Gavi: Covid-19

Baroness Walmsley Excerpts

Monday 18th May 2020 Lords Chamber

[Baroness Sugg]

My Lords, Gavi itself will help fund equitable access to and the distribution of vaccines. That is why it is so important that the world comes together to ensure that it gets the funding it needs.

[Baroness Walmsley (LD)]

My Lords, health systems in the countries where Gavi operates programmes are very stretched, and routine vaccination programmes are suffering from movement restrictions. What assessment have the Government made of the risk of a re-emergence of the diseases which have been suppressed or even eliminated through Gavi’s work?

[Baroness Sugg]

My Lords, we are concerned about a resurgence. In addition to helping health systems respond to Covid-19, Gavi is helping poor countries adapt immunisation programmes. In areas where childhood immunisation services are disrupted, Gavi is planning an immunisation catch-up campaign to reach unimmunised children.

Tokyo Nutrition for Growth Summit

Baroness Walmsley Excerpts

Tuesday 28th January 2020 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, I thank the noble Lord, Lord Collins, for securing this important debate this evening. I strongly suspect that there will be considerable agreement with what he just said from across the House. I certainly agree with him.

Malnutrition is the main driver of illness and poor human potential worldwide and the UK has been a leader in taking action against it. We have to admit that while asking for more, as we always do. Action on nutrition is one of the most cost-effective things we can do to help us achieve the sustainable development goals and to maximise the potential of the global population. Value for money is £16 for every £1 spent on nutrition. As it happens, such action is closely linked to the other global crisis, climate change: improve one and you beneficially affect the other. The scale of the problem is enormous, as we have heard, with over 20% of children stunted and unable to reach their education potential, and very susceptible to illness.

It is, of course, children who suffer most because of their vulnerability, but it is also girls and women who are particularly susceptible to anaemia and consequently give birth to underweight babies, thereby perpetuating the problem. We have long known that if you support a woman’s health, you benefit a family, and this is a cost-effective way of benefiting the economy of fragile countries. However, we must not forget malnutrition in older people who are more likely to lack the finance necessary to feed themselves properly and who often lack influence in their community, so get forgotten. I am told that one in three older people in hospital in this country is malnourished.

It is tempting to think that malnutrition is something that happens somewhere else and is the responsibility only of the contributions of DfID. However, malnutrition includes undernutrition, shortage of micronutrients and obesity; one in three children globally suffers from one of these three, including here in the UK. Actually, I strongly suspect that it would be a good deal worse if it were not for the existence of food banks, the wonderful school breakfast initiative, the nutrient standards of school meals and the availability of free school meals. I congratulate those local authorities that ensure that children on FSM also get fed during the holidays. Although the main focus of this debate is the Government’s pledges at the Tokyo Nutrition for Growth summit, what action are they taking to address child and elder malnutrition, in all its forms, in the UK?

As we have heard, the current DfID funding for nutrition around the world ends this year. We all hope that the Minister will be able to go a little further when she replies than she did in answer to the Oral Question from the noble Lord, Lord Collins, earlier this month and say whether the Government will up their game a little and pledge £800 million a year for the next five years. Could the Minister also say what analysis has been made of the most effective nutrient-sensitive and nutrient-specific programmes so that we know that the money is being spent on what works best?

As a fellow of UNICEF, I have always been a great admirer of its child nutrition programmes. Part of that is the programme on breastfeeding which also takes place in the UK as the Baby Friendly Initiative. The wonderful thing about breastfeeding is that it helps to protect the mother from breast cancer as well as nourishing the child at minimal cost and risk. It also provides the child with valuable immunity from common diseases. Exclusive breastfeeding for six months and carrying on until 11 months could prevent over 800,000 child deaths and 20,000 maternal breast cancers. What are the Government doing both here and abroad to promote breastfeeding? To protect poor mothers from spending scarce resources on breast milk substitutes, are we providing education about the benefits of breastfeeding? I echo the plea from the noble Lord, Lord Collins, to make sure that we work with partners to ensure the enforcement of the International Code of Marketing of Breast-milk Substitutes.

Talking of working with partners, despite all we do, it is clear that the UK cannot solve malnutrition alone. However, we have already set an example and can do a lot to encourage others. Part of that would be to make the early pledge at the July event in Tokyo that the noble Lord, Lord Collins, asked for and show commitment at the top level by the presence of the Prime Minister.

What plans do the Government have to match fund or co-finance nutrition initiatives to support nutrition plans in the most fragile countries? Will the Minister commit to programmes which strengthen the resilience of food production in poor countries in the light of the effects of climate change? It is much healthier for populations to eat their own normal, fresh diet rather than have to rely on dried food brought in by aid organisations in response to famine, war or natural disasters.

