID. We no longer used international or overseas aid as a national policy tool; it was for poverty relief. In 1999, Tony Blair’s speech to the Economic Club of Chicago talked about “the international community”. The Canadian Government published their report The Responsibility to Protect following the failure of the international community to intervene in Rwanda. There was an extraordinary period of idealism, and we were not alone in this. The German Foreign Minister, Frank-Walter Steinmeier, foresaw in 2007 that Russia would be so intertwined with the EU’s exceptional role model of international co-operation that it would inevitably get like us. It was Steinmeier who helped the Russians join the WTO in 2011. The German phrase was “Wandel durch Handel”. The world would change because we would trade with them and, because we would be so intertwined through trade, they would all become like us—liberal democracies. I know some noble Lords are starting to wonder where I am going with this little history lesson. Even centralised states such as China were beginning to think that only by becoming a liberal democracy could they be economically successful.
The global financial crisis of 2008 changed all that—then, even the capitalist liberal democracies were seen not to be in control of capital flows. The World Trade Organization is now in the position that virtually everyone is either a member or has observer status. I think the only three countries that are not are Eritrea, Kosovo and North Korea. Its institutions are completely dysfunctional and the dispute-resolution process is not working. Curiously, while Russia completely ignores the WTO, China takes a very different approach. It has a twin track of co-operating and being quite rule-compliant, in some ways.
I wanted this debate so that we would reflect on two things. First, the world around us is changing, whether we like it or not. If all we do is simply continue to identify what we think are threats, without defining what we think the world should look like, we will only ever be responsive to other people’s actions and, I suggest, will be losing. Secondly, given that it is close to Trafalgar Day—I declare my interest, together with the noble Baroness, Lady Anderson, on the other side, as an honorary captain in the Royal Navy—I will take the liberty of quoting Vice-Admiral Horatio Nelson, who said:
“I owe all my success in life to having been always a quarter of an hour before my time”.
In other words, you look ahead. That does not mean some strange blue-sky thinking, but looking a step ahead to see what is coming. I suggest that there is a big battle coming that will determine the most dominant global power. That battle will be between America and China.
It is no good talking about enemies. This is about democracies, and democracies have to stick together. Economically, quite frankly, we cannot live for six months without China, but China can quite happily live for six months without us. I urge the Minister to consider whether we should define what “good” looks like and start moving away from economic indicators and have coalitions of democracies that work together, fighting for what they stand for and making it much clearer why it is worth fighting for.
Lord Hannan of Kingsclere (Con)
My Lords, we often talk about the way in which liberal democracy is in retreat in the part of the world that we have just been hearing about, particularly in Russia. I wonder whether we have not put that question back to front. The Russian state was founded in 882. If we look at the period between its foundation and the present, we see that it has been an autocracy for 1,120 years. There was a little moment of constitutional monarchy in 1905; there was the period between February and October 1917; and then, if we very generously count the early Putin as well as the Yeltsin years, we can come up with 23 years in which Russia has adhered to something that we would recognise as the rule of law and representative government. That is not a whole lot of democratic muscle memory to fall back on.
The point I want to make is that this is very normal. One way of explaining the rise of Putin is to look at what happened in all the other ex-Soviet states—what happened when the USSR suddenly broke apart and, in almost every case outside the Baltics, went into some kind of autocracy. What was it that all those strongmen had in common—the Karimovs and Aliyevs and so on? Was it charisma? Was it some demotic connection with their people? Was it intelligence? No. They just happened to be the Soviet officials who were in charge of the Uzbek SSR—or whatever it was—at the time when the break-up came. They suddenly found themselves in charge of sovereign states and they very quickly set about ensuring that their grip on power would be unchallenged and there would be a kind of one-party state.
That is the norm. That is the sobering thought. We in anglophone western democracies are the exception. It is not the Putins and the Karimovs who are extraordinary but the Washingtons—the people who do not try to set up hereditary dictatorial power. That should make us aware of the fragility of our model and of the constant need to defend it, by being ready not only to deploy arms proportionately in defence of freedom but to defend it intellectually and culturally at home. This is where the challenge of the Shanghai Cooperation Organisation comes from. It is a fundamentally illiberal alternative model, and it is growing; it is popular. All these new countries are adhering to it because that autocratic way of government appeals to something very deep in the human psyche. It is how we administered ourselves for the 10,000 years between the discovery of agriculture and a couple of hundred years ago, at most—an eyeblink in evolutionary terms.
That is why this matters. It is not because of the strategic importance of the region—every region thinks it is strategically important, including central Asia. When I was a new MEP, my noble friend Lord Callanan and I were put on the central Asia delegation. As an MEP, if you were a goody-goody federalist they gave you the Caribbean or South Africa. We were critics of the single currency, so they gave us central Asia, and I am very glad they did. I got to know the region pretty well, and I loved it. I visit it still; I have friends there. But with the best will in the world, it is not of great strategic importance to us—not as a maritime country. Sir Halford Mackinder used to say that it was the inventor of geostrategy, the key region, the heartland:
“he who controls the heartland controls the world”.
Barely had he said that than the First World War came along and disproved him, as did the Second World War. It may have had some tangential strategic relevance to us at the height of the great game, when Stoddart and Conolly were murdered in Bukhara in 1842, but it is a stretch to say that it matters to us now, as an archipelago at the western tip of the Eurasian land mass.
This matters not for reasons of direct geostrategic interest but because there is this cultural challenge—this alternative way of running our affairs—which appeals to people, including in the west. The reason that India, Pakistan, Iran and all these places are adhering to organisations like the Shanghai Cooperation Organisation —the clue as to who runs it is in the name, by the way—is that they think that our system is in decline. One reason they think that is because we keep telling them. We have become so ready to dismiss and distance ourselves from our own past. We have this extraordinary lack of self-confidence. If our children get any history at all, we tend to present it as a hateful chronicle of racism and exploitation.
I would be prepared to defend the proposition —I cannot prove it—that almost any child in a primary school in this country would be much more familiar with the names of Rosa Parks and Martin Luther King than those of Lilburne, Locke, Wycliffe, Wilkes, Milton or Millar; and that is just the Johns. We are not teaching them our own history of freedom and personal responsibility, of the elevation of the individual above the collective and of the importance of the rule of law. That, it seems to me, is our challenge as legislators. We need to emphasise that we are inheritors of this sublime tradition, that it is better than the alternative and that it raised the human race to a pinnacle of wealth and freedom. Keeping that heritage going means teaching the next generation about why it is special, why they are lucky to be the guardians of this sublime patrimony, why they will hold it—as we do—on a repairing lease and why they, too, will have a commensurate obligation to pass it on intact to those who come after.
Baroness in Waiting/Government Whip (Baroness Anderson of Stoke-on-Trent) (Lab)
My Lords, it is the turn of the noble Baroness, Lady Bennett.
Baroness Bennett of Manor Castle (GP)
No worries. My Lords, I thank the noble Baroness, Lady Stuart of Edgbaston, for securing this important debate and for her clear introduction, which rightly highlighted Francis Fukuyama, who was always bizarrely hubristic with his end-of-history thesis and indeed now looks very far into the past.
My contribution will have two foci. The first is to urge that we consider the Shanghai Cooperation Organisation in the context of the behaviour of its second-most powerful member, Russia, and its allies in the continuing attack on Ukraine, and of other organisation members, including Iran and Belarus and, of course, China. My other focus will be somewhat in disagreement with the noble Lord, Lord Hannan, on one aspect of what has been described as the “Shanghai spirit” and one particular part of it: the so-called respect for the diversity of civilisations.
To return to my first focus, I wish to report to the Committee a little of my experiences last week when I travelled with fellow parliamentarians—with financial support from British companies, which I will be appropriately declaring in due course—to Ukraine as part of a delegation from the All-Party Parliamentary Group on Explosive Weapons and their Impact. The focus was on the clearing of mines and unexploded ordnance, something that the Ukrainians have to deal with at a totally unprecedented scale, at least in the form of risk. Some 29% of their nation, or 174,000 square kilometres, is at risk of being affected by mines and unexploded ordnance. We visited the State Emergency Service of Ukraine and the Mines Advisory Group and Halo Trust projects.
