United Nations Relief and Works Agency

Lord Collins of Highbury Excerpts

Tuesday 4th September 2018 Lords Chamber

[Lord Bates]

I am very happy to do that, and I am very happy to give this Government’s strong and unequivocal support to the work of UNRWA, which provides vital education, healthcare and other services to the refugees in that area. What is more, we have underscored that by the fact that when this crisis first arose, an emergency meeting took place, which the Minister, Alistair Burt, attended, and we brought forward £28.5 million in support planned for this year. Then in June, we announced a further £10 million for that cause. There is our government commitment, and at the same time, we have encouraged other countries to step up to the plate to ensure that this vital work continues.

[Lord Collins of Highbury (Lab)]

Of course, the noble Lord is absolutely right. The United Kingdom’s response cannot be the only solution because the gap would be so huge. This is a brutal attack on the Palestinian people—brutal in terms of the basic services that are provided. Can the Minister give more detail on what we are doing with our EU partners to ensure that there is no diminution of the basic services, and that they are able to continue with the sort of action Germany has taken?

[Lord Bates]

There are a number of things we can do. Certainly there has been ministerial contact with the US. There have been official-level contacts with our EU partners. The European Commission’s ECHO fund is the second largest donor, and of course we contribute significantly through that. There is a meeting next week in Brussels, and I am sure this will be on the agenda. It is a constant area of engagement and concern that other people should do more.

Civil Partnership Act 2004 (Amendment) (Sibling Couples) Bill [HL]

Lord Collins of Highbury Excerpts

2nd reading (Hansard): House of Lords
Friday 20th July 2018 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I am extremely grateful to the noble Baroness, Lady Barker, for her submission today because it summarises my own thoughts on this matter. I too begin by thanking the noble Lord, Lord Lexden, for his incredibly hard work on behalf of the LGBT community, not only in this country but globally. I know he has fought against all kinds of discrimination, and he has led the charge over the criminalisation of homosexuality in Commonwealth countries. I consider him very much a friend, and we work together on these issues. On this matter, though, I fundamentally disagree with him. I think he and many noble Lords today have identified a problem. I hope the Minister will be able to address that problem but not through the solution offered up by the noble Lord, Lord Lexden. Clearly there is a problem, particularly for siblings who have shared a home together and then suffer a detriment, partly because of rising property prices and partly because of the length of time that they may have been living together.

However, I come back to the point—the noble Baroness, Lady Barker, put this extremely well—that this cannot also be a mechanism for simply driving a coach and horses through tax legislation. If there is an issue to be addressed then, as the noble Lord, Lord Hamilton, said, it should be a matter for the Treasury to look into and come up with proper evidence-based solutions to an identified problem. That is what lawmaking should be about. I do not want to see a situation where—and perhaps I am taking his name in vain—the Duke of Westminster might enter into a civil partnership. For what purpose? Perhaps he would do so with a member of his family. After all, many members of the aristocracy live in their parents’ homes for many years, far longer than the 12 years that is identified in the Bill. When we have seen Britain’s heritage being under threat, we have looked at that in terms of how we protect it and address the laws of inheritance that way. We did not come up with a solution that talked about civil partnerships.

Many noble Lords have referenced songs, but what came to my mind when I was sitting here was Salt-N-Pepa: “Let’s talk about sex, baby”. For many years, my identity was—and it still is in many circumstances—invisible. There are still many places in this country where I cannot walk down the road hand in hand with my husband. Many heterosexual couples can, but we cannot because we will still suffer abuse. When the Civil Partnership Act was going through this House, my partner and I were planning a ceremony. The amendment that has been talked about today caused our ceremony to be delayed by a year. We could not get married on my 50th birthday; instead, 12 months later we got married on my 51st birthday. So I know that people have genuine concerns, but let us not pretend that the concerns about sibling partners were a genuine reason to delay the Civil Partnership Act in 2004. That Act was significant progress on the road towards equality for LGBT people. We finally got full equality with the Marriage (Same Sex Couples) Act 2013, which again was something that we in this House worked together on across the parties. However, when that Bill was going through, many people in this House made arguments about why gay couples should not be able to get married. That is why I have got quite emotional today.

I want the problem of siblings whose homes they have built together to be properly addressed. I want the Minister to take that away and say, “Let’s properly gather the evidence”. I am sorry that Penny Mordaunt did not respond properly, because there is an issue there about taxation. However, as the noble Baroness, Lady Barker, said, this is not about making marriage between brothers and sisters. That is not what people are really proposing, is it? Let me make it clear that civil partnership was on the road to equal marriage and equality; it was addressing the issue of identity and ensuring that I did not remain invisible as a loving couple—a romantic, loving couple—which many people still in this country deny us. I hope that this debate has ensured that we identify the problem, seek a solution, but do not undermine those hard fought-for rights that we have so proudly established in this House.

Neglected Tropical Diseases

Lord Collins of Highbury Excerpts

Wednesday 11th July 2018 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I, too, thank the noble Lord, Lord Trees, for initiating today’s debate. Like the noble Baroness, Lady Hayman, I am pleased that he has kept up the tradition of maintaining this debate on a regular basis since the 2012 summit, which set out the way forward towards achieving a world free of NTDs. I was just thinking, as noble Lords were talking about pronunciations, that I have successfully managed throughout five years of debates not to use one Latin word—so I will continue with that and avoid slipping up with any mispronunciations.