Our track record on these matters is something we can be proud of, but there is much more to do. Therefore, we need the Minister’s assurance that the UK will continue to make a major contribution to tackling the scandal of child and elder malnutrition across the world and start this new decade with a major announcement in Japan in July.

Independent Inquiry into Child Sexual Abuse

Baroness Walmsley Excerpts

Wednesday 28th November 2018 Lords Chamber

[Baroness Williams of Trafford]

The noble Lord is absolutely right: a response is required and will be forthcoming very shortly. On top of that, the Government are acutely aware of the age and declining health of so many former child migrants. We are, as I say, committed to providing a considered response to the inquiry’s recommendations as soon as possible.

[Baroness Walmsley (LD)]

My Lords, does the Minister accept that every week the Government delay in taking a grip on this issue means more young people having their lives destroyed? When they are considering their response, will the Government take account of the mounting evidence, added to only this week by evidence about the Catholic Church, that unless people are forced to report child abuse to external agencies, and report only within the agency concerned, very often these organisations will cover it up because they are afraid of reputational damage? Will the Government take that into account?

[Baroness Williams of Trafford]

I totally accept the noble Baroness’s point—I have just made it myself—that nobody wants to see any further delay, certainly given the age of some of these former child migrants. On reporting sexual abuse to external agencies, the noble Baroness is absolutely right: unless there is a proper system of support for these allegations, there is then further opportunity for internal cover-up.

Universal Sustainable Development Goals

Baroness Walmsley Excerpts

Thursday 22nd November 2018 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, I congratulate my noble friend Lady Suttie on the comprehensive and powerful way in which she introduced this debate today.

I will start by quoting a sentence from a briefing I received this week, prior to this debate:

“Failure to act on climate change now will significantly increase the difficulty of achieving many other SDGs, and will have serious consequences for the stability of global financial systems”.


This sentence could have come from any briefing from any organisation campaigning on climate or environmental matters, but it did not—it came from the Institute and Faculty of Actuaries. It cheered me a lot, because it indicated to me that climate change has developed from being something that only a few biologists and physicists were worried about to a mainstream issue that rightly concerns people in all walks of life. And of course it should, because it is affecting all of us right now, and will affect our children and grandchildren even more in future. The actuaries are quite right that action on climate change can assist us in achieving many of the other SDGs, from education to poverty, from water and sanitation to equality. They also reinforce my view that we need to bring forward our climate change objectives, from 2050 to 2030. We have not much time, and giving permission for fracking is the last thing we should do.

The fact is that, even if we achieve the target of no more than a 1.5 degree rise in mean global temperature, given the rise we have already had, we will still have to face major negative climate events, changes in habitats, loss of biodiversity, poverty and mass movements of people. If we exceed that target, we will reach the tipping point beyond which we cannot stop it and, if that happens, I fear for the future of our species, as well as the rest of life on earth. So, even if we take a selfish point of view relating to our own species’ survival, it is absolutely vital that we do everything we can to slow down and halt global warming. Every degree of change in global temperature makes it more difficult for the diverse life on this planet to survive. That should matter to all of us.

The interdependence between human life and that of other species was illustrated very well in an item on Radio 4 yesterday, when they interviewed a researcher who had identified a gene in a species of fish which enables it to repair faults that arise in its own heart. Her work on this may help us understand, and indeed treat, heart disease in human beings. We rely on other species not only for our food, our clothing, our shelter, our arts and culture, cleaning up the air we breathe and reducing CO₂ but for our health. The natural environment contributes to our well-being and mental health, as well as our economy. For these and many other reasons, we must halt climate change and not do a Donald Trump and stubbornly deny that it has anything to do with wildfires in Florida or, of course, flooding in Yorkshire. Can we hear about the Government’s progress on action against climate change?

The interrelationship between the various SDGs has been well illustrated to me in visits I have made to other countries. On a visit to India with UNICEF—one of those frontline NGOs referred to by the noble Lord, Lord Judd, and of which I have the honour to be an honorary fellow—I was shown women earning money maintaining the pump on the village well or manufacturing sanitation products. Through this work, they gained dignity and earned money to send their children to school, and the village got clean water and sanitation. When the children went to school, as well as education they got access to clean, safe toilets and clean water, lessons in hygiene and soap to wash their hands before lunch, and a child measurement programme that measured their development and identified malnutrition. In the homes, I saw stoves that used gas produced by biomass from animals and human waste, which prevented the women getting respiratory problems, which they used to get from burning smoky wood to cook indoors.

In Madagascar, I saw the devastation of vast areas of highly diverse primary forest caused by burning trees to make charcoal for cooking, in a country with more sunshine than you could ever hope for and the highest percentage of unique indigenous species in the world. Species such as lemurs and special kinds of woods on the red endangered list were being illegally exported to China, against the Government’s best endeavours. The problem is that you cannot blame the people for using what is there to survive. They are some of the poorest in the world and need to cook, eat, shelter and provide for their families, so they will sell what they can, use whatever is available for cooking and overharvest endangered species for food or medicine, without realising that they are killing the goose that lays the golden egg. It is for developed countries such as ours to use the expertise we have to help them make the most of the riches they have around them, their unique habitats and biodiversity. But here in the UK we face many of the same things. In our case, 15% of our species face extinction, mainly because of habitat loss and climate change. We may not know the value of what we have lost until it is gone.

