Clean Water and Sanitation (Africa)

Debate between Jim Shannon and Andrew Percy

Thursday 21st April 2016 Westminster Hall

[Jim Shannon]

I thank the hon. Gentleman for bringing that to our attention. I will touch on those issues now, as they are vital. When we consider water and sanitation, we must consider disease as well. I want to underline some of the issues addressed by the all-party parliamentary group on child health and vaccine preventable diseases, which was formerly chaired by Jim Dobbin, who passed away. Those of us in this House who knew him, even for a short time, were aware of his magnificent contribution. He outlined the issues from his personal experience of visits to Africa with vaccine programmes, where he witnessed at first hand deplorable hygiene and water facilities in hospitals. People can vaccinate and do all sorts of other things, but if they do not have water and sanitation, it is not going anywhere.

The scale of the problem is massive. In 2014, the lack of access to adequate water is estimated to have killed some 3,500 children under five years of age every day. The latest figures show that every year some 600,000 children lose their lives to diarrhoeal diseases, to which the hon. Member for Argyll and Bute (Brendan O'Hara) referred. Most of those deaths are of children less than two years of age in the poorest countries of the world.

Rotavirus is the most important cause of diarrhoeal mortality in children; it is associated with 28% of the deaths from diarrhoea. Despite the advances in treating water poverty, which have saved millions of children’s lives by protecting them against diarrhoeal disease, rotavirus remains the second leading killer of children worldwide.

We have to implement a combination of health, safe water, sanitation and hygiene solutions, and then we can do what the hon. Gentleman said—save more lives. That is part of the purpose of this debate. We can save the lives of children who are still at risk with simple interventions: improved safe water; sanitation; hygiene; exclusive breastfeeding; and vaccines that prevent rotavirus.

I will pose a couple of questions at this stage to the Under-Secretary of State for International Development, the hon. Member for Ruislip, Northwood and Pinner (Mr Hurd), and to his officials who are here. The United Kingdom has a very proud history of providing expertise, resources and global leadership to improve children’s health worldwide. It continues to provide leadership and support to build upon the positive trends. Perhaps the Minister can tell us how we can build upon the success that we have had so far in order to try, with others, to close the clear gap that exists? Can the UK continue to invest in a package of life-saving tools and services, which includes the vaccines, the medicines, the water, the sanitation, the hygiene and the nutrition, too?

What priority and weighting are given to the water, sanitation and hygiene, or WASH, strategies in the upcoming bilateral aid review, which we all know about and which the Minister will hopefully speak about in his response to the debate? Where do the Government sit regarding ongoing support and commitment to the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea, which was introduced by the WHO and UNICEF? How do the Government intend to ensure that

“sustainable management of water and sanitation for all”,

as outlined in sustainable development goal 6, is achieved? What fall-back do they have if that goal is not achieved? Let us consider what happens if we do not get there. What action does the Department for International Development intend to take—I am conscious that this may cross departmental boundaries—in the Nutrition for Growth summit in Rio in August? Has DFID discussed that with stakeholder organisations? If it has, what has been the outcome? Is the Minister yet in a position to state the level of funding that will be provided through the Ross Fund for health interventions, and whether WASH will benefit from the fund? Those are the questions that I wish to pose at this early stage.

Although this issue goes back as far as we can remember, the United Kingdom’s commitment to dealing with it could be significantly better. Investment in water, sanitation and hygiene is extremely cost-effective. According to WaterAid, for every £1 spent we can get £4 in return. In fact, the World Bank has declared that hand-washing with soap is the single most cost-effective intervention. As I mentioned earlier, the Movilla church in Newtownards has sent bars of soap over to Africa, because that is one of the small ways in which we can make a difference.

The lack of sanitation services is estimated to cost the world more than US$250 million per annum. The United Kingdom currently spends some 2% of its bilateral aid budget on water and sanitation, compared with around 13% on education and 19% on health. However, we need to be careful that we are not jumping the gun on this one, as access to clean water and sanitation can often be a prerequisite for success in other development areas such as education and health, and we must acknowledge the overlap between these issues.