As we have heard, neglected tropical diseases are the most common infections among the world’s poorest communities. Like the noble Baroness, Lady Hayman, I use the term “communities” because it is not about rich countries and poor countries: it is about poor people, and poor people have suffered the most from these diseases. It is a vital issue, and one reason why I have been so pleased about this annual event is that it is a way of keeping the public and the Government aware of the impact of these diseases and ensuring that they continue with the battle against them.

While their effects are not always fatal, their effects on individuals and families can be devastating, and the brunt is often felt by women and children, which acts as a serious impediment to economic development. I remember that, before one of the debates we had, the noble Baroness, Lady Hayman, introduced me to John Kufuor, the former president of Ghana, who said:

“There is no silver bullet remedy to helping a country break the cycle of poverty, but investing in the health of its population offers one of the best options for unlocking economic potential. With full support both from national governments and from the global community, we can … put an end to NTDs on the African continent”.


That sums up what tonight is all about.

We have heard that treating NTDs is extremely cost effective, and heard about the tremendous impact that public-private partnerships and the commitment of pharmaceutical companies to donate nearly all of the drugs necessary for counteracting the seven most common NTDs have had. Like the noble Baroness, Lady Hayman, I recognise the huge progress that has been made, which was highlighted in the fifth progress report. I also pay tribute to the Minister for his continued activity in this regard, pushing the Government. I know that I have done this in the past, and I am sure that it has not necessarily helped his career, but I will continue to do so.

As the fifth progress report rightly highlights—noble Lords mentioned this—the programmes that have been introduced have been an important gateway to universal health coverage, reaching as they do some of the world’s most isolated and poorest communities. They do so by training health workers and empowering health facilities with scant resources to reach more people effectively. As the noble Baroness, Lady Hayman, said, they can fuel innovation, which is crucial to ensuring universal health coverage, and can ensure that everyone has access to high-quality essential healthcare without suffering financial hardship—which of course is what the SDGs are all about.

DfID has promised to help countries build “resilient, responsive health systems”. Will the Minister say how his department is using the lessons learned from the NTD programmes to deliver on that DfID promise? Labour is committed to establishing a new centre for universal health coverage to give technical and policy assistance to support low-income countries to strengthen and expand their own free, universal public health systems. As we have heard tonight, despite the striking progress since the 2012 summit—it has been striking—the long-term elimination goals cannot be reached without addressing the primary risk factors for NTDs, such as access to clean water and basic sanitation, vector control, and, as I mentioned, stronger health systems, particularly in endemic areas.

As we have also heard, many of the issues and concerns raised in our last debate on the subject still hold. As my noble friend Lady Warwick said, one of those concerns is Brexit and the impact it may have on our research institutions. I hope that the Minister will be able to respond to questions in a direct way.

The other threat that we referred to in the last debate is the impact that President Trump’s changes, particularly to USAID, might have. The United States, through its private foundations and as a Government, has played a critical role in the NTD campaign. As we have heard, Governments and private philanthropists have been providing generous funding, with $812 million pledged at the 2017 summit.

The progress report calls on existing donor countries such as the UK to invest more to support NTD programmes and to support the leverage that can occur from those donations, multiplying the impact, particularly with donated drugs, of every dollar committed. I know that the Minister may have difficulty in answering this, but can he tell us what steps the Government are taking to ensure that the US stays the course until these diseases are eliminated and to encourage new donors to join this global effort? For example, will the Prime Minster raise this issue with President Trump when she meets him this week? US aid is a critical factor in these programmes. The report also calls on us to encourage new donors to join the global effort. Will the Minister tell us whether the Government have made representations to others who have not yet committed to encourage the programmes?

My noble friend Lady Warwick highlighted trachoma —I have managed to pronounce one term—which is a bacterial infection that can lead to permanent loss of sight. It is one of the world’s main infectious causes of blindness. As we have heard, five countries have been validated by the WHO as having eliminated trachoma. The Minister was present at the CHOGM where I was extremely pleased to hear the announcement that the UK would step up its programme to combat the disease that affects 52 million people across 21 Commonwealth countries. That support is extremely welcome and will be added to by additional donors, including the Queen Elizabeth Diamond Jubilee Trust, which is working towards elimination in 12 Commonwealth countries.

Later this month, the UK will host the first Global Disability Summit with its Charter for Change, which aims to ensure rights, freedoms, dignity and inclusion for all persons with disabilities. One way of delivering real change would be to ensure that lessons from initiatives such as the UK-funded trachoma programme are shared so that all people with disabilities are empowered and no one is left behind.

South Sudan

Lord Collins of Highbury Excerpts

Wednesday 4th July 2018 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I too thank the noble Lord, Lord Curry of Kirkharle, for initiating this debate. I know that the noble Lord, Lord Bates, has referred on numerous occasions to the situation in Sudan, and particularly South Sudan, as a manmade crisis. It is a manmade crisis that can, as we have heard in the debate, be avoided. I want to stress, as did the right reverend Prelate, that speakers on all Benches have reflected the mood of hope despite some of the circumstances that we have seen in the past.