Many charities and universities are taking up the challenge. In Madagascar, we saw a project run by Kew Gardens, one of the world’s leading botanic gardens working in plant conservation in this country and around the world. It is protecting a valley of primary indigenous forest using local labour, trained by expert botanists from Kew, to protect their environment. They earned some money for this, which alleviated their poverty and allowed them to avoid some of the environmental depredations. Kew needs money to provide the benefit of its experts to developing countries and to our own environment. In that respect, I am concerned that the government grant to Kew has been reduced. I wonder whether the Government can give me any hope that this situation might be reversed in the light of the work Kew does to help with the UK’s contribution to SDG 15 on life on land, goal 13 on climate action and goal 11 on sustainable communities.

I also saw a UNICEF project where children were rescued from the streets, having been left there by parents who could not afford to feed them. UNICEF was educating, feeding and clothing them but also trying to reunite them with their families and help them to get work. Here in the UK, as my noble friend Lady Suttie mentioned, we have thousands of children in food insecurity, whose parents rely on food banks and on breakfast clubs and holiday lunch clubs at schools. Universal school lunches in primary schools has been a great success and contributed not only to children’s nutrition and physical health but to their education and mental health. Will the Government expand that programme? Poverty is caused by low wages or employment or benefit uncertainty. The Minister might like to use this opportunity to explain the current status of the review of universal credit.

These few examples illustrate how interlinked the various sustainable development goals are, both here and abroad. Can the Government say what attention they are paying to the links between action on the goals and the individual goals? Sometimes spending on one can bring dividends in several other areas. After I had written the above, I saw the WWF briefing and its recommendations to the Government for the voluntary national review. I was interested to see recommendation 3:

“The VNR should look at interlinkages between the goals, identify accelerators and develop plans to take them forward”.


All I can say is that I agree.

This brings me to where I think the UK has failed most seriously in the way the SDGs have been implemented at home. We are not alone on this earth; we are not the only country and we are not the only species, and although we should help other countries, we need to do it all at home as well. Goal 3 is good health and well-being. Goal 10 is reduced inequalities. In this country, we have a shocking level of poverty, as clearly illustrated recently by the UN’s rapporteur on poverty, and a high level of health inequality. We have a poor rate of perinatal mortality and child obesity and, as announced this morning, 10 times as many children suffering from type 2 diabetes than was originally thought. Finally, we now even have falling life expectancy. These two failures are closely linked. They are also linked to goal 1, eliminating poverty; goal 2, zero hunger; goal 4, quality education; goal 7, affordable clean energy; goal 8, decent work and economic growth; goal 11, sustainable communities; and goal 13, climate action.

I think I have made my point: the health of the nation is a whole-government responsibility. I have long proposed a special high-level Cabinet committee on the health of the nation to which all other departments must report when developing new policies. Do they contribute to the health of the nation, or do they damage it? If they damage it, the department should think again. I still hope that the new Secretary of State for Health, with his understanding that the NHS will not be sustainable unless we focus more on prevention of ill health, will eventually come to the same conclusion. If he is not persuaded by me, perhaps he will be persuaded by this debate, which will show where we are failing and why it would be in the interests of all our people, now and in the future, for us to take a holistic view of health and well-being.

The evidence shows that poor people do not eat well; they live in areas with higher air pollution, in houses which are often cold, damp and expensive to heat because they are poorly insulated. Because of their disadvantages, they achieve less in education and so are less well equipped with the knowledge of how to promote their own health and to get a good, stable job. Their access to junk food is high and their access to good public services is low. Their local authorities are so pressed for cash that they have had to close sexual health services, weight management services, drug, alcohol and smoking cessation services, swimming pools, sports centres and children’s centres. All these impact most on the poor and particularly affect their health—QED.

Will the Government now act to improve our performance against goals 3 and 10 by addressing goals 1, 2, 4, 7, 8, 11 and 13?

Drugs Licensing

Baroness Walmsley Excerpts

Tuesday 19th June 2018 Lords Chamber

[Lord Rosser (Lab)]

I thank the Minister for repeating the Statement made earlier in the House of Commons, and endorse the views expressed in it of sympathy for Billy Caldwell, Alfie Dingley and others like them, and for their parents, who, as the Statement says, have been under unimaginable stress and strain.