We also saw the crucial efforts to treat those who have fallen victim to the mines at the charities Superhumans and Unbroken. We saw the human cost of the continuing Russian assault. We also saw close up the vicious, and sometimes internationally illegal, weapons that the Russians and their allies are using against civilian populations. Holding a submunition, a cluster bomb—obviously, once it had been rendered safe—and seeing a children’s storybook booby-trapped with explosives was an acute demonstration of the sheer difficulties that the Ukrainians face and the nature of the actions of the Russian-led alliance, many of whose members were in Tianjin.
Understandably, in the face of the horrors of the Israeli assault on Gaza and the desperate desire to get the Israeli hostages home, the media and even the political focus have not always been on Ukraine. However, I want to stress the importance of continuing to provide the Ukrainians with practical support and moral support, both directly and through projects such as that of BBC Media Action, which is assisting in the vital task of explosive ordnance risk education. Behind that must be a strong, determined delivery of the message from the international community—or as much of it as we can bring together—that there is a principle that larger countries cannot simply decide to take chunks out of their neighbours. Further, that there are rules of war and breaking these must not just be called out, but must have genuine, long-term, serious consequences for the regimes responsible. The human race has a long way to go. It was back in 697 that the law of innocence was promulgated by Gaelic and Pictish nobles at the Synod of Birr. It extended what had been protection for monks and religious male figures to women and other non-combatants. That is a very long time ago and we still have failed to deliver that, as I saw in Ukraine.
I come now to the to the second part of my contribution today, which is around the term “civilisations”, which, as I noted, is described as part of the Shanghai spirit. This language is increasingly penetrating many international settings, frequently from the influence of China. I note, for example, that on 7 June 2024 the UN General Assembly adopted 10 June as the international day for dialogue among civilisations. I agree with the words of the US representative during that debate that we should instead be talking about cultures. The US representative then urged vigilance over how words such as “civilisation” are used.
This is a term in the form of western civilisation that we are hearing increasingly in your Lordships’ House, and I would ask those who are increasingly using it to consider how they are playing into the hands of dangerous forces which are using it in places such Xinjiang. Making claims of exceptionalism, of the purity of one historical cultural formulation over another, is playing into the hands of the narrative that we are hearing from China and other countries that needs to be challenged, not accepted.
I am pleased to say that there a growing reaction against that, against the idea of discrete, distinct civilisations, an international shedding of civilizational thinking. I note that on display today in your Lordships’ Library is the cover of Josephine Quinn’s excellent book How the World Made the West which addresses this issue. She notes Polybius’s remark that the Romans were a multicultural melting pot willing to substitute their customs for better practices from elsewhere. There is no such thing as pure Roman civilisation or indeed western civilisation. This book explicitly takes aim at Samuel P Huntington’s influential 1996 clash of civilisations thesis, which is effectively being adopted in this debate. It is deeply dangerous and a framing for a great deal of Islamophobic and other xenophobic rhetoric and action. Challenging this claim is an urgent task.
Responding to the noble Lord, Lord Hannan, I point out that democracy and democratic elements have a very long history going back, of course, as is often cited, to ancient Greece, but much further than that to a millennia before in ancient Assyria.
Lord Skidelsky (CB)
My Lords, I do not want to follow the noble Baroness, Lady Bennett, in her discourse on the Ukraine war. My position is known on that. As for the rest of it, I have more sympathy with the spirit of the noble Baroness, Lady Stuart, than I have with that of the noble Lord, Lord Hannan.
I may have a closer connection with Tianjin than any Member of either House having gone to school there nearly 80 years ago. I hope this will not in itself cause me to be thought of as a security risk. I agree with the noble Baroness that the Shanghai Cooperation Organisation poses challenges to the international order. I accept that, and I think we all do, but we need to be clear about the nature of the challenges and of the order being challenged.
The challenges referred to by the noble Baroness arise from the fact that power in the world is shifting. The clout of the NATO world is shrinking while that of the non-NATO world is growing, and accommodation of the international order to these shifts in the balance of power is absolutely inevitable. That has always happened throughout history, and the question is whether it will be peaceful or violent. The numbers are striking—the noble Baroness mentioned some of them.
In the late 1980s, the countries later to form the Shanghai Cooperation Organisation accounted for only about 5% of global output while western nations produced well over 50%. Today, the SCO’s member states generate 23% of global output while the western share has shrunk to 30%. To take demography, whereas in the late 1980s the west still represented close to a quarter of the world’s population, today the SCO countries account for 42% while the NATO world has shrunk to about 10%. If we take BRICS-plus, the scale of the shift is even more dramatic, with 56% of the world’s population, roughly 40% of the world’s global output, being controlled by this non-western grouping. So we should find nothing surprising about the Tianjin summits initiative. They are designed to insert a large group of countries into the structure of global governance, from which they felt they have been excluded. That is the essence of it.
Shifts in global power always hard to accommodate peacefully because we do not have a world Government —we cannot simply vote out one lot of people and vote in another lot. The reason why we in Britain find it so hard to accept the current shift is that we mix it up with morals. We claim to stand for a set of rules, institutions and power arrangements which are or should be morally binding on everyone. We therefore interpret any challenge to that order as, ipso facto, immoral and to be resisted, if possible by war.
The view from Tianjin is of course very different. President Xi calls the western rules-based international order a cloak for the “bullying behaviour” and “hegemonic ambitions” of the United States. China, we need to recall, had most of its coastline divided up between colonial powers. Tianjin, where I went to school in 1948, had just emerged from extraterritorial status. So, multipolarity is also a moral position, not just an assertion of power. It is also a moral, anti-imperial position. Properly interpreted, it means the quest for peace through agreement between powers with different value systems; that is the only way we will get a peaceful world. It means we in this country have to accept domestic policies we find abhorrent, accept the notion of spheres of influence, accept as legitimate the use of soft power by China and others to influence opinion in this country without becoming paranoid about it, as I think we tend to be.
It is our highly negative attitude to multipolarity which has caused it to spill over into economic warfare—I mean both economic sanctions and tariff wars. Can our rulers not see that it is the policy of economic sanctions which has led to the world dividing into economic blocs? That is not an inescapable tenancy of multipolarity but it comes out of the union of geopolitics and economics—economics used as an instrument of geopolitics. In addition, except for very small examples, sanctions have never deterred or stopped behaviour of which we disapprove. What they do achieve is to divert trade in money and goods away from their comparative advantage to protected areas, which therefore makes the world poorer, and that is what is happening today.
We must accept the reality of a multipolar world, and we must reform the institutions best fitted to govern it. The noble Baroness referred to one or two of them. The UN Security Council, the IMF and the WTO have to be reformed. China needs to be a partner in this process, and that means accepting China’s right to share in the governance of the world. We have not done that so far, and the importance of this debate is to draw attention to that fact.
Lord Moynihan (Con)
My Lords, it is an honour to follow the noble Lord, Lord Skidelsky, not least because I am in complete agreement with the last point that he made. It is a central one in this debate.
We face a new world order in which diplomacy is adapting, somewhat slowly, to the characteristics of populist government. A populist, social media-driven world is inherently less stable, less predictable and more dangerous. Against this background, the SCO and the western-led liberal orders offer very distinct frameworks for international co-operation and governance, which will need to adapt to these changes.
As highlighted by the 2025 Tianjin summit, the SCO emphasises collective security, counterterrorism and regional stability, valuing sovereignty and non-interference by the West. The western-led liberal order prioritises free market economics, democratic governance and human rights. The SCO, primarily centred on Eurasia, with key members such as China, as we have heard, Russia and India, fosters regional alliances. The western-led order is global in scope, with institutions such as the UN and the World Trade Organisation seeking to play central roles, while populist leaders in the West condemn their ineffectiveness and outdated irrelevance. How should the British Government respond?
First, I argue that we need to update our analysis of UK policy in the region to take account of fast-moving post-SCO meeting events. New objectives must be redefined through engagement opportunities. The UK could and should more vigorously engage with SCO countries to enhance trade ties and collaborate on security issues, particularly in combating terrorism and drug trafficking. With the western-led order, we should continue and strengthen participation which supports our economic interests and growth through bilateral and global trade, while reinforcing but not seeking to impose democratic values and human rights.
