Health and Social Care (Safety and Quality) Bill

Debate between Fiona Bruce and Jeremy Lefroy

Friday 7th November 2014 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

May I begin by congratulating my hon. Friend the Member for Stafford (Jeremy Lefroy) on his Bill, which, if implemented, has the potential to provide significant improvements right across this country to the treatment and care of patients requiring medical assistance? Indeed, the improvements proposed by the Bill would have an immediate and real impact.

The national health service is an institution of which the whole nation can be proud. It serves our society with outstanding professionalism and admirable compassion. However, as a few specific, terrible instances have shown, there is room for improvement.

I salute my hon. Friend’s tireless work to do everything possible to ensure that this country never again experiences tragedies of the type reported from Mid Staffordshire hospital. Indeed, my hon. Friend’s constituents have cause to be extraordinarily proud of him as their elected representative and of the thoughtful, tireless and effective work he has done on their behalf in response to the issues raised at Mid Staffordshire hospital. I do not believe that any other Member could have worked harder for their constituents in this connection. He has raised their concerns in this House countless times.

The Bill is another carefully considered and utterly compassionate response—so characteristic of my hon. Friend—to those events. It is a focused, effective and, above all, practical proposal. It has one overriding focus: patient care. It deserves to be fully supported in its passage through the House. Its proposals are specific, realistic and immediately applicable. It will bring about real changes in the lives of real people right across the country at their weakest and most vulnerable moments.

As I have said, particular situations hit the headlines. Although they were extreme, the House must remember that they are part of a wider national picture. We must use the lessons to inform future policy, and the Bill does just that. It is all about patients and their care, and about promoting consistency across the country so that all patients are cared for safely, and are seen to be cared for safely, to an accepted and understood standard. The NHS is an institution that the British people own, fund and use, and it is right for us to be concerned about public confidence in the quality and safety of the care it provides.

I understand the concerns of those who say that the NHS cannot be run on the basis of public opinion—I will speak about that when I come to clause 5—but that does not negate the fact that public confidence in the NHS is an essential concern, not an optional extra. Indeed, an NHS or local hospital that loses the confidence of the public will quickly cease to be able to serve effectively the community for which it is designed.

The first purpose of the Bill is to set in stone the priority of patient safety in NHS standards not just as a power but as a duty of the Care Quality Commission, as my hon. Friend has said. We have learned from the Francis report that patient safety is not an optional extra; it is essential and should be at the heart of good health care. The recognition of every single person’s dignity and value has characterised the proud history of the NHS and must always remain central to its practice, no matter what pressures it comes under on a wider scale.

The priority of safety in the work of the CQC will help to enshrine the dignity of individuals in a system that must inevitably focus on what is efficient in the wider structural picture. Putting safety first will ensure that it is not lost within bureaucracy and procedures. The nature of the NHS clearly means that health care professionals are always under all sorts of pressures to decide how they can most effectively allocate their resources of time, expertise and treatments.

Clause 1 will be a buttress to the rights and dignity of each and every individual within the larger picture. It will make sure that safety is one of the key non-negotiable factors that guide professionals and institutions as they make decisions. The clause acknowledges that there is no such thing as risk-free health care, and it allows for a certain margin when those providing the service cannot reasonably avoid risk. The responsibility that the clause will permanently place on health care professionals, institutions and those assessing the CQC should ensure that the recent tragedies in patient care are far less likely to happen in future. Ideally, no one in the House would want them to happen and to be reported again.

The second aim of the Bill relates to transparency and the integration of health care. A more integrated health care system must surely be a better system. It would promote shared expertise, shared learning and greater safeguards. The care provided for patients should reflect the fact that disconnected and fragmented health care is weak health care. These provisions will aid heath care professionals with regard to not just safety, but good practice across the board. I hope that it will simplify, rather than—as some fear—make more complex, the system of health care provision for patients. A consistent patient identifier and wider information sharing should create clearer channels for the integration of health and social care for individuals. This is the way of the future, particularly given the needs of our increasingly elderly population. I applaud my hon. Friend for those practical proposals.

As I have said, the NHS is a unique institution with a unique connection to the public. Public confidence is not an optional extra, but to achieve it requires transparency. I am sure that many health care professionals in the NHS will welcome greater transparency. The overwhelming majority of those who work in the NHS do an outstanding job, of which they—and we—can be proud.

The British Medical Association has certain concerns about the NHS number being used as a universal identifier, so I am pleased to highlight the fact that the Bill does not require any particular identifier to be used. The Bill seeks to promote the principle and merit of having an identifier, but which identifier is to be used can be left to the discretion of the Secretary of State, who I am sure will consult interested parties.

Provisions for sharing information in the Bill are also important. They will facilitate better health care treatment for every individual across all areas of their treatment, allow professionals to do a better job, and allow patients to know with confidence that those looking after them are fully informed about their care requirements before they provide treatment. Currently, patients cannot be sure that their medical and care history and priorities are being shared between professionals responsible for their care. My hon. Friend has cited cases where that has caused problems, which is no doubt typical of many.

Care must be taken to ensure that information is shared in a responsible way that upholds the privacy of the individual—that is critical. Questions of who information is shared with and how consent is assumed or obtained from patients are important, and there will be the opportunity to discuss such matters further in Committee. As the Bill rightly points out, patient data should not be shared where that is not appropriate, or in an unsafe manner—for example, where a person’s medical record contains confidential information about another person. Critically, the sharing of information must always be in the best interests of that person’s care and treatment. The Bill would not require the sharing of identifiable information for purposes other than direct care. As Dame Fiona Caldicott said:

“For too long, people have hidden behind the obscurity of the Data Protection Act or alleged rules of information governance in order to avoid taking decisions that benefit the patient. Personal data must be protected lawfully, but common sense and compassion must prevail.”

The third and final aim of the Bill is to ensure that the various health care regulators, including the Professional Standards Authority when making decisions on cases of conduct or misconduct, have consistent overall objectives in mind: the maintenance of public safety, public confidence in the relevant profession, and proper professional standards of conduct on the part of health care professionals. The proposals have not sprung up in a vacuum; they are consistent with recommendations in the Law Commission’s report, “Regulation of Health and Social Care Professionals”. It noted with concern the inconsistencies in the way different professional regulators assess individual fitness to practise. The relevant section of the Bill, recommended by experts, should ensure fewer examples of poor practice, and that it is properly addressed. Everyone—practitioners and regulators —should know the primary principles by which professional performance in the health care system is to be judged.

I understand that some professionals, and the BMA, are concerned that the link to public confidence could lead to an inappropriate link between volatile public opinion and the decision of regulators. Those are reasoned concerns but they underestimate the capacity of regulators to make appropriately sound judgments against set benchmarks. The legal position already requires attention to be paid to public confidence. The Law Commission’s report stated that

“the concern is that in cases of clinical misconduct or deficient professional performance they—”

that is the regulators, and for the benefit of the House I will elaborate a little on what “the regulators” means, because it is an extensive group of organisations—

“are more likely to look at whether the instances of clinical misconduct or performance are remediable than to fully consider all of the factors, including public confidence in the profession.”

The Bill addresses that concern.

Concerns that this will lead to inappropriate links between regulation and public opinion, perhaps especially as it relates to so-called scare stories in the press, should prove unfounded. Far from it: the Bill should encourage greater clarity and rigour in the grave task of regulators in assessing professional standards and promoting best practice. The impact of the Bill in this regard should not be underestimated. The extensive list of regulators—the bodies that regulate health and care professionals in the UK and will be affected positively by the Bill—includes: the General Chiropractic Council, the General Dental Council, the General Medical Council, the General Optical Council, the General Osteopathic Council, the Health and Care Professions Council, the Nursing and Midwifery Council and the General Pharmaceutical Council.