With yesterday’s Urgent Question in the other place on the medical use of a cannabis-based medicine uprated to today’s Statement on drugs licensing, this appears to be another example of the Government making decisions on the hoof, in a flap and in response to embarrassing media stories, rather than being a proactive Government who make measured, fully thought-through proposals to address developing issues before they hit the national headlines. Despite this, we still welcome the Home Secretary’s statement that the Government will look more closely at the use of cannabis-based medication in healthcare in the UK, and that they will review the scheduling of cannabis. As the Minister said, what started this off was the case of a 12 year-old boy suffering from severe epilepsy, whose cannabis-based medication was confiscated on arrival at Heathrow from Canada—a decision now modified by the Home Secretary. It contains THC, the primary psychoactive constituent of cannabis, which is illegal in this country but not in a number of other countries, including Germany, the Netherlands, Italy and much of America.

Yesterday, the Government said that the Chief Medical Officer for England had been asked to establish a panel to advise on an individual-case basis on when medicinal cannabis-based products should be prescribed. How many such cases per month do the Government anticipate the panel having to adjudicate on and advise, and against what criteria will that advice be given? What fresh instructions have been issued to officials over allowing through or confiscating cannabis oil and other medicinal cannabis products as from now at our borders and entry points in the light of the Billy Caldwell case? Through what procedure and process will an individual case reach the expert panel? How many instances have there been during the past 12 months of cannabis oil needed for medical use being confiscated at our borders and entry points, and how many of those cases were reviewed by the then Home Secretary, and with what result, under the powers which have apparently just been used by the current Home Secretary? What is the Government’s estimate of the time it will take for the two-stage review just announced by them to conclude its work?

The Statement says:

“If the review identifies that there are significant medical benefits, we will reschedule”.


In other words, the Government do not yet know whether there are such significant benefits. In which case, against what criteria or evidence will the expert panel of clinicians being set up to advise Ministers on any individual applications to prescribe cannabis-based medicines—based firmly on the medical evidence, as the Statement says—make its judgments? I ask that because the Government believe that a two-stage commission is needed to decide whether there is even a case for any change on scheduling in the light of the available evidence.

I come back to the Statement and the words:

“If the review identifies that there are significant medical benefits, we will reschedule”.


Would that apply if the Advisory Council on the Misuse of Drugs came to the conclusion that there were also significant harms from rescheduling, which is what the ACMD is apparently being asked to consider under stage 2?

Finally, a recent report in Private Eye, under the heading “Pot and Kettle” and referring to the Alfie Dingley case as does the Statement, stated:

“A UN report this month found that the UK is in fact the largest producer of legal cannabis in the world—responsible for almost half the global total … As … the drug reform think tank Transform, said: ‘The government is denying that cannabis has medical uses but at the same time licensing production of the world’s biggest medical cannabis production and export market”.


Is that report correct?

[Baroness Walmsley (LD)]

My Lords, I, too, welcome the Statement and thank the Minister for making it. I thank her also for her efforts in this cause and those of her noble friend Lord O’Shaughnessy, who is in his place. I welcome the fact that Professor Sally Davies will now review the mountain of evidence for the medicinal and therapeutic benefit of cannabis-based medicines. She will undoubtedly find that the fact that there are no legally recognised benefits is quite wrong and must change. By what means will Professor Davies hear evidence from the many patients who already know about the benefits? Their doctors know the benefits, too. If she does not already, I am quite sure that Professor Davies will soon know them as well.

I also welcome the fact that the Government will reschedule cannabis when Professor Davies demonstrates those benefits. It should never have been scheduled as a drug without any medical benefits in the first place. Can the Minister estimate how long this process will take, as thousands of patients await the outcome in pain and discomfort?

While we wait for this to be done, it is very welcome that the Government have set up an expert panel to advise Ministers on any applications to prescribe cannabis medicines. It is outrageous that the Dingley family’s heroic doctors should have been put through the wringer by the inappropriate processes which the Home Office has imposed on them during the past four months.

I cannot say how delighted I am that Alfie Dingley and Billy Caldwell will get their medicines at last. However, it should not have taken four months since the Prime Minister promised Alfie’s mother, Hannah Deacon, when she visited No. 10 with me and a group of Peers and MPs, that her son would get a licence for his cannabis medicines on compassionate grounds and speedily. During that four-month period Home Office officials were trying, mistakenly, to operate a system for licensing which was not intended for such cases but was intended for normal clinical trials. It became clear very quickly that the system they were trying to use was not fit for purpose, yet they persisted. I would like to be assured that a system that is fit for purpose will be put in place. Will the Minister give me that assurance? It should not have taken a child, Billy Caldwell, being put in a life-threatening situation for the Government to take this action but I am delighted that they now have.

During the campaign I have been convinced of the Minister’s good faith in this matter but, frankly, although she is always welcome in her place, it should be a Health Minister standing there at the Dispatch Box. I am delighted to see the noble Lord, Lord O’Shaughnessy, in his place listening to this debate. Drug licensing is a health matter, not a Home Office matter and clearly the Secretary of State for Health and Social Care agrees with that, so how will the Department of Health and Social Care be involved in the new arrangements outlined in the Statement and those that will inevitably follow?

