Coronavirus: British Citizens Imprisoned Abroad

Baroness Masham of Ilton Excerpts

Monday 2nd March 2020 Lords Chamber

[Baroness Sugg]

My Lords, I agree that it is absolutely right that we should get the balance of our reaction correct. Of course, public safety is our top priority and I thank all those already working around the clock so that we are ready at home and can ensure the safety of UK nationals abroad. Our approach in this country is being guided by the Chief Medical Officer, Professor Chris Whitty, and independent experts. We will continue to work closely with the World Health Organization and the international community to ensure that we get our response to this outbreak right.

[Baroness Masham of Ilton (CB)]

My Lords, is it true that the prisoners who are ill abroad are not being tested? Surely all of them should be tested and treated.

[Baroness Sugg]

If the noble Baroness is referring directly to the prisoners in Iran, as I say, we are working closely with the Iranian authorities to ensure that we have access to them and that they get the testing and the medical attention they need.

Female Genital Mutilation

Baroness Masham of Ilton Excerpts

Thursday 7th March 2019 Lords Chamber

[Baroness Williams of Trafford]

One thing the noble Baroness might find helpful is that it is an offence to fail to protect a girl from FGM. She mentions schools—clearly, they have not only a safeguarding role but a welfare role. Professionals are now being trained to look out for the signs of whether a girl has gone through FGM, forced marriage or another form of illegal practice.

[Baroness Masham of Ilton (CB)]

My Lords, is the Minister aware that in 1985 I took the first bit of legislation on female circumcision through your Lordships’ House and that the noble Lord, Lord Glenarthur, who is here today, was the Minister? This shows how difficult the situation is, as there have been several bits of legislation since 1985.

[Baroness Williams of Trafford]

I commend the noble Baroness for the work she did back in 1995—

[Baroness Masham of Ilton]

In 1985!

[Baroness Williams of Trafford]

In 1985—even further back. I also commend my noble friend Lord Glenarthur. The noble Baroness points out the difficulties of this. If people, particularly family members, are reluctant to come forward, it becomes very difficult to drive out. However, we have made a small amount of progress, and certainly some of the FGM protection orders that we have introduced have helped to stop girls from being cut.

Nursing

Baroness Masham of Ilton Excerpts

Monday 14th May 2018 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank my noble friend Lord Crisp for all that he does to promote good health globally. There are very many nurses helping to promote global good health, but there is so much to do in this fragile world. The UK does give generously and many people in Parliament, and Ministers, have given their help in supporting global health.

It must not be forgotten that there was a terrible outbreak of Ebola in Sierra Leone. I pay tribute to the nurses who volunteered to look after these very infectious patients. It is important that lessons are learned from such epidemics, which can break out anywhere in the world at any time. With so many infections becoming resistant to antimicrobials, developing vaccines for such diseases as drug-resistant tuberculosis and diarrhoea is vital. Nurses across the globe are often the people at the front line. They need education, training and support. In many countries, stigma associated with infectious diseases is a problem and needs addressing. Nurses, who are so often the leaders, are the people who can do this, but they need support. The All-Party Parliamentary Group on HIV and AIDS is an active group which is helping with the campaign STOPAIDS. The group works with many countries globally that look towards the UK for support. It is important that NGOs, Governments, the pharmaceutical industry and local people work together so that prevention of ill health is high on the agenda.

A record number of nurses and midwives from the EU’s 27 countries left Britain last year. Between 2017 and 2018, a total of 3,962 such staff left the Nursing and Midwifery Council register, but only 805 joined it. The Home Office is not issuing or renewing visas for key health workers who are willing to work here. This is putting the UK in an impossible situation. Nurses who have to nurse sick patients with inadequate staffing have to bear the brunt of worried relatives and stressed patients. The RCN is supporting and actively participating in a number of nursing alliances in Europe and the Commonwealth. These not only seek to influence European and global policy but also spread advanced practice in the key role of nurses in tackling antimicrobial resistance and addressing the health of the health workforce.