We must be more sensitive to the fact that change takes time, so the macropolitical message from Tianjin for us is to evaluate which partnerships align most with our long-term national interests. We must engage in dialogue and definitely not disengage with both SCO and western-led countries. We must explore mutual benefits and seek a balance between promoting democratic values and securing economic interests. We should forget calls for cultural imposition and the forceful use of unequal power dynamics: they lead years of work in building co-operation and respect down an abrupt cul-de-sac.
There is certainly a case for more active diplomacy and fewer public shouting matches, so we should be leveraging diplomatic, economic and cultural tools to influence and engage with SCO member states through bilateral dialogue, multilateral platforms and cultural, sporting and educational exchange programmes. We must rediscover the might of soft power. Above all, we should encourage UK businesses to adopt responsible trade practices that emphasise ethical standards, seeking through diplomacy and respect to influence human rights and to reach out for global action on global challenges such as climate change, where equitable co-operation is vital. It is such a platform that allows for the most effective advocacy for human rights and fair governance, with support for like-minded NGOs that we can fund and support in their work towards human rights and fair governance in SCO countries.
I will give one example of how we can put this approach into practice in countries of the SCO and, in particular, in Uzbekistan. The relationship between the UK Government and Uzbekistan is currently marked by a spirit of co-operation and growing engagement. With a growing economy, young population and active foreign policy, Uzbekistan serves as a key for transportation, logistics and cultural exchange in Eurasia. From a purely strategic point of view, Uzbekistan can be seen as a potential world-class provider of rare earth minerals. Keen to develop its significant and mostly untapped resources, Uzbek Government-led entities seek to form joint ventures, attract foreign investment and explore new projects, with a view to becoming major global suppliers for high-tech and green energy industries.
Uzbekistan and the UK have already signed an ambitious co-operation programme for 2025-26, covering politics, economics, education, energy and climate change. Frequent visits and meetings between senior Ministers support regular strategic dialogue and promote trust. The UK’s involvement in Uzbek higher education is a central pillar of this relationship, and the UK actively supports Uzbekistan in ensuring governance reform, economic development and human rights.
Collaboration on border security, training and climate resilience reflects a broadening agenda beyond trade. Uzbekistan is critical to security in the region and beyond, not least with its shared border with Afghanistan, and that is an important part of our national security. We should be more active on the front foot with Uzbekistan. For example, an invitation to the President is long overdue, in my view. At the very least, we should continue to build on the significant strengths of countries such as Uzbekistan, whose focus on pragmatic multivector diplomacy means that we should strengthen the relationship with the country as a valued partner, to act as a balance to the somewhat less advanced relationships with some other members of the SCO.
For all the concerns that have been expressed, the outcomes from the meeting of the Shanghai Cooperation Organisation in Tianjin are an opportunity for careful engagement, while always being aware of the potential risks and challenges. In the new world reality, we would be unwise not to identify and pursue these opportunities, fully respecting and understanding the differences that separate us.
Lord Bruce of Bennachie (LD)
My Lords, to comment on the speech of the noble Lord, Lord Moynihan, on Tuesday I was at Oxford University, where the head of the presidential administration of Uzbekistan was presiding at the launch of the Uzbek language and cultural centre at the university. Indeed, this month, the University of Cardiff opened a campus in Kazakhstan, so we are active.
I congratulate the noble Baroness, Lady Stuart of Edgbaston, on this debate, which is very sparsely populated. It needs to be taken to the Floor of the House, because it is crucial that we think through what is going on in the world and how we respond to it. However, I slightly resist one or two of the comments that implied that this change is inevitable and we just have to adapt to it; I do not accept that. We have to have a dynamic role to interact with it and possibly try to help it move in a slightly different direction from what they may intend. I do not mean that in a destructive sense, but we need to engage.
It is interesting that, at the moment, the Government do not seem to know what their relationship with China ought to be. So, today, the head of MI5 said that China is a threat, but the Government are saying that we do not want to upset them. We need to think it through. The noble Baroness is absolutely right about the presentation of the SCO. I say in passing that the photo at the end of it was of 15 men—they were all men—of which 14 were autocrats. There is no doubt at all that this is a different organisation from ours. It is in some way inimical to us, but it exists.
On the figures, it is worth pointing out that the strength of those numbers depends an awful lot on India—and, of course, China, but China is at the core of it. India is a democracy, the one country that is, so that, clearly, is a basis for us to engage, if ever there was one. That is not to say to India, “You shouldn’t be doing this”, but to say, “You are a democracy and they’re not”. It is really important that we have an open channel through and with India on that basis.
I also want to talk about the influence of Russia and China in Africa. China’s belt and road initiative across Asia and Africa is pouring massive resources and potential dependency into countries in Africa, reinforced by what was the Wagner regime, now the Africa Corps, from Russia, whose objectives are not benign. As the noble Lord, Lord Skidelsky, said, we should expect the SCO to use its soft power, but it is a bit ironic that it is doing so just as we are dismantling ours. It seems to me that this is a good pause for us to think about how we use all our influences.
Earlier today, the Minister said, quite rightly, that this is not just about aid. I accept that; it is about all the resources that characterise what we stand for: trade, investment, culture, the British Council, the BBC and aid. It is about all those things, and we need to promote them much more vigorously.
We have to recognise that China is a major player. People sometimes express surprise that China has emerged in this category but, if you look at the history of the last 2,000 years, China was a major power for most of it. It is hardly surprising that it is now, and it has numbers, capacity and strength. Engagement is clear, but we have to decide what our interests are, what our security is and how we will deal with that. China needs to understand that, while we are willing to engage, trade and co-invest, we are not going to compromise our security any more than China would compromise its own. That is where we have not got it right, right now; we look a bit confused and unclear, and we need to sharpen that up.
The other problem is where the leadership is coming from. The current leadership of the West—the United States—is causing us a lot of difficulties. It does not seem committed to the values that we talk about. President Trump is very happy to talk about his friends in Hungary and Slovakia who are undermining most of our principles, but he is okay about it. He likes strong men—autocratic men, as far as I can see—and is less interested in the rule of law and human rights. He seems a bit cavalier about them, so we cannot rely on the United States to be the leading champions of this.
That puts a role on us to be clearer—if we are sure about our values—about how to assert them much more emphatically than we have done. The noble Baroness, Lady Stuart, was right at the beginning that we are at a pivotal point. It has been going on for a long time, but it is only just dawning on people how pivotal it is. We need to assess that.
Noble Lords will not be surprised to hear me say that we need to improve our relationships with our own continent. We may have differences of view—unlike others, I believe that the exit from the European Union was both bad for us and bad for them; I would love to go back, but I am not pushing that point—but it is clear that we have to find common values. If we are to address this world order, we need to do it in common cause with like-minded parties and countries such as Canada, Australia and New Zealand, which share our values.
I congratulate the noble Baroness and plead for the Government to allow more time and space for these issues to be debated more widely, with inputs that may help the Government get a clearer handle on where we are. We cannot afford to walk away from China—I do not think we should—but we need to be sure, when dealing with China, that it knows where we are coming from and that we know where it is coming from. It needs to be much more open and clearer that we have a different set of values.
My final worry is that when there is a vote in the United Nations, all these countries in Africa, hardly surprisingly, tend to feel that the lead comes not from us but from elsewhere. If we do not do something soon, we will not win any votes in the United Nations.
Lord Callanan (Con)
My Lords, I also pay tribute to the noble Baroness, Lady Stuart of Edgbaston, for securing this debate and to all the other fascinating contributions. There seems to have been a concentration, in this corner, from the noble Lord, Lord Bruce, and my noble friends Lord Moynihan and Lord Hannan, of talk about Uzbekistan—somewhat surprisingly. As the noble Lord, Lord Hannan, reminded us, when we were MEPs, we had the opportunity to visit that country on two or three occasions. It was fascinating, and we suffered from what was referred to as “terrorist hospitality”: on a number of occasions, food and drink was literally forced on us and we were unable to refuse, whether we liked it or not. It did, of course, have an appalling human rights record, at the time, machine-gunning demonstrators and boiling opponents in oil. This was a number of years ago; I hope its record has got slightly better recently.