[Jeremy Lefroy]

I am most grateful to my hon. Friend for taking on the role of enunciating all the regulatory bodies. Does she agree that we would be wrong to downplay the great common sense of the British people when talking about public confidence? Public confidence in health care professionals, by any objective reasonable measure, is at a very high level and we do not just need to look at press headlines for that. Does she agree that, when it comes down to it, the British people have a huge amount of common sense and the profession should not be afraid of public opinion? It is very much on its side.

[Fiona Bruce]

I entirely agree. In saying what I have said, I in no way want to denigrate my hon. Friend’s intervention. I absolutely agree with him.

In closing, let me repeat my support for this profound and potentially far-reaching Bill. If passed, it would influence the life of every citizen in this country. Let me repeat my support for the excellent work my hon. Friend has done in bringing it to the House, and in working to drive up standards in the NHS, both locally in his constituency and nationally, and protect people across the country from a repetition of the sad and tragic events documented at Mid Staffordshire. The Bill will strengthen relationships between patients and health care professionals, and between the NHS and the public in general. It will help to lift confidence in the NHS even further. Most of all, it will help to ensure that every person who relies on the NHS in their most vulnerable moments will be safer wherever they live and whatever their condition. For that reason, I commend my hon. Friend’s Bill to the House.

Job Creation: Developing Countries

Debate between Fiona Bruce and Jeremy Lefroy

Tuesday 24th June 2014 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

Thank you, Mr Hollobone. It is an honour to serve under your chairmanship. I would like to draw attention to my various entries in the Register of Members’ Financial Interests. The debate is about supporting job creation in developing countries and much of my working life has been spent in that area, so it is inevitable that I have some interests to declare.

Last week, the Select Committee on International Development visited Sierra Leone and Liberia. In both countries, we had the honour of meeting the President. Both, without prompting, listed unemployment, particularly among young people, as something they needed to tackle, and tackle quickly. They see the need particularly clearly because of their recent experience of terrible civil wars that were fuelled by the resentment of people who had no real income, felt divorced from any development taking place in the country and saw an elite disconnected from the needs of the population. As a result, they are both determined to do whatever they can to avoid that situation arising again. As the UN says in another context: create more jobs or risk unrest.

[Fiona Bruce (Congleton) (Con)]

I commend my hon. Friend and colleague on the International Development Committee for his dedication to this subject and for bringing forward this debate. Does he agree that in Rwanda we now see a genuine example of job creation, growth and stability, which has come out of a very traumatic period for that country, proving that that can indeed happen?

[Jeremy Lefroy]

I am most grateful to my hon. Friend for that intervention. She is absolutely right. Of course, in Rwanda people would say that they have much further to go. They want to concentrate on developing the skills of their population, and in particular young people. They are looking at, for instance, the IT sector, because Rwanda is a landlocked country without large natural resources, apart from its own people and the beauty of its landscape. As I said, my hon. Friend is absolutely right.

High levels of unemployment or underemployment, especially among young people, are a problem in most countries in the world. When we ourselves have a youth unemployment rate approaching 20%, we recognise that this is a shared problem and there may well be—in fact, there should be—shared solutions. It is estimated that 1 billion additional jobs will be needed in the next decade for those who are currently out of work and those who will be coming into work over that time. Throughout my remarks, I shall use the word “job” to include self-employment and work in the informal sector, particularly in agriculture.

--- Later in debate ---

[Jeremy Lefroy]

My hon. Friend and the hon. Member for Upper Bann (David Simpson) have obviously read my notes in advance—either that or they are most prophetic—because I will come on to that subject in a moment.

Jobs, in the widest possible sense, will need to bring in more than merely an income on which people can barely survive. The World Bank has set two goals for 2030: to eliminate absolute poverty, which is vital, and to promote inclusive growth by concentrating on the lowest-income 40% in each country. I commend the World Bank president, Dr Jim Yong Kim, on his relentless focus on that. He sees that we must not only eliminate absolute poverty, vital though that is, but raise the living standards of everybody, particularly those at the lowest end of the income scale.

[Fiona Bruce]

My hon. Friend is being generous in giving way so much. Does he agree that one way to raise the living standards of the poorest is to ensure that women in some of the poorest communities in Africa have the opportunity to develop businesses and access finance, even if only small amounts of finance? All the evidence shows that when women are given such an opportunity, the benefits of their businesses are returned to their local communities and are exponential.

[Jeremy Lefroy]

My hon. Friend is absolutely right, and I will say a little more about that. It is vital that those benefits are spread throughout the community. Let us not forget that since the International Development (Gender Equality) Bill, which was introduced by my hon. Friend the Member for Stone (Sir William Cash), received Royal Assent a couple of months ago, Britain’s international development work must now show equality towards men and women, boys and girls.

Work at subsistence level may take someone out of destitution, but it will not bring inclusive growth. That is not to say that subsistence work is pointless, but we must aim higher. As the head of the International Monetary Fund, Madame Christine Lagarde, has said, in far too many countries the benefits of growth are being enjoyed by far too few people. There are ways in which we can help to counteract that, and the Department for International Development does so. One way is to promote fair trade, which began in agriculture but has spread through a number of industries, most recently the garment industry. DFID has done some excellent work in Bangladesh on labour standards among garment workers, together with the British companies that those companies supply. As my hon. Friend the Member for Congleton (Fiona Bruce) has said, it is vital that such work extends throughout the community, particularly to women. As she rightly says, they will probably reinvest the most back into their communities, because they see that as the best safeguard for their children and families.

Let me set out briefly how I believe we can support developing countries to create the jobs that they and we need—our economies are increasingly interrelated. The UK continues to run a large trade deficit, and one of our best hopes for dealing with that lies in trading with developing countries as they grow. I will start by setting out something that I take for granted: a stable and secure state and an economy that is relatively open to the private sector are essential, given that 90% of jobs in the developing world are created in the private sector. Work to improve security and economic governance helps to develop an environment in which jobs can be created. DFID is doing a tremendous amount of work in that area, and I commend it on that. However, I will not dwell on that, because it is the subject of another debate.

A large number of the 1 billion jobs that are needed will, at least initially, be in the informal and agricultural sectors. In 2018, 63% of jobs in developing countries are forecast to be in agriculture still, which will represent a fall of only 8% since 2000. Industry will account for 10% and services for 27%. That is why I believe that one of the most important ways of supporting job creation in developing countries is to teach business skills at school. If most students will be earning their living in some form of self-employment, whether in agriculture or informal sector services, it makes sense to give them the right tools.

Last week in Liberia I met graduates and teachers of the Be the Change academy from Paynesville. Along with David Woollcombe, one of the founders of the organisation, I met Zuo Taylor, who runs the academy’s operation in Liberia, and some young British volunteers who were there as mentors and supporters on the programme, which was exclusively for young business women. I met two young women who had just finished the course, Manjee Williams and Mattee Freeman, who both had businesses already, one as a hairdresser and the other as a caterer. Both said not only that the training and support they had received would help them to organise and run their businesses in a more professional way, but that it had enabled them to consider giving work to others. The caterer already employed several other people—six, I believe—and planned to employ many more.

I believe it is vital to teach self-employment skills not only in schools in the developing world, but right here in the UK. That is done, and it is often done well, but it is supplementary to the curriculum rather than an integral part of it.

[Fiona Bruce]

My hon. Friend and I have experience of teaching business skills, in Rwanda and Burundi. Does he agree that there is an enormous hunger on the part of those who are in business or starting up a business in Africa to learn such skills? Does he also agree that there is a real opportunity, which we need to highlight, for those who have been in business in this country to help to mentor and support growing businesses in Africa, whether by travelling there or by using electronic communication? We must focus on that and encourage it much more.

[Jeremy Lefroy]

My hon. Friend is absolutely right, and it has been a great privilege and pleasure to share that work with her over the past few years. I reiterate that I believe such work to be essential for the UK as well. It is not simply a matter for developing countries. As I have said, we must learn from some of the work going on elsewhere in the world, and I believe we must integrate that sort of business education into our schools. We are not talking about sophisticated business education; we are talking about basic skills that are relevant to the self-employed or those in the informal sector. Many of our young people who are at school will end up being self-employed or working in the informal sector; that is true more than ever in the modern economy. We need to give them those skills, not just through excellent programmes such as Young Enterprise—I am proud to support that programme in my constituency, and I have no doubt that several colleagues do likewise—but as a core part of our curriculum.

