Oral Answers to Questions

Anas Sarwar Excerpts

Wednesday 18th March 2015 Commons Chamber

[Justine Greening]

My hon. Friend is right to point out that our work on livelihoods can have far broader effects—for example, work with private sector companies such as Unilever can not only help to raise incomes and prosperity, but be a route by which employees can, in that example, improve health and hygiene measures.

[Anas Sarwar (Glasgow Central) (Lab)]

In the last year of the previous Government we spent £56 million on private sector development. That is projected to rise exponentially to £1.8 billion. Rather than the Conservative party’s ideological approach of trickle-down economics, should not that investment be made on the promise of decent work, fair pay, good conditions and the right to join a trade union?

[Justine Greening]

I can assure the hon. Gentleman that our work is about raising prosperity, raising incomes and helping people to get the dignity of work with, of course, the sorts of safeguards he talks about in relation to working conditions. We are right to expand our work in this area and I hope I can get cross-party support for that.

HIV Treatment: Low and Middle- income Countries

Anas Sarwar Excerpts

Wednesday 11th March 2015 Westminster Hall

[Anas Sarwar (Glasgow Central) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Main. I start where my hon. Friend the Member for Dumfries and Galloway (Mr Brown) ended, by congratulating my hon. Friend the Member for Airdrie and Shotts (Pamela Nash) on securing this important debate. I also recognise her unflinching commitment and her leadership on this important issue, and the tremendous work she and the all-party group have done on the “Access Denied” report. We can tell from her contribution that she has a genuine passion and commitment on the issue, which she has championed in Parliament for the past five years, and which I hope she will be championing here for many years to come.

The previous Government and this Government have done constructive work on this important issue, and we require a reaffirmation of that commitment on HIV/AIDS as we move forward, but I start by mentioning a few things from the report that shocked me. Two thirds of adults with HIV do not have access to treatment or are not on treatment. Three quarters of children with HIV do not have access to treatment—that is completely unacceptable in the modern day, and something must be done about it. Children and adults in low and middle-income countries have seen support from the international community fall and prices from pharmaceutical companies rise, which is a stain on the international community. By 2030, 55 million people are expected to need HIV treatment. Last year, 1.5 million people died of HIV when that disease can be managed, although we do not have a cure. Again, that figure is a stain on the international community.

My hon. Friend the Member for Airdrie and Shotts said some thing that struck me—people need to come before profits, which is a powerful phrase. Treatments are available to help to manage conditions, but people do not receive them because they are too expensive, there is no health care system or stigma is attached to HIV/AIDS. That is completely unacceptable. We must remember that behind the statistics are real people, who have the basic human rights that we all share. They have the right to life, health, and dignity, and to contribute positively to their family and society.

It is easy to focus on doom and gloom, and obviously there is much that is negative, but there are also things to welcome. According to data, last year, for the first time, more people gained access to HIV drugs than were infected with the virus; the ONE campaign has called that the tipping point. In 2013, the most recent year for which data are available, 2.3 million people gained access to HIV treatment programmes, compared with 2.1 million people with new infections. That is a welcome statistic, but we cannot be complacent.

We do not want such progress to be reversed. The ONE campaign’s recent report noted that the US, France and the UK in particular have carried what it calls an “unsustainable” share of the burden in the international community. It is incumbent on the Government and their international partners to press donor countries, and indeed those developing countries able to provide support to those who need it, to do more. I look forward to hearing more details about that from the Minister.

The November 2014 UNAIDS report talked of a fast-track approach to end the AIDS epidemic by 2030, with a target to be reached by 2020, called 90-90-90. The target is that 90% of people living with HIV should know their status, 90% of those who know it should have access to treatment and 90% of those being treated should have suppressed viral load. That is a difficult but positive target, achievable if there is the will in the international community. It has been said that turning the target up to 95-95-95 would be tantamount to ending the epidemic.

A further report, “Fast track: Ending the AIDS epidemic by 2030”, also said that nearly 28 million new infections and 21 million AIDS-related deaths could be averted by 2030 if the target were met. However, it also warned that “business as usual” could mean missing the opportunity to end the epidemic for a long time to come. UNAIDS estimates that, by June 2014, 13.6 million HIV-positive people around the world had access to antiretroviral therapy, but an estimated 35 million need it. It will be interesting to hear the Minister’s response to the UNAIDS 90-90-90 target, what partnership work the Department for International Development is doing with it towards that aspiration, and what global leadership we are showing to get our bilateral partners and multilateral funding agencies to reflect those priorities.

It is important to talk about funding and to recognise the responsibility of the UK and the global community to support HIV and AIDS treatment. In 2012, the UK Government contributed 10.7% of all bilateral aid for HIV. That statistic is welcome, and so is the fact that between 2008 and 2013 DFID’s overall spend, including bilateral and multilateral funding, averaged £300 million a year. At the time of the recent global health fund replenishment, a commitment was given to provide £1 billion for 2014-16, which means that the annual contribution will increase significantly to £500 million. I am sure the Minister will confirm those figures.

I wonder, following the UNAIDS report, whether that funding and support have been reflected on. We have heard today, in the context of DFID funding, about budget spending that has been committed and unallocated funding. Might there be scope to look again at the funding and support we give to the global health fund, particularly given our withdrawal of funding for the International AIDS Vaccine Initiative, which my hon. Friend the Member for Airdrie and Shotts pointed out? I welcome the fact that we spend £300 million annually, and the £500 million commitment for 2014-16, but cutting by up to 80% our support to IAVI—the fund trying to find a cure and a vaccine—is unacceptable.

I look forward to hearing the Minister’s explanation for that cut. We should not give up on the dream and hope of finding a cure and a vaccine for HIV and AIDS. I would like to think that we could find those things in my lifetime and bring an end to a global injustice.

Although the UK has come in for praise from the ONE campaign, as have the US and France, there is still a hell of a lot of work to do. Global funding for anti-HIV programmes reached an all-time high of $19.1 billion last year, but that is still an estimated $3 billion a year short of the annual $22 billion to $24 billion that the UN says we need to spend.

By 2020, low-income countries will need $9.7 billion, lower-middle-income countries $8.7 billion, and upper-middle-income countries $17.2 billion for the fight to bring the epidemic to an end. However, the report says that if the money is forthcoming and enough effort is made to reach the 2020 targets, the need for more funds will decline. That is an interesting point: the fund could decline if we matched the UNAIDS aspiration. By 2030, the funding needed globally could drop from $35.6 billion in 2020 to $32.8 billion. If we make an initial big investment—not taking any wasted route, in terms of value for money, but investing in genuine care and treatment to help to save lives—the long-term positive effect will be not only those lives saved and a reduction in the proliferation of the condition, but money saved that can be used to fund other areas of work.

