EAC Report: Development Aid

Baroness Hussein-Ece Excerpts

Monday 22nd October 2012 Lords Chamber

[Baroness Hussein-Ece]

My Lords, as the 20th speaker in this excellent debate, I, too, have significantly reduced what I was going to say, because so many others have made excellent points that I would have wished to make. I thank the noble Lord, Lord MacGregor, and the Economic Affairs Committee for this report and the opportunity to debate and consider its content on foreign aid and its potential and benefits for developing countries.

Whether we measure poverty by the 1 billion who go hungry each day or other factors, such as the 8 million children who die each year from preventable diseases such as diarrhoea and malaria, the fact that poverty on this scale still exists today is unacceptable to our common humanity. Levels of poverty impact beyond national borders and it is therefore of global importance. We live in an increasingly shrinking world. Countries are more dependent on one another for their security, safety and prosperity. It is in all our interests.

There is strong evidence that the majority of the British public, and in particular young people, who are far more aware of what is going on globally, support the United Kingdom’s overseas aid programme. But it is also quite right, as we have heard, that we are vigilant and have a right to demand that aid achieves value for money and is free of corruption. After all, it is the poor who bear the real brunt of the misuse of valuable aid, as the noble Lord, Lord Shipley, and others have mentioned.

Over recent years, DfID has identified increasing the number of people with access to clean water and sanitation as a top priority for a number of African countries. There can be few more important and effective interventions than clean water. Diarrhoea, caused by lack of access to these basic human rights, is the biggest killer of children under five in Africa, so it is hardly surprising that the United Nations development programme estimates that for every £1 invested in water and sanitation, £8 is returned to the economy through increased productivity. Oxfam reports that the global fund for HIV, tuberculosis and malaria has a proven track record of delivery, saving more than 5 million lives since its inception. It tells us that continued UK support for the global fund is essential. The 2p a day that every person in the UK gives to the global fund to fight HIV/AIDS, TB and malaria saves a life every three minutes. I believe that these are real outcomes, as the noble Lord, Lord Lawson, said.

The report suggests that there is evidence that in some instances aid fosters conflict, but surely supporting fragile nations prevents conflict and reduces the number of refugees and displaced people. Last year, in response to the now Republican vice-presidential candidate, Paul Ryan, who proposed that the United States should cut back significantly on its foreign aid, US commentators replied that,

“foreign aid is not a luxury but a critical investment in global stability”.

I would appreciate it if my noble friend the Minister could address this point in her response as it has come up on a number of occasions.

I was a little surprised to see that there was little mention in the report of the impact that aid has on the lives of women and girls. Therefore, I would like to mention some of the enormous benefits that UK aid has brought to their lives. Aid, particularly in fragile states or in areas of poverty, brings the greatest benefits to women and their families. We know that once women earn a wage they gain more independence and are more likely to put their earnings into the family, thus enabling their children to be educated. These countries are less likely to condone violence, trafficking and other forms of crime which affect women and girls. Businesses that treat women equally as regards seniority and pay benefit through greater productivity and profit. As a global business leader has said, enhancing economic opportunities for women will result in increased incomes, enhanced skills in business, increased stature within the community and improved potential for the communities.

Earlier this year I attended the United Nations Commission on the Status of Women conference in New York. As a delegate from your Lordships’ House, it was a source of great pride to me that the UK, through DfID’s Strategic Vision for Girls and Women, has put girls and women at the heart of its development programme. We are the world leaders in this area and I can report that DfID’s reputation at the conference was second to none. The vision set out in the report has four key themes for action for girls and women: to delay the first pregnancy and support safe childbirth; get economic assets directly to girls and women; get girls through secondary school; and prevent violence against girls and women. The programme outlines where we are making great strides to support girls and women: for example, primary education for girls; maternal health; and access to financial services.

In the past year alone, UK aid has provided at least 740,000 women with access to financial services, improved the rights to land and property for at least 210,000 women; and has supported 2.5 million girls in primary school and 260,000 girls in lower secondary school. It has supported 1 million additional women to use modern methods of family planning. We know that the benefits of focusing on girls and women are significant. When a girl in a developing country receives more than seven years of education she marries four years later and has 2.2 fewer children and her children are more educated and likely to be healthier. Evidence also suggests that societies that have more gender equality tend to be freer and fairer, have greater female participation in politics, and the labour force is associated with lower levels of corruption.