One might argue that such training has little relevance to someone involved in small-scale agriculture, but I absolutely disagree. I have seen many examples of how farmers who have just a small amount of land can, using business acumen, create vibrant businesses that are based on agriculture, but go beyond it into activities such as food processing, retail and feed manufacture.

[Jeremy Lefroy]

I absolutely agree with my hon. Friend. Such events are vital. The more connection we have with markets in the developing world, the more we can trade and invest—both ways, these days—and the closer our relationship, the better. That is why I welcome DFID’s focus on livelihoods and on bringing in British business. My right hon. Friend the Secretary of State took British businesses to Tanzania to help with development work in that country through enterprise. That is absolutely vital.

My hon. Friend the Member for Reading West (Alok Sharma) has already mentioned finance. Once someone wishes to start a business, or take a business on to the next stage, they soon find that the next obstacle is finance. Banks provide very little credit to businesses other than those that are well established and fairly large. One might think that that is a familiar refrain even in this country, but what is true of this country is far truer of developing countries, where it is almost impossible for anyone other than a fairly well established, medium to large-sized business to obtain much credit from banks. There are various reasons for that. Bank overheads are high, which means that minimum loans are often far greater than the loan required by a business because the banks need to generate enough income from the loan to sustain their overheads. Bank salaries in some developing countries are not far short of bank salaries in this country, certainly at branch level.

In my experience, banks are also reluctant to lend without substantial security, which is often worth far more than the value of the loan—perhaps 200% of its value. Indeed, central bank rules in some countries may make that compulsory, so any business that does not have a lot of additional security to offer against a particular loan is almost shut out of the market.

Additionally, in countries where the Government run a substantial deficit and dominate bank borrowing, it is often safest and simplest for banks to buy Government bonds. As we learned last week, until recently that was the case in Sierra Leone, where Government bonds were offering something like 30%, well above the rate of depreciation, so it was easiest and simplest for the banks to sit back, buy Government bonds and watch the money come in. There was no need to take the risk of lending to small or even medium-sized businesses.

Of course, there are many good initiatives that assist the provision of finance to businesses in developing countries, although at the moment those initiatives provide just a fraction of what is necessary. Microfinance has been around for some time; although people tend to think of it as more about lending for consumption, microfinance has increasingly been involved in lending to micro and small enterprises—MSEs—as well as for personal consumption, which I am glad to see. This morning I was speaking to the chief executive of a microfinance bank based in Botswana that has operations all over sub-Saharan Africa and is now entering the MSE market.

[Fiona Bruce]

My hon. Friend may remember that we visited the Women’s Initiative for Self Empowerment, the establishment for microfinance in Bujumbura. The initiative informed us that, because of the personal relationship between the women who borrow small amounts of money and the administrators of the lending, the default rate is very low. Should that not encourage us to look further at such microfinance organisations, and perhaps to encourage them through DFID?

[Jeremy Lefroy]

My hon. Friend is absolutely right. The default rate is often lower in such organisations, which rely on a substantial element of trust, as well as on prudent lending and investigation of borrowers. We have seen that default rates of less than 5%, considerably lower than some banks take, are common. Default rates are sometimes as low as 2% in such organisations.

There is also internet-based lending, which is increasing substantially. We see that in this country with peer-to-peer lending, but there are also organisations such as Kiva and Lend with Care, which is run by the charity CARE International. Such lenders typically provide very small loans in which donors from across the world can invest as little as £20 or £30 in loans to MSEs. Such is the power of technology these days that they are able to run such schemes without extremely large overheads.

Furthermore, there are initiatives such as DFID’s programme in Pakistan in which local banks, as we saw, were given a guarantee by DFID so that they could lend to businesses. That means that DFID does not have to do the lending itself, but, as the risk is taken out of the lending, a local bank is able to lend to businesses to which it would not otherwise have lent.

In this case, I believe the guarantee of some £10 million, if I remember rightly, was not drawn on at all, which shows it was an excellent example of lending at no cost to the British taxpayer, with the British taxpayer giving a guarantee. Banks will still carry out the same degree of due diligence, but the guarantee gives them a bit of extra confidence to go and lend to businesses to which they would not otherwise have lent. The key in all those areas is to find cost-effective ways of reducing risk so that financial institutions are prepared to lend, or investors are prepared to commit equity, to a project.

I will mention one particular fund because I have personal experience of being an investor in a company that took advantage of it some years ago. The Africa Enterprise Challenge Fund was set up under the previous Government, with substantial funding from DFID—I believe that DFID currently funds more than 50% of the entire fund. The fund focuses on investments of which the primary beneficiaries are people earning less than $2 a day. Those people may be suppliers to a business or consumers who now have access to a reliable source of seeds or fertiliser, for instance. The fund matches the entrepreneur’s investment up to a certain amount. In Sierra Leone, we visited a chicken farm that is expanding production through support from the AECF. One of the new investments was a modern feed mill that will not only improve the quality of feed, and hence chickens, which have hitherto been imported, but provide a regular customer for many small farmers from whom maize and other crops are purchased.

The AECF effectively acts as a catalyst, and its various funds now total more than $200 million. I have said in the past in the House that I believe that the AECF should provide less in the form of outright grants and more as returnable capital, loans or equity, which can be reused to help other businesses. I am glad to see in the latest figures that just over half the funds advanced by the AECF have been loans, and I encourage it further to increase that proportion because the more it does, the more that can be recycled in to other businesses. If a business is successful, it is right that those who have helped it—in this case, the British taxpayer and taxpayers from other countries that contribute to the fund—should share in that success.

I now come to the point well made by the hon. Member for Upper Bann. Without adequate infrastructure, it is almost impossible for businesses to grow and reach their potential. I recall visiting a road project in the Democratic Republic of Congo near Bukavu with the International Development Committee. The project was substantially funded by DFID, and the road was connecting Bukavu with a town several hundred kilometres away that had been cut off from the rest of the world for some 20 years. That town is not small, and people travelled from there to Bukavu, one of the major population centres of the Democratic Republic of Congo, with great difficulty.

We travelled on the first 60 km to be completed, and people told us that it now takes just two hours for people, generally women, to bring their produce to market in Bukavu, whereas previously it had been a five-day walk carrying produce, in which time a lot of the produce probably would have gone off and become unsalable. The road project is a clear example of rural infrastructure that directly benefits farmers and the rural poor and creates jobs in the widest possible sense. There are many other examples, but that is the clearest example I have seen in which so much difference has been made in such a short space of time.

We heard that Sierra Leone and Liberia have some of the highest electricity prices in the world. That is extraordinary in countries where income is so low. Capacity is another issue. There are many countries in which the entire generating capacity is a fraction of the 900 MW output of Rugeley power station in my county of Staffordshire. As far as I know, Rwanda has less than 500 MW of output, and we were told that Sierra Leone has less than 100 MW of output, although it is currently building more capacity. Those substantial countries have electricity supplies on which a medium-sized town in the UK would not be able to survive. Without electricity, business clearly cannot flourish, and jobs cannot be created. Of course people can buy generators, but as anyone who has ever run a generator will know, the cost is prohibitive and adds enormously to the cost of doing business.

One final infrastructure issue is ports, which are a hindrance in many countries instead of an asset. We can see how, for countries that have invested in ports and run excellent ones, they become an entire competitive advantage in themselves; I think of Singapore, which has become a hub of trade in the far east and globally. Almost anything going in that direction transits through Singapore. I think of one or two ports in the middle east that have been developed into enormous entrepôts. Earlier still, the classic example in Europe is Rotterdam, through which effectively everything transited. We lost a lot of trade to Rotterdam because we were not fast enough in developing our own ports here in the UK, although that has been reversed to some extent since.