The hon. Member for Brighton, Kemptown (Simon Kirby) and my hon. Friend the Member for Airdrie and Shotts noted the important point made in the report about middle-income countries. There are many issues related to extreme poverty besides HIV and AIDS, including access to education and other health care, such as drugs and treatment for TB and malaria. We still have a lot of work to do in middle-income countries: 50% of people in extreme poverty live in those countries, so the international community, and particularly the UK, cannot afford to ignore or pass by their challenges. We must still engage with them, and consider need, as my hon. Friend said, rather than classification.

We need to support people as those countries graduate from the low-income to the middle-income group, rather than thinking that that means our job is done. Quite the opposite: sometimes in those cases, even more support is needed, particularly when there is a lack of governance, although some people might think that the graduation to middle-income status means Government officials can think less about their obligations to the poorest citizens.

I have in mind two examples raised by my hon. Friend and in the “Access Denied” report, which have been the subject of much discussion and negotiation. South Africa and India, with their continuing struggles, still need our support—particularly technical assistance and help with strengthening health care systems. Currently, 58% of people who are HIV positive live in middle-income countries. By 2020, the proportion is expected to rise to 70%. We cannot ignore that 70%; we need to engage and work with them.

There are a couple of other issues. First, 52% of people suffering from HIV and AIDS in low and middle-income countries are women. One young woman contracts HIV every minute. The report also found that in sub-Saharan Africa the proportion of young women aged 15 to 24 living with HIV is twice that of young men. There are also cultural issues. Given that carers and people with caring responsibilities when loved ones are unwell are often women and girls, we have a responsibility to support people with conditions and to support people who support those with conditions. Perhaps the Minister will respond to that, too.

My hon. Friend the Member for Dumfries and Galloway rightly mentioned child treatment and transmission. When I read some of the stats in preparation for today’s debate, the stat that got me most was that, across the world, there are 3.2 million children with HIV and that 20,000 children a month are still being infected. Up to half of all new paediatric HIV infections occur during breastfeeding, which is a heartbreaking tale: a mother trying to do her very best to give her child the best possible start in life has, through breastfeeding, transmitted HIV and AIDS to that child.

In many cases, perhaps, the mother had to choose whether to breastfeed her child, knowing that the child would suffer because of her condition. That is heartbreaking indeed. More work needs to be done to ensure that we are giving adequate treatment to women and girls to prevent the transmission of the disease to children in the first place. If children contract the condition, they should get the support, medicine and treatment they need.

I have two further points in relation to women and girls. First, education is crucial. There should be education for all, and we should ensure that people know about the risks of HIV and AIDS. Secondly, we must address violence against women and girls. The Minister and I have talked about the important issue of female genital mutilation and violence against women and girls more generally, particularly in conflict. We have talked about putting women and girls at the heart of development, and putting women and girls at the heart of support for HIV and AIDS is also crucial and must be considered much more carefully.

Another issue raised in “Access Denied” that has perhaps been mentioned less in the debate is the support given to people who inject drugs. If we are to follow the “no one left behind” principle, we must ensure that we give adequate support to people who inject drugs, which means access to clean syringes, opioid substitute treatment and naloxone to prevent overdose and the spread of infections.

We have two good cases where treatment has helped to make a difference. Tanzania and Kenya have demonstrated good practice on those issues, but we must scale that up and ensure that we give them and other people in the region the same adequate support and treatment. UNAIDS estimates that $2.3 billion is needed annually to fund preventive measures for those who inject drugs, but all global donors combined spend only $160 million—that is $160 million when we need $2.3 billion every single year. How can we ensure that those issues are more fully considered?

We have heard colleagues talk about the obstacles faced in licensing and about companies putting profits before people. I welcome the progress that has been made on relaxing intellectual property rights to produce low-cost generic drugs for first-line treatment. I welcome the coalition of five big pharmaceutical companies that is granting licences for generic production to the UN-backed medicines patent pool, but more can and must be done.

Second-line drug combinations are far more expensive than the basic cocktail, which costs no more than $100 per person per year, although we have heard that in South Africa people are being charged exponentially even for first-line treatment. Granting licences for second and third-line drug combinations must be implemented much more efficiently than in previous decades. We must reduce the price of front-line drugs to a much more manageable level. That is the responsibility of the UK Government, working in partnership with the international community and other key development agencies, whether in country or through multilaterals. It is also for the drug companies to ensure that second and third-line drugs are available and affordable for all, irrespective of the income or the affluence of a person or a country. I emphasise the 80% cut to IAVI.

We can all get wrapped up in one fundamental issue, and I say that particularly in the climate of the discussions on sustainable development goals, which are ongoing and will continue—hopefully, they will conclude later this year. We see a lack of strong universal health care systems in developing countries. We see clinics popping up for tuberculosis, malaria and HIV and AIDS, but what we need is holistic care so that people, whatever conditions they turn up with, receive adequate support and the care they need.

There is no better example than our own national health service. We have a system that is based on people’s need, not their ability to pay. If we have that great system in the UK, it is incumbent on us to work with the international community to help to promote such a system of universal health coverage globally. That is why we have already said that we would set up a universal health coverage institute within the Department for International Development to provide technical assistance using the expertise of the Department, of the people who work with and for the Department, and of the NHS.

The institute would bring together the expertise of people who put together tax systems to help to create and build models in developing countries so that those countries may have universal health care systems that have the support they need, but are sustainable and able to raise their own funds. There is no greater example than the Ebola crisis. In Nigeria, where money has been spent on the health care system, Ebola was brought reasonably under control, which helped to save lives, and in Sierra Leone, which did not have such a system, the Ebola crisis worsened and up to 10,000 people lost their lives. I encourage the Minister to move forward with universal health care systems and access to health for all.

Today, let us resolve to do as my hon. Friend the Member for Airdrie and Shotts and the wider all-party group on HIV and AIDS have done and put this important issue at the forefront by talking about it, discussing it and debating it. We must put the solutions at the forefront, too, so that in my lifetime, and in the Minister’s lifetime, we can bring HIV and AIDS to an end.

--- Later in debate ---

[Mr Swayne]

The commitment of an average of €60 million per year for 20 years has been and will be met, but it is an average. There was a reduction, and my understanding is that it was made good with a €40 million contribution. The contributions are being met and we are fulfilling the requirements.

HIV treatment is linked to broader issues of health development, the strengthening of health systems, gender equality, and stigma and discrimination. All those things have to be addressed. We have to have a rights-based prevention and treatment regime. That remains a key policy objective in tracking how our contributions and investments deal with those issues. We need to be much better informed, and we must understand how to tackle stigma. Only when that happens will more people be able to access preventive programmes, get tested, and initiate and adhere to treatments.

