NHS: Global Health

Baroness Thornton Excerpts

Monday 20th December 2010 Lords Chamber

[Baroness Thornton]

My Lords, the noble Lord, Lord Crisp, has a passion for this important issue, and I congratulate the noble Lord on initiating this debate tonight, the quality of which has proved his passion to be correct.

Good health in one country cannot be maintained if there is widespread ill health and disease in so many others. I have always felt privileged to be able to participate in debates in your Lordships’ House when such expertise and personal commitment is shown and, as so many noble Lords have said tonight, in a globalised and interdependent world, one in which disease certainly knows no boundaries, health is a global issue. The rich world has a responsibility to the developing world to support the growth of their health infrastructures and the growth of their medical education.

The nature of our responsibilities includes without doubt the need for overseas doctors to train in the UK without unacceptable barriers being placed in their way, or expense, and indeed the need for UK doctors to spend time abroad. We recognise that is a legitimate part of their qualifications, as mentioned by the noble Lord, Lord Patel, and others. It also includes the need to prepare our own UK-based doctors for the implications and effect of globalisation in our own health service and the UK population. The noble Lord is quite right—our medical training must encompass this challenge and its complexity.

The previous Government, with no small help, I suspect, from the noble Lord, Lord Crisp, produced Health is global: a UK Government strategy 2008-13 in September 2008. In it there was recognition of the fact that a healthy population is fundamental to prosperity, security and stability. It also linked the Government’s domestic and international objectives to the issue of improving global health. Could the Minister tell the House, therefore, what the Government are doing to continue this work? Has the department embraced the recommendations contained in that strategy?

We can look at the threat that global disease can pose. SARS and swine flu are two of the most dramatic examples where the world had to work together to protect itself. There is no doubt that a weakness in the healthcare in one country can put millions at risk. Nearer to home, however, in the UK, and particularly in London, we only have to think about TB and the communities most at risk. I am reminded of this by the noble Baroness, Lady Masham, who questioned me many times when I was a Minister about this.

Seventy-two per cent of UK cases of TB are among people born abroad, and about 40 per cent of cases in England are in London. It is vital, therefore, that the health service in London understands the nature of this problem, the communities at risk, and what needs to happen. The increase in migration into the UK means that UK doctors treat patients from all over the world, and medical students must be prepared for this change and understand its implications.

The report, Tomorrow’s Doctors, referred to by several noble Lords, has very wise words on these matters. It says that this is,

“leading to demands for greater cultural competency in the doctor-patient interaction”.

That is quite right. It continues:

“Medical students have to be prepared carefully for this change, with curricula exposing them to an understanding of why migration happens and specific migrant health issues as well as how to treat a broad range of diseases not routinely seen in the UK”.

Can the Minister say, therefore, whether TB and other conditions and their management are adequately included in the training of doctors in the UK? Indeed, would the forthcoming change of the Health Education Board mentioned in the document referred to by the noble Lord, Lord Jay, which will be an issue for the House in months to come, encompass the proposal made by the noble Lord, Lord Crisp, and other noble Lords today?