I am also concerned about discussion on moving away from the 0.7% commitment that all parties gave at the general election and which is not only within the coalition agreement but is an international agreement. I believe that we want a more stable and secure world. As others have mentioned, I do not believe that the 0.7% is excessive, given the scale of the challenges that the world is facing.

If the Government are serious about this commitment, they should bring forward the legislation. Legislating will move the debate forward. We need to look at how effectively aid is spent, far more than at how much aid is spent. The spending of £1 on prevention saves £4 being spent on disaster response. In 2009-10 alone, UK aid ensured that 15 million people had enough food to eat. Nevertheless, there are significant funding gaps, for example, in sectors such as child health. Reducing our spend on aid would risk denying millions of poor and vulnerable people around the world the vital assistance that is helping to lift them out of poverty and disease and encouraging greater economic stability. This is a comparatively small contribution to the global problem but makes a real difference in areas of enormous need.

Ideally, we would like to move to “trade not aid”—of course we would—because we know that aid is not an end in itself. But the evidence of the good it is doing is overwhelming. Backing away from our commitment to the 0.7% will also risk the level of contribution that other richer countries make and may start a ripple effect in that direction, which would not be a positive thing. The UK has a long-sustained commitment to reducing poverty, inequality and inequity in the developing world, and for this we should be proud.

UN: Sustainable Development and Family Planning

Baroness Hussein-Ece Excerpts

Monday 19th March 2012 Lords Chamber

[Baroness Northover]

My Lords, that question is slightly wide of scope but I refer the noble Lord to the Answers given by my noble friend Lord Hill assuring the House that this area is extremely important wherever it is found.

[Baroness Hussein-Ece]

My Lords, is the Minister aware that, following the Somalia summit hosted by the Prime Minister last month, it was agreed that security and justice were essential both to a successful political process and to development, yet when I was part of the recent British IPU delegation to the UN Commission for Women last month, we were told by NGOs there that Somali women would not be part of the delegation to Rio as security is “not an issue for women”? Does the Minister agree with me and with the UN Women Executive Director Michelle Bachelet that listening to and supporting rural women is fundamental to ending poverty? What representations will Her Majesty’s Government be making to address this?

[Baroness Northover]

My noble friend is right. Rural women and girls currently have limited access to all sorts of resources. Often it is difficult for them to participate in conferences like this, yet it is very important that they do. Ultimately, of course, it is for the Governments themselves to determine the make-up of their delegations. We can but encourage and make the points that my noble friend has made about the importance of this issue.

Health Professionals: EEA and Non-EEA Citizens

Baroness Hussein-Ece Excerpts

Thursday 8th September 2011 Lords Chamber

[Baroness Hussein-Ece]

My Lords, I thank the noble Viscount, Lord Bridgeman, for securing this very important debate.

Since the inception of the NHS in 1948, it has relied heavily on overseas-trained nurses and staff to bolster its workforce. The NHS was built with the help of immigrant workers and professionals from across the world when the call went out around the empire that the UK needed their labour. Thousands of doctors and nurses migrated here from the West Indies, as it then was, Pakistan, India, and elsewhere during the 1950s, 1960s and 1970s. They were recruited in response to a health service in desperate need of health professionals in the post-war years. The value of their huge contribution has always been recognised, and it is that diversity on which the NHS was based and is now run. It has been a success story.

We know that more than 30 per cent of NHS professionals were born overseas. Without them, the NHS would come to a standstill. In some cases the NHS is now less reliant on overseas trained professionals to deliver services, but international recruitment has been regularly used as the main option for employers trying to fill vacancies in both health and social care, and in professions and specialisms with recognised shortages. Many Asian and black health professionals have been the backbone of the NHS, often concentrated in the lowest paid roles, the least glamorous specialisms, and in the least popular parts of the country. Some have faced racism and, for many, there has been slow promotion in their working lives.

