Health: Maternal Health

Lord Patten Excerpts

Wednesday 12th January 2011 Lords Chamber

[Lord Patten]

My Lords, one of the best weapons in the Government’s armoury that could help to meet the entirely laudable aims of millennium development goal 5 would be to press for better governance, on the way to the holy grail of good governance, in the countries that we seek to help in this respect. Outright corruption and bribery—with their twin and just as damaging siblings of weak regulation and indolent service delivery, often using donor aid—hit healthcare hard.

Look at sub-Saharan Africa. The World Bank’s African Development Indicators 2010 shines a revealing spotlight on the severe effects that follow from what it delicately terms “quiet corruption”. The report cites examples such as that about half the drugs that are sold in Nigerian drugs stores are counterfeit. The same report equally politely refers to “provider deviations” from the norms of expected behaviours of some doctors, nurses and other front-line providers, with the petty palm greasing, attendant absenteeism and low levels of effort. Those are very uncomfortable but very true facts, which are well documented.

Above all, we must face up to the fact that private donor aid, as well as public spending from countries such as the United Kingdom, will in the end comprehensively reduce mortality only when governance is better and transparency about performance and behaviour is vastly improved. We need that if we are to bring help in an area where more than half of all births occur without trained personnel being present, despite the excellent efforts of UK-based charities such as CAFOD. CAFOD’s innovative birth attendants training schemes in the selfsame Nigeria help to lead the way, as do the initiatives of the other faith groups that were referred to by the right reverend Prelate the Bishop of Derby in his very telling remarks.