Created in 2011 after decades of conflict, South Sudan was a symbol of hope for post-conflict societies, yet after just two years civil war broke out when President Kiir accused his former deputy, Riek Machar, of attempting a coup, and we have seen the consequences. Of course we had the peace deal that was brokered in 2015 by the regional Intergovernmental Authority on Development, but by July 2016 the conflict started again and since then we have seen escalating violence and tensions. According to Oxfam, around 4 million people have been displaced out of a total population of just 12 million; half the population is experiencing extreme hunger and over 60% is in need of humanitarian assistance.

All noble Lords speaking in this debate have referred to the ceasefire last week and the agreement reached between Kiir and Machar. The agreement introduces a pre-transitional period of 120 days, in which as we have heard there are still outbreaks of violence, and then there is to be a power-sharing Government for three years that will be led by Kiir and will include three vice-presidents, the most senior of whom is to come from the Machar faction. After the failure of the previous agreements, the key issue for the international community and for the United Kingdom is how to maintain the pressure to keep the South Sudanese leaders engaged in this process. Like the noble Lord, Lord Curry, I would like to hear from the Minister about the concrete steps we can now take to hold those leaders to account, and like the noble Baroness, Lady Anelay, I think that targeted sanctions are an important element of the suite that we have available. I also certainly agree with the noble Lord, Lord Alton, that the Government should consider using the powers in the Sanctions and Anti-Money Laundering Act 2018, as it is now. Of course, there were many debates when that Act was going through on how precisely we can use targeted sanctions to hold people to account and ensure that they comply with international law. That will, I hope, have an important response from the Minister this evening.

The Government have also been using the Conflict, Stability and Security Fund for programmes in South Sudan. It was, of course, used very heavily in the 2015 agreement. What are the Government considering about how that fund can be used to underpin the new agreement? I know that we can look at failures, but we should also look at concrete examples of where it has worked, and I hope that the Minister can respond on that. Noble Lords have all referred to neighbouring countries, particularly Uganda, so I hope that the Minister can also outline how we can—as the noble Lord, Lord Alton, said—increase diplomacy with the President. I hope that the Minister will be able to say this evening that there are direct talks with the Foreign Secretary to ensure that the process is underpinned and that we do not just leave it to chance.

I have no doubt that the noble Lord, Lord Bates, will highlight exactly what the United Kingdom has been doing through DfID to support projects in South Sudan. The UK spends around £130 million annually and is constantly one of the world’s top three donors. Its work has involved providing life-saving food assistance to 440,000 people in 2016 and, in 2017, offering emergency food aid and livelihood support to nearly 500,000 people. As we have heard in the debate, the United Nations is now warning and predicting that famine will return and that food insecurity will be greater this year than last year, with starvation once again being used as a weapon of war—it is a manmade humanitarian crisis; that is what we need to remind ourselves. In stories of conflict it is, as we have heard from the noble Earl, Lord Sandwich, women and children who pay the highest price, particularly through the use of rape as an instrument of terror.

I conclude with the evidence presented to the International Development Committee in its evidence session last December, in which Dame Rosalind Marsden, the former ambassador and EU special representative for Sudan and South Sudan, claimed that the UK could do more to focus on local peacebuilding, taking regional factors into account, and understanding,

“the different dynamics of the conflict in South Sudan at subnational level”.

I hope that in his summation of the debate, the Minister will be able to tell us how we are going to devote more efforts to peacebuilding in the programmes across South Sudan.

International Widows Day

Lord Collins of Highbury Excerpts

Thursday 28th June 2018 Grand Committee

[Lord Collins of Highbury (Lab)]

My Lords, I too thank the noble Lord, Lord Loomba, for initiating this debate; it is because of his commitment that we have International Widows Day. I have had the privilege of participating in this debate in previous years. It is often a time to reflect on the journey that we have been on ourselves. My mother was widowed in the 1960s with four young children. When we talk about economic empowerment, it was certainly needed then. We lived in a tied house because of my father’s job and she faced eviction and searching for a job, but she had community support to ensure that she had that economic empowerment. She also had support because she soon joined a trade union and it was that sort of community that enabled her to continue the fight for women’s empowerment.

The 2015 report, raised by the noble Lord, Lord Loomba, highlighted the increase in the number of widowed women as a result of conflict and the severity of their living conditions as a consequence. All over the world, women and girls suffer the most from conflict and underdevelopment. In the MENA region, conditions are desperate—we have had many debates about this, and the noble Lord, Lord Alton, has been one of the initiators of those debates. We have also seen the widespread sexual violence inflicted on Rohingya refugees fleeing Rakhine state in Myanmar. The perpetrators, of course, act with impunity, something on which I hope this Government will always continue to push for action.

Successive UK Governments of different political persuasions have championed international women’s rights on issues including girls’ education, preventing sexual violence in conflict and family planning, an important aspect of women’s empowerment. It is important that we build on this record by using our influence as a country to ensure that the gains of recent years are not lost. The progress we have made is under threat, from the Trump Administration’s “global gag rule” on reproductive rights to moves to relax the laws on child marriage in Bangladesh. Many noble Lords in today’s debate have highlighted the problem of child marriage.