There are legitimate concerns that the countries from which the nurses and midwives are recruited suffer from a knowledge and skills drain, reducing their capacity to provide healthcare to their own populations. But there have been huge advantages when professional staff have returned to their country of origin, taking with them the skills and development that they have acquired here. No one is advocating uncontrolled immigration but the introduction of a cap on non-EU health workers is insulting to those doctors and nurses who came to work in Britain’s hospitals. Many of them have faced difficult circumstances but have made enormous contributions. In light of the increasing evidence of how reliant we are on migrant workers, the cap could have unintended consequences by blocking much needed specialist workers from settling in Britain when they are vital for our economy and public services.

Social care is another area which is being hit by these procedures. It remains one of the lowest-paid sectors, and it is notoriously difficult to recruit for here in the UK. The National Care Association paints a rather stark picture of the policy's impact on social care. It is already complaining that the care sector cannot get the workforce needed to deliver services in this country. It is estimated that 1 million extra workers will be needed to support the UK's ageing population by 2025. In 2007, one in three care workers was recruited from outside the UK, while an estimated 60 per cent of London care workers were non-EU migrants. Meanwhile, we have the same problem with children's services where there has also been a cap, putting vulnerable children at risk because of the shortage of qualified and experienced social workers in some parts of the country, particularly in London. While measures put in place to train people from the UK and EU for roles now filled by non-EU migrant workers will help, it will take more than three years to have enough suitably qualified candidates to fill these positions.

I believe that successive Governments have failed to put the compelling case to the UK public that communities, from hospitals to schools, right through to local authorities, need to be encouraged to develop a more realistic understanding of immigration matters in this respect, and of how reliant we are on skilled migrant workers for our public services. In addition, we need to shape a practical, common-sense approach to this issue, one that reflects our heritage and our values.

Poverty in the Developing World

Baroness Hussein-Ece Excerpts

Thursday 28th April 2011 Lords Chamber

[Baroness Hussein-Ece]

My Lords, I too thank the noble Lord, Lord McConnell, for securing this very important debate and allowing us all to make a positive contribution.

I wish to focus my comments on the role of women in combating global poverty. Worldwide, women and girls bear the brunt of poverty, as was mentioned by other noble Lords earlier, and of hunger and discrimination. They comprise more than 60 per cent of the world’s chronically hungry people. Inherited hunger, when malnourished mothers give birth to malnourished children, is a huge obstacle to development in countries ranging from Afghanistan to Haiti. It is estimated that 70 per cent of those living in poverty are women. Women and girls continue to suffer from gender discrimination, violence and further human rights violations in all societies. Women not only cook for their families but sow, reap and harvest food. Women comprise well over half of all farmers worldwide. Eight out of 10 farmers in African countries, and six out of 10 in Asia, are women. For example, in Kenya, female farmers have fewer opportunities and resources than men. While women receive the same farm inputs that currently benefit the average male farmer, they have nevertheless increased their crop yield by 22 per cent.

I know from my family experience about the role that women have played in supporting their families. My maternal grandmother married at the age of 14. She was illiterate and had no opportunity to go to school because she lived in a small village in Cyprus. She fed her seven children by baking bread and selling the loaves each day for a very small amount of money to people in her village, and by taking in washing and laundry.

We know that women are crucial to unlocking sustainable solutions to hunger and poverty. As the World Food Programme’s executive director said recently,

“Women are the secret weapon to fight hunger … Our experience at the World Food Programme also shows that in the hands of a woman, food is far more likely to reach the mouths of needy children. That’s why, in emergencies like the catastrophic earthquake in Haiti, we channel our relief through women whenever and wherever feasible. More than half of the people we feed, globally, are women and children”.

There is widespread agreement that educating women and girls is the cornerstone of economic and social development, and it is the key to smash the cycle of generations of inherited hunger. Empowering women in every sense is not just a female issue, but a human rights issue—the right to a peaceful, healthy and prosperous future.

Like many women, when I was pregnant I got a bit fed up with the number of people—usually men—who said things such as, “Giving birth is the most natural thing in the world. Women in Africa just squat down and give birth in the fields then go right back to work”. How many women have heard that? Not only were such comments not helpful, I found them offensive. It just is not true. The World Health Organisation says that complications during pregnancy and childbirth are among the leading causes of death and disability among women of reproductive age in developing countries. Most women—99 per cent in 2008—of those who die while pregnant or after having a termination live in developing countries, mainly in sub-Saharan Africa and south Asia. There is an African proverb that a pregnant woman has one foot in the grave. This is the biggest health gap in the world today and one of the greatest injustices.