The product development partnerships model has been very successful in bringing forward new drugs to the market. It has brought forward 43 new drugs in the past 10 years, and there are 350 under development. The Department for International Development is a strong supporter of PDPs; indeed, we were the first Government donor to them. I congratulate the Labour party on its initiative in 2008 and on driving forward that innovative agenda. It was an important contribution. We remain a globally significant player in that field, having committed £154.2 million between 2013 and 2018.

I was asked any number of questions. Let me start with those about vaccines and the International AIDS Vaccine Initiative. There has been no cut. We fulfilled the contract that we had with IAVI. All the money that we had committed was paid. We have a new contract now for £5 million, for which it competed, for a slightly different programme.

Let us be clear about what has happened. It is quite right that we have withdrawn from something that we were previously involved in, just as any organisation continually reviews its operations and does what it does best. I understand that some six vaccines went for field trials and we were funding that process. The results were disappointing, so it was back to the laboratory. We do not consider laboratory work as part of our comparative advantage. There are organisations in the world that are much better at dealing with that sort of scientific funding and do that work. Frankly, I believe that our funds are better expended elsewhere, where we have a comparative advantage.

Remember that we have not made a saving; we are spending more than we were spending before. We are spending it differently and I believe that we are spending it effectively, although we are not funding IAVI to the extent that we were in the past. That is a perfectly reasonable position to have taken, given the change in the situation.

[Anas Sarwar]

The Minister mentions the six vaccines that went to field trials and the “disappointing” results. He does realise that we only need success once, but we need to fund that programme to be able to get that one success.

[Mr Swayne]

Absolutely, but the difference is this. Funding field trials is one thing but going back to the laboratory and working there is a different field of endeavour, one where we have no comparative advantage. [Interruption.] I think we will just have to agree to disagree about this one, but there has absolutely been no cut in our funding of IAVI. We fulfilled our contracts and entered into a new one—a quite different one—with IAVI.

Now we come to the big question of the middle-income countries. I accept entirely that, when a country becomes a middle-income country, it hits a double whammy: one, the funding is withdrawn; and, two, all the prices go up. But hey—they are middle-income countries, and we are trying to encourage people to invest properly and to step up, as they are richer countries, and fund their health systems properly and have properly integrated health systems. That is an important part of the deal.

I accept entirely that that is a bit like falling off a cliff. Perhaps we should have some system akin to, say, universal credit, where there is a taper, as countries move from low-income status to middle-income status. I accept that there is an argument—a case to be made here. I am open to that discussion. It is something that we would have to agree with our international partners; I do not think we would have leave to change the system ourselves. Hon. Members have drawn attention to a very clear problem. The way we get around it at the moment is through the funding of the Robert Carr network, to which we have committed £4 million until the end of this month, and then we will have to replenish it. That is underfunded; there is a £13 million funding gap in respect of the Robert Carr network. We have to work with our donor partners to try to see how that gap can be filled.

I agree entirely with the hon. Member for Airdrie and Shotts that viral load testing is the top end. It is exactly what we should be pursuing. I am glad that the price has fallen significantly as a consequence of the market shaping; it is down to a cap of $9.40, which is down some 40% in low-income and middle-income countries. The problem is, as she rightly pointed out, that that requires a developed network of laboratory testing. Again, I entirely share her view that we have to continue investing in alternative point-of-care technology, and in research and development in that area. I know that there have been more than 924,000 CD4 tests at point of care, but she is right that load testing is a much better and much more valuable tool. The way the Global Fund works is that it asks countries that are capable of supporting the network with laboratories for viral load testing to apply for that funding, and it asks other countries that are not able to support that to apply, certainly for the moment, for funding to deal with CD4 and whatever else may be brought forward. The work of UNITAID and the Clinton health foundation has been instrumental in reducing the price of viral load testing, which was one of the principal problems with it.

I come on to the Transatlantic Trade and Investment Partnership and the impact of any trade negotiations. I was asked whether we have formal input into the process. The reality is that, as a consequence of decisions taken in 1975—decisions that might be reviewed if the election result turns out the way I want it to—trade policy is a European Commission competency. Within the UK Government, the Department for Business, Innovation and Skills is the lead Department in relation to that, but DFID successfully ensures that issues such as access to medicines and intellectual property rights lead to joint discussions between our Departments. It is physically in BIS but it is actually staffed by DFID officials. Therefore, we do that.

On the issue itself, my own view is that it is down to the negotiations at the time, on a case-by-case basis. When we make a trading agreement, we have to ensure that we are absolutely certain that we are not compromising ourselves on intellectual property and that we are not going to restrict access to drugs as a consequence of the decisions we make. That is just down to being vigilant when we come to make these arrangements.

I was specifically asked about research and development. That agenda has been driven forward largely by civil society, rather than by nation states and Governments. Nevertheless, it is important. Frankly, it is unlikely that there will be a legally binding instrument for health research and co-ordination. The Government’s view is that any agreement needs to be built on existing mechanisms, such as that proposed by the expert working group.

The background to the issue is that for the past 10 years the World Health Organisation has convened a number of working groups to discuss and suggest solutions to the issues that the hon. Lady has raised, namely, funding flows, innovative funding mechanisms and co-ordination of health research. The latest of these groups—the consultative working group—suggested that we should establish a WHO global R and D observatory and a pooled fund for product R and D, together with a co-ordinating mechanism to support the fund.

The World Health Assembly is due to discuss that matter later this year. My concern is this: will countries wish to put more into this pool than they are putting in at the moment to contributions to R and D, particularly when the pool will be controlled by a mechanism other than the countries themselves? My estimate is that most countries would want to put research funding into a direct contribution that they control and to know where it is going. I will not go any further than that, because I was asked about 90-90-90 and I have one minute left to respond. It is a very interesting thing. It is far too soon to tell. My concern is that it adds a very substantial burden to the funding that already exists, and the emphasis must be on the poorest and the sickest first. I would want to see a little more about how the UNITAID proposals are brought forward before committing myself irrevocably to the 90-90-90 strategy.

Sustainable Development Goals

Anas Sarwar Excerpts

Wednesday 28th January 2015 Commons Chamber

[Anas Sarwar (Glasgow Central) (Lab)]

As we have heard from a number of speakers, 2015 has the potential to be an historic year for international development. The international community will come together in September to agree the sustainable development goals and at the end of the year to agree a framework to tackle climate change. That will happen just in year one of the next Parliament. The next five years must be about not just making the right agreements but, crucially, delivering on them. That will require commitment, energy and, crucially, leadership on the international stage. We will need the ability to set the agenda, to advocate and persuade, to build alliances, and to use our influence to make a difference for some of the world’s poorest and most vulnerable people.