I would like to bring to your Lordships’ attention the problems which nurses have been having in our prisons, especially Holme House, a Spice-riddled prison where there have been 376 medical emergencies in a year, caused by inmates smoking spliffs. Nurses have been ordered to stop tending sick patients because of the risk of breathing in mind-altering smoke in a fug-ridden wing which has become so contaminated. There is a shortage of nurses working in prisons and a problem with recruiting and retaining them. Nurses are an important part of the present workforce, as prisoners can have so many conditions, such as diabetes, hepatitis C and mental health problems, to mention only a few.

I would like to say how important specialist nurses are to people who have long-term conditions. They can become a lifeline, as so many general nurses do not understand the varied consequences if patients are not treated in the correct way according to their specialty. As president of the Spinal Injuries Association I am very grateful to some generous people who fundraise for our association. Without this help, we would not have been able to employ two specialist spinal nurses. As there is a shortage of spinal beds in the special units, these nurses go to general hospitals to advise on what is needed. They help with continuing healthcare. They also maintain links with a wide network of relevant stakeholders, including NHS Improvement and the Royal College of Nursing, which are currently in discussions with the SIA regarding bowel management and whether this can be returned to the nursing curriculum at some point.

Parkinson’s UK has 350 specialist nurses across the UK, but there are still 14 areas covering Scotland, Northern Ireland and England where people do not have access to a dedicated Parkinson’s nurse. All specialist nurses for diabetes, cancer and all sorts of conditions are invaluable.

At this time of crisis in the health service we should be grateful for volunteers, who do so much to help. It is of grave concern that the demand is greater than what is available for the care of all patients.

Neglected Tropical Diseases

Baroness Masham of Ilton Excerpts

Monday 3rd April 2017 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank my noble friend Lady Hayman for all she does on this subject. One aim of the declaration is to enhance collaboration and co-ordination on neglected tropical diseases at national and international levels, through public and private multilateral organisations, in order to work more efficiently and effectively together. If so many countries were not ravaged by wars, which produces so many refugees and poverty, there might not be so many health problems.

In 2015 alone, pharmaceutical companies donated an estimated 2.4 billion tablets—enough for 1.5 billion treatments—to prevent and treat NTDs. There is now a global problem with the growing resistance to antibiotics, especially in poor countries, which need more education. I had a very good friend, a Holy Rosary nun, who was a health visitor; she worked in Ethiopia and the Cameroons and told me that it is no good bringing babies into this world if they are to die from disease from contaminated water. She became an expert in sinking wells and providing sanitation.

It is encouraging to hear that South Sudan is soon to be certified free of Guinea worm disease, which thrives in poor areas where there is little sanitation and people bathe in and drink stagnant water. I have visited a leprosy colony on one of the islands, and two babies died in half an hour from malaria when I visited a ward in Mombasa where a friend worked. These people working with NTDs are the unsung heroes. There is much to do, and they need concerted support from Governments and anyone involved.

A neglected disease that is a global danger is tuberculosis, which has not had new drugs for a long time. In 2013-15, there were an estimated 480,000 new cases of multidrug resistant TB in the world. There are substantial differences in the frequency of MDR-TB among countries. In some cases, more severe drug resistance can develop; extensively drug-resistant TB is a more serious form of MDR-TB, caused by bacteria that do not respond to the most effective second line anti-TB drugs, often leaving patients without any further treatment options. Worldwide, only 52% of MDR-TB patients and 28% of XDR-TB patients are successfully treated. Infections that are resistant are much more expensive and take much longer to treat. It is vital that global leadership be provided on matters critical to TB. Ending the TB epidemic by 2030 is among the health targets of the newly adopted sustainable development goals but, unless there is less poverty in the world, that will be difficult to achieve. Also, resistance to a form of HIV treatment, antiretroviral therapy, is increasing around the world. The co-infection of HIV and TB, which are resistant to treatment, is very serious. So many people have been working on vaccines. Like my noble friend Lord Rea, I ask the Minister what hope there is of vaccines for TB, HIV and other diseases.

Health: Ebola

Baroness Masham of Ilton Excerpts

Wednesday 9th March 2016 Lords Chamber

[Baroness Verma]

My Lords, as the noble Lord knows, we are currently undergoing bilateral and multilateral reviews. We will learn from that process where our future funding will go. To take the noble Lord’s point about concentrating on fragile countries, a number of the countries to which the noble Lord referred will be among the 50% that we are targeting in our support for conflict-ridden and fragile states.