The denial of the rights of women and girls remains the most widespread driver of inequalities in today’s world. Gender-based violence, taking many forms, is a major element of this massive and continuing failure of human rights. While it is important to focus on SDG 5 on gender equality—as we have in this debate—the advance of women’s and girls’ rights manifestly makes a substantial contribution to efforts to meet all the SDGs: poverty reduction; improving health and education; and securing peace and security. In particular, on SDG 8 on sustainable development and economic empowerment, support for women and girls provides real opportunities to have choices.

As is often stressed by my noble friend Lord McConnell, we must ensure that the sustainable development goals run through all development priorities in all Whitehall departments, and ensure that the public priority given by the Government to women and girls runs through every one of the SDGs. The Government, through the national action plan on women, peace and security, say they will be putting girls and women at the heart of their work to end conflict in nine countries, including Iraq, Nigeria and South Sudan. We have referred to these countries in debates today, but can the Minister tell us how DfID will promote equality in countries beyond the nine specifically targeted in the national action plan, particularly, as raised by my noble friend, ensuring that no one is left behind?

The national action plan champions girls’ education, a crucial part of DfID’s activities in transforming the lives of those caught up in conflict and promoting global stability. DfID is of course targeting the poorest countries to provide 12 years of education for girls. What work is being done to replicate any successful policies from these schemes, to improve access, specifically to technical and vocational education, as a means of helping to provide employment for girls and women? We have heard about the impact of widowhood on young girls, but is DfID looking at older women, many of whom are widows, to remove the specific barriers to training and employment that deny them the opportunity of economic activity and therefore economic empowerment?

I conclude by repeating my mantra from previous debates: we must work with like-minded Governments throughout the world, but we also need to ensure that all aspects of civil society, including trade unions, church groups and women’s groups, are able to stand up and argue the case for full women’s emancipation.

Forced Marriage

Lord Collins of Highbury Excerpts

Thursday 24th May 2018 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I agree with the noble Baroness on translating the communiqué into action. One thing that can be done is to support the Commonwealth Office for Civil and Criminal Justice Reform. That would mean member countries translating commitments in the charter into legislative changes, so that people’s rights can be protected. What are the Government doing to ensure that the Commonwealth Secretariat receives support for expanding that work?

[Lord Bates]

Clearly, it is a very important stream of work. The responsibility for implementing what has been signed up to by member states in the communiqué of course lies with the member states, but it is also right that we should be involved in the ways that I have outlined, through the various programmes and initiatives, to support countries to build more inclusive societies. We will continue to do that.

Overseas Development Assistance: Fossil Fuel Subsidies

Lord Collins of Highbury Excerpts

Tuesday 15th May 2018 Lords Chamber

[Lord Bates]

The noble Baroness makes a good point. As she rightly said, the CAFOD report refers to 2010-14. That precedes the SDGs, which have brought about a whole host of changes in how we promote renewable energy, and another change was the Paris Agreement on climate change. The numbers she referred to also include UK export finance, which supports the UK’s oil and gas industry, but it is not overseas development assistance. We do not use ODA to support fossil fuel subsidies at present.

[Lord Collins of Highbury (Lab)]

My Lords, one of the key things is that the CDC has a five-year plan—the Government have ploughed billions into it—and a lot of the existing investments include fossil fuel investment. What is the Minister doing to ensure that, within the CDC’s five-year investment plan, we are not just not investing in fossil fuels but taking a proactive approach to investment in renewables? That is the solution. These countries need energy.

Nursing

Lord Collins of Highbury Excerpts

Monday 14th May 2018 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I too thank the noble Lord, Lord Crisp, for initiating what has become a timely debate. Of course, it was not originally scheduled for now, but it has been incredibly timely, for all the reasons that noble Lords set out in the debate. I also thank the noble Lord, Lord Willis, for putting out a tweet earlier about trying to prompt a debate among nurses. At my early morning swim at 6.30 this morning I ran into a couple of nurses—it is true, I was there. I spoke to a nurse and he then subsequently tweeted about tonight’s debate and it generated quite a thread of comments, which I really appreciated. One thing I am certain about is that nurses certainly have a lot to say and are showing concern, not just about their own situation but about the global situation. The most common thing I heard was that health and disease know no boundaries. We have to address this and see it as a global issue.

A key goal of the UN’s 2030 development agenda is that everyone in the world should have access to healthcare—universal health coverage—and that nobody should be left behind. Today’s debate and the Nursing Now campaign make the case very strongly that this cannot possibly be achieved without strengthening nursing globally. This is partly about increasing the number of nurses. One thing we have heard in the debate, and certainly I read it on Twitter today, is that nurses have real concerns on staffing, inadequate facilities and resources, and the lack of effective support. All these things impact negatively on the ability of nurses to provide a safe and effective service. But strengthening nursing is also, as we have heard, about making sure their contribution is properly understood and enabling them to work to their full potential.