There are a number of problems with ports, not least corruption. I have personally experienced the problems with theft and corruption in ports, but it is clear that many ports are simply too small: they need more quays and they need dredging. The difference that better ports can make to job creation and business is enormous, particularly for landlocked countries. Many countries in sub-Saharan Africa are landlocked. In order to give them access to markets, the countries that house ports have a business opportunity, but also a responsibility, to make those ports as efficient as possible. It is estimated that sub-Saharan Africa needs a minimum of $100 billion a year for its infrastructure, and that the whole of Asia needs perhaps $1 trillion. Given that total overseas development assistance is less than $150 billion a year, it is clear that such investment can be done only through Government and private financing.

That is where initiatives such as the Private Infrastructure Development Group come in. Today I checked the results of that initiative, which was set up by the previous Government and continues under this one. The 2012 report stated that 39 projects were operational at the time, employing about 200,000 men and women in their construction and operation and providing services to 97.6 million people. Every $1 contributed by members through the PIDG facility—I am proud to say that the UK is by far the biggest donor—mobilises $39 in finance from other sources for projects. That is a tremendously effective use of money. Even if we take some of the figures with a little scepticism, as I always do, we would have to be extremely sceptical not to acknowledge that that is good value for taxpayers’ money in terms of the return created and the jobs generated.

I will come to the end of my remarks fairly shortly, but I will touch on a few areas that I believe are extremely important to supporting job creation in developing countries. The first is agriculture. We have already heard how many people are employed in agriculture in developing countries, but what must we do to make it work for them so that it is much more than just a subsistence livelihood? We need to help them invest in productivity. I have spoken about productivity before, as have others in other debates, so I will not go into it in great detail, but the issue is about processing, both on-farm—much is lost through poor processing—and post-farm, when raw food is made into finished products that can be sold. Post-farm processing creates a tremendous number of jobs. When we were in Afghanistan, we noted that many raw products from Afghanistan were going to Pakistan for processing and then coming back to Afghanistan in processed form, so we encouraged Afghanistan to invest in its food processing facilities.

Marketing is also important, as are land rights, which come up time and again. Land rights are essential to developing an economy. We have mentioned on a number of occasions the excellent DFID programme in Rwanda in which some 10 million plots of land were given titles, meaning that people have security over their land and can invest in it. They are therefore able not only to borrow against it but to gain additional productivity from it.

Green jobs are also relevant, and not only to the UK and developed countries; they are important in developing countries, because they link sustainability and growth. I was pleased to see that one of the more recent infrastructure projects funded through PIDG was a solar farm in Rwanda. Sometimes one wonders whether solar farms built in the UK are of much use, although I am glad to say that, over the weekend, I was able to have a couple of baths from the hot water solar panel on the roof of my house, even in Staffordshire. However, in countries such as Rwanda that have the benefit of the sun, it is great to see projects such as solar farms being developed to provide low-cost electricity for tens of thousands of homes.

Another way of encouraging job creation that might seem slightly difficult, particularly to those of us on this side of the House, is tax creation. You might share with me, Mr Hollobone, a scepticism about whether collecting taxes can create jobs, but I believe that it does, as long as it is done fairly and rationally. There are a number of reasons why. First, it creates a level playing field. Many countries that I have seen have an arbitrary way of collecting taxes. For various reasons that I will not discuss, some businesses are let off paying the whole amount and others are penalised, perhaps because they are more honest. A proper tax collection system should be neutral. It should enable everybody to flourish in the right way, paying what one would hope is a fairly low rate of tax while contributing to the benefit of everybody.

Secondly, taxes fund security and good governance. As we said at the beginning of this debate, without good governance and good security, business cannot be conducted. Finally, taxes fund public services. To refer again to the remarks made at the beginning, education is absolutely critical to the success of business, as is a health system in which people are looked after so they do not get sick with malaria every other week and go missing from work or, if they are self-employed, end up destitute because they simply cannot get out into the fields.

I have not attempted to do more than provide a brief overview of what I see as the most important areas in which job creation in developing countries can be supported. I have spent most of my working life trying to support it; I remember that when I first went to Tanzania, the business that employed me had about 20 employees. My ambition was that it should have 100 employees after four years, and we succeeded. We had some ups and downs afterwards, but by and large, that was my biggest source of satisfaction: not necessarily the bottom line, but the fact that more and more people—hundreds and hundreds—could get a livelihood from the kind of work in which we were involved.

The stakes could not be higher. If we solve this, we will solve so much else in terms of peace, security, development, the elimination of poverty, and shared prosperity for both developing countries and, as I have said, for ourselves. It is not beyond us, with committed and visionary leadership.

Persecution of Christians (Middle East)

Debate between Fiona Bruce and Jeremy Lefroy

Tuesday 5th November 2013 Westminster Hall

[Fiona Bruce]

I will indeed, time permitting. The suffering of the Copts in Egypt is a critical issue.

Christians in the middle east have suffered from a domino effect of violence that began in Iraq, spread to Syria and overshadows Egypt, leaving the survival of the Church in jeopardy. According to reports, Christians are leaving in droves, ending the presence of the Church in its ancient heartlands. We must remember that Paul’s conversion was on the road to Damascus. That is a key part of the Christian story and heritage. Such countries formerly had large Christian communities—Syria had more than 1.5 million, and a similar number in Iraq is now down to about 300,000—so those are tragic reductions in countries where there are large numbers of the faithful. Persecution is also happening in countries such as Yemen, where the faithful are few in number.

[Jeremy Lefroy (Stafford) (Con)]

I congratulate my hon. Friend on securing this debate. On the situation in Syria, one of the greatest tragedies is that it was that country that offered a haven to refugees, Christian and of other faiths, during the civil war in Lebanon from 1975 to 1990, and indeed during the war and civil war in Iraq, and yet, in Syria now, Christians and others are being persecuted.

[Fiona Bruce]

That is absolutely right. Barnabas Aid reports that until 2011, Syria was one of the freest places to be a Christian in the middle east. It was a place of sanctuary for Christians escaping persecution in Iraq. Suddenly, all of that has changed. Christians made up a sizable minority—around 10% of the population—and were allowed to live out their faith without much hostility from Muslims around them. The Patriarch of Antioch, Gregorios III, said that it was often Christians who provided a bridge between disparate Muslim groups in the region. They had a collegiate approach towards living there. However, as clashes between Government forces and opposition fighters escalated into the brutal civil war that the country has experienced, Christians emerged as particular targets for rebels who assumed at times that Christians were Government supporters.

As Islamist bands have become some of the most prominent groups among rebel fighters, Christians are increasingly being targeted. We hear, for example, of one village where the parish priest has to collect $35,000 a month to pay rebel groups to protect the Christians from armed attacks. That is outrageous, but that is what is happening now.

Recent estimates put the number of Christians who have fled Syria at between 450,000 and 600,000—about a third of the Christian population before the atrocities began. Barnabas Aid estimates that about 600 have been martyred for their faith. For those who stay, the picture is bleak. The report that I mentioned states that entire populations of predominantly Christian villagers around Homs fled for their lives in 2012. In February this year, rebel fighters invaded al-Thawrah, seized Christian homes, confiscated possessions and threatened people with death because they did not comply with sharia law. On 27 May this year, rebel fighters massacred almost 40 men, women and children in the Christian village of Dweir on the outskirts of Homs. Some victims were tortured before being murdered.

The report’s authors told of meeting Syrian Christian refugees in Jordan, who had been told while they were in Syria:

“Don’t celebrate Easter or you will be killed like your Christ.”