I echo the comments of my right hon. Friend the Member for Dulwich and West Norwood (Dame Tessa Jowell), who rightly mentioned how we strove for consensus. Let us remember that the consensus was built by the last Government; it was not there from the beginning. It is also important to recognise that our criticism of the Government is not that they do not act on the international stage on international development—of course they do and we welcome that—but it is the force of their advocacy and leadership. Compare that with the last Labour Government. We created the Department for International Development. We trebled the aid budget. We founded the Global Fund to Fight AIDS, Tuberculosis and Malaria. We led on cancelling debt. We created the Extractive Industries Transparency Initiative and we drove the efforts on the millennium development goals.

In contrast, the Government have failed to show leadership at home, never mind abroad. They had a clear manifesto commitment to legislate on 0.7% gross national income in international aid—[Interruption.] If the hon. Member for Skipton and Ripon (Julian Smith) listens, he will find that we are much more in agreement and perhaps he too will be open to transparency, accountability and debate—things that both sides of the House welcome. The 0.7% aim was in the Conservatives’ manifesto and the coalition agreement. Thankfully, the right hon. Member for Berwickshire, Roxburgh and Selkirk (Michael Moore) delivered a Bill on 0.7% and I pay tribute to him and all the Members who got behind the Bill to make sure that we delivered on our international obligations. I just wish that it had been done in Government time, which would have shown more leadership—

[The Lord Commissioner of Her Majesty's Treasury (Mr David Evennett)]

The Government supported it.

[Anas Sarwar]

Well, we should also highlight the fact that more Labour MPs voted in favour of the Bill than MPs from every other party combined.

With crucial negotiations and agreements coming up, I want the next Government to be drivers, not passengers. The new sustainable development goals must go faster to eliminate extreme poverty and focus on tackling inequality, as mentioned by my hon. Friend the Member for Stoke-on-Trent North (Joan Walley). To add to that, we would prioritise universal health coverage, human rights for all, including women, children and the disabled, and the effects of climate change.

Access to health care should be based on a person’s need, not their ability to pay. It should be a right, not a privilege. That is why, unlike the Government, we will support a stand-alone goal on universal health coverage. Universal health coverage does not just help improve health outcomes, it would help reduce inequality and stop 100 million people a year from falling into poverty. I pay tribute to two Conservative Members who spoke passionately about causes that are dear to them. The right hon. Member for Arundel and South Downs (Nick Herbert) has shown a tremendous commitment to the fight against tuberculosis and raised the important point of multi-drug resistance. Universal health coverage could be an important element of that fight in the future. I had the privilege of serving on the International Development Committee with the hon. Member for Stafford (Jeremy Lefroy) for almost 18 months, and he spoke of his commitment to the issue of malaria, and the work done by the last Government and this to tackle it. I know first hand, from our conversations and from serving on the Committee, of the good work that he does. I am sure that that will have the support of both sides of the House and, I hope, the next Labour Government.

Negotiations on universal health coverage are also about resilience to humanitarian disasters or outbreaks of disease, and we have already heard about the difference that can make. Nigeria, which has invested strongly in building its health systems, was able to contain and beat the Ebola virus, but Sierra Leone—let us remember that the Government cut support for that country—has struggled to cope, resulting in loss of life and the need for even greater support from the Government and the international community.

On the issue of Ebola, I wish to put on record again, on behalf of both sides of the House, our thanks to and appreciation of Pauline Cafferkey and all those from the United Kingdom who volunteer to go and help in the fight against Ebola. Pauline is an example of a real hero in our community, and I am sure that we all want to send her our best wishes as she recovers from Ebola and returns home to Rutherglen in Scotland.

I echo the comments made by my right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr Clarke), who rightly paid tribute to our tremendous staff at the Department for International Development. They are heroes in their own right, struggling and fighting to make a difference to people’s lives across the world.

[Pauline Latham (Mid Derbyshire) (Con)]

The hon. Gentleman mentioned that we had cut aid to Sierra Leone. We have spent more money on health in Sierra Leone in every year of this Parliament than the previous Government. Where is he getting his figures from? It is duff information.

[Anas Sarwar]

It is good to see the hon. Lady taking part in the debate. She was not here earlier when we were discussing that very important issue. She may want to refer to the House of Commons Library and to a Westminster Hall debate with the Minister of State, Department for International Development, the right hon. Member for New Forest West (Mr Swayne) on this important issue. In that debate, the Minister admitted he did not know how much money the Government were spending in Sierra Leone. He also said he would go away and find out. I am still waiting for an answer.

Another point raised with the Minister in that debate was how we recruit from developing countries to our NHS. The Minister said he would investigate and come back on that. I would be interested to hear the result of that investigation. There is a sad irony in the UK recruiting one in four doctors trained in Sierra Leone into our NHS, when it has an acute need itself. Our NHS—thought of, created and saved by Labour—is the envy of the world. The previous debate is proof enough of this Government’s shoddy commitment to it and its values. That is why only Labour can be trusted to make the case for universal health coverage at home and abroad.

Another priority is to put women and girls at the heart of the sustainable development goals. We would like gender equality, access to education, clamping down and taking action against female genital mutilation, and making sure every child is protected from slavery or abuse to be included.

On private sector development, Labour agrees that a thriving and free private sector is vital to the elimination of poverty, but it cannot be based on the ideology of trickle-down economics. Labour believes the most sustainable and dignified route out of poverty is work. We must ensure that that also means decent pay, fair conditions and the freedom to join a trade union. That is why we will reverse the Government’s decision to slash funding to the International Labour Organisation. DFID’s spending on private sector development in 2011-12 was £549 million. That now sits at £1.8 billion—a fifth of DFID’s budget.

At the same time, we have seen Ministers completely fail to ensure value for money or transparency, a point raised by my hon. Friends the Members for East Lothian (Fiona O'Donnell) and for Llanelli (Nia Griffith). It is very difficult to establish what DFID is spending that money on. It is channelled through private bodies such as the Private Infrastructure Development Group, a multilateral organisation that is considerably less transparent. Government Members may criticise Labour’s approach, but the National Audit Office and the Government’s own Independent Commission for Aid Impact warn that oversight of this funding is inadequate and risks wasting taxpayers’ money. We await the Public Accounts Committee report tomorrow.

It is completely unacceptable that any Government Minister can fail to answer basic questions on how we spend £2 billion of taxpayers’ money. It is not just the Government who have a responsibility, but companies too. It is an absolute scandal that every year three times as much is lost in tax revenues to developing countries than the global aid budget combined. That is why we must make tackling tax avoidance a priority at home and abroad. We must look at supply chains adopting the same principles we apply in this country.