As the Global Health APPG report, in which noble Lords participated, said, strengthening nursing will have a triple impact in improving health, promoting gender equality and supporting economic growth. I shall return to that point later. To bring about the change we have heard we need, we really need to persuade politicians to work with the profession, addressing how nurses are perceived. Their potential is, sadly, overlooked because of strict hierarchies and engrained ideas about what nurses can and cannot do. I hope the Minister will take up the suggestion of the noble Lord, Lord Crisp, of a high-level meeting with the profession, so we can talk about these issues, not just in the context of the National Health Service but how DfID’s strategy is addressing these issues globally.

As the noble Baroness, Lady Masham, said, Ebola taught us that tackling that crisis required the strengthening of healthcare systems: growing the number of primary healthcare staff and their training; building scientific capacity in diagnostics and public health labs; and supporting public health messaging and outreach generally. Of course, this touches on education, which is such an important element of primary healthcare. Many countries have had insufficient investment in their health systems. Universal health coverage can make more countries resilient to health concerns, particularly about new diseases that may emerge, before they become widespread emergencies.

Another clear lesson from Ebola was the role of community engagement, which has all too often been regarded as a soft and relatively non-technical add-on to medical interventions. A good example, which I know I have raised in previous debates, was the DfID-funded social mobilisation action consortium in Sierra Leone, which brought together the local BBC Media Action group, the Centers for Disease Control and Prevention, Focus 1000 and Restless Development. Through their activity those NGOs, working with community and religious leaders, and partner radio stations covering every district in Sierra Leone, achieved tangible behavioural change around safe burials, early treatment and social acceptance of Ebola survivors. The stigma of disease is another issue that we have to address through education.

As noble Lords have said, the health professionals closest to the communities are the nurses, who are promoting good health and preventing disease as well as providing care at the community level. They are at the heart of most health teams. They support and supervise community health workers and link to more specialist care when needed.

The noble Lord, Lord Crisp, spoke about the £5 million which is certainly an extremely welcome grant from DfID. However, I want to hear from the Minister tonight just how DfID is translating the lessons that we have learned from the Ebola case, for example. How are we translating those lessons into specific action, particularly in Africa? We have heard about ageing populations and the rapid rise of diseases such as diabetes and heart disease, which are putting all health systems across the globe under strain. But in poorer regions, that comes on top of the burden of infectious diseases such as HIV/AIDS and malaria. The global shortage of health workers means that there simply are not enough to tackle these threats.

This debate has highlighted not only the importance of nursing but the work of our international development strategies. It has highlighted the fact that we do not deal with health simply in isolation. We must see these as global threats but also as having global solutions. It is not only that other countries can learn from us but more importantly, as the noble Lord, Lord Crisp, has said, that some of these innovations, particularly in Africa, are ones that we can learn from. That is why we should be focusing on this issue, and I welcome this debate.

[The Minister of State, Department for International Development (Lord Bates) (Con)]

My Lords, I, too, welcome this debate and join others in paying tribute to the noble Lord, Lord Crisp, for securing it and for the enormous personal contribution which he has made to raising the profile of nursing both here in the UK and around the world. The debate has drawn on the immense depth of expertise that resides on this subject in your Lordships’ House.

It is worth noting, for the record, as I found when I prepared for the debate, that contributions have come from two nurses—crucially, I start with them—but also from a former Permanent Secretary and a former chief executive of NHS England, a former Secretary of State and Minister of State for Health, as well as a fellow and an honorary vice-president of the Royal College of Nursing, a former president of the Royal College of Surgeons, a former president of the Royal College of Psychiatrists, a professor of nursing and a former hospital chairman.

[Lord Collins of Highbury]

I do not know what category I fit into.

[Lord Bates]

Swimmers, of course, are doing health promotion, and we pay tribute to the noble Lord’s work in this area.

This has been an excellent debate and I will respond to some of the points. The noble Lord, Lord Crisp, set the tone by reminding us of the critical role that nurses play in ensuring the delivery of holistic, patient-centred healthcare. The noble Baroness, Lady Bottomley, reminded us that nursing is the most trusted of professions. That carries wider benefits to health efforts. The noble Lord, Lord Willis, reminded us that nurses can be a catalyst for change in developing countries. The noble Baroness, Lady Masham, reminded us of the courage of our NHS volunteers who went out to tackle the outbreak of Ebola in Sierra Leone. The noble Baroness, Lady Cox, gave many powerful, practical examples of nursing achievement in delivering clinical care in remote and challenging situations. My noble friend Lord Ribeiro hit the nail on the head when he spoke about the role that nursing has in women’s empowerment, which is critical across so many areas.

The noble Baroness, Lady Hollins, talked about how nurses could be there in early intervention in mental health conditions. The noble Baroness, Lady Watkins, spoke about seeing nurses as a global resource in delivering the sustainable development goals relating to health. The noble Viscount, Lord Bridgeman, reminded us of the costs and administrative burdens faced by those coming to study nursing in this country. The noble Baroness, Lady Jolly, summed it up by saying that nursing delivers equality, prosperity and health. The noble Lord, Lord Collins, reminded us that, in these matters, the issues of health and disease know no national boundaries in the way they operate and therefore that they demand a different set of solutions.