On 17 August this year, the Christian area of Wadi al-Nasara, called the valley of the Christians, was attacked. Church buildings were targets. In January this year, church attacks were condemned as war crimes by Human Rights Watch. On 4 September, the historic Christian village of Maaloula—one of the few places in the world where Aramaic, the language of Jesus, is still spoken—was attacked. Rebels linked to al-Qaeda went into every Christian home and destroyed evidence of the inhabitants’ faith. At least seven were killed, and most of the village’s residents were forced to flee. Christians who fled said:

“Let history record that Maaloula is crying today.”

A growing trend is the use of rape as a weapon. In early 2013, a fatwa was issued, via YouTube, that called for the rape of women who were not Sunni Muslims. A tragic example is the horrendous ill-treatment of Mariam, a young Christian woman from al-Qusayr. She was forcibly married to a man who raped her on the same day. Later that day, he repudiated the marriage. The next day, another Islamist man did exactly the same. It continued day after day. For 15 days, 15 different men abused her in this way. Finally, when she was showing signs—unsurprisingly—of mental instability, they killed her. She was just 15 years old.

Christian Church leaders are being kidnapped and disappearing, including two senior bishops, Yohanna Ibrahim and Boulous Yazigi. I am informed that they are of the same seniority as the Bishops of Liverpool and of Manchester; if they had been kidnapped and had disappeared, and were possibly dead, there would be an international outcry. We should exhibit the same response.

For many years, Christians in Syria have formed a cohesive part of the community. At the launch of the report that I have referred to, the Patriarch of Antioch, head of one of the largest Christian Churches in the country, said movingly in this place:

“All Syrians are our brothers and sisters—we have no enemies—yet we are victims. We have not asked for weapons and I have told my parishioners, ‘don’t seek arms.’ We are a church of reconciliation and we are seen by many Muslims as the only one—let the rest of Europe hear that. Persecution is not in our history and we have a long history of collegiality in the region. Let us understand our role and mission—both the historic one and one going forward. But you cannot have a role if you are not present.”

In Egypt, we hear that despite the persecution they engender, Egyptian Christians have forgiven their persecutors and are not retaliating. Although it has experienced enormous hardship, the response of the Coptic community has been one of unprecedented non-retaliation. In some areas, they stand hand in hand with Muslims—I pay tribute to the Muslims standing with them—to protect their churches from further damage. Muslim families in lower Egypt have given blankets to Copts who have lost their homes.

Since the fall of the Islamist Government in Egypt, Christians have seen no improvement in their condition. On the contrary, they are suffering one of the worst periods of targeted violence against them in modern history. More than 140 attacks have been documented since the middle of August—a “reign of terror”, as it has been called by Christian Solidarity Worldwide.

As I have said, we bemoan to this day the persecution of the Jews in Germany, but in August 2013, The Times reported ransackings of homes, hospitals and schools similar to those that took place in 1938, when Jewish synagogues and buildings were ransacked and pillaged. It stated:

“Dozens of churches, homes and businesses have been set alight and looted in Egypt, forcing millions of Christians into hiding amid the worst bout of sectarian violence in the country’s modern history. Some Coptic Christian communities are being made to pay bribes as local Islamists exploit the turmoil by seeking to revive a seventh-century tax, called jizya, levied on non-Muslims.”

The morning after the terrible attacks in mid-August, Bishop Kyrillos William Samaan of Assuit told staff of Aid to the Church in Need that, during a spate of violence against Christians, nearly 80 churches and other centres were attacked in less than 48 hours. Fear of attack means that thousands of Christians are now too afraid to leave their homes. He said that in some villages, people were heard crying:

“Save us. We cannot go out of our houses.”

Joe Stork, the acting middle east director of Human Rights Watch, has reported that dozens of churches are in ruins, and that

“Christians throughout the country are hiding in their homes, afraid for their very lives.”

Only last week, a young Christian minister was kidnapped, tortured and killed when his family could not pay a ransom. How long can we remain apparently indifferent to regular reports of the abduction, forced conversion and marriage of Christian girls, and to the accompanying violence, rape, discrimination, beatings and abuse?

I accept that growing militant Islamism is not the only reason why Christians are being attacked—there is also political instability, poverty and desperation resulting from the displacement of refugees—but that issue nevertheless poses a real threat to other societies. As Barnabas Aid reported in mid-September,

“Western Muslims are going to fight alongside jihadists in Syria…returning home to become potential jihadists themselves. Western countries are not fully grappling with this problem.”

Post-2015 Development Goals

Debate between Fiona Bruce and Jeremy Lefroy

Thursday 4th July 2013 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

I apologise for arriving in the Chamber a bit late. On the subject of roads, does my hon. Friend agree that one of the most important things that the Department for International Development is doing in places such as the Democratic Republic of the Congo is supporting rural road infrastructure? As we saw in, I think, 2011, a road was built to a place that had been cut off for 20 years. Rather than it taking five days for people to get to market, only 60 km of new road meant that they could do so in two hours, which enabled them to bring their produce in, sell it and enjoy their livelihoods.

[Fiona Bruce]

That is an excellent example of the importance of roads. Another relates to Ethiopia, which the Committee also visited. Roads have been built into areas that were originally little more than bush, and, as a result, a health centre and a school can then be built. There is a degree of “villagisation”, whereby families who had perhaps been eking out a living separately in the bush can come together, form a community and support one another. My hon. Friend is absolutely right: roads are essential.

Jobs, too, are essential. Africa is a young continent, but one where, unless we focus on job creation, we will face an increasing employment challenge for youngsters aged up to 25, as the generations, which are now often in school, develop from childhood. One challenge is that we have focused so much—quite rightly—on primary education: there are now probably millions of children with some form of primary education, but with very limited opportunities for secondary and, certainly, tertiary education.

As we develop the new goals, we must consider how we can provide high-quality, targeted tertiary education, vocational skills and professional training, so that we can ensure that there are the business leaders, the technical skills and the young people to run with the vision of developing industries in their communities. If we do not get those skills and do not focus on developing them, we will miss a massive opportunity to help the people in those communities—young people with massive aspirations—to help themselves.

We should consider how to transport some of our skills and strategic understanding of how to develop business and build technical skills. We have to harness those things and consider also how we can harness the energies of people who have perhaps not thought of being involved in development work before. I cite my personal experience of doing business training in Rwanda; I hope to do the same this summer in Burundi.

I do not have a medical or teaching background, but I have a business background, so I went to do some business training. That showed me that every individual who is interested in supporting the developing world has something to offer—people might be interested in going out there to help to support countries that are, as our Chairman said, far less well off than ours. In further education and business development, we need to consider how people who might have taken early retirement but want to give something back can have the opportunity to do so.

I digress slightly, but may I mention the global poverty action fund? We need to re-examine whether it is focused correctly. A minimum of £250,000 is a huge amount of money—for example, an aspiring group of people in this country seeking to help to build a medical or teaching centre may not need to raise such a sum—so will the Minister look at that again? Furthermore, the fund is open for applications for an extremely limited time, often only several weeks—I believe that the current window closes on 9 July, after only a few weeks—but we want to encourage people who might have run businesses in this country to consider applying to the fund to see how they can share skills.

Returning to jobs as a means to end aid dependency, one thing that we need to do is ensure that local authorities in developing countries can maximise any opportunities for inward investment from countries throughout the world. The BRIC countries—Brazil, Russia, India, China—are looking to invest in Africa, and we must ensure that, when new factories and developments are built, the indigenous population and their local authorities have an opportunity to benefit. Local councils should be able to negotiate with contractors, developers and industrialists to ensure that the local community benefits properly. Those are sophisticated skills, but the UK can support them and we need to ensure that the new MDGs are focused on them.

We also need to consider a more holistic approach to job creation, ensuring that there is a suitable environment for business development in those countries. Thus, water is necessary not only for the development of individual, family and village life, but for businesses. Water and sanitation are critical, and unless people have access to sanitation they cannot run a decent business. Land title is essential, as is access to finance and the ability to run a business strategically. There is a huge opportunity for us to examine how local authorities in those countries can work with local business people, so that we in turn can support them and maximise the opportunities for local job creation.