Given the domination of China-related news in recent days, I am sure noble Lords will have arrived at this debate with the topic at hand already at the forefront of their minds. This is an extremely topical debate—the noble Baroness, Lady Stuart, must have had a vision of the future when she secured it. I hope that we can leave here after the contribution from the Minister feeling somewhat slightly less bemused by the Government’s approach to China. I also hope, however, that ongoing events have made them acutely aware the threat of the Chinese Communist Party’s growing global influence to international stability and order. As my noble friend Lord Hannan pointed out, the clue to who runs the Shanghai Cooperation Organisation is indeed in the name, and as the noble Baroness, Lady Stuart, pointed out in her excellent introduction, the international order that has held since the end of the Cold War is fraying.
Out from under the threat of communism arose a liberal system that centred itself on the rule of law through robust yet unimposing international treaties and institutions—in no small part catalysed and maintained by this country—an order emerged that allowed states, both big and small to interact, to coexist freely and with their own sovereignty. Now, as growing economies begin to compete with the upholders of the prevailing peaceful order, new spheres of influence are cropping up to fracture the old and impose their authority on the new. The Shanghai Cooperation Organisation—slightly misnamed in my view—and its component countries, has no small part to play in that.
The Russian Federation, nations that it engulfed under the Iron Curtain just half a century ago, India, Pakistan, Iran and China make up nearly half the global population and are using their strength and manpower to ally and to exert their influence in an aggressive and partisan manner. The last of those countries, China, has managed to influence and manoeuvre some of the most developed nations in the world—and we here are indeed a case in point. Imagine the free rein that they have with the more underdeveloped nations in search of a route to supposed prosperity. It may seem an attractive notion: rich and poor partnerships aimed at guiding countries to the promised land but the empirical evidence suggests otherwise. The belt and road initiative, coated as a benevolent partnership, has led to many countries in Africa and elsewhere becoming shackled to the Chinese by a collar of unshakeable debt, allowing their guarantor to exercise control and coercion with no repercussions whatever.
The SCO is the other side of that same coin but, rather than one nation, it is, as I said, a near majority of the globe acting to impress themselves into the international order. It is a danger under the guise of a developer. Let me just cover a few of the demonstrations that we saw from the organisation’s summit last month, when it announced, with no hint of irony, its global governance initiative. It pledged to promote democracy when leading members are explicit authoritarians. The interesting sole exception to that is of course India, as the noble Lord, Lord Bruce, pointed out. I struggle to see why it would want to be part of such an organisation. The SCO pledged to abide by the international rule of law, “equally and uniformly”, it says in its declaration, all of course while one of its members is waging an illegal war on Ukraine. It preaches multilateralism when decisions are made unilaterally and with force on smaller surrounding countries.
The SCO represents a clear worry to the peaceful system that has governed our relations for the past three and a half decades. The current Government, I say with sadness but not surprise, have not so far stepped up to this threat. The only place that I can begin is with a brief overview of what has unfolded with regard to China in the past few weeks. A prosecution accusing two men of spying on behalf of China was dropped on 15 September due to a lack of evidence, a decision followed by proclamations of astonishment and surprise from Ministers. The Minister of State for Security told the Commons that the decision had been entirely independent, before the DPP revealed that he had spent months asking the Government to release evidence before the case was dropped. The Education Secretary was then wheeled out at the weekend to do the media rounds, in which she changed the Government’s tune, claiming that the Prime Minister’s National Security Adviser was not involved in “the substance” of the case, whatever that means, amid speculation as to whether or not he attended a meeting on whether a conviction would have negative economic and diplomatic effects. Then, on Monday, the Minister of State for Security once again took to attempting to convince the House that the National Security Adviser does not actually advise on matters of national security.
At PMQs yesterday, in the most explicit and unequivocal of terms, the Prime Minister affirmed that neither the National Security Adviser, the Home Secretary nor anyone at No. 10 made decisions about this case. The case is developing as we speak—there are more news releases all the time—but perhaps the noble Lord, Lord Lemos, representing the Government today, can clarify how these two diametrically opposed courses of action can be modified.
In light of the SCO summit and its overt aims at securing more global influence at our expense, and this Government’s mishandling of our national security interests, it would be helpful for several steps to be laid out in the Minister’s response. What practical steps are being taken to compete with the economic opportunities that are offered to developing countries by China, thereby bringing more countries into our rules-based liberal system? Secondly, what is being done to counter the aggression of the Chinese Government towards Tibet and other nations surrounding the South China Sea? Thirdly, when will all the facts be released about the Government’s role in the failed prosecution? Lastly, given the information that has already come to light, will the Government now oppose a Chinese super-embassy in London in the interests of national security—although I just saw on my phone as I was standing up that a news release has just come out that the Government have now delayed yet again, for the second time, a decision on that embassy. I look forward to hearing the Minister’s response.
Lord in Waiting/Government Whip (Lord Lemos) (Lab)
Apparently, I have nine minutes to deal with the whole of the global security situation.
I thank all noble Lords and Ladies who participated in this debate, particularly the noble Baroness, Lady Stuart, for what has turned out to be a very timely debate—I am sure she knew that when she called for it. Ministers like me are told to say it is an honour, and the speeches have all been brilliant. On this occasion it is an honour, and the speeches have all been terrific, so I am deeply grateful for that. I hope I can deal with the specific points that noble Lords have made as we go through, but if I run out of time, I will check Hansard and respond.
As noble Lords will know, the UK is not a member of the Shanghai Cooperation Organisation, but we respect each country’s right to choose its own path and its own partners, including which international groupings it associates with. The SCO serves as a platform for China and other member states to promote their interests and project leadership on the international stage—I will say a bit more about that in a moment. Our view is that all countries have the right to initiate new formats for multilateral co-operation.
Following the Shanghai Cooperation Organisation summit in Tianjin, China hosted its Victory Day parade in Beijing, marking the end of the Second Sino-Japanese War and the Second World War, as the noble Baroness, Lady Stuart, noted. While noting the military dimension of the parade, it is important to clarify that this event was separate to the Shanghai Cooperation Organisation summit, and indeed, Prime Minister Modi did not attend. The UK recognises the significance of this anniversary for China and its people and respects their right to commemorate this occasion in their own history.
We will continue to exercise our own agency, including as a permanent member of the UN Security Council. We remain strongly committed to the international rules-based system, which has supported peace, prosperity and co-operation for decades, and we will continue to encourage and call for China and other responsible members of the SCO to do the same.
The China audit has informed the UK’s consistent, long-term and strategic approach to China. As stated in the Statement made by the former Foreign Secretary, we will never compromise
“on our national security, recognising the complexity of the world as it is, engaging confidently, carefully and pragmatically, and delivering secure growth”.—[Official Report, Commons, 24/6/25; col. 991.]
I know that noble Lords have asked for a very clear statement on our approach to China, but it is true to say that all speakers in this debate have acknowledged that we cannot have a simple or one-dimensional approach to the relationship with China.
I confirm we will continue to co-operate where our interests align, such as on climate change and global health, but we are prepared to challenge China where its actions undermine our values. Sometimes we will also compete with China for global growth opportunities, and we will continue to be vigilant against the full range of cyberspace and other threats from state and non-state actors, including those that emanate from China.
On the parliamentary espionage case, which the noble Lord, Lord Callanan, raised, the Prime Minister said at PMQs yesterday that he had sought legal advice, and he has published the witness statements. The view of the Government remains that we are disappointed that the case did not reach full trial and that that was the decision of the Director of Public Prosecutions. As the noble Lord, Lord Callanan, acknowledged, this clearly has some way to go. There will be an Urgent Question on it, I think on Monday, but certainly next week, and noble Lords will have an opportunity on the Floor of the House to continue the discussion on that case.