Yesterday the Prime Minister said a system is already in place for the medicinal use of cannabis and that government policy would be driven by “what clinicians are saying”. The system has failed thousands of patients, but it is good news that the Government are now trying to put that right, and I thank the Minister for that. Can she say whether expert evidence from countries such as the Netherlands, where cannabis medicines have been safely used for some time, will be heard during the review?

[Baroness Williams of Trafford]

My Lords, I did not do it yesterday, but I welcome the noble Lord, Lord Rosser, back to his place. It is such a pleasure to be debating with him. The first question he asked me was about whether we are doing this on the hoof given the Alfie Dingley case. We are not. One of the noble Lord’s further questions was about why it took so long between Alfie Dingley’s family coming forward and him being issued with a licence today. That is because the correct process was followed. Noble Lords would expect the correct process to be followed. The reverse of this is that a child gets given the wrong drug and becomes very ill. The correct process was followed here. The Home Office and the Department of Health and Social Care have worked extensively together over the past three months to ensure that Alfie has been well cared for, and the licence for his drugs was issued today.

The noble Lord asked how many people would be on the panel. I cannot say. It was announced today, and numbers and people will be announced in the coming week. He asked about the criteria the panel will use for who will be issued with drugs. I assume that there will be clinical experts on the panel and that they will base their criteria on their clinical judgment of the benefits.

On stuff being confiscated, I hope that people do not present at the border with drugs that are not yet licensed, and will come forward to the panel for consideration and for drugs to be issued if that is appropriate. The noble Lord asked how long the review will take. Cannabis is a very complex substance, as noble Lords probably know. It will be a complex review, but the Home Secretary expects an interim report to him within three months.

The noble Lord asked about the expert panel and the advice that it will give. Again, the proper process will be followed. It will be a scientific process with clinical judgment at its heart. He also made the Private Eye point about the UK being the largest producer of cannabis. I do not think that the Government are saying that there are no benefits to be had from cannabis; they are saying that cannabis as a whole plant is currently classified as a Schedule 1 drug, as we have discussed previously. However, as we have seen, constituent parts of it have huge benefits, particularly in the areas of MS and, now, epilepsy.

The noble Baroness, Lady Walmsley, asked for details of the review. We are working through those. I certainly know, because my noble friend has just told me, that Sally Davies will be carrying out a literature review. There are findings from across the world. Much work has been done on this and that will be very informative.

The noble Baroness also made the point about the Dingley family being put through the wringer. Again, it was important that the proper process was followed, and it was. A licence application needed to be made. It was made and I am very pleased to say that Alfie Dingley’s licence was issued today. She asked for an assurance that a system fit for purpose will be put in place. The answer to that is firmly yes: the system has to have longevity. This has been a very big and important step for the Government today.

Cannabis-based Medication

Baroness Walmsley Excerpts

Wednesday 21st February 2018 Lords Chamber

[Baroness Williams of Trafford]

With respect, I point out to the noble Lord that the Question is specifically about the medicinal use of cannabis for a very specific case. The noble Lord is probably straying on to the legalisation of drugs in a controlled way. I am not going there today because I have not been asked a question about it, but I have had many debates about it and the Government remain of the view that such drugs remain illegal.

[Baroness Walmsley (LD)]

I am grateful to the Minister for her commitment to explore every option. Is she aware of the legal opinion from Landmark Chambers making it clear that there is an exception under Section 30 of the Misuse of Drugs Act 1971, which allows that a licence for possession of a controlled drug can be permitted for medical purposes? Will she make use of that exception to save this little boy’s life?

[Baroness Williams of Trafford]

Well, I hope that I made it absolutely clear that we would explore every legal avenue that we could, and that both the Policing Minister and the Home Secretary would look at all legal avenues within the regulatory framework, so I hope that she takes comfort from that.

Women: Events Industry

Baroness Walmsley Excerpts

Tuesday 30th January 2018 Lords Chamber

[Baroness Williams of Trafford]

My Lords, I think the noble Baroness has made the point that I was trying, perhaps not very articulately, to make. A gagging clause will not, in and of itself, protect an employer or someone who is, say, employing, a waitress for an evening. In fact, it will go further than that and void that contract or agreement.

[Baroness Walmsley (LD)]

My Lords, does the Minister agree that if you want to influence the behaviour of men you should start when they are boys? That is why it is very important that the curriculum for PSHE lessons includes elements that ensure that young people leaving school understand that both genders should be properly respected.

[Baroness Williams of Trafford]

The noble Baroness makes a very good point. It is only in educating our children through PSHE, relationships and sex education that that culture of respect towards one another, the opposite sex, and, for young girls, towards themselves, will change.