The millennium development goals include reducing maternal mortality by three-quarters, as well as achieving universal access to reproductive healthcare. The goals set a target of halving extreme poverty, halting the spread of HIV/AIDS, providing universal primary education and ending gender discrimination in education. We know that progress has been mixed, with action on maternal mortality being particularly slow. I should welcome the Minister’s comments on this important aspect.

Here in the UK, where we are used to discussions about motherhood focusing largely on lifestyle choices—whether to be a working mother; whether to breastfeed, and so on; there are endless discussions on “Woman’s Hour” on such issues—it is all too easy to forget that for women in large parts of the world, having a child is literally a matter of life or death. As the noble Baroness, Lady Gardner, said, some of us living in the West sometimes need to take stock and reflect on how much we have.

I welcomed the UK Government’s announcement at the United Nations summit that they intend to refocus their aid programme to put the lives of women in developing countries at its heart. The key aim to invest in girls and women is absolutely right. The government commitment to doubling the number of lives of women and babies saved through UK aid by 2015 is ambitious. As a result of the new strategy, the aim is that at least 50,000 more women and 250,000 babies will survive, and millions more couples will get access to family planning. Other countries, both donors and developing nations, need to be challenged to do the same and more.

Amnesty International’s report, From Promises to Delivery, outlines crucial steps that Governments can take to deliver meaningful progress on the MDGs over the next four years. The report states:

“The MDGs promised some of the world’s most impoverished and excluded a fairer future but it is now painfully obvious that unless urgent action is taken governments will fail the most vulnerable communities”.

Three main issues—gender equality, maternal health and slums—are highlighted in the report to illustrate the gulf between the current MDGs framework and international human rights standards. I should like the Minister also to comment on this aspect and to say what progress we are monitoring and expecting. On gender equality, the report shows how the MDGs fail to ensure that Governments address women’s human rights across all targets despite their being an essential element in tackling poverty. Where gender equality is listed in the MDGs, it is limited to a single target to eliminate disparities in education.

“In Haiti … women are the unbreakable core of families and communities. This country will only be rebuilt if that core is strong and empowered,”

said Concern Worldwide’s country director. As part of its clean-up effort after the terrible earthquake, and to simulate the economy, Concern Worldwide kicked off a series of cash-for-work projects and one-off cash transfers, with women being the main beneficiaries. The director explained that:

“In getting the local economy going again with injections of much-needed cash, it makes perfect sense to make women primary beneficiaries”.

Women have traditionally played a crucial role in the progress of their families but are now pushing for a level platform by breaking taboos and inspiring others to do the same. While we know that there is a long way to go in developing countries to meet the MDGs’ three targets, women are key to tackling inequality and global poverty in developing countries. If we fail to achieve these goals—and there is a short time to go before the target date of 2015—it would be unacceptable from both the moral and practical standpoints.

Socioeconomic Equality Duty

Baroness Hussein-Ece Excerpts

Thursday 18th November 2010 Lords Chamber

[Baroness Verma]

My Lords, the relevant clauses have not commenced. The Conservative Party made it clear that it opposed them, so we do not have to act further. As I have said repeatedly, we supported a large part of the Equality Bill. We worked incredibly hard with the then Government to ensure that it had a safe passage through this House.

[Baroness Hussein-Ece]

My Lords—

[Noble Lords]

No.

[Lord Hunt of Kings Heath]

With respect, the noble Baroness rose on the 19th minute.

[Baroness Hussein-Ece]

Thank you. This is a quick question, but I have been thinking about it. We know that the gender pay gap has widened. The Equality Act was a long time in gestation and the pay gap is a central tenet of trying to reduce inequality in our society. What parts now being enacted will help to narrow that gender pay gap? That in itself would mitigate so much inequality in our society.

Health: Cancer

Baroness Hussein-Ece Excerpts

Thursday 11th November 2010 Lords Chamber

[Baroness Hussein-Ece]

My Lords, I, too, congratulate the noble Lord, Lord Howard, on his excellent maiden speech and on his new important role in leading the hospice movement. I also thank the noble Baroness, Lady Finlay, for securing this debate and for the leadership that she shows in this subject.