On the question of China’s embassy application, as I think all noble Lords know, planning is quasi-judicial in nature. The case is before Ministry of Housing, Communities and Local Government Ministers for decision, and I do not think I should comment further.
The recent SCO summit was striking in its failure to mention Russia’s illegal war of aggression against Ukraine. The noble Baroness, Lady Bennett of Manor Castle, drew our attention to some of the tragic consequences there. Instead, the gathering was another example of China using its diplomatic engagement with Russia to reduce Putin’s isolation on the world stage. We consistently challenge China’s and other countries’ political and military support for Russia, which prolongs the war and is not in China’s interest. China remains the essential state in helping Russia continue the war against Ukraine. That is the Government’s view. The UK continues to call on China to use its influence to support peace and stability. That includes urging President Putin to end the war, withdraw Russian troops from Ukraine and respect international law. With regard to the observation by the noble Lord, Lord Bruce, the Government work closely with not only European but G7 partners to make common cause on that.
On the multilateral system, strengthening multilateral institutions, which a number of noble Lords mentioned, to uphold the global consensus against aggression and realise a just and lasting peace in Ukraine with full respect for the UN charter is critical. These groupings, such as the SCO—I think I am coming to the heart of the intentions of the noble Baroness, Lady Stuart, in raising this debate—provide China with a platform to promote alternative norms, often prioritising state sovereignty and non-interference over universal human rights and democratic governance. The noble Lords, Lord Callanan, Lord Skidelsky and Lord Moynihan, referred to that. The UK’s response to these initiatives—this is really the heart of my comments—is to defend and strengthen the institutions that matter and that represent the international consensus, including the institutions that many noble Lords have mentioned, such as the United Nations and the World Trade Organization, and to help reform and revitalise them so that they are more inclusive, effective and resilient in responding to global challenges. That was the challenge from the noble Baroness, Lady Stuart, and I think it is important. We welcome China’s support for those institutions in which it is also an active partner. We are actively engaged in efforts to reform and revitalise key institutions through initiatives to reform the United Nations and our work with the multilateral development banks to ensure they are more representative, responsive and effective in addressing today’s global challenges.
I recognise the starting point of the noble Baroness, Lady Stuart, that this is a changed world. China seeks to expand its global influence through the SCO and attempts to reshape the multilateral system to suit its own interests. Our response is clear. We stand firmly behind Ukraine, we defend the multilateral institutions that underpin global stability, and we are renewing bilateral partnerships of the sort that the noble Lord, Lord Moynihan, talked about across the global South. We will continue to engage China in a principled and measured way, as many noble Lords have encouraged us to do. We will continue to support the values and institutions that have helped deliver peace and prosperity around the world, and we will do so with confidence and in the spirit of genuine partnership.
Fracture Liaison Services
Lord Black of Brentwood
To ask His Majesty’s Government what progress they have made towards establishing fracture liaison services across England, and what plans they have to meet their commitment to provide universal coverage by 2030.
Lord Black of Brentwood (Con)
My Lords, at the start of September the Prime Minister made it clear that his Government are now entering the delivery phase. I take him at this word and would like our debate today to focus on helping him to do just that, by setting out how they can deliver on three goals: reducing waiting lists and saving lives; boosting economic growth; and protecting the most vulnerable in our society, particularly the elderly. There is one simple way to deliver speedily on all three: publish the long-awaited bone plan before Christmas.
During the election, the Health and Social Care Secretary said, to his great credit, that developing the rollout plan for fracture liaison services would be one of his first acts in Government. Unfortunately, we are still waiting. In recent years we have had numerous debates on osteoporosis, resulting in clear commitments to move forward, but the truth is that, while their expansion has happened at pace in Wales, we have seen no progress at all in England.
The case for doing so is as strong as ever. Half of women aged over 50 and one-fifth of men will suffer disabling and potentially fatal fractures because of osteoporosis. There are effective medications that prevent fractures and preserve people’s independence, but, shockingly, two-thirds of osteoporosis patients are missing out on that treatment because this Government—and indeed the last one, I readily admit—have so far failed to match words with deeds. The end result of untreated osteoporosis is a broken hip, which results in a three-week hospital stay and kills one-quarter of people within a year. The majority of those who survive face a life infinitely smaller and consumed with pain. I know because I saw it with my own mum, whose latter years were dominated by agony and disability because her osteoporosis was not treated properly.
Campaigns run by two newspapers, the Sunday Express and the Mail on Sunday, have brought this injustice out of the shadows and achieved a consensus on the way forward. This is not a partisan issue; I suspect that we all agree on both the ends and the means. We just need to get on with it.
To turn back to delivery, during the election the Health Secretary made two commitments to people living with osteoporosis. The first was to increase the number of DEXA scans. I thank him and the Government for the £2 million for new scanners released to fulfil that first promise. That is a good start, but fracture prevention relies on more than just a scan. If heart disease patients got only ECGs but then no treatment, there would be outrage. If you want to prevent secondary heart attacks, you do not stop at a cholesterol test.
That is why the second commitment made by the Health Secretary is much more consequential. He promised to expand fracture liaison service clinics to all areas by 2030 so that we can prevent 74,000 fractures by that date, including 31,000 life-threatening hip fractures. Ministers have repeatedly given that commitment to Parliament and, thankfully, the policy is enshrined in the 10-year plan. Again, that is a good start but, despite those commitments, we have heard nothing about how or when it is to be implemented, hence this debate today. The time between now and Christmas is critical if we are to meet the Government’s promise. This afternoon, I ask the Minister to consider three reasons why publishing the bone plan is now extremely urgent.
First, the stakeholder community that will make implementation possible is ready and raring to go. It simply needs the starting gun to be fired. The Royal Osteoporosis Society has been in the vanguard, and I pay immense tribute to its tireless campaigning, but it is much more than one organisation. There is now a community of interest around fracture prevention, composed of 60 organisations with various stakes in women’s health, healthy aging, easing burdens on the NHS and keeping older employees in the workforce. On the medical side, that includes seven royal medical colleges along with the representative bodies for physiotherapists, radiographers, social workers and paramedics.
Leading business voices and the trade unions have called for nationwide FLS because economic growth is being stunted by older workers stopping or reducing work due to fractures. Last year, a dozen eminent societies formed a shadow implementation group to help Ministers deliver the FLS policy. An exemplar rollout plan and high-level recommended approach was submitted, but there has been no response from the Government. The current information vacuum is undermining confidence among these organisations. Unless the bone plan emerges by the end of the year, it will be impossible to maintain belief across the sector that FLS will ever become a reality.
Secondly, every year that we delay we see a cascade of preventable fractures, and that costs money, which we all know is in short supply. If we had rolled out FLS in summer 2024, by now we would have saved £60 million, two-thirds of the money needed to pump-prime every FLS across England up to break-even point. I sympathise with the Health Secretary’s comments, reported in the press last week, about “invest to save” initiatives such as FLS needing investment before savings accrue, but achieving the shift that he rightly wants to make from treatment to prevention must start somewhere. You will not find many other treatment models that break even within just 24 months and deliver £1.88 for every £1 invested. This is about replacing badly-spent money with sensible investment in prevention.
It is not just about the money that is being wasted. Every year that we delay the FLS rollout, another 2,500 people die following broken hips, which FLS clinics could have prevented. That’s 2,500 mums and dads, grandmas and grandpas.
Thirdly, the vacuum of information around FLS is in fact causing perverse outcomes which undermine the prevention of fractures. For the last 16 months, government spokespeople have consistently told newspapers that a national rollout of FLS is imminent. Ministers have given the same commitments repeatedly to both Houses of Parliament. That is great but it should therefore not surprise the Government that commissioners who would have acted on FLS independently have, as a result, paused their plans awaiting a national rollout plan and that, since the election, no new FLSs have opened. That is why I make this appeal to the noble Baroness and her colleagues: please publish the bone plan. You may otherwise be unintentionally harming the important cause of fracture prevention rather than advancing it.
A huge amount of energy and impetus have built up around this issue over recent years. Numerous organisations want to help Ministers, in good faith, to turn it into an example of NHS reform under this Government—serving all three of the strategic shifts that the Health Secretary wants to drive. But uncertainty is eroding that energy and good will, when it could so easily be harnessed for the public good.