Transfer of Responsibility for Relevant Children (Extension to Wales, Scotland and Northern Ireland) Regulations 2017

Baroness Walmsley Excerpts

Monday 22nd January 2018 Lords Chamber

[The Minister of State, Home Office (Baroness Williams of Trafford) (Con)]

My Lords, in bringing forward this secondary legislation the Government are seeking to extend the scope of the national transfer scheme for unaccompanied asylum-seeking children to Wales, Scotland and Northern Ireland. The scheme, which the Government launched on 1 July 2016, makes it easier for local authorities to transfer legal responsibility for unaccompanied asylum-seeking children to another participating local authority. The scheme is designed to encourage a fairer distribution of unaccompanied children in local authorities across the UK so that a small number of local authorities are no longer asked to look after a disproportionate number of unaccompanied children and safeguard the best interests of the children concerned.

The national transfer scheme is underpinned by provisions in Part 5 of the Immigration Act 2016. Section 69 of the Act creates a mechanism in England to transfer the responsibility for caring for unaccompanied children from one local authority to another. Section 70 enables the Secretary of State to direct local authorities to provide information about their support to children in their care. Section 71 enables the Secretary of State to direct a local authority that refuses to comply with a request to accept an unaccompanied asylum-seeking child, with written reasons explaining its refusal. Finally, Section 72 enables the Secretary of State to require local authorities to co-operate in the transfer of unaccompanied children from one local authority to another.

These provisions currently apply only to English local authorities. This has meant that local authorities in Wales and Scotland and health and social care trusts in Northern Ireland have not participated in the scheme so far. In extending the scope of the transfer provisions in the Act, this statutory instrument provides the legal framework for local authorities in Wales, Scotland and Northern Ireland to accept transfers under the scheme.

I want to make it clear that the national transfer scheme was designed as a voluntary scheme and we hope that local authorities in Scotland and Wales and health and social care trusts in Northern Ireland will feel able to participate. My officials have worked closely with their counterparts in the devolved Administrations and the local government associations in Scotland and Wales to take account of the unique circumstances in each nation.

As I have already mentioned, there are provisions in the Act for the Secretary of State to mandate the scheme. The Government want the scheme to remain a collaborative effort between central, local and devolved government, and it is in that vein that we have worked with partners across the UK to develop proposals to extend the scheme.

The national transfer scheme has made significant progress since it was launched in July 2016, and we are grateful for the support provided by local authorities that are looking after unaccompanied children. Up to the end of September 2017, 555 unaccompanied children had successfully been transferred. That is a significant achievement but obviously there is more to do. There are still more than 4,500 unaccompanied children in English local authorities, and a handful of local authorities continue to look after a disproportionate number. If we are to achieve a fairer distribution of caring responsibilities across the UK, we need local authorities from all parts of the UK to be able to participate in the scheme so that all children can be afforded the best possible care and support.

We know there is support for the national transfer scheme across the country. That is why it is so important for this legislation to come into force: so that we can build on the excellent work of local authorities in every part of the UK in caring for asylum-seeking and refugee children, and ensure that the national transfer scheme is truly national. I beg to move.

[Baroness Walmsley (LD)]

My Lords, we on these Benches support the national transfer scheme. We believe it is only fair that it should be extended, preferably on a voluntary basis, to the devolved Administrations, particularly since they have been widely consulted. We thank and congratulate those local authorities that have accepted children. Often it is a significant burden, particularly to certain local authorities because of their geographical location, so it is only right that the burden should be spread.

However, I have some questions. How many unaccompanied asylum-seeking children have already been received by the devolved Administrations under the voluntary scheme? What representations have been received from the devolved Administrations about the adequacy of the financial support available to them? How well are families who look after asylum-seeking children supported? There are considerable language and cultural issues with which they need support.

What about the social workers and, preferably, guardians who are needed to steer the children through the process of giving statements to solicitors and to the Home Office? They need advice on the meaning of, for example, “leave until 17 and a half”, which actually means the refusal of an asylum application although it does not sound like it. They need proper professional advice. Lastly, under the present circumstances, what will be the effect on these regulations, if any, of the lack of a power-sharing Administration in Northern Ireland?

[Lord Dubs (Lab)]

My Lords, of course, the transfer scheme has been necessary. There has been more pressure on Kent and Croydon than on other parts of the country, so no one questions the necessity of the scheme. Therefore, it is good to bring Scotland, Wales and Northern Ireland within its scope. I am a little puzzled as to why that has not been done sooner. The scheme has been going for some time. Either it was unnecessary earlier, in which case the Minister will tell us, or there is some other reason. Perhaps she could also tell us how some children have been transferred to Scotland without being part of the scheme, which did not then exist.