I congratulate the noble Lord, Lord Crisp, and the noble Baroness, Lady Watkins, on their leadership on this issue since the launch of Nursing Now, which, the noble Lord, Lord Willis, reminded us, was attended by Her Royal Highness the Duchess of Cambridge and was a great success. I am delighted that my colleague, the Minister of State at the Department for International Development, Harriett Baldwin, attended and used that opportunity and platform to announce our support for nursing globally and for the campaign through our health partnership programme, starting in 2019. It is a £5 million programme that a number of noble Lords have welcomed. It will be allocated to focus on nurses and midwives. The programme is designed to address the priorities identified by countries and will focus on nurse leadership where it is part of a country’s health workforce strategy.

Through these partnerships we will work with countries to build comprehensive and effective healthcare systems, not just to deliver separate projects. The programme brings benefits to developing countries and to the UK health system from the increased skills and motivation that UK health workers acquire when working overseas. That is why this campaign recognises the vital role of nurses at the centre of every health system around the world. Nurses account for nearly 50% of the global health workforce. Their knowledge, skills and motivation are crucial in delivering health services to all, including to the poorest.

As the Triple Impact report and the Nursing Now campaign highlight, many countries are grappling with enormous challenges, including shortages, skills, gaps in leadership and challenges mentioned in particular by the noble Lord, Lord Crisp. In the UK, nurses are at the heart of our NHS. We want to keep these hard-working staff and build a workforce fit for the future. My noble friend Lord Ribeiro and the noble Lord, Lord Willis, among others referred to concerns they had about our capacity to train the nurses we need. We have announced 5,000 more nurse training places from 2018, alongside new routes into the profession and continuing measures to improve the work/life balance.

Globally, the World Health Organization and the World Bank estimate that countries will need to create around 40 million new health and social care jobs by 2030—a point raised by the noble Baroness, Lady Watkins. Low-resource countries, where these are needed most, face the greatest shortages of 18 million health workers. We must support them to train and deploy the health workers they need so they can access essential health services.

The noble Lord, Lord Ribeiro, spoke about the importance of the retention of trained staff in Ghana. The noble Baroness, Lady Jolly, spoke about her experiences at the conference and talked about the importance of the retention of staff in South Africa. The noble Baroness, Lady Watkins, rightly raised ethical questions about recruitment from some developing nations. That is why the UK Government support the World Health Organization’s Global Code of Practice on the International Recruitment of Health Personnel, which ensures that developing nations that are experiencing critical shortages of healthcare staff are not targeted for recruitment.

As the noble Lord, Lord Crisp, has argued, this is not just about health services. Investments in the health workforce go beyond improving health. The health sector offers employment opportunities for women and strengthens local economies. The UN High-Level Commission on Health Employment and Economic Growth, which the noble Baroness, Lady Watkins, referred to, found that in 123 countries women make up 67% of workers in health and social sectors. The noble Baroness, Lady Bottomley, and the noble Lord, Lord Crisp, referred to this as well. The commission has estimated that women would take between 59% and 70% of additional jobs created in education, health and social services. These opportunities will be even more important in low-income countries, where women are often excluded from formal employment.

To promote these opportunities in the health sector, a DfID programme in Bangladesh, for example, is aiming to ensure that 4,300 licensed midwives are employed. Some 30% of these will be in remote areas, providing opportunities to young women where other formal employment opportunities are scarce. To deliver and sustain this triple impact, the Government remain committed to working in partnership with countries to strengthen their health systems by improving their health workforces, including addressing the global shortage of nurses and midwives, to ensure that no one is left behind. DfID improves access to and the quality of health services by supporting training, mentorship and supervision for health workers; for example, in Kenya we have trained 7,000 nurses and midwives in emergency obstetric and newborn care. This has already resulted in a 10% reduction in maternal deaths.

Our programmes also invest in nurse leadership, which the noble Baroness, Lady Bottomley, referred to. Through a UK partnership, 20 nurses in Uganda have been trained by UK volunteers in nurse leadership for palliative care. I think the noble Lord, Lord Crisp, referred to this programme. These nurses have supported the training of 154 other health workers and empowered them to take on care traditionally delivered by doctors and to broaden access to palliative care.

In the time available I will turn to some of the questions that were raised. If I do not cover them all, I will of course write. The noble Baroness, Lady Masham, and my noble friend Lord Bridgeman asked about EU nurses leaving after the referendum. Overall, there are 3,600 more EU staff working in the NHS since the referendum. We have seen a small reduction in the number of EU nurses working in the NHS over the period. However, this is due mainly to the introduction of new language tests by the Nursing and Midwifery Council.

The noble Baroness, Lady Cox, asked about healthcare in challenging conflict situations. The UK Emergency Medical Team, including nurses, spent over six weeks training more than 3,000 Rohingya people, with local Bangladeshi nurses working alongside them, learning vital infection prevention and control skills. The local nurses are now tackling diphtheria in the Cox’s Bazar camps.

The noble Lord, Lord Willis, was right to pay tribute to Jackie Smith, the Nursing and Midwifery Council chief executive, who has announced that she is retiring. We join the noble Lord in paying tribute to her leadership of the NMC over the past six years and wish her every success for the future.