I am sure that in her response, to which I much look forward, the noble Baroness will repeat the reassurances given repeatedly to Parliament that FLSs will be implemented by 2030. But I beg her to ask her colleagues, please, to fire the starting gun now by publishing the implementation plan by year-end. Everyone here today—I thank noble Lords so much for taking part, which shows how important this debate is—wants simply to get on with it. Let us make it happen by Christmas. For thousands of families and vulnerable individuals, it would be the best possible present they could ever receive.
The Deputy Chairman of Committees (Lord Haskel) (Lab)
My Lords, the timer seems to have stopped. We will take a short break while it is being fixed.
The Deputy Chairman of Committees (Lord Haskel) (Lab)
My Lords, the Grand Committee has been suspended as a result of technical issues. We will now resume and finish at 5.16 pm. Will noble Lords please bear that in mind and maybe knock a minute or two off their speeches?
Baroness Donaghy (Lab)
My Lords, I thank the noble Lord, Lord Black of Brentwood, for his contribution, which was so stunning that it put the lights out. I will cut my speech short to allow others to get in, in the time available.
As people who know about the subject know, the fracture liaison service was pioneered in Glasgow in 1999. Other countries have picked up this model very successfully to the extent that we, in England at least, are in danger of falling well behind. More than a decade ago in New Zealand, for example, the Government set out to make fracture liaison services available to everyone, backed by targeted central investment. Today, 99% of New Zealanders have access to a fracture liaison service. It is a striking example of how clarity from central government, supported by a plan, can deliver universal coverage in a short time.
Japan offers another lesson. Faced with the oldest population in the world and a growing number of hip fractures, the Japanese Government introduced a simple FLS incentive scheme in 2022. In just three years, the number of services has more than doubled, and every region now has at least one FLS. It is a reminder that, when Governments set clear expectations, progress follows.
In the meantime, progress in England has stalled. Just over half of NHS trusts have an FLS, meaning that thousands of people are treated for a fracture each year but never investigated for underlying causes. The Government’s commitment is welcome and, more importantly, achievable, but commitments alone will not deliver the service. As the noble Lord, Lord Black, said, a delivery plan is now urgently needed to show how that goal will be achieved. That should be this year, preferably by Christmas; otherwise, we will be halfway through this Parliament.
Baroness Bull (CB)
My Lords, I declare my interest as an ambassador for the Royal Osteoporosis Society, and I congratulate the noble Lord, Lord Black of Brentwood, on securing this important debate. Since the campaign for universal access to fracture liaison services was launched, I have seen osteoporosis evolve from an issue oft overlooked in public policy to one that now enjoys cross-party support, with the noble Lord a doughty and persistent champion. Every party endorses the importance of universal fracture liaison services: they are in Labour’s 10-year plan for health, the Conservative manifesto, the Liberal Democrat manifesto and even in the policies of the Reform Party.
However, despite this almost unique level of consensus meaning this should have been an open goal, yet somehow the ball has been lost in kerfuffle and confusion. The confusion is not about intent or even value. Everyone agrees that universal fracture liaison services will save lives and money, but communication between different parts of the system has broken down. The Royal Osteoporosis Society, Ministers, NHS England and local commissioners and indeed the extensive list of networks and organisations that we heard about earlier are all working towards the same goal, yet they seem to be doing so on different pitches. The proposal, for instance, to include fracture liaison services in neighbourhood health centres could one day prove valuable but, as an idea, it was poorly communicated and has just led to greater uncertainty. Commissioners are now unsure whether they should act locally or wait for a national steer and, as a result, progress has stalled.
We know that Ministers face multiple pressures and competing priorities, but a clear commitment was made, and those who fought for it need to see that it still stands. What we need now is to convert confusion into clarity so that we can harness the current consensus to drive change. Commissioners, clinicians and patient groups all need to understand what is expected of them and when. A straightforward statement from the Government that sets out responsibilities, timelines and how the FLS rollout fits within the 10-year plan and neighbourhood health centre programme would resolve much of the current uncertainty.
There is no shortage of evidence to support the case for universal FLS and no shortage of the will and expertise necessary to make it happen. The obstacle is obfuscation. A clear statement from government, followed up by collective action to get everyone on the same page would translate the current confusion into clarity. As we have heard, if the Minister can make that happen before Christmas, we could turn the broad agreement into real delivery.
Baroness Chisholm of Owlpen (Non-Afl)
My Lords, I thank my noble friend Lord Black for securing this debate. We all share the same goal: all noble Lords speaking today and health leaders across the country want to see more fracture liaison services available to more people. Those who suffer from osteoporosis, with its distressing, painful and debilitating consequences, were given hope before the last election by the Government, who made a clear and welcome commitment to ensure that every part of England will have access to fracture liaison services by 2030, and it now forms part of the 10-year health plan for England.
However, I am fearful that we are not moving forward. No new fracture liaison services have opened, and 2030 is only just over four years away, as the noble Baroness, Lady Donaghy, mentioned in her speech. Of course, resources are tight, the NHS faces extraordinary pressures and new funding is difficult to find. If resources are holding things up, I ask the Minister to work with the Royal Osteoporosis Society, which has done so much to support and champion fracture liaison services over many years and again stands ready to help, working closely with the department, to develop a practical, phased rollout plan.
I welcome the media coverage a fortnight ago when the Health Secretary said that he wanted to develop a plan for delivery with the Royal Osteoporosis Society. Such a plan need not be perfect. I have been involved with the Royal Osteoporosis Society for many years, and I know that it is pragmatic and aware of the constraints and challenges faced by the Government. We are all hoping that a practical landing zone will be found for a policy that we are all championing.
I share the concerns expressed by my noble friend Lord Black that a plan needs to emerge by Christmas. Given that a commitment was given to the media that this would be an early priority of the Government and that there is a need to maintain trust and confidence across the network and among partner organisations that this change will happen, let us get on with it and make it happen.
Lord Lexden (Con)
My Lords, my noble friend Lord Black is, thankfully, a persistent person. The subject we are discussing today is one that he has brought before your Lordships with some frequency, through debates and Oral Questions. Those who suffer the pain and distress that osteoporosis brings have no more determined parliamentary champion than him. Evidence continues to accumulate in support of the action for which he has long called and which he has reiterated so powerfully today: the urgent need to establish fracture liaison services throughout our country.
For some years the Royal College of Physicians has charted a steady rise in the number of hip fractures. Its latest annual report, published last month, records yet another increase. It also shows, once again, how unevenly the services that could reverse this trend are spread across our country. Indeed, there could be no clearer example of that much-reviled phenomenon: the postcode lottery.
Curiously, there seems to be no figure for the total number of hip fractures in the United Kingdom. Scotland appears disinclined to share information. In the other three parts of the country the total now stands at some 70,000. Without the action for which my noble friend Lord Black is calling, the number will go on mounting remorselessly. Experts believe that it will double by 2060, bringing the total to 140,000. The bill will be crippling. Today each hip fracture costs the health and care services around £28,000. Total expenditure, which now stands at some £2 billion, is likely to reach £3.8 billion by 2060—virtually doubling the huge burden borne by our overstretched NHS.
The burden can and must be reduced. The key to this is to ensure that those who incur smaller, less severe fractures are correctly diagnosed as suffering from osteoporosis and are treated accordingly. That would cut the number of hip fractures dramatically, but it will not happen without the major change for which my noble friend Lord Black and others have long been pressing. At the moment, around half of those who break a hip have experienced an earlier, less severe fracture without being correctly diagnosed and treated. That means that tens of thousands of people are being discharged from hospital at severe risk of hip fracture and, in due course, some of them will suffer one. More than one in four of those who have a hip fracture will die within a year.
No one, I think, disputes that the most effective way this state of affairs can be remedied is through the provision of fracture liaison services which identify and treat people after their first fracture, helping to prevent a second. Yet, as we have heard, only around half of NHS trusts provide such a service. Like everyone —I think—taking part in this debate, I hope the Government, who have shown that they understand the need for urgent action, will publish before Christmas their plan to extend fracture liaison services throughout the country.