I notice from the Explanatory Memorandum that the Government intend to review the funding to be provided for local authorities. I know that the Explanatory Memorandum is not an integral part of the regulations, but it is nevertheless interesting that it has been stated there, and I very much welcome it.

I also welcome the reference to the safeguarding strategy. Can the Minister assure us that the strategy, which was agreed some time ago, will apply equally to Scotland, Wales and Northern Ireland? I think that was the intention, but I am not sure it has happened.

Will the Home Office set up a new consultation to deal with the process of getting children to Scotland, Wales and Northern Ireland? I assume that it has some method of contacting the local authorities there directly—perhaps the Minister will confirm that—so that they can respond immediately; or will this be done through the Scottish Government and the Welsh Assembly? In any case, as the noble Baroness, Lady Walmsley, said, there is also the question of what will happen specifically in Northern Ireland.

We have discussed before the adequacy or otherwise of previous Home Office consultations with local authorities, and we need a new one. If we are to have another consultation on children covered by the transfer scheme, could it not also address other unaccompanied asylum-seeking children dealt with under the new agreement reached between the Prime Minister and President Macron a few days ago? The Home Office could have one wider consultation covering local authorities’ possible responses to the new children coming in, and to those who are the subject of the transfer scheme. This is not the occasion fully to discuss the Sandhurst agreement. All I would say is that, as far as it goes, it is very welcome.

Zika Virus

Baroness Walmsley Excerpts

Tuesday 2nd February 2016 Lords Chamber

[Baroness Verma]

My Lords, I am grateful to the noble Lord for welcoming the work that DfID is doing in responding to this outbreak. He referred to the response to Ebola and the lessons we have learned from that: for example, that health systems on the ground needed to be strengthened. Since then, we have worked to ensure that there is strong reform of how the WHO responds.

The noble Lord also referred to funding. While the UK plays its role, other major donors must also raise their own contributions. As the noble Lord is aware, we work very closely with partners to ensure that we get appropriate funding. We have learned many lessons. Part of that was ensuring that people on the ground are able to respond fully, with trained people in place. Therefore, we have concentrated on looking at how the systems are responding, particularly in Brazil, where we have seen the larger outbreak. This outbreak has elevated itself into people’s minds. The Zika virus is well known in Brazil. Research is being undertaken in a number of areas. Public Health England has offered support through the Pan American Health Organization. We are waiting for that offer to be taken up. The Ross fund, to which the noble Lord referred—the £1 billion that was announced by the Chancellor—will provide funding for research and development. Included in that will be the UK vaccines network, which will have £120 million of funded support and will be headed by the chief scientific adviser from the Department of Health, Professor Chris Whitty. The UK is doing a range of things and is responding. We know very well that we do not have antiviral for this virus at this moment in time. Those exercises are currently taking place.

[Baroness Walmsley (LD)]

My Lords, 80% of those infected show no symptoms. However, a test is about to be made available all over Brazil. It is effective as long as it is given within five days of infection. Therefore, will the Government ensure that the test is available immediately for any pregnant woman returning from one of the 24 infected countries who thinks that she may have been exposed? Is the UK planning to follow the US by banning anyone who has travelled to one of the infected countries from donating blood until it can be determined that they are not carrying the virus?

[Baroness Verma]

My Lords, on the issue of testing when pregnant ladies come back, if anyone has a concern—whether they are travelling to or from the country—the best advice is to go and see their doctor. It is really important that people who have a concern go and see their doctors. However, the actual virus does not travel well because the climate in the UK is not consistent with its doing so; nor is it passed from person to person. So the risks in the UK are low, but my advice would be to see a GP if there are concerns.

I do not have a response to the noble Baroness’s second point about blood donors. I will have to find out the answer.

Sub-Saharan Africa: Healthcare

Baroness Walmsley Excerpts

Thursday 16th July 2015 Grand Committee

[Baroness Walmsley (LD)]

My Lords, I thank the noble Lord, Lord Boateng, for introducing this very important debate. It is a pleasure for me to pay tribute to the more than 1,000 UK health workers who have volunteered to go to Sierra Leone to help combat the terrible Ebola virus. Eradication of this virulent disease presents particular cultural challenges as well as the need for rigorous medical practice. That is what makes it special.

The UK has made a tremendous contribution to the global effort due to three things: first, the willingness of so many generous skilled people to go to Africa to help others; secondly, the preparedness of the UK to help in such medical and disaster emergencies due to the training and care programmes for volunteers of the UK International Emergency Trauma Register; and, thirdly, the support for the campaign offered by DfID, the Department of Health and the NHS.

That support has been vital in providing the cash and facilities necessary to ensure that the volunteers are well trained, well supported and well cared for on their return. It is a tribute to the rigour of the systems that UK-Med and its NGO partners have put in place that only a handful of UK health workers in Sierra Leone have contracted the virus. Thanks to the quality of care that they have received, they have, thankfully, survived.