The noble Baroness, Lady Watkins, wondered, after the World Health Organization’s appointment, how long it would be before there was a chief nurse at the Department of Health. The Chief Nursing Officer for England, Jane Cummings, advises the Government on nursing workforce issues. We are delighted that her office is working with the noble Lord, Lord Crisp, and the noble Baroness, Lady Watkins, on the Nursing Now campaign.

The noble Baroness, Lady Bottomley, spoke about the Commonwealth connection. I am pleased to confirm that Nursing Now representatives took part in a recent Commonwealth summit event through the Commonwealth Nurses and Midwives Conference.

The noble Lord, Lord Crisp, asked whether nurses were at the forefront of health strategies. The UK recognises the critical role played by nurses. Our bilateral programmes, our support for the World Health Organization’s leadership and our investments in strengthening health systems all promote this essential role.

The noble Baroness, Lady Hollins, asked about mental health and specialist nurses. We recognise that nurses deliver specialist services. The UK funds a research programme called PRIME and a programme in Ghana, improving the care of patients with mental health issues. The disability summit in July this year will highlight the need for services to be inclusive and cater for all needs so that no one is left behind.

There is a wealth of expertise in this area in this House which has been demonstrated in this Chamber today. We remain open to other ideas on how we can build on our commitment to support nurses and midwives through health partnerships.

The noble Lord asked me a specific question on the round table. I will take that back and talk with my ministerial colleagues about it. It seems a sensible way forward and I know that the Ministers Burt, Baldwin and others have appreciated their engagement with him on the Nursing Now campaign. Through DfID and other departments we are committed to playing a part in enhancing the vital contribution of nurses and midwives in healthcare and prevention for all, especially for the poorest people in developing countries.

Yemen

Lord Collins of Highbury Excerpts

Tuesday 24th April 2018 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I thank the Minister for repeating that response to the Urgent Question asked in the other place. Clearly, Saudi Arabia has the right to protect its territory and its people from the missile attacks witnessed in recent weeks, but this does not excuse the targeting of innocent civilians. Despite UK training to the Saudis on international humanitarian law compliance, we have seen the rate of civilian casualties increase.

UN special envoy to Yemen, Martin Griffiths, said at the Security Council that if intensive operations were launched in Al Hudaydah, one of the main entry points for aid, it would, as he put it,

“in a single stroke, take peace off the table”.

If an attack on Al Hudaydah were to go ahead, causing an already horrific humanitarian situation to get worse, what measures, apart from condemnation, would the Government take to bring pressure on the Saudis? Surely, these are the circumstances when the suspension of arms sales must be considered.

[Lord Bates]

The noble Lord is absolutely right to say that there is never any excuse for this. There is a joint incident assessment team in the Saudi-led coalition which investigates these incidents and produces reports, 55 of which have already been published. But we have been very clear at the UN in our most recent wording and language. The UK is the penholder at the UN Security Council on the Yemeni issue and we are urging restraint on the part of Saudi Arabia, particularly in the context that the noble Lord is referring to. For that to happen, it is also very important that the Houthi rebels, in this context, do not perpetuate or worsen the situation by continuing their missile strikes into Saudi Arabia. So, it is a very complex and fast-moving situation. We do not want it to deteriorate further and we are actively engaged at a humanitarian level, and very much at a diplomatic level.

Syria

Lord Collins of Highbury Excerpts

Thursday 29th March 2018 Lords Chamber

[Lord Collins of Highbury (Lab)]

My Lords, I too thank the noble Lord, Lord Roberts, for securing today’s debate. He has been determined to raise these issues over the past few weeks, through Oral Questions as well as today’s debate. As we have heard, seven years of bloodshed has claimed more than 400,000 lives, driven 11 million people from their homes and caused a humanitarian tragedy on a scale unknown anywhere else in the world. Of course, since the beginning of the war the United Kingdom has had a proud record as the second-largest bilateral donor of humanitarian aid in Syria, providing life-saving support to millions of people. The UK has delivered 26 million food rations, 9.8 million relief packages, 8 million vaccines and 10 million medical consultations. Last year alone the UK provided clean water to more than 5 million people and contributed to the formal primary and secondary education of more than 700,000 children affected by this crisis.

However, as we have heard in the debate this afternoon, it is not enough simply to talk about aid for Syria, important and essential as that is: we must also focus on diplomatic efforts to support the peace process. I think the Minister is in a difficult position, as a DfID Minister. I know that he wears another hat, as a Treasury Minister, but perhaps this afternoon he should be wearing an FCO hat as well. I have no doubt that his response will focus on those diplomatic efforts. Of course, we have seen welcome progress in the fight against Daesh—although from today’s Statement in the other place the Government clearly remain concerned about pockets of Daesh elements in Syria—but for the people of Syria, as the noble Lord, Lord Ahmad, acknowledged last week, the violence continues and the humanitarian situation remains dire. When the Government made the case for military intervention in Syria three years ago they did so purely on the basis of the need to stop Daesh establishing a safe haven in the country. With Daesh losing 98% of its territory, as the Statement said, I ask the Minister what the current objective of our intervention in Syria is.