Baroness Hayter of Kentish Town (Lab)
My Lords, it is a great pleasure to follow the noble Lord, Lord Lexden, and to speak again in a debate initiated by the noble Lord, Lord Black. When the Government confirmed last year that they would deliver FLS across England by 2030, it was a real mark of genuine progress and warmly welcomed by all of us—not least, of course, by the noble Lord, Lord Black, himself, who has been asking for this for so long. But despite this, I share the concern of many about the slow rate of progress.
The Government have said that fracture liaison services
“are commissioned by integrated care boards, which are well-placed to make decisions according to local need”.
Now that should be the case, but it unfortunately always tends to be the neglected health conditions, such as osteoporosis, that are overlooked without national co-ordination and insistence—and, surprise, surprise, it is usually women’s issues that are overlooked most.
I was delighted to hear this week a lot on the radio about prostate cancer. However, where is the similar attention to those living with osteoporosis, two-thirds of whom will miss out on treatment? That silence is inexcusable. Luckily, we are in general living longer, but hospitals will not be able to cope with the spiralling numbers of hip and spinal fractures if we do not have that FLS to prevent these breaks. Over just the past two weeks, two of my friends have fallen and broken their hips. I do not know whether they had a particular predisposition but the pain that they are suffering, and the cost to the health service of patching them up, would probably pay for half of a local FLS in their area.
The Health Secretary recognised all of this when he committed to a national rollout of FLS by 2030. Indeed, before the election, Labour’s election platform singled out a small number of health conditions for targeted action and osteoporosis was one of them. We all cheered. I know and understand that a national plan tends to jar with the move towards greater localisation but, given that commitment to implement FLSs by 2030 —only five years off now—surely we can make an exception for that national initiative here. Rather like the pledge to end new HIV transmissions by 2030, which the 10-year plan says will be set out in a delivery plan, we need this for FLS. Let us have the same in this area.
Achieving these two targets on HIV and FLS would be a major boost in preventing ill health. We can help provide a better service for older people, particularly the half of women who are vulnerable. If they could all get a bone plan under their Christmas tree, I think we would all be very happy.
Lord Shinkwin (Con)
My Lords, I, too, thank my noble friend Lord Black of Brentwood for his indefatigable championing of this crucial issue. I will not repeat the strong arguments that he and others have already made, but I pay tribute to his dogged determination to persuade the Government, as others have said, to turn the “What?” into the eagerly anticipated “How?” and “When?” Like him, I also pay tribute to the Royal Osteoporosis Society for its tireless campaigning on this issue. The rollout of fracture liaison services would strengthen the NHS. I also take this opportunity to thank the Secretary of State for Health for the action he has already taken on an issue that is currently waiting for the NHS.
Whenever we discuss the care of people with a bone condition such as mine, I am inevitably reminded of my childhood orthopaedic surgeon, to whom I owe so much. He came to this country as a teenage refugee from racism—abhorrent, toxic, genocidal racism—the sort of racism spouted by Dr Rahmeh Aladwan. How sad that in the 60th anniversary year of Labour’s Race Relations Act, we are seeing the repugnant resurgence of a racism that claimed the lives of all my surgeon’s relatives who came to wave him off as he left Nazi-occupied Prague, so I would be grateful to the Minister if she could convey my thanks to the Secretary of State for his commitment to reform the system governing the regulation of the UK medical register, and, to quote a departmental source, “to make it easier to kick racists out of the NHS”.
No one has an interest in allowing our NHS to be weakened by racism, and I am sure that my Jewish surgeon would have applauded the Secretary of State’s principled stand, but I am also confident that he would have urged him to detail the how and when of the rollout of fracture liaison services. He was dedicated to me, his patients and the NHS. The rollout of fracture liaison services would build on my surgeon’s life-enhancing legacy. It would change so many people’s lives for the better, as we have already heard, and it would strengthen our NHS. I look forward to the Minister’s reply.
Baroness Royall of Blaisdon (Lab)
My Lords, my thanks also go to the noble Lord, Lord Black, for this important debate, but most importantly for his persistence, which I believe has been instrumental in securing the Government’s commitment to deliver universal fracture liaison services by 2030—and I love his insistence on delivery.
It is essential that the FLS plan is delivered this year. I gently suggest to my noble friend the Minister that the forthcoming update to the women’s health strategy might offer the ideal opportunity to make progress. I understand, of course, that osteoporosis affects men as well, but it is one of the most common long-term conditions affecting women. Half of women aged over 50 will experience a fracture caused by osteoporosis. I, like many others, speak from a personal perspective. My mother had chronic osteoporosis, so I joined the Royal Osteoporosis Society, which has helped me enormously. I too pay tribute to it for its campaigning, for the information and support it provides for sufferers and for the support it provides for researchers. I am glad that the Government wish to work with it.
As we know, more than 2.5 million women in England are living with the condition, and most do not know until they break a bone. The last women’s health strategy focused on reproductive and gynaecological health, but the update offers an opportunity to address conditions that threaten women’s independence in later life. Including a rollout plan for fracture liaison services within that update would show that the Government mean what they say about taking action over words. I hope the Minister will relay that message to her department as it prepares the updated women’s health strategy.
We know these services work, yet the postcode lottery remains stark. A part of the country I know well, Gloucestershire, still has no fracture liaison service at all. A woman who slips and breaks her wrist in my area, the Forest of Dean, or in Cheltenham will be patched up in A&E and sent home, her osteoporosis undiagnosed and untreated. Yet just 40 miles away in Oxfordshire, where the noble Earl lives, the local FLS identified and treated more than 2,500 people last year. The contrast between these neighbouring areas shows why a national rollout plan cannot wait. Commissioning takes time. From approval to maturity, an FLS can take five years to establish, so the decisions made this year will determine whether the 2030 target can be met.
Like the noble Lord, Lord Black, I welcome the Government’s commitment in their plan on reforming elective care for patients to boosting the number of bone density—DEXA—scanners by investing in up to 13 DEXA scanners, six of which will replace existing machines. This would be brilliant as it would enable an extra 29,000 bone scans a year. However, it also requires radiographers to enable the scans to take place, so I ask my noble friend the Minister for her assurance that there will be an adequate number of them.
I would be grateful if the Minister could also tell me what consideration, if any, her department is giving to treating osteoporosis with MBST. This uses magnetic resonance therapy to stimulate bone regeneration and increase bone density. I understand that a neighbourhood health hub at the University of East London is providing MBST therapy—that experience could provide invaluable information.
Recognising osteoporosis as central to women’s health would fire the starting gun on delivery and give millions of women confidence that progress is finally being made.
Lord Rennard (LD)
My Lords, I too welcome the persistent, skilful and incredibly determined approach of the noble Lord, Lord Black of Brentwood, to achieve what is clearly needed—that is, the expansion of the use of fracture liaison services to 100% coverage by 2030. This commitment, contained in the 10-year health plan, is the right goal.
When we consider the issues around osteoporosis, we are discussing a public health crisis. Osteoporosis is a condition that is asymptomatic until fragility fractures strike. These fractures are painful. They can lead to social isolation and a significant loss of mobility and independence, and too often to mental health conditions such as depression. Osteoporosis-related fractures claim as many lives as lung cancer or diabetes. They rank as the second highest cause of bed occupancy within the NHS. We all know how expensive the occupancy of hospital beds is and we are aware of the dangers to many patients of being in hospital. These include the risk of infections, sometimes as serious as sepsis.
We need to try to act further to avoid fractures and the resulting stays in hospital. Fracture liaison services proactively identify patients aged 50 and over with a fracture, assessing their bone health and their falls risk to try to prevent what may be a devastating subsequent fracture. We have heard for many years about the laudable ambition of achieving 100% FLS coverage in England by 2030, but we may fail to achieve that target if we fail to heed the lessons from Wales, where they have achieved that goal.
The Government’s current commitment to action is not as rapid as that which has already been achieved in Wales. In February 2023, the then Welsh Health Minister, the noble Baroness, Lady Morgan of Ely, issued a decisive national mandate. She instructed all health boards to establish fracture liaison services within 18 months, backed by pump-priming investment. By September 2024, the target was met and every acute health board in Wales had a functioning service.