[Baroness Masham of Ilton (CB)]

My Lords, could the Minister encourage the Governments of the countries involved with the Ebola virus to teach their populations not to eat bush meat, which can carry the virus?

[Baroness Verma]

My Lords, the noble Baroness raises an important point about causes, but these are lessons that we will learn as we review all the work that we ourselves, other agencies and the Sierra Leone Government have done. We are also undertaking a lot of research in this area, so I thank the noble Baroness for her question.

Ebola: Sierra Leone

Baroness Masham of Ilton Excerpts

Tuesday 19th January 2016 Lords Chamber

[Baroness Verma]

My noble friend is absolutely right. We must of course pay tribute to all those people who put themselves at risk on the front line, including our military personnel and staff of the NHS, among many who have gone there and worked on the ground, putting their own lives at risk. We must also pay tribute to the people of Sierra Leone themselves, who were very much instrumental in being able to restrain this outbreak.

[Baroness Masham of Ilton (CB)]

My Lords, how was it that a swab was taken only after the poor woman died? Surely, diagnosis should have been done when she became ill. Was she not looked after?

Sierra Leone

Baroness Masham of Ilton Excerpts

Monday 29th June 2015 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank my noble friend Lady Hayman for having secured this debate on the catastrophic epidemic and its results in Sierra Leone, one of the countries in west Africa affected by the Ebola virus. With cases of this very infectious condition still appearing, it is clear that the epidemic is far from over. The efforts to end it must not be relaxed.

The medical personnel who have been helping in Sierra Leone rightly have the admiration of many people. It was good news that the nurses who developed Ebola and came back to be treated in the special unit at the Royal Free Hospital recovered, but I take this opportunity to ask how, with all the training that they had had, they became infected. It is important that that is known so that others learn from it. Prevention of infection when working first hand with infected people is vital.

A total of 869 confirmed cases of health worker infections have been reported from Guinea, Liberia and Sierra Leone since the start of the outbreak, with 507 reported deaths. It is said that the initial response by WHO regional staff was slow and poorly targeted, and it has since been heavily criticised as one of the contributory factors in the early expansion stage of the epidemic. It is notable that the WHO Global Outbreak Alert and Response Network, which had such a pivotal role during the SARS outbreak, was mobilised at a late stage after other groups, including Médecins Sans Frontières, had been in action for weeks or months. Even at that point, the WHO concentrated on advisory support rather than mobilising logistics, and clinical and diagnostic support. Several UK agencies, including Public Health England and the Defence Science and Technology Laboratory, were among the European groups to get specialist manpower on the ground at an early stage.

I cannot stress enough how important microbiology and pathology are in combating infection. I think that sometimes the value of their contribution to tackling epidemics is not highlighted enough. At the latest G7 summit, responding to lessons from the Ebola crisis, G7 leaders pledged to help strengthen the world’s ability to prevent, detect and respond to disease outbreaks. I quote from the Society for General Microbiology:

“Emerging zoonitic diseases … pose an increasing global health and economic security threat. Recent outbreaks include Ebola, H1N1 swine flu and severe acute respiratory syndrome … An interdisciplinary ‘One Health’ approach involving human and animal science, health and policy is vital for mitigating this threat”.

There is a huge need for public health improvements. Acute infectious diseases remain the leading causes of mortality, and children under the age of five are disproportionately affected. Since the Ebola outbreak, the impact of malaria has almost certainly increased owing to reduced and/or delayed access to treatment, leading to increased case fatality rates. There is only one paediatrician in the whole of Sierra Leone. Maternal morbidity rates are very high. Over 70% of the population live in poverty and, therefore, the majority of the population’s basic need for food and water is not satisfied. Half the population in Moyamba drink from unsafe water sources. There are few areas with adequate sanitary facilities. One-third of children are stunted; malnutrition is common and under-recognised. During the Ebola outbreak, when the need has been great, the supply of supplementary food has stopped. Thus, unmet nutritional needs of the population have increased.

