Health: Neglected Tropical Diseases

Lord Trees Excerpts

Thursday 6th February 2014 Grand Committee

[Lord Trees (CB)]

My Lords, it is my pleasure to join others in thanking the noble Baroness, Lady Hayman, for initiating this important debate. The control of NTDs is a challenge, the success of tackling which has been to some extent quite remarkable to date. To make it a total success story, it is critical that the international community maintains the momentum of the London declaration of 2012 to achieve the goals of the WHO NTD 2012 road map on implementation for the control, elimination and in some cases eradication of NTDs between 2015 and 2020.

Most of the NTDs are parasitic or bacterial diseases characterised, as has been said, by high morbidity and chronicity, which affect some 1.4 billion people in the world. These are severely debilitating and, in some cases, disfiguring diseases, which have profound social, cultural and economic effects. They contribute to poverty and poverty contributes to their causes in a potentially permanent cycle of poverty. This restrains economic development, social justice, equality and female emancipation, as females and children are particularly at risk. The targeting of these diseases is therefore an important contribution for the attainment of the millennium development goals and any such targets to be set thereafter.

Historically, these have been relatively neglected diseases, although, as a number of noble Lords have commented, not by the very strong UK scientific community working in this area. Indeed, we can take pride in the efforts of British scientists such as Professor David Molyneux at Liverpool, Professor Peter Holmes in Glasgow—he is chairman of the NTD committee of WHO—and many others. We have heard about the contributions from Dundee, Imperial and others. We can take great pride in the contribution of those British scientists to ensuring that these diseases are getting adequate research attention. Critically, the WHO and the Bill and Melinda Gates Foundation, among other NGOs, are now taking these diseases seriously.

The other major factor, which has not had a great deal of attention in this debate so far but is a major contribution to the control of these diseases, is the generous donation of drugs worth between $2 billion and $3 billion a year by a number of pharmaceutical companies. In spite of this remarkable commercial philanthropy, there is still a funding gap, as the noble Baroness, Lady Hayman, has commented, not only in ensuring adequate surveillance, monitoring and delivery of the drugs that we have, but also in research to improve therapies and to provide, in some cases, vaccines. British institutions have a major role to play in this.

Only 0.6% of overseas development assistance for health is devoted to NTDs. The British Government have set an excellent example, along with the US Government and NGOs, but I join the noble Baroness, Lady Hayman, in urging the Government to exert all the pressure that they can on other richer countries, particularly in the EU, to ensure that they contribute more to this endeavour.

If ever there was a case of enlightened self-interest, this is it. Healthier, wealthier populations can feed themselves better, relieving the pressure on global food supplies; they are more stable, relieving the pressure on migration; and, ultimately, they will be purchasers of the products and services that richer countries can provide. Tackling the NTDs gives a big bang for one’s buck. Huge benefits accrue from relatively modest investment. Not only does it make economic sense, but it satisfies our obligations to relieve poverty, create opportunity and achieve fairness and social justice for all in our world.

Leveson Inquiry

Lord Trees Excerpts

Friday 11th January 2013 Lords Chamber

[Lord Trees]

My Lords, it is with considerable excitement, a great sense of honour and no little trepidation that I rise to give my maiden speech. In thinking about it—because of the postponement, I have had rather longer to think about it than I might have wished—I realise that the custom in this House of not being able to speak freely from the Floor until one has given one’s maiden speech is a very polite way of ensuring something that I personally always observe when entering any new organisation; namely, for a while, it is wise to keep one’s ears open and one’s mouth shut. However, the time has come to open my mouth.