We must look at the issue holistically. We start young people here considering jobs and job opportunities between the ages of 12 and 14, before they start to study for their GCSEs, and we need to do the same for children in Africa and other countries, and consider secondary and early-years education to see what education, skills and training can be invested in those young people to link directly into job opportunities in their countries and local communities. We need an holistic approach to job creation and the reduction of aid dependency through new jobs in the developing world.

--- Later in debate ---

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Havard. You will be glad to hear that I will not speak about HS2—not this week anyway. It is also a pleasure to follow my hon. Friend the Member for Tewkesbury (Mr Robertson), and to be in the same room as him and the Minister of State, Department for International Development, my right hon. Friend the Member for Rutland and Melton (Mr Duncan). They will not remember this, but I certainly do: they were the two Members of Parliament who interviewed me for the candidates’ list about 12 years ago. They may regret their decision, but I do not.

This is an incredibly important debate, and it is a pleasure that the Minister with responsibility for the millennium development goals and post-2015 MDGs will respond. The goals represent one of the best things to come out of the United Nations and the world community in the past 30 or 40 years. They are probably the most significant thing since the declaration, back in 1970 or 1971 after the Pearson report, that developed countries should aim to give 0.5% of GNI as development assistance. I am glad to say that this country will achieve that for the first time this year.

The MDGs have been important because they have been accessible and achievable. Not all have been achieved, and certainly not in all countries, but many of them have been achieved in some of the countries to which they apply. Without going through them all, I want to mention the drastic falls that we have seen, for instance, in malaria, in deaths from malaria, and in maternal and child mortality.

It is important that the post-2015 MDGs build on the success of the MDGs. They should not pretend to be hugely different, and they should learn from areas in which there was not quite so much success.

I shall concentrate on four issues. The first is young people and, particularly, job creation, although my hon. Friend the Member for Congleton (Fiona Bruce) spoke eloquently about that, so I shall not spend too long on the subject. It is estimated that 150 million people are unemployed in the world outside the developed countries, and 60 million of those are young. Women are particularly affected, and some 1.49 billion people are in vulnerable employment. I suggest that those are underestimates, frankly, but they are the figures that we have. It is vital that the new post-2015 MDGs take that situation fully into account.

Although there was an MDG concentrating on that issue, it was probably the least successful one. Over the past 10 or 15 years, vast numbers of people have been pulled out of poverty in countries such as China, but that has not been seen as much in other countries that suffer from acute poverty. The main reason was the lack of job creation, which is why we have to concentrate on that. It is all very well to say that some of those countries will now have great opportunities, because mineral wealth or oil and gas are being discovered, but those industries do not create huge numbers of jobs. The key is that revenue from that natural wealth is put into real investment that creates jobs. Agriculture in particular, and especially small-scale agriculture, has a huge role in creating jobs.

Before I talk about the World Bank, I must declare an interest, as I have just been elected chairman of the parliamentary network on the World Bank and the International Monetary Fund. The hon. Member for York Central (Hugh Bayley) was once the chairman of that network, and he played a great role in setting it up a few years ago. The World Bank has two goals: first, to eliminate absolute poverty by 2030—by which it means people on $1.25 a day or less—and, secondly, to concentrate on the bottom 40% of the income range. That is vital, because this is all about reducing income inequality while increasing the incomes of those who need the most. That is where employment and job creation comes in and, in that area, we must take account of the role and potential of young people. As Nik Hartley, the chief executive of Restless Development, said:

“We should take the lead in ensuring young people are not bit players but central to the leadership of and governance of the new development framework. They will be the job creators or the unemployed, the new democratic leaders or drivers of revolution and rebellion”.

The task of the present generation is to meet development challenges without compromising the interests of future generations.

My hon. Friend the Member for Congleton mentioned many drivers of job creation, such as land title and access to finance. It is good that DFID is heavily involved in both those areas. I have mentioned this issue before in the House, but I will do so again today, because through an excellent programme in Rwanda, which I believe is coming to an end, DFID financed the creation of title deeds into pretty much every single part of the country. There are 10 million individual plots at a cost of about £40 million. It is one of the best development projects I have seen funded by DFID—in fact, it is one of the best of all, so I congratulate the Department. I encourage it to look at other countries in which that particular programme could be rolled out. I am glad to say that the software used was created in the UK and that the implementation was done by a company from the United Kingdom. I know that DFID takes access to finance very seriously and is involved in work on that in many countries throughout the world.

My second point is about maintaining the gains. I am chair of the all-party group on malaria and neglected tropical diseases, and we are delighted at the progress that has been made on tackling malaria. Over a decade, the number of deaths has come down from about 1 million a year to probably no more than 600,000 a year through the mass introduction and distribution of long-lasting, insecticide-treated bed nets, through rapid diagnostic tests, and, of course, through the latest drugs that are based on combination therapies with artemisinin.

However, malaria can rapidly come back if we do not continue to control it, as we are doing, for instance, with indoor residual spray. We saw in Zanzibar in the 1960s that malaria had almost been eliminated, but the foot was taken off the pedal, so within 10 or 20 years, it was a scourge again right across the islands of Unguja and Pemba. We have seen that in other countries as well, including, even more recently, in Zambia, where malaria staged a bit of a comeback two or three years ago. It is therefore vital that we continue programmes tackling malaria, HIV/AIDS, tuberculosis and neglected tropical diseases. In the case of neglected tropical diseases, the mass drug distribution programmes that have been so successful have been financed by a public-private partnership between the pharmaceutical companies, which have provided the drugs free of charge, and aid agencies, such as DFID together with the Gates Foundation.

That brings me on to my third subject—health systems. We often, and rightly, want to tackle individual diseases, be that polio, pneumonia, malaria, HIV/AIDS or TB, but this is actually often about tackling many of those things together through health systems. On a recent visit to Tanzania, I was delighted to see that rather than there being a silo mentality on individual diseases, that country, with support from DFID through the London school of hygiene and tropical medicine and the Liverpool school of tropical medicine, was taking the approach of working on things together—as a system—to tackle these diseases at once.

Finally, I would like to talk about the environment and environmental sustainability. I understand that there was a great deal of discussion about whether to have separate environmental goals and developmental goals. We in the Committee believed that it was not possible to separate the two. We cannot go for tackling the problems of development but ignore the environment or put it in another box, as the two go together.

[Fiona Bruce]

I am very much enjoying my hon. Friend’s speech, which I know comes from a great deal of first-hand knowledge. I can offer an example of first-hand understanding of where development has affected a local environment very seriously: the introduction of large-scale fishing in Lake Victoria in Tanzania. The introduction of the Nile perch, and factory farming of the fish in Lake Victoria, has resulted in the eradication of smaller fish that all the families living around the shores of the lake ate—and survived on. That has created a difficult sustainability challenge for the whole area.

[Jeremy Lefroy]

I am most grateful for that intervention, because that point is absolutely true. While we are on the subject of fish, there has also been a problem in recent years of very large trawlers of European Union origin—I will not mention the particular country—coming down the east coast of Africa and, under arrangements agreed by the European Union at the highest level, hoovering up large quantities of fish, but without much benefit going to the individual countries off whose shores they are fishing.

In tackling these vital environmental challenges, we must not overburden developing countries with global environmental issues that they had no real part in causing in the first place. To a large extent, it is up to us to take the lead on that, so I am glad to say that the UK Government are doing so.

It is vital that the four areas that I have set out—there are many others, which I am sure the Minister and the hon. Member for Bethnal Green and Bow (Rushanara Ali) will address—are covered by the post-2015 MDGs. They are: job creation, particularly for young people; ensuring that we preserve the gains that have been so painstakingly achieved in the past decade and a half; ensuring the environmental sustainability of those gains, so that we do not achieve short-term gains that cannot be maintained in the long term because they are simply not environmentally sustainable; and the development of health systems. This week, we are proud of the 65th anniversary of our national health service, which has led to great improvements in public and general health in this country. That is the kind of system that we should want to provide such gains in health in developing countries.