My hon. Friends the Members for Bristol East (Kerry McCarthy) and for Cardiff South and Penarth (Stephen Doughty), and many other colleagues, raised the issue of climate change. Labour will, unlike this Government, put the fight against climate change front and centre of international agreements. We will use the G8 in Germany to push for climate change to be a permanent standing item at the UN Security Council. It will be on the agenda of every meeting with world leaders here in the UK. Leading on the sustainable development goals; leading on climate change; leading on private sector development; leading on universal health coverage; and leading right around the world. That is the leadership this country needs.

Oral Answers to Questions

Anas Sarwar Excerpts

Wednesday 17th December 2014 Commons Chamber

[Justine Greening]

As my hon. Friend has said, for the first time overseas territories have signed up to action plans, and the next step is to ensure that they implement them. In fact, a number of countries need to stand by the promises that they made and deliver on them. However, we are delivering on our own promises.

[Anas Sarwar (Glasgow Central) (Lab)]

I am sorry, but the Secretary of State can do better than that. We know that tax revenues amounting to three times the entire global aid budget are lost to developing countries every year, and that nearly a third of the estimated $32 trillion of private financial wealth that is held in tax havens comes from those countries. A year ago, the Prime Minister said that there would be a public register of beneficial ownership. That must include the overseas territories and Crown dependencies. By dithering and delaying, whose interests is the Secretary of State protecting?

[Justine Greening]

There was dither and delay for 13 years under the last Government. I do not think we need take any lectures from them, either on the closing of our domestic tax gap—which grew under Labour—or, indeed, on the closing of the international gap. The hon. Gentleman would do better to welcome all the work that this Government have instigated, not least the setting up of the HMRC unit which I mentioned, which is enabling our officials to give invaluable help and advice to tax institutions around the world.

Health Systems (Developing Countries)

Anas Sarwar Excerpts

Thursday 11th December 2014 Westminster Hall

[Anas Sarwar (Glasgow Central) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Osborne. I congratulate the Select Committee on International Development on its two fantastic reports, the second of which we will debate in a moment.

I had the great pleasure of serving on the Committee at the start of this Parliament for almost a year and a half. Having worked with many of its current members, I can say that it is full of people who are dedicated to ensuring that we spread the values that we hold dearly in the UK around the world to maximise opportunity in the fight against poverty. Two of my former colleagues on the Committee—the right hon. Member for Gordon (Sir Malcolm Bruce) and my hon. Friend the Member for York Central (Hugh Bayley)—are retiring before the next Parliament. We all wish them both the very best for the future. The fact that both of them have used their last term in office to try to improve the life chances of the poorest and most vulnerable people in the world speaks volumes. The right hon. Member for Gordon has been a member of the International Development Committee since 1997, for which he deserves a special prize. I pay special tribute to the Department for International Development staff and health workers who have gone from the UK and elsewhere to help in the fight against Ebola and have risked their lives to protect the lives of others.

I am particularly pleased to be able to make the case for universal health coverage, as the Committee has done, given that the UK is a global leader on that issue. We should be the strongest global advocate for universal health care because our NHS is the envy of the world. It supports people from the cradle to the grave, and it is based not on people’s ability to pay but on their need. We should spread that health care model around the world.

In the current crisis in Sierra Leone, more than 1,600 people have lost their lives, and every week 200 to 300 people are dying and 400 to 500 people are becoming infected. That is a real and sad example of why sound health care systems are crucial. It also demonstrates why the UK and the Department for International Development are right to emphasise promoting private sector growth. Sustained economic growth, higher employment, strong infrastructure and other good development work can be lost in an instant during such epidemics.

Sierra Leone’s GDP growth has sharply declined, despite its positive growth in recent years. All its post-war achievements in the health, education, justice and employment sectors are in jeopardy. The Committee will know from its visits and from the testimonies it has heard that all the schools in Sierra Leone have been permanently closed, and there is a real risk of losing a generation. A generation of young people in Sierra Leone will never get the education they need to improve their life chances, get into meaningful work, break the cycle of deprivation, create a better life for themselves, their families and their communities, and create a better Sierra Leone in the process.

Let me compare three African countries with varied health systems. Sierra Leone, as my hon. Friend the Member for York Central said, has about 136 doctors and just over 1,000 nurses for 6 million people. That is the equivalent of one doctor for almost every 50,000 members of the population. Sadly, since November, more than 100 health workers, including five doctors, have lost their lives to Ebola. It is even worse in Liberia, which has an estimated 60 doctors and 1,000 nurses for 4.3 million people.

In contrast, Rwanda has more than 55,000 health workers for its population. The president of the World Bank, Jim Yong Kim, said:

“If this had happened in Rwanda we would have had it under control.”

That shows the difference that a meaningful health care system can have. It demonstrates that there is no substitute for adequate local health care cover. If there is no functioning health service, a single outbreak can turn into a global crisis.

[Jeremy Lefroy]

Will the hon. Gentleman also acknowledge Nigeria’s tremendous success in preventing the spread of Ebola? Some attribute that to the health systems built up through, for instance, the polio vaccination campaign.

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[Anas Sarwar]

I thank the hon. Gentleman for that intervention. I recall our many travels and our debates on many issues. I pay tribute to his first-hand experience of development issues and the work he did in Tanzania before he became a Member of this House. He is absolutely right to point to the positive interventions that the Nigerian Government were able to carry out because of their pre-planning and their thought leadership in advance, which enabled them to deal with the Ebola crisis. Sadly, Liberia and Sierra Leone were not able to do that, but the lessons from Nigeria and Rwanda can be learned by other countries.

Universal health coverage not only helps to prevent outbreaks and improve health outcomes, but can help to reduce inequality and tackle the fact that 100 million people a year fall into poverty. That is why universal health coverage matters, and why the UK must make it a top priority. The UK must use the opportunity of the 2015 negotiations on the sustainable development goals to push for universal health coverage to be a key element of those goals. I say gently to the Minister that we must be an active, vocal advocate for that agenda and use our experience, expertise and our influence with multilaterals and institutions to make our case. The report makes it clear that the Committee is frustrated that the Department and the Government are not using the strength of our voice to make that case on the global stage. I hope the Minister will address that point. I ask him to outline what advocacy work the Government have done on universal health coverage.

As DFID’s budget increases, more money is going to multilaterals, at the expense of the budgets of many bilaterals; I will return to that point. A World Bank study showed that the economic cost of Ebola could be as high as $33 billion over the next two years if the virus spreads to neighbouring countries in west Africa. Although I welcome the support given to multilaterals such as the World Bank, the Committee said in the report that it does not believe that many of our international partners give the same priority to the development of health systems as the UK. When they do, the same priority is often not given by the recipient Government. Let me give a practical example: only $3.9 million out of $60 million of EU health sector support given to Liberia was passed on by the Liberian Finance Ministry to the Health Ministry over a two-year period, leaving the Liberian health system struggling.