Yesterday I had the chance to speak to representatives of some organisations who were keen to add their comments, to help with this debate. When we consider health, water and sanitation, we also have to consider the environment. I will just mark up one thing. Management of habitats is important; it can lead to better water access or worse water access, and to better or worse sanitation. I heard a comment yesterday about Madagascar, where people’s access to water is threatened by habitat destruction over huge areas. The destruction of the African wetlands deprives people of access to drinking water, and threatens livelihoods that depend on water, such as fishing, and the core survival of some people, including some tribes. In Madagascar, deforestation and erosion threaten almost every wetland, and as a result many thousands of people are in trouble and many species could be lost for ever.

I will just mark something else up; it is completely off the line of this debate, but is none the less important. The Wildfowl and Wetlands Trust is trying to help to save the Madagascar Pochard, or the “Mad Pochard” as it is called, which is the world’s rarest duck; I am not sure whether calling it “mad” is a compliment or not. In any case, there are only a few dozen left. The point that I am trying to make is that if something is not done about the water and wetland where that duck lives, it will not be able to provide drinking water for the local people or be used for sanitation, and it will not have any fish living in it either. Again, 6,000 people benefit from that clean water; many livelihoods go with it. That is just a reminder that conservation of nature goes hand in hand with looking after people who depend directly on the natural world.

As I have said, the United Kingdom currently spends some 2% of its bilateral aid budget on water and sanitation, compared with around 13% on education and a large percentage on health. For example, the delivery of quality healthcare in Africa has been seriously hampered by the lack of access to safely managed water. That is why I gave the example from Madagascar.

Sanitation and hygiene also affect practices in healthcare facilities. The WHO and UNICEF estimate that 42% of healthcare facilities in Africa do not have access to a safe water source within 500 metres. According to the WHO, 50% of malnutrition is associated with infections caused by a lack of access to water, sanitation and hygiene.

Globally, malnutrition accounts for some 45% of child deaths, of which a large proportion are within Africa. Children in sub-Saharan Africa are more than four times as likely to die before the age of five than children in developed regions. And after the first month of life, pneumonia and diarrhoea are the leading causes of the death of children under the age of five. Both pneumonia and diarrhoea are inextricably linked to a lack of water, sanitation and hygiene.

We have not had a debate on water aid or sanitation in this Session of Parliament. That is why we have asked for this debate today. First, we aim to raise awareness; secondly, the debate gives hon. Members a chance to participate and add their contributions; and, thirdly, we aim to highlight the issues that we feel are so very important.

Approximately 800,000 children aged between one month and five years died from pneumonia in 2013. Around 1,400 children die every day from preventable diarrhoea, and 58% of diarrhoeal deaths are caused by unsafe water, poor sanitation and poor hygiene. That is incontrovertible evidence that access to clean water and sanitation is essential if we are to see any meaningful development in other areas.

In conclusion, I will just give two examples of what I have talked about; nothing better illustrates the case I am trying to prove than case studies. The first involves child health. The name of the mother is Peggy Mpundu. She is 36 and part of the Mwasha village in Lubwe in Zambia. Peggy recently gave birth to twins, Kapya and Mpundu, in hospital. Two days later, they were discharged as healthy babies. However, one day after returning home, both babies started having problems breathing. Their parents, Peggy and her husband Sylvester, rushed them back into hospital, but tragically they both died that day. Peggy said:

“I was then told that water from shallow wells was harmful for babies.”

That was the same water that she had used for years. She continued:

“Having bathed my children using water from a shallow well just left me with a feeling of guilt and regret. I wish I knew that water could be so harmful”.

That is the true story of Peggy Mpundu.