The Welsh Government then committed to achieving international quality standards by 2030. That will mean ensuring that these services are resourced to serve at least 80% of the over-50s. The Welsh Government faced the same hurdles that England faces—the same financial pressures, the same workforce challenges and the same competing priorities—but the difference was urgency and focus. In England, without national co-ordination, commissioners are recognising the value of FLS, but they appear to be waiting for direction before committing scarce resources. The result, as we have heard, is that England now runs the risk of falling behind the rest of the UK in osteoporosis care. We must not let that happen.
The Earl of Effingham (Con)
My Lords, I thank my noble friend Lord Black and other noble Lords for their valuable contributions, which appear unanimous. This is clearly an important issue, which speaks to one of the fundamental objectives of any Government, regardless of political persuasion, when it comes to health—namely that prevention is better than cure. Every £1 spent on prevention saves an estimated £5 in downstream NHS costs. This is money well spent and guarantees multiple returns on investment, which are the kind of words that every Chancellor of the Exchequer wants to hear.
In government, we committed to the goal of 100% FLS coverage and we welcome that the current Administration have taken on the baton to complete that by 2030. We know that there is already 100% coverage across Scotland and Northern Ireland, and it is crucial that we follow in their footsteps. Indeed, without successful intervention, research indicates that one in two patients will potentially have another fracture within two years. This is a serious problem: it creates an unnecessary burden on the taxpayer of at least £650 million over five years but, more importantly, it leads to a loss of independence within a year, which then leads to anxiety, isolation, depression and worse. This has further profound societal and economic consequences, which no one wants to see—as was so well highlighted by the noble Lord, Lord Rennard.
The challenge is to identify, to assess, to intervene and to follow up. That is a tried and tested road map that works and that should be provided by a well-oiled FLS. We might ask whether the Government have made an assessment of integrating fracture risk assessments into routine GP health checks for patients over a certain age. Is there an opportunity to improve sex and region aggregated data, so that we can better understand the scale and nature of the problem and the resulting strategies?
I focus briefly on prevention. Strong muscles lead to strong bones, and strong bones help to minimise the risk of fracture. It has been suggested by many research pieces that strength training can even build bone so, if the Government wish to succeed with their goals, when and how will they ensure that everyone understands the huge benefits of daily exercise and strength training, which would solve so many of the issues that we currently face, not just fractures?
His Majesty’s loyal Opposition welcome action on this, via any specific measures that will address the situation. We ask the Government whether they will take guidance from Scotland and Northern Ireland on how they achieved 100% FLS coverage. A precedent has been set but, as many noble Lords have suggested, actions speak louder than words.
Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)
My Lords, I congratulate the noble Lord, Lord Black, on securing this important debate and thank all noble Lords for their significant contributions. I pay tribute to his personal background; it has brought such depth and strength of feeling to the subject, and I am sure many noble Lords have similar experiences. His persistence in carrying on with this is noted and welcomed. He is right to highlight the importance of reducing waiting lists, driving economic growth and safeguarding the most vulnerable members of our society.
We know that patients, including those with osteoporosis fragility fractures, are waiting too long for care and treatment, which needs to change, as I think all noble Lords have mentioned. This is why, between July 2024 and August 2025, the NHS provided more than 682,000 DEXA scans to patients across the country. As announced earlier this year, we are investing in 13 DEXA scanners to support improvements in early diagnosis and bone health and provide an estimated 29,000 extra scans a year once operational. I completely understand the points in the noble Lord’s speech about the need for follow-up action once the scans have been implemented.
I shall pick up the comments made by my noble friends Lady Royall and Lady Hayter. I think there is an enormous recognition of the need to focus on women’s health; that is an accepted aspect of all the work that we are doing. More generally, we want every person, including those with osteoporosis, to receive the highest quality compassionate care. In the past three years, two new drugs have been recommended by the National Institute for Health and Care Excellence for the treatment of osteoporosis in postmenopausal women, for example. Going back to women’s health, through our 10-year health plan and the women’s health strategy update, we are delivering our manifesto commitment that never again will women’s health be neglected.
The three shifts that I will go on to talk about—hospital to community, analogue to digital and treatment to prevention—are key aspects of the work that we need to do. Following from that, the 10-year workforce plan will ensure that the NHS will have the right people in the right places with the right skills to care for patients when they need it. That is a critical aspect. I will write to my noble friend Lady Royall with the more specific detail, if that is okay.
As the noble Lord, Lord Black, illustrated so powerfully, fracture liaison services can play a vital role in reducing the risk of refracture, improving the quality of life and increasing the years lived in good health. This Government and NHS England support the clinical case for services that help to prevent fragility fractures and support patients who sustain them. As we have heard, we are committed to rolling out fracture liaison services to every part of the country by 2030. As my noble friend Lady Hayter said, this is a genuine commitment. One of the early priorities of the 10-year plan will be a modern service framework for fragility and dementia. This is the first time that this has been introduced.
Going back to the 10-year plan, it is absolutely critical that we provide better care for people with osteoporosis, fragility fractures and other MSK conditions. The noble Lord, Lord Rennard, mentioned the problems with public health that we all know—as a former local government leader I know them only too well. Supporting the shift to prevention, the health system is working to prevent fractures occurring in the first place. Advice from NICE for clinicians includes information and advice on lifestyle changes a person can make to reduce their risk of fragility fracture, which the noble Earl, Lord Effingham, mentioned. These include increasing vitamin D intake, eating a balanced diet, drinking alcohol in moderation, stopping smoking if applicable and participating in a combination of exercise types. These are all absolutely fundamental in working towards the prevention agenda.
We are working to deliver the Getting It Right First Time MSK community delivery programme. The specific teams in this area are working with integrated care board leaders to reduce community waiting times and improve data, metrics and referral pathways to wider support services. Under the 10-year health plan, patients with MSK conditions will soon be able to bypass their GPs and directly access community services, including physiotherapy, pain management and orthopaedics, via the NHS app.
Our vision for a neighbourhood health service is also core to achieving the three shifts. The Department of Health and Social Care and NHS England are working closely together to progress our commitment to shift to a neighbourhood health service. The 10-year plan includes fracture liaison services as a specific example of the services that neighbourhood health centres could host.
As we have heard, fracture liaison services are commissioned by integrated care boards, which we believe are well placed to make decisions according to local need. This Government are committed to giving integrated care boards the freedom and autonomy they need to focus on the job of meeting patients’ needs and improving the communities they serve. I am pleased to say that 41 out of the 42 ICBs have a women’s hub. We need to make sure that they are delivering in this space.
Officials in the Department of Health and Social Care are working closely with NHS England to consider a range of options to ensure the improved quality of and access to these important preventive services. We need to be honest about the scale of the action needed, the challenges faced across the health and care system and the fact that change will not be possible overnight.
I recognise that many are dedicated to campaigning for fracture liaison service expansion. I thank the noble Lord, other contributors to this debate and the All-Party Parliamentary Group on Osteoporosis and Bone Health for its work. It is absolutely critical that we raise awareness of this vital issue and try not to wait until it is too late and a fracture has occurred. This is a very important aspect of the work that everyone is pulling together. I thank the clinicians and commissioning bodies that play such a vital role in delivering fracture liaison services.
In response to the noble Baroness, Lady Chisholm, on this point, we talk about politicians, but over the past year, officials, including senior civil servants, have engaged on various occasions with the Royal Osteoporosis Society on fracture liaison services, and they will continue to do so.
I do not have time to respond to all the comments, but I will pass on the comments of the noble Lord, Lord Shinkwin, to the Secretary of State. I thank him for his very clear exposition of his experience. I also undertake to pass on the comments of the noble Baroness, Lady Royall.
I close by simply restating the Government’s commitment to ensuring access to care where and when it is needed. Once again, I thank noble Lords for today’s discussion on such an important topic.
The Deputy Chairman of Committees (Lord Haskel) (Lab)
My Lords, I am sure we all thank the speakers for their brevity in reaction to the technical issues.