The current Ebola outbreak is reducing and efforts will continue towards its elimination from the country, but the population will remain at risk of future outbreaks. There is a desperate need for ongoing education. Changes in behaviour such as hand-washing and safe burial practices reduce this risk but the population risk profile has not dramatically altered. There is still a high consumption of bushmeat in Moyamba and other rural areas of the country. I congratulate BBC Media Action on its programme “Kick Ebola out of Sierra Leone”, which it is producing in partnership with Cotton Tree News, broadcast on 40 radio stations across the 14 districts. In recent months, the programme has evolved to focus on concerns about complacency.

I hope the Government will give money to this very poor country. There are successful, rich countries which are getting our support: why not give it to these countries in west Africa?

Sudan

Baroness Masham of Ilton Excerpts

Tuesday 11th February 2014 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords—

[Baroness Masham of Ilton (CB)]

My Lords, have other aid organisations also been banned? It is most extraordinary that the Red Cross has been banned as it is a non-religious, non-political organisation.

[Baroness Northover]

We are hoping that the ICRC will be able to deliver the humanitarian relief that it was delivering before. Negotiations are at a delicate stage. A number of other international organisations are working with enormous difficulty in the area, some with greater reach than others. Some are still there, but a number have had to pull back.

Animal Welfare: Methods of Slaughter

Baroness Masham of Ilton Excerpts

Thursday 16th January 2014 Grand Committee

[Baroness Masham of Ilton (CB)]

My Lords, I declare an interest as I breed sheep. I have to admit that I try to shut out the fact that some of them have to go to market for slaughter. I feel this is something that the general public do not think much about, as long as they have their burgers, steaks and chicken tikka masala. I take part in this short debate on behalf of the animals. I ask that religious leaders—who have traditions—look at the welfare of the animals that give them food. I ask them whether the practice of killing the animals is the best that can be done to relieve the suffering. Animals must sense a horror of going to a slaughterhouse, as has been shown when some animals make violent attempts to escape.

I have been involved with the legislation concerning female mutilation—circumcision. This is a barbaric practice of mutilation of young girls without anaesthetic, all because of some people’s traditions and customs. Animals which are hung upside down and have their throats cut without stunning or anaesthetic must also be terrified. Do the proprietors of these customs realise the cruelty they are inflicting?

The Jewish method of slaughter, shechita, requires animals not to be stunned before slaughter. Recent data collected by the EU Dialrel project show that 100% of the animals and birds slaughtered by the UK abattoirs service for the production of kosher meat were slaughtered without prior stunning. At four establishments, 1,314, or 3%, of cattle and calves were slaughtered by the Jewish shechita method, with 10% of these stunned immediately after bleeding. Does that mean they are still alive after bleeding? These figures were published by the Food Standards Agency in 2012. The National Animal Welfare Advisory Committee of New Zealand recommended a dispensation for kosher slaughter in 2001, but the new code does not allow any exemptions. Among the countries which have banned shechita are Iceland, Norway and Sweden. I hope the Jewish community will see the light—that the animals which give us so much need respect when they have to die.

Global Fund to Fight AIDS, Tuberculosis and Malaria

Baroness Masham of Ilton Excerpts

Tuesday 3rd December 2013 Lords Chamber

[Baroness Northover]

My noble friend is absolutely right. Cambodia, for example, which was highlighted in the programme, has seen an 80% decline in malaria deaths, a 45% fall in TB and a 50% decline in HIV cases. I pay tribute to what my noble friend has done to highlight the challenge of HIV/AIDS and to his fight for the global fund, which has been transformative in this area.

[Baroness Masham of Ilton (CB)]

My Lords, does the Minister agree that it is in the interests of the world to prevent these conditions? I congratulate the UK on what it has done, but will the noble Baroness encourage other countries to do more?

[Baroness Northover]

The noble Baroness is right in terms of the impact. Yesterday, President Obama pledged $5 billion to the global fund. The US has said that it does not wish to contribute more than one-third to the fund. In other words, it wants to bring in other partners. Other countries, including Canada and the Nordic countries, have put in money and are coming forward in an encouraging fashion.