[The Minister of State, Department for International Development (Mr Desmond Swayne)]

I have looked into that criticism; the EU denies that it happened, and it has checked in Monrovia. I have asked for that matter to be reinvestigated.

[Anas Sarwar]

I thank the Minister for that helpful intervention. In the spirit of transparency, and to ensure that we do not darken the name of any Government and that we have the strong trust of the people on every penny spent by the UK Government and by our EU partners, I encourage him to share any information gleaned from those investigations with the House and the Committee.

[Sir Malcolm Bruce]

I am very glad to see the hon. Gentleman back in the international development debate. To clarify how this issue arose, we were told by the Health Department in Liberia that the money had been earmarked for it and that it had not received it—that the Minister of Finance had either held it back or was spending it elsewhere. I am grateful for the Minister’s intervention, and I am interested in his reply that our Government have checked and found that that is not the case. I just want to be clear that this information was given to us in good faith and on the face of it, it was shocking. We just thought it was important, and if it has been checked and it has not happened, that is absolutely fine, but nevertheless, it was a significant factor. When money is given, sovereign Governments can, of course, in the end redistribute it, but the question of whether it went where it was meant to go should really be followed up on.

[Anas Sarwar]

The Chair of the Committee mentions an important issue, and it is right that the Committee raised it and that the Minister has looked into it. I think we would all welcome that information and clarity, but it also highlights an issue in recipient countries, where perhaps that information is not shared between Departments. That undermines both the way in which Departments can operate and the state-citizen relationship in recipient countries. That information should be shared with the Committee, and there should be a way to share that information with a recipient country’s Government, and particularly its Department of Health.

It would be interesting to hear what indicators are in place to measure how much of the money spent through multilaterals is used specifically on strengthening health systems, and in which countries, and how the success of that spending is measured. Transparency is again the key issue, in terms of gaining the public’s trust. That same principle should be reflected in our bilateral agreements, ensuring that where we do give budget support, an emphasis is put on universal health coverage by recipient countries. Aid should never be a blank cheque. Recipient countries must make a commitment to medium-term goals and take responsibility for long-term health system development. We should never be afraid to take a tough line with Governments who do not adhere to that principle.

However, we must not fall into the trap, as we often do, of believing that our biggest impact comes just from the money that we spend and the global influence that we exert. There must also be a recognition, as has been made clear by many Members today, that through our NHS, we have built up expertise, and if we share that, we can help shape global systems. We have the talent among our health workers to develop strategies and plans, to provide professional and personal development, and to manage and learn in a meaningful two-way relationship with recipient countries. That is why we should encourage volunteering, as the hon. Member for Congleton (Fiona Bruce) suggested.

I push the Minister to respond more thoroughly to the Committee’s recommendation to build schemes that are more co-ordinated, structured and scaled up. That should include detail on how the Government would support those people who choose to volunteer with specific benefits and entitlements. Such schemes would help to promote the good work that the Department and this country do on development and would also help build public support and trust at a time of public cynicism.

Linking that to the Ebola crisis, I want to re-emphasise the question that my hon. Friend the Member for York Central asked. We know that 650 NHS front-line staff and 130 public health staff have volunteered to work in Ebola-stricken west Africa, but how many have actually gone? We still do not have a specific figure from the Government, and I hope that the Minister will have an answer for us today. We should not shy away from giving all the support that we can to the people who are bravely volunteering their expertise and putting their lives on the line, in many senses, to go and protect the lives of others. We should absolutely support them.

[Mr Swayne]

Rather than wait, I can give the figures now. Thirty NHS staff flew to Sierra Leone on 22 November. A second wave of 25 arrived on Sunday 7 December. They will work on a rotation pattern of four to six weeks; then they will be replaced by others. Many more volunteered, but after negotiations with NHS trusts and others, the actual numbers travelling are somewhat lower. That is the picture so far.

[Anas Sarwar]

I thank the Minister for that response; I am sure that the Committee and many of the non-governmental organisations will be happy to hear that information. It would also be interesting to get information about the number of volunteers and health workers, or people with health expertise, who are not linked to the NHS, but are none the less based in the UK and who have gone to Sierra Leone and other territories specifically to help on the Ebola crisis, perhaps through NGOs or other schemes. I hope that the Minister can look into that for us.

The International Development Committee raised the important issue of the NHS pulling health workers away from Sierra Leone. In particular, my hon. Friend the Member for York Central made a powerful case about the no-harm principle that should be applied to the way in which we operate our education system and NHS system in the UK, so that we do not harm daily the very countries that we are seeking to help.

Sierra Leone is one of five African countries with an expatriation rate of over 50%, meaning that more than half the doctors born in Sierra Leone are now working in countries of the OECD. I have already mentioned the shocking doctor-population ratio. We can never find that situation acceptable. The right to migrate is not in question, of course, but it is unacceptable that a country with one of the weakest health systems in the world is, in many ways, subsidising the country with one of the strongest, if not the strongest.

[Mr Swayne]

I accept entirely what the hon. Gentleman and the hon. Member for York Central (Hugh Bayley) said. It is a very difficult issue, because some countries export health workers and draw remittances from them as a positive in their balance of trade, or certainly their balance of payments. However, I recognise that difficulty and I shall surprise the hon. Member for York Central: we are commissioning a review of NHS use of foreign workers in exactly the way that he challenged me to.

[Anas Sarwar]

Excellent. I think we all welcome that announcement from the Minister; it is amazing what people can achieve when they think on their feet. It would interesting to know when that will be reporting and what impact assessment is being done on that, in terms of our health service here in the UK.

To give an illustrative example, 27 doctors from Sierra Leone are believed to be working in our NHS. The data do not record a level at which they are working, so let us assume, for argument’s sake, that all 27 are junior doctors. It costs the NHS just under £270,000 to train a junior doctor. It would represent a saving of £7.3 million to the UK if those doctors were trained in Sierra Leone and came to work in our NHS. The Committee noted that the UK Nursing and Midwifery Council register lists 103 nurses who were trained in Sierra Leone. It costs the UK £70,000 to train a nurse in the UK, so that is a saving of £7.2 million. Together, that would represent at least a saving of £14 million—if not more, if many of those doctors were GPs or consultants.

I welcome the Government’s agreement that the NHS needs to review overseas recruitment, and the fact that the Department of Health endorses the World Health Organisation global code of practice on the international recruitment of heath personnel, and implements it through the UK code of practice for international recruitment. It is important, as the Minister has outlined, that the Department of Heath works closely with DFID on reviewing the definitive list of developing countries that should not be targeted for recruitment of health care professionals.

[Andrew Rosindell in the Chair]

Turning to the specifics of DFID spending, I think that it is unfortunate that DFID is cutting bilateral support, especially at a time when its budget is increasing and particularly after the historic vote last week, when, with support from hon. Members on both sides of the House, we were able to enshrine our 0.7% commitment in law. I note, though, that there were more Labour MPs supporting the Bill than MPs from all the other political parties combined.