The second case study is about opportunities for girls. The name of the girl involved is Erika Makalli, from Tanzania; I know that the hon. Member for Stafford (Jeremy Lefroy), who is here today, has particular knowledge of that country. Erika, who is 12, lives in Mbalawala village, in Tanzania. Like so many young girls, she was responsible for collecting water for her family, leaving her little time, if any, to go to school. The Tanzanian Government estimate that 58% of the country’s rural population do not have access to a safe water supply.

Discussing her old routine, Erika said that previously:

“I had to get up at 4 am and walk a long distance to find water. It took two hours and I could only collect a small amount of water to take home. That meant that Mum had to spend most of the day finding water so that we’d have enough to drink and cook with. I used to try and rush to get to school and wouldn’t be able to wash or have any breakfast beforehand. Most of the time I missed school altogether because I was sick or just exhausted. There were so many diseases in this village.”

I am very pleased that two officials from WaterAid are here in Westminster Hall today; they have helped me in preparing for this debate. WaterAid started working in the Mbalawala village two years ago and now there is a tapstand 15 minutes’ walk from Erika’s house and in her school. Erika now attends schools with her friends. Get the water right, get the health right, get the education, give them opportunities—those things follow on from each other. She is a prefect. Discussing the transformation in her life, she said:

“If I still had dirty water I wouldn’t be going to school anymore. I probably wouldn’t have had any real education at all. Also, most of my friends would probably also have died from the diseases we used to get. Life would be miserable. I feel I can at last look forward to a brighter future. Perhaps I will be a health and hygiene teacher when I leave school.”

WaterAid, this House, our Government and all the many other organisations—whoever they may be, and whether they are Churches, individuals or groups—have enabled that to happen.

Dr Lee Jong-wook, the former director general of the World Health Organisation, said:

“Water and Sanitation is one of the primary drivers of public health. I often refer to it as ‘Health 101’, which means that once we can secure access to clean water and to adequate sanitation facilities for all people, irrespective of the difference in their living conditions, a huge battle against all kinds of diseases will be won.”

I conclude with a question for the Minister. I am convinced that his response will be positive and helpful; I have no doubt about that. The contributions we all make show how united the House is on the issue. I will say it again: in this House, we are fortunate to have access to water for all purposes, whether that is washing, cleaning, sanitation or regular showers. Many of us have a shower every morning, but many people elsewhere would just love to have that water. We have it every day. We have to be the voice for the voiceless. We have to speak here on behalf of those who need help, wherever they may be in the world. Can the Minister give us some idea of the Government’s bilateral and multilateral aid reviews? Will he set out and prioritise water and sanitation in the reviews? We need to be ever mindful of the fact that if we start with water and sanitation, then health, education and opportunity follow.

[Andrew Percy (in the Chair)]

The Front Benchers will be called at the usual time. There is plenty of time for the debate, so there is no need for a time limit or anything like that.

Care Homes (Regulation)

Debate between Jim Shannon and Andrew Percy

Wednesday 4th November 2015 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Thank you for calling me, Ms Vaz. I congratulate the hon. Member for North Devon (Peter Heaton-Jones) on bringing this topic to Westminster Hall, setting the scene and explaining its importance from his personal experience and knowledge.

Care homes should and must provide care and services to some of the most vulnerable in society. I believe and the House believes that those who have worked hard and have contributed to society and the economy all their lives deserve appropriate care and dignity in their old age. We have the opportunity to be a voice for those who cannot be a voice for themselves. That is the issue the hon. Gentleman has brought to the House today. The people involved are often at the fringes of society and are of all ages. Many people in care homes do not have immediate family and that is another concern. We read stories in the press and we may be suspicious of them, but they illustrate the problem. There is no smoke without fire, so if there is a story in the press there must be at least some truth in the story.

Some people may be physically unable to look after themselves, including those who are elderly or have learning difficulties, dementia or Alzheimer’s. They deserve the very best care in care homes and their families need the assurance that they are well looked after. If someone has dementia, Alzheimer’s or a physical disability, they deserve the same treatment and care as others to ensure that their meals are correct and that they are given a wee bit of time, compassion and understanding, as the hon. Gentleman said. It is imperative to do all we can to protect those in care homes and to ensure that they receive the care and dignity they deserve.