Charitable Registration

Debate between Fiona Bruce and Jeremy Lefroy

Tuesday 13th November 2012 Westminster Hall

[Fiona Bruce]

Absolutely. I thank the right hon. Gentleman for saying that so plainly.

“Public Benefit” by the Plymouth Brethren church—I will touch on some points for the record, to get them in Hansard—includes support for families, care for young people, disaster relief, visits to prisons, hospitals, donations of substantial funds to many charities, including the British Heart Foundation, Royal National Lifeboat Institution, Macmillan nurses, and dozens of others.

[Jeremy Lefroy (Stafford) (Con)]

Would not my hon. Friend say that that exemplifies the fact that not only are they there for the promotion of religion, but for the promotion of education and the relief of poverty? The work that they do in my constituency and elsewhere, particularly in providing work and jobs for people who might not otherwise have them, should be commended, not opposed or obstructed.

[Fiona Bruce]

My hon. Friend makes a characteristically astute point and I thank him for it.

I specifically want to mention the Preston Down Trust, because it is the subject of the appeal. I have additional information about its social action in the past two to three months, including the provision of free meals to members of the public, assisting at accidents, collecting for charity and street preaching and the distribution of tracts. It has that in common with all Plymouth Brethren churches. Surely no one can argue that they do not provide public benefit.

On the website, the Brethren say that

“we hold the same faith as every true Christian, we publicly preach the gospel and engage with the broader community through fund-raising and volunteer work. We work and live alongside people from many walks of life and many Brethren own businesses that collectively employ thousands of non-Brethren. Brethren characteristically are caring, active and contributing members of their local community.”

Someone might say, “Well, they would say that, because they are saying it about themselves”, but I assure people that I have spoken with a constituent of mine who describes himself as a lapsed atheist. He is certainly not a Christian, by his own admission, and he works for one of the several Plymouth Brethren businesses in my constituency. His name is Glyn Rushton, he is happy to go on the record and he works with Delta Balustrades, where he is a production manager. He got his job through the jobcentre in 2005 and he has the utmost respect for the Brethren, describing them as model employers:

“I would always view Brethren as a force for good in any area. They are industrious, independent minded people who care about those around them. They set out to solve more problems than they create and rarely feature in crime statistics”.

His point about the positive aspects of the Brethren way of life should not go unnoticed, and I draw attention to page 17 of the booklet to which I referred earlier.

It is important to raise the issue of information circulating on some internet sites that gives a negative portrayal of experiences to do with the Plymouth Brethren. I understand that such matters have not been a cause of the Charity Commission deciding to refuse charitable status. In a letter of 7 June, the commission states:

“We do not have any evidence before us at this time to demonstrate disadvantage which may serve to negate public benefit.”

No one would claim that any organisation is perfect, but if the Charity Commission has any such concerns the proper thing to do is to investigate thoroughly and to substantiate or discount them. At present, however, having checked with the Plymouth Brethren as late as this morning, I understand that that is not an issue in the appeal case of the Preston Down Trust.

Care of the Dying

Debate between Fiona Bruce and Jeremy Lefroy

Tuesday 17th January 2012 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

I support all that has been said by those hon. Members who have spoken today. I want to touch particularly on the importance of how we can develop the excellent hospice care that already exists in our country today. Dame Cecily Saunders has been quoted. She said that the hospice movement should have three components: care, research into good care and education of professionals and the community in care and end-of-life issues. Communities today need hospices to operate at that level not just within their buildings, but outside. Fantastic care is given in hospices, but to a relatively small number of people.

In Cheshire, for example, St. Luke’s hospice, which serves my constituency, has just 14 beds, but through various initiatives, it has a far greater beneficial impact on the wider community. I should like to share some of the initiatives that St. Luke’s is developing. It has recently been invited to share those initiatives with the all-party group on dying well. To give confidence and skills to others to share well the care of family members, it has a community outreach programme, and I will refer to one of those programmes in my constituency.

The village hall in a village near Alsager opened its doors one day a week, but that is now being extended, so that those who are not within the hospice may come for day care. Nurses from the hospice spend a day at the village hall, and a group of volunteers cook lunch for the community’s elderly residents, who are often in some difficulty with their physical and mental capabilities. They can have counselling in a private room, a massage, treatments such as manicures and pedicures and engage in hobbies. I saw some wonderful art work that they had done over a period of months. They are provided with an excellent lunch, preceded by a small glass of sherry if they want it. There is much laughter and much support, and that enables the people who visit the centre not only to remain in their communities, but to have their lives enhanced and supported by the work of the hospice, augmented by a substantial number of local volunteers. In turn, those volunteers go into those people’s homes.

[Jeremy Lefroy (Stafford) (Con)]

I am grateful to my hon. Friend for describing the innovative care that hospices in our local communities provide. In my constituency, Katharine House hospice does the same. I want to draw her attention to the community lodges that the Douglas Macmillan hospice has set up in an area near her constituency. They allow families to come together and to support their loved ones in a lodge as they are dying.

[Fiona Bruce]

My hon. Friend is absolutely right. As Siobhan Horton, the director of St. Luke’s hospice said:

“Hospices need to actively transfer their enormous expertise in health and social care more broadly to ensure more benefit from high quality care”

for more people. St. Luke’s also provides education for all those in the Cheshire area who are involved in hospice work. I have visited the hospice. The ground floor contains 14 beds, and the first floor is a resource centre with a library, and advisers to inform and enable carers and professionals to extend their expertise throughout the Cheshire community and beyond. Hospices can do that excellently, because of their unique expertise, not only in this country, but throughout the world.

Another project that St. Luke’s is undertaking is to develop a public health approach to end-of-life issues, so that ageing well and dying well are part of living well. It is working with the local community to improve communication with family members who are coming to the end of their lives, to resolve outstanding issues, to reduce regrets, to open up conversations that others may be reluctant to engage in, to work with family members and to encourage the engagement of their wider community in supporting the family and individuals who are struggling to support themselves towards the end of a life in the family. The aim for all who are supported in that way is a good death. I think that we all have that aspiration: a death within the loving embrace of our family and local community. St. Luke’s is undertaking serious research into that, and I look forward to hearing more about its developing public health approach to end-of-life issues.

I want to touch on the work that St. Luke’s is doing in connection with care homes. It has been involved in care home education for many years, and although it believes that some care home care is excellent, it also believes that much expertise can be shared both ways. It is considering how to have a closer, more supportive relationship with care homes locally and is commissioning a report on strategic planning and what sort of relationship and support would make a positive difference to care home delivery of end-of-life care. Let us support such innovations and others throughout the country to develop the excellent work of the hospice movement here, of which we can all be proud. I look forward to hearing from the Minister how the country and the Government can continue to support and promote the extension of the excellent palliative care in this nation.

North Korea

Debate between Fiona Bruce and Jeremy Lefroy

Wednesday 11th January 2012 Westminster Hall

[Fiona Bruce (Congleton) (Con)]

It is a pleasure to speak under your chairmanship, Mr Davies, and to have secured this debate at such a momentous time, so soon after the succession of Kim Jong-un, the new leader of North Korea, following the death of his father, Kim Jong-il, last month. It was even more gratifying to hear, only yesterday, of the North Korean Government’s announcement that they will grant an amnesty for prisoners to mark the birthdays of those two leaders. We look forward to hearing more news about the prisoners to be released.

[Jeremy Lefroy (Stafford) (Con)]

On that amnesty, does my hon. Friend hope for the release of Dr Oh, who has not seen his wife and daughters for 15 years?

[Fiona Bruce]

I thank my hon. Friend for raising that very important case, on which a number of my colleague parliamentarians have made representations. I believe that the Minister is aware of that case, and I look forward to hearing his comments. I also hope that further representations can be made to the North Korean Government about the release of Dr Oh’s family as part of the amnesty.