Sierra Leone is a good example. In 2014-15, DFID reduced its bilateral budget for Sierra Leone by 18.6% relative to its commitment in 2013-14. That was central money that could have been used to strengthen health care systems. Since then, the UK has been the lead donor in Sierra Leone on the Ebola crisis, pledging £230 million of additional support as well as logistical support from the Ministry of Defence. That is of course to be welcomed. However, given that that crisis will have a lasting impact, will the Minster today consider reinstating the bilateral budget on a long-term basis?

It was unacceptable that, as the Select Committee found, DFID and the previous Minister—not the current Minister—did not know the total annual expenditure in Sierra Leone. I am sure that the current Minister would love to intervene to tell us the specific amount being spent annually in Sierra Leone. Equally, I am sure that if he cannot, he will, as with other things, go and investigate and report to the Committee how much we spend every year, not just in Sierra Leone but in every other country, in the spirit of transparency and accountability. I notice that he has gone slightly more silent than he was a moment ago.

[Mr Swayne]

No, I will be dealing with that matter.

[Anas Sarwar]

Also, how will DFID act on its commitment to develop indicators—knowing that they will be reviewed in 2015—and other mechanisms that allow it to track its investments in and impacts on health system strengthening in new programmes from 2015, both for use in its own work and to feed into global processes?

As we know from our UK experience, building an effective health care system requires sustainable revenue streams, if Governments are to fund these vital services. That is why greater tax transparency is crucial. Many of these countries suffer from the so-called resource curse: there is vast mineral resource, but that is not turned into a nation-building positive agenda. In 2011, Sierra Leone spent more on tax incentives than on its development priorities, and in 2012 it granted $224.3 million in tax exemptions. That is eight times the budget allocated for the health sector, which is $25.7 million. In addition, many of the tax incentives are negotiated between Government and companies behind closed doors, making the negotiation process extremely opaque and open to accusations of corruption.

To encourage domestic growth through tax collection, the National Revenue Authority of Sierra Leone needs to be fully involved in the negotiation and design of the exemptions. That is why DFID must make sure that its work with the National Revenue Authority links with its work with the National Minerals Agency, to ensure that Sierra Leone’s natural resource wealth is used to help to meet development objectives and not just for the benefit of a few international investors.

Finally, I want to deal with a couple of other key issues raised by the Select Committee. I see the Minister looking at me. He should not worry: I am almost done, and I am sure that he will be robust and succinct in his reply. A couple of other very important issues from the report have not been mentioned so far, but are worthy of comment.

First, there is the huge issue of female genital mutilation, which Sierra Leone is one of the worst countries for. I know that it is a politically sensitive issue in Sierra Leone, but that does not prevent the UK Government from doing something, or at least trying to do something about it. That is why it is important that the UK Government work with the victims and survivors of FGM to see what they can do to have a more meaningful programme and combat FGM in Sierra Leone.

The other important issue raised by the Select Committee was unemployment, particularly youth unemployment and the lack of formal jobs being created in the economy of Sierra Leone. Three million people out of a population of six million are unemployed, but only 90,000 formal jobs are available in the economy. An estimated 800,000 young people are actively searching for employment. It would be interesting to hear from the Minister what work is being done to try to improve the availability of jobs and employment in the country, especially as DFID set itself a target of creating 30,000 jobs in Sierra Leone by 2015. How many jobs have been created so far? Does DFID expect to meet the target in the next three weeks? How is it helping to create jobs? What measures are in place to ensure that the jobs created are in line with the International Labour Organisation definition of decent work? How many jobs have been created using small business enterprises in-country, and have any British companies benefited from any of the investment to create employment in Sierra Leone?

I thank the International Development Committee again for its very thorough and rigorous report and for its continued work. We look forward to working with the Committee as it pursues the issues that are of interest to it and to the wider British public. I look forward to hearing the Minister’s reply. I know that I asked several specific questions, but I can tell from the way he has conducted himself already that he has very good answers for us.

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[Mr Swayne]

I agree entirely and take on board exactly what my right hon. Friend says about the secret societies and the role that senior females—the “cutters”—have in them. Given the priority that the Secretary of State has attached to gender and the role of women and girls, it is vital that we do not shy away from this challenge and put it in the “too difficult” box. We must deal with it.

[Anas Sarwar]

I completely support the Minister’s comments about FGM. He seemed to skirt quickly over the issue of jobs and employment, and he did not say whether he accepts that the commitment made to create 30,000 jobs by 2015 has not yet been met and will be reviewed after the Ebola crisis—or has that commitment been met?

[Mr Swayne]

I would be very surprised if it has been met, but I cannot answer that question now. Given what has happened, it is unlikely to be met, but it remains vital that we continue our work on employment, which should be taken forward by the post-Ebola team; however, much of that work has undoubtedly been disrupted by Ebola.

[Anas Sarwar]

Of course, Ebola has taken away the emphasis from much of the work going on in Sierra Leone. The Minister seemed to suggest that, after the Ebola crisis, the budget reduction in the bilateral agreement between Sierra Leone and the UK Government will be restored in full. We should remember that that budget was cut before the Ebola crisis, so is he suggesting that we will go back to the pre-crisis levels?

[Mr Swayne]

What I said—I hope I was not misunderstood—was that I expect the spend to fall next year, simply as a consequence of Ebola preventing us from fulfilling our planned programmes. Of course, we will be spending much more in Sierra Leone as a consequence of our commitment to dealing with Ebola, but I will come on to how we spend our money, whether bilaterally or multilaterally, shortly.

First, I want to deal with the questions the report raised about centrally managed programmes and how we co-ordinate with bilateral and multilateral programmes. The approach should work precisely as I described to the Committee a fortnight ago, when we discussed parliamentary strengthening: it must be context-driven. The country team, within the context it faces, examines exactly what is required and what our programmes are to be, and then goes shopping to find the best fit. That best fit might be a bilateral programme. I made clear then—I stick by what I said—that my prejudice is in favour of bilateral programmes and bilateral aid, not least because I want to see it badged with the logo: “UK aid from the British people.” That is important to me and, I submit, to our constituents.

However, it is clear that, in some cases, international organisations must have a role. If we are dealing with malaria, for example, which takes no cognisance of international borders, we will have more leverage if we deal with a large organisation that is dedicated to dealing with such problems. Equally, there will be times when it is desirable to take account of international expertise that might not be available bilaterally, or to use economies of scale, through working through a large global or regional organisation. They clearly have a place, and in my view it is for the country teams to work out what is the best fit.