Currently, despite a small resurgence in the disease that the noble Lord mentioned, the support that the UK has given to developing local health services has meant that UK-Med and the International Emergency Medical Register are not looking for any more UK volunteers for the Ebola programme at the moment. In a way, that is encouraging, because it means that the local health services are sort of coping. Sadly, it is clear that the outbreak was so serious in the first place because the health system in Sierra Leone and the other victim countries was broken. However, local health services need to be forever vigilant, since rapid response to any small outbreak will be vital to ensuring that the outbreak is contained. So perhaps I could ask the Minister what the UK is doing to ensure that the improvements in local health services are maintained and taken even further, as the noble Lord demanded.

As for the NHS, we need to help the organisation to be geared up for releasing staff for this important work and other medical emergencies that will arise in future. We must remember that, by building a capacity to respond to health emergencies overseas, we increase our own capacity to respond nationally here at home at the same time. Following Ebola, we now have a cadre of NHS staff who have first-hand experience of treating and caring for patients with a highly contagious and lethal condition, exercising full barrier nursing and care. This will be a huge advantage when we have a major outbreak of what is likely to be an airborne infection in this country. We constantly hear about new virulent strains of influenza, for example, and the travelling habits of the world’s population make it inevitable that they will reach our shores sooner or later. Not only are these well-trained former volunteers a direct asset themselves but they can also train their colleagues wherever they work, so that these difficult cases can be managed safely and effectively.

By responding to Ebola and, indeed, earlier medical emergencies, we have built a national emergency healthcare workforce, which can quickly be mobilised to respond to emergencies overseas but is equally available for emergencies in this country, should we need it. What is to be done to ensure that we continue to have that workforce? Three initiatives have been suggested to me by Professor Tony Redmond, a trustee of UK-Med and professor at Manchester and Keele universities, to help to strengthen our response readiness.

First, on humanitarian posts, as he points out there is a great deal of altruism within the NHS and many staff wish to volunteer to help vulnerable people in other countries. However, they can find it difficult to take a break from their job, so he proposes that humanitarian posts be established in specialties and areas where it is difficult to recruit and therefore there are vacant posts. Those who take these posts will be guaranteed a period each year where they can be seconded to work overseas, either in an emergency or to help to build the capacity in vulnerable countries to which the noble Lord, Lord Boateng, has referred.

Secondly, there should be cross-trust volunteering. At present, it is difficult to work across two NHS trusts when you are not formally employed by both. The suggestion is to establish an agreement across the NHS so that volunteers who are on the register and appropriately trained and accountable can also deploy as cover across different trusts when teams are deployed overseas. This volunteering to cover for colleagues should have equal recognition with those who actually go overseas. This would also strengthen the UK’s resilience in the event of a major outbreak or mass casualty event at home.

Thirdly, volunteering needs to be incorporated into job plans and appraisals. As I have highlighted, many staff in the NHS are already engaged in volunteering to help support more vulnerable countries and also support the emergency response to disasters overseas, but this work is not recognised in training or in professional development and appraisal. Not only does volunteering help some of the most vulnerable in the world, it also increases overall job satisfaction, because healthcare workers, by and large, enjoy the opportunity to exercise their altruism. Most importantly for the UK, volunteering builds up very relevant skills and experience in managing conditions in difficult circumstances, managing resources effectively, and being exposed to a wide range of conditions and diseases that are rarely seen in the UK but which are important to recognise and to know how to deal with when they occur. The All-Party Parliamentary Group on Global Health has produced a very good document on volunteering and Professor Redmond and his colleagues would look for its recommendations to be widely supported.

I would like to ask the Minister whether the Government will consider these proposals and let your Lordships know whether they will be supported. I know that the NHS is keen to have a positive legacy from its response to the Ebola crisis. By facilitating volunteering overseas, that legacy will be strengthened. However, it is vital that, for volunteering to be safe, effective and of true benefit to the countries to which volunteers are invited, those volunteers are fully trained, insured, vaccinated, accountable and registered to practise in the relevant country. All of these things are promoted and facilitated through the International Emergency Medical Register.

Finally, I will say just a word about those left behind after the Ebola outbreak. I understand from recent research that the number of women who have been widowed by Ebola is considerable. Many have children but find themselves unable to look after themselves, let alone their families. Widows and their female children are often left in particularly vulnerable situations. Reports in the media highlight the disproportionate effect that the situation is having, as it unleashes secondary effects on economic and social development, all of which have harmful implications for women and girls. The charity Street Child reports the story of a young girl who, on the death of her father, became pregnant when she sold herself for sex in order simply to get food for her family. Widows can also face further hardship and abusive practices, such as losing their property and being shunned by society because they have no man to protect them. Therefore, I ask the Minister whether the Government are adding something to address these problems to the very significant medical programme that they have launched to eradicate this disease. Ebola will never be yesterday’s story for these people.