You may wonder why a veterinary surgeon such as myself should want to speak in the Leveson debate. I shall come to that in a moment but, first, there are some courtesies to observe that I am very pleased to do. Like others before me, I have received a very warm welcome in this place from all the Members and staff of all types, and I am extremely grateful to everyone for their kindness, good advice and the warmth of their welcome. I should also like to thank my two supporting Peers at my introduction: the noble Lord, Lord Owen, was the chancellor of the University of Liverpool throughout the seven years that I was dean of the School of Veterinary Science there—he was a great supporter of the faculty; and the noble Lord, Lord Soulsby, as your Lordships will know, was the first veterinary surgeon to enter this House, and was indeed the only one until my arrival. Moreover, Lawson Soulsby has been a great personal academic friend and colleague. We are both parasitologists. That has caused some of my veterinary colleagues rather uncharitably to wonder if the study of parasites is an appropriate requisite to serve in this House, but I could not possibly comment. Finally, I would like to thank my noble friend Lady Mar who has been a great support to me before entering and since and is a source of constant advice, thanks to her 37 years, I think it is, of experience in this place.

On the more substantive issue, why speak on the Leveson debate? I am a veterinary surgeon. I am a member of the Royal College of Veterinary Surgeons and we are subject to a self-regulatory process underpinned by statute, which is exactly what Leveson proposes. As a member of the Royal College of Veterinary Surgeons, I have been subject to that professional regulation throughout my professional career up to and including now. As president of the Royal College of Veterinary Surgeons some three years ago, I was part of the executive arm of that regulatory framework sitting on the preliminary investigation committee, which is analogous to the complaints mechanism that Leveson proposes.

I am sure that those of your Lordships who have had contact with the veterinary profession will agree that the system works and that the veterinary profession provides a fantastic system of healthcare for the animals in this country and for their owners. It is a system of the highest integrity and ethics in the public interest, which does not curtail individual professional freedom.

I appreciate that analogies between professional regulation and press regulation are not entirely apt. When we talk about press regulation we are talking about the regulation of journalism, not of journalists. That is partly because of the problem of defining who is a journalist.

Strictly speaking, journalists are not members of a profession in a technical sense. They do not undergo an accredited period of training leading to entry to a register, the acceptance of a code of conduct or the acceptance of disciplinary processes and sanctions which may ultimately remove them from that register or list. Therein may lie some of the problem, but I suggest that is a different debate and one to which the journalistic profession, if I may call it that, might like to give some thought.

While the analogy is not entirely apt, there are some general principles in any regulatory system which are essential to give it credibility and to assure the public. They include such things as inclusivity; all the relevant parties must be involved. Public protection cannot be an optional extra left to the individual whim of the operator to join in with or not as they see fit. There must be a code, of course, agreed by all. There must be independence of the regulator. Here I would like to mention something that has not been mentioned so far: the important role that lay persons can play in regulatory bodies. There must be appropriate sanctions and, I would suggest, statutory backing, which among other things is there to ensure the inclusivity and effectiveness of sanctions.

These are all elements of professional regulation and of course they are essential elements recommended by Leveson in his report. The last element—statutory underpinning—is the most controversial; however, I stress that the proposal is about the process of regulation, not the action of individuals. It is difficult to see how one could ensure inclusivity and also that sanctions are enforceable without a degree of statutory underpinning.

Leveson offers an ingenious solution regarding inclusivity. It is the recognition body that has the statutory underpinning; it is there just to ensure that the regulatory body, which is at arm’s length, properly does its job and particularly that all the news publishers of importance are included in and subject to the regulatory body, which itself is independent. To suggest that the freedom of the press would be curtailed is to ignore that critical separation. It is also to ignore the important role the lay members of the recognition body and the regulatory body would play. Those lay members will be every bit as anxious to preserve the freedom of the press as they will be to ensure that it behaves ethically and properly.

It is not just vets who are subject to professional regulation with statutory backing. Many in this House who are members of the legal profession are so regulated. Are we suggesting that lawyers and barristers cannot seek truth and justice, cannot ensure fairness and freedom and cannot root out crime and corruption because they are subject to regulation with statutory underpinning? No.

This is the seventh report, I think, in as many decades on this subject. Not to act decisively on this occasion would be like St Augustine—who, your Lordships may remember, was troubled with thoughts of lustfulness all his life—asking God not once, but for the seventh time, “God grant me chastity, but not yet”.