The Government have also confirmed that UK military personnel are involved in so-called stabilisation activities in what the United States calls, “liberated areas” in northern Syria. With that being the case, when do the Government intend to come back to Parliament to seek a fresh mandate for the new military involvement in Syria? As we have heard, Eastern Ghouta, besieged by the Assad regime, is a particularly tragic example of the ongoing violence. Only this week Peter Maurer, the president of the International Committee of the Red Cross, became one of the few international observers to visit the bombed-out suburbs of Eastern Ghouta, describing it as, “one of the top five difficult places” he had been to over the past six years as president of the International Red Cross. In an interview for an article following the visit, he says:

“The residents of Eastern Ghouta are living an ‘underground life’, forced into shelters to escape the bombing. People are pale and cannot even manage the ever-growing number of dead bodies”.


The ICRC’s latest struggle, the article continues,

“is to get medical aid into Eastern Ghouta: The Syrian government periodically allows flour bags and food parcels but blocks trauma kits and basic medicine, such as insulin, from entering the area”.

In the interview, Maurer points out,

“the lengths that the ICRC goes to push the Syrian government to expand the scope of aid delivery”.

The article continues:

“The organization has provided 3 million people with food across Syria in the past year, and more than 1 million people have been able to access health care services … In Eastern Ghouta alone, tens of thousands of people benefit from food, clean water, and hygiene kits provided by the ICRC”.


In addition, the article says the ICRC are clear that this is,

“impossible to deliver without working with the Syrian government”.

However, it continues that the Syrian Arab Red Crescent —the ICRC’s local affiliate—is:

“On the one hand … legally linked to the government; on the other, it is part of the International Red Cross and Red Crescent movement and committed to its principles”.


Finally, in the interview, Maurer says that it was always his assessment that,

“the chances of doing better assistance and protection to the Syrian people was outweighing the risk of having a leadership which was close to”,

the Assad Government.

Many UK NGOs have expressed concern for aid partners in Eastern Ghouta; one has already lost two staff members in recent attacks, and some are now displaced to the UNHCR camps and have had to surrender their ID cards. The NGOs are concerned that they, and others working for NGOs in those areas, will be considered activists by the Syrian Government and targeted by them. As we have heard, internally displaced people from Eastern Ghouta have been transferred to collective shelters run by UNHCR, and it has been reported that they have also been required to hand over their IDs to the Syrian Government’s army.

This is a potentially difficult and dangerous situation, particularly for those working for NGOs, who may be considered enemies of the state. I hope the Minister can reassure us that we are seeking assurances from the Syrian Government that NGO members working in opposition areas taken by the Assad army are not criminalised, and are allowed to carry out humanitarian and other life-saving work. I think we all want to understand that, on the part of our Government and our allies, the fullest effort is being made to ensure that there is full humanitarian access for aid relief to all areas of Syria. I hope the noble Lord can reassure us on that point.

Turkey’s invasion and occupation of the Kurdish enclave of Afrin has created a fresh displacement crisis in the north of Syria. The UK Government Statement that we considered said that the protection of civilians must be balanced with,

“Turkey’s legitimate interest in the security of its borders”.—[Official Report, 13/3/18; col. 1561.]

I hope the Minister agrees that this incursion is neither legitimate nor justified, and that it has no basis in international law. Around 98,000 people have been displaced from the area, the majority of whom are women, children or elderly. Meanwhile, both in Afrin and among the displaced population, humanitarian needs are very high and host communities are being stretched even further.

Alistair Burt, the Minister of State for the Middle East, has said—and no doubt the Minister will repeat this—that the best opportunity for peace and security is,

“to support the Geneva process … and to work as hard as we are diplomatically to get the parties to find a better answer to the conflict”.—[Official Report, Commons, 12/3/18; col. 677.]

What is the Government’s latest assessment of that process? What have we been doing at the United Nations? How do we move things forward? Does the Minister really believe that there is potential for a political solution and that Daesh will be defeated, when Turkey sees its priority as stopping the Kurds rather than getting a political solution? These are the issues on which we need to hear from the Government.

We know that the crisis in Syria has created one of the biggest refugee crises and that the host nations in the region need support and aid for their economies, which are seeking to support millions of refugees. I have asked the Minister this question before, and received a very positive response, but I would be grateful if he could update the House on what additional support the Government are able to provide in the region. These refugees have been in the host nations not for weeks or months but years. We need to ensure that those host nations are not left in a difficult situation, with the crisis expanding.

The noble Lord, Lord Alton, highlighted the horrific evidence of the torture, the mass hanging and the crimes that have been perpetrated against thousands of Syrian citizens and refugees. All the speakers in the debate have made it absolutely clear that such crimes cannot be committed with impunity. We must ensure that those who are responsible for crimes against humanity are held to account. The Minister needs to respond to the noble Lord, Lord Alton, and tell him what we are doing, in addition to ensuring that there is evidence, to ensure that there are processes in place to hold these criminals to account. I hope the Minister will be able to respond to these key areas but I know that all noble Lords in this House are totally committed to one thing: supporting not only the humanitarian efforts that are being made by the United Kingdom but all efforts to achieve a peaceful solution.