All people who have cancer want high quality services and want to be involved as equal and active partners in decisions about their treatment and care. I welcome measures to improve cancer services in the UK over the years. Attitudes towards cancer care and quality of life have changed, and many want to ensure, as has been mentioned, that cancer care and early diagnosis are given the same priority as research into treatments and cures. Improving quality of life matters as much as improving quantity of life.

Dealing with a cancer diagnosis is difficult for both the patient and their family and friends. Being given the right information and support, whether that is someone to talk to, information about specific cancers or advice on benefits, can make a difference and make living with cancer a little easier.

More than 109,000 people of working age are diagnosed with cancer each year. The impact of this usually means people making changes to their working lives or leaving work. The effects of cancer and treatment can impact on people’s lives in many different ways and can affect them for weeks, months or even years after treatment has ended. Fatigue—extreme tiredness—is a very common and frustrating problem, with 65 per cent of cancer survivors saying that they have to deal with fatigue following treatment. Then there are the practical problems when people who are diagnosed with cancer need to take time off from work for treatments or check-ups. Practical problems such as these can make a person’s working life difficult, especially if employers are not supportive or understanding of their needs.

I was interested in what support is currently given to people with cancer to help them remain in work or return to work. The truth seems to be that too many people do not receive enough help or support. There is a lack of information available for people who want to remain in work, and there seems to be a lack of knowledge of legal responsibilities. A supportive employer can be vital in helping someone with cancer return to work. However, new research shows that the majority of employers do not know about their legal responsibilities towards people with cancer—for example, fewer than half of employers know that cancer is covered under the Disability Discrimination Act. Equally, employees also lack knowledge of their employers’ legal obligations to them, and so will often not request the support they are entitled to.

Fewer than 40 per cent of people with cancer know that cancer is covered by the DDA. From 1 October this year, all disability discrimination legislation falls under the Equality Act, as we know. Under the Equality Act, employers must consider requests such as flexible working hours or physical adjustments to the workplace from someone who has cancer. If they meet these obligations, they can avoid potential discrimination charges along with damage to their reputation, legal fees and lost time. Employers who support an employee with cancer will generally foster a greater sense of loyalty from them and improve engagement and morale. Seeing a colleague supported in this way can also reinforce other employees’ sense of fairness and trust and fosters a positive image of that particular employer. Sometimes it will take a minor adjustment to help that employee to remain in work. I ask my noble friend the Minister what can be done to address the lack of information to patients on this matter.

I turn to an issue that, sadly, is not consistent across the UK. Overall, England spends 5.6 per cent of its healthcare budget on cancer, compared with 7.7 per cent in France and 9.6 per cent in Germany. Spending on cancer services has increased by an estimated 36 per cent over the past five financial years, but survival rates have not improved at the rate they should have done, given the increased investment. In January this year, research found that patients from deprived areas in England were more likely to have a late cancer diagnosis and be admitted to hospital as an emergency, as a study suggests. Women and older people also fare worse in getting a prompt diagnosis, as a study team from University College London found. Patients from deprived areas were also less likely to undergo key procedures for rectal, breast and lung cancer, despite the good news that there was a downward trend in the proportion of patients with breast cancer admitted as emergencies. In all, though, patients from deprived areas, older people and women are more likely to be admitted as emergencies.

We know, as has been mentioned, that good-quality palliative care, which helps the most seriously ill and terminally ill to make the most of the time they have left, can provide a period of quality of life for terminal cancer patients. A recent study found that patients who started, soon after their diagnosis, on palliative care along with usual cancer care lived nearly three months longer than people given only standard cancer care, even though this second group had more chemotherapy. I touched on my own experience in a recent debate in your Lordships’ House when my own late father had a very late diagnosis followed by an extremely poor standard of care. This seems to vary from hospital to hospital. Older people are also less likely to receive appropriate pain control than their younger counterparts. This is especially so for patients with dementia.

We need to focus not on the question of additional resources but on ensuring consistency across the country. Older people in particular should be given the same treatment as a young person.