The amnesty announcement emphasises what many see as a fresh opportunity, at the start of a new era, to forge further relationships with the people of North Korea. That is the hope of many people in Britain who have worked often for years to develop relationships, and indeed friendships, with people in North Korea to share knowledge, understanding and support. Several of my parliamentary colleagues from the all-party group on North Korea have visited the Democratic People’s Republic of Korea—the DPRK—in recent years, as have many other delegations from the UK. Interestingly, in 2010, that included the Middlesbrough Ladies football team, who apparently attracted a 20,000-strong crowd of spectators.

On a more modest level, but no less importantly, the Speaker of the House of Commons has met the Speaker of the North Korean Assembly, Choe Thae-bok. Mr Speaker was able to raise human rights concerns with his DPRK counterpart in a very constructive discussion. Most recently, the DPRK authorities extended an invitation to the Archbishop of Canterbury to visit their country soon, and I hope that he accepts.

The most recent visit of the all-party parliamentary group was in autumn 2010, after which it produced a report, “Building Bridges Not Walls: the Case for Constructive, Critical Engagement with North Korea”. The report describes a welcome commitment from DPRK officials to dialogue, with particular reference to negotiating a peaceful resolution as regards the relationship between North and South Korea. “Building Bridges Not Walls” also states that the APPG had

“the opportunity to see some encouraging developments, including the establishment of a Russian Orthodox Church in which Russian diplomats freely worship; a Protestant seminary; the work of British Council teachers; English-language teaching at Kim il-Sung University…a newly opened e-Library at Kim il-Sung University; and the establishment of the impressive Pyongyang University of Science and Technology (PUST), with a faculty of teachers from the United States, the United Kingdom and the Netherlands. These are welcome developments which we hope will…contribute towards the establishment of a more open and prosperous society for all the people of North Korea.”

I believe that I speak on behalf of many people in this country who fervently hope that the accession to leadership of Kim Jong-un will further pave the way for that.

The APPG delegation also voiced concerns that cannot be batted away with diplomatic niceties about the need to discuss grave human rights issues in North Korea through a process of constructive critical engagement. That should be done in the same way that President Ronald Reagan and Margaret Thatcher established the Helsinki process with the Soviet Union. The APPG reports says:

“It is time for peace, and ‘it is time for Helsinki with a Korean face’.”

In other words, as the human rights researcher David Hawk says, a process is to be encouraged that would

“pursue peace, engagement, and reconciliation in association with the promotion and protection of human rights”.

That sums up more eloquently than I ever could the process that many in Britain desire to see develop in this new era. I would appreciate the Minister’s comments on how the British Government can help to facilitate dialogue to that end.

I turn to the protection of human rights, on which it has to be said that North Korea has, by any international standard, a deplorable record. I was stirred to call for this debate by a visit two months ago to the UK Parliament by a remarkable young man who is now in his late 20s, Shin Dong-hyuk. I understand that he is the only person ever to have escaped from a North Korean prison camp. On hearing Shin’s story, I was moved, by compassion for the North Korean people, to highlight their dignified suffering in order to encourage support for them in their plight. May I record that I called for this debate holding no hatred of the people of North Korea? I am motivated by a deep love for the North Korean people, and by concern for their needs and their deep suffering over decades.

Zimbabwe

Debate between Fiona Bruce and Jeremy Lefroy

Wednesday 8th December 2010 Commons Chamber

[Jeremy Lefroy]

I entirely agree with the hon. Gentleman; in fact, in the example in Tanzania that I gave, two or three of the farms were taken back on long leases by the farmers who had developed them in the first place.

[Fiona Bruce (Congleton) (Con)]

The need to improve the ailing infrastructure for water and sanitation is referred to frequently, as it has been in this debate, in relation to the need to provide clean water to prevent disease. My hon. Friend makes a good point about infrastructure: we need to invest in it to support the nation’s agriculture. I hope that DFID will consider how to promote the development of infrastructure in a way that involves good governance and accountability, thereby instilling confidence in the partners who need to involve themselves in such large infrastructure projects.

[Jeremy Lefroy]

I entirely agree. DFID and aid agencies that give bilateral and multilateral support can play an important role in supporting infrastructure. I have discussed infrastructure in relation to agriculture, and I would add irrigation to that, but infrastructure for sanitation, health and education is also important.

Small Businesses

Debate between Fiona Bruce and Jeremy Lefroy

Tuesday 7th September 2010 Westminster Hall

[Jeremy Lefroy]

The hon. Gentleman makes two powerful points. The second point is true; as someone involved in small business for many years, I have been on the receiving end of that kind of draconian attitude many times—although not every time, I hasten to add. I am sure that the Minister will want to say something about red tape. I, too, have spent many late hours going through the red tape for my business, after having spent the rest of the day trying to make some money. Whatever the truth—it probably lies somewhere in between all the figures provided—it is clear that a substantial number of SMEs approach banks but do not obtain the funding that they need to maintain or expand their business.

In my constituency, I have seen the difficulty that farmers are finding in business diversification. Money is pouring in to help farmers buy land or get involved in agricultural activities, but they receive a limited response from the banks for the laudable process of rural diversification, which will create more jobs in that area.

It is likely that there are some people not yet in business who wish to start up on their own. However, as my hon. Friend the Member for Newton Abbot (Anne Marie Morris) mentioned, they might find it even harder to obtain that funding, perhaps because they have been made redundant. There might be good reasons for banks to refuse applications, and they must be confident that they will receive their money back. However, anecdotal evidence from my constituents—as, I am sure, from those of all hon. Members in the Chamber—suggests that banks are unwilling to take even the smallest risk if they find it difficult to assess viability, which is often the case with new and young businesses.

[Fiona Bruce (Congleton) (Con)]

My hon. Friend makes an excellent point, and I declare an interest in this debate as someone who has run a small business for over 20 years. A linked issue is the shortage of skilled employees across a range of businesses, which hampers their development. For example, I know from my own business that it is difficult to recruit legal secretaries. Businesses in my constituency claim that they cannot recruit engineering staff or that they need scientific staff. There is a small, green technology business in my constituency, based in Middlewich. It has about 30 staff who convert used cooking oils to diesel but it cannot recruit people with those skills. It is proud that it is training up young men who were stacking shelves at the local supermarket but are now becoming lab technicians. Nevertheless, the cost of training skilled staff is a disproportionate burden on small businesses. That is a funding challenge because finance for that training cannot be obtained from banks. It is not like the purchase of property where some form of collateral can be offered, but the country desperately needs such investment. If we are to recover economic health and well-being, we need an increased skilled work force and at the moment we are not providing the funding for that. I ask the Minister to look urgently at that matter because it is not easy for a small business to obtain funding from a bank for that purpose.

[Jeremy Lefroy]

I am grateful to my hon. Friend for her contribution. I had the pleasure of working with her on a training course in Rwanda one month ago, so I know how expert she is on the subject of training, and how much she knows about it. Her words must be taken extremely seriously.

The Government must step in on the issue of small business finance—indeed, they have already intervened. Since 1981, there has been a small loans guarantee scheme. The previous Government set up the enterprise finance guarantee in January 2009, and the current Government committed an additional £200 million in the June Budget. The public often demand evidence of cross-party consensus in the national interest, and this issue provides a fine example of that.

In his response, I would be grateful if the Minister answered questions on the enterprise finance guarantee, and told us how he assesses its performance to date. He is no doubt aware that the Institute of Chartered Accountants in England and Wales—of which I am a member—has called for the scheme to become more like the former small loans guarantee scheme in its design and operation. I would be interested to hear his views on that.

If a loan guarantee scheme proves successful and pays its way, it needs to be expanded further and rapidly at this critical time, so that as many SMEs as possible can be assisted. I would be grateful for the Minister’s views on that. Finally, on bank lending, what progress are the Government making to bring together banks and small business representatives to ensure that instead of the stand-off that we appear to have at the moment, we have genuine co-operation in our country’s most vital interests?