I welcome the opportunity to question how the Government intend to improve regulation of the industry so that the people who are cared for are protected. I am always a bit suspicious of statistics—as the saying goes, there are lies, damned lies and statistics—but they are clear. Only 64% of care service providers in England are registered with the Care Quality Commission, so there is a question to be answered. I have great respect for the Minister’s understanding and I think the world of him, so I am sure that in his response we will hear the compassionate understanding that he feels personally and as a Minister. I look forward to that.

The Care Quality Commission monitors and regulates care organisations to ensure that they are continuing to meet national standards, and herein we encounter the first issue about regulating care homes. We need to press for much higher levels of registration if we are even to think about improving regulation. We cannot improve regulation if we do not have registration. I hope that we can make higher levels of registration a key part not just of this debate, but of the Government response. We cannot improve regulation if 36% of care service providers are not registered with the main body for monitoring and regulating the industry. Indeed, we should express immediate concern about whether those unregistered care providers are up to the national standard. I am not saying that they are not, but Government observation and monitoring is needed to ensure that they are.

Last year, following years of scandals, the Care Quality Commission announced that it would reinspect all care services and then rate them individually. We do not want to go into too much detail about the most horrible stories and incidents, but they do resonate with all of us as elected representatives. Care homes judged to be inadequate would be shut down and their directors banned from working in such positions again.

[Andrew Percy]

The hon. Gentleman is making a very important speech. He references the examples of abuse, mainly involving physical abuse, that we have heard about. Does he share my concern that in other care homes the problem is not physical abuse, but people not receiving proper nutrition? It is a national scandal that £13 billion of NHS money is spent every year dealing with poor nutrition, much of it in the elderly population. There are no doubt some very good nursing homes and care homes, but the quality of the food in homes often contributes to the decline of residents, and the CQC needs to get a handle on that as well.

[Jim Shannon]

I thank the hon. Gentleman for his intervention; he is right. I tried to make the point earlier about the food that residents eat and its nutritional value, and about the time that may need to be spent looking after someone and feeding them. I thank the hon. Gentleman for highlighting another very important issue.

The National Audit Office found that just 9% of services had been assessed as of July this year, despite the deadline for inspections being February next year—a deadline that has been pushed back. Obviously, the February deadline cannot now be met, because 91% of homes cannot be inspected in that time, but perhaps when the Minister responds we can get an idea of a new deadline in relation to the inspection regime.

However well intended the Care Quality Commission system is, there are clear failings in the current way of doing things, and today’s debate gives us the opportunity to discuss the way ahead in terms of improving the poor rate of inspection. The right hon. and hon. Members who are here will illustrate that very clearly. Concerns have been raised across the political spectrum, both in newspapers and by political representatives, and I hope that the solution to those concerns can also be found on a cross-party, bipartisan basis. After all, this matter concerns us all. It is not a matter of scoring points—it is never that with me anyway, but it certainly is not with anyone in this debate, because we all have the same focus and commitment to delivery of the same level of care and to ensuring that all homes reach a certain level.

We have had many issues in the past in Northern Ireland. I know that this is a devolved matter and the responsibility of someone else, but having the appropriate protection and regulation is so important to ensuring that abuses are not happening. The historical and the up-to-date abuse cases that we see in the papers need to become a thing of the past.

We can come together from both sides of the House, set the right course, address the issues and hopefully, through the Minister and the shadow Minister, the hon. Member for Worsley and Eccles South (Barbara Keeley), provide some direction in relation to the solutions. I hope that my contribution and the issues I raised have been noted by the Minister—indeed, I know that they have been—and that they will prove useful to eliciting a strategy and a response from Government to ensure that this matter is addressed correctly as a matter of urgency, as the hon. Member for North Devon said, and to the best of our ability.