I entirely agree with the Committee that it is completely unacceptable that the country team should almost be left out of the equation, and not know under precisely what terms the bilateral aid is being delivered, or what the projects are. So we are introducing a new protocol, to ensure that the country team will be involved in the specification, design and monitoring of any multilateral programme that affects their country. I believe that is fundamental. I retain my prejudice for acting bilaterally, but if we are going to involve multilaterals we must have that intimate connection with the programmes.

I was as shocked as the Committee was disappointed when I discovered that it is not immediately obvious how much money is being spent in a particular country. When I asked those questions, about countries for which I am responsible, I found it hard to understand that a straight, easy answer could not be given. Having now looked at the problem I can understand that to an extent we are at the mercy of the time-lag reporting of large multilateral organisations, or of the fact that it is not entirely clear how much of the administrative, scientific and research costs of a large multilateral programme are allocated to each country, or how that is done.

I understand the problems, but clearly we must be able to address those, so that we know and I can say with confidence “Yes, we may have reduced the bilateral budget to Sierra Leone, but actually we are spending more there because I am confident that with what we have put into a multilateral programme we will be spending a clear and understood amount in the country.” So things are changing. We have already begun a system of mapping expenditure from the multilateral organisations back to the country, so that we can have a clear idea of what has been spent. I understand that that is a largely administrative, manual process. We are looking for a much better solution to the problem towards the end of next year, but it strikes me as vital to address that.

What happened in Sierra Leone and Liberia was a powerful illustration of what happens when a country does not have robust health systems. That leads to a question, as well as a criticism: we are the largest bilateral donor, and have been working for many years in Sierra Leone and spending a significant amount of money on health—so why were the systems so lacking in robustness and so quickly overwhelmed by the crisis? We have been investing in important health care options in Sierra Leone. We have been training staff, providing for drugs and spending money on infrastructure, but we have also spent a lot of money on a programme to deal with malaria. We should remember that many more people in the region will die of malaria this year than will die of Ebola.

[Anas Sarwar]

That very issue has been raised with me by various NGOs working on the ground in Sierra Leone. They fear that issues such as malaria have taken a back seat, despite malaria costing more lives than the Ebola crisis. They fear that the funding that was going to those issues—or even the priority given to them within the country—has fallen down the scale. Does the Minister accept that, and, if so, what is being done to make sure that more lives will not be lost because of it?

[Mr Swayne]

None of us should accept that. We must be vigilant to prevent that from happening to our focus on important long-term development issues, and I will certainly make it my business to prevent it.

The investment that we have put into Sierra Leone has, I believe, made a significant difference; but we started from a very low base. The figures given to us—the statistics on doctors and nurses per head of population—are very low, and well below the regional average. I think the figure is 1.7 nurses to every 10,000 of population—I do not have it to hand; that is from memory—against a regional figure of 12. It is a very low base, and, frankly, it would have been a lot worse had we not done the work we did.

Building robust health care systems is vital; but what does success look like? What is a strong health care system? I believe that, ideally, it is a free one. The hon. Member for Glasgow Central challenged me and asked what we were doing about advocacy for universal free health care. I am glad to tell him, in case he was not aware, that tomorrow is universal health coverage day. We are making a presentation and speaking at an important event tomorrow—when I say “we” I do not mean myself personally, but DFID—promoting exactly that.

[Anas Sarwar]

You should be there.

[Mr Swayne]

The hon. Gentleman is very kind; but quite right.

Clearly, it is important that health care, if not free, should be affordable—it should not impoverish the recipient—and available within a reasonable distance. When people arrive for treatment there should be someone there who will treat them and is trained to do so and able to deliver health care, whether by means of drugs or equipment, or anything else. That implies a level of funding to cover trained people who can distribute the drugs, of which there should be a guaranteed supply, and the availability of equipment. Also, taking up that health care should not make someone worse than they were when they sought the treatment. That implies sanitation, a water supply and electricity.

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[Anas Sarwar]

I am aware of the time, so I promise that this will be my last intervention. The Minister mentioned the Government’s presentation tomorrow, but my point was different. I was asking about advocacy not for what will happen but for what has happened. What advocacy are we carrying out on the international stage to demonstrate that we are the global lead on universal health coverage, and to make sure that it forms a key part of our sustainable development goals?

[Mr Swayne]

We have been negotiating with respect to the post-2015 agenda. We are, I think, by virtue of the fact that we have the largest free, universally provided health care system in the world, among the lead players. However, we have been in this business now for more than 30 years. We spend a quarter of our development budget on providing such health care, and it is vital that we drive forward that agenda.

How do we do that? It is horses for courses. Every country is different. When we create strong health care systems, we must recognise that countries require different kinds of support, depending on the state they are in. The Committee was right to say that we do not have effective measures to chart our success. We are leading funders in the field to identify such measures. We are funding high-quality studies and research to come up with ways to chart improvement in health care. The hon. Member for York Central (Hugh Bayley) drew attention to the QALY measure, which is used by DFID, NICE and NICE International. Clearly, there has to be much greater knowledge about what works, particularly in low-resource economies. We have invested, and continue to invest, considerable resources into such study.

Health care strengthening requires a number of partners, and I acknowledge that that involves a tension, to which the Committee has drawn attention and which has been evident in the debate. One accusation levelled at large vertical funds, such as Gavi and the Global Fund, is that they do little or nothing to strengthen underlying fundamental health care systems. I understand that criticism, and I think there are elements of truth in it. I am less persuaded by the argument that because the targets and deliverables of the large vertical funds are so much more measurable, deliverable and reportable, we skew our budgets away from fundamental health care strengthening and into vertical funds. There must be an element of synergy. I was interested to hear my hon. Friend the Member for Stafford draw attention to the fact that bed nets were delivered by large international organisations through existing health care systems. The same thing can happen with immunisation. We must do better at negotiating with the funds to ensure that is the case, but we must recognise that that is not their primary objective and that they have a significant input into world health.

I agree that we must work harder at making our own experience and expertise count in the councils of the world. We are shy, to an extent, as the Committee has pointed out, and we need to take more of a lead. We will explore with the Department of Health new ways of making better use of what the UK has to offer. I have already dealt with the point about recruitment in an intervention. We must not allow the agenda of health care strengthening to slip backwards; it is fundamental that we drive it forward. I accept the Committee’s challenge on providing global leadership. To that end, I accept the recommendations that we have accepted. Most importantly, we will develop a framework to support health care strengthening, to tie all those things together and drive the agenda forward.

Disability and Development

Anas Sarwar Excerpts

Thursday 11th December 2014 Westminster Hall

[Anas Sarwar (Glasgow Central) (Lab)]

I congratulate the International Development Committee on its tremendous report. I thank the right hon. Member for Gordon (Sir Malcolm Bruce), my hon. Friend the Member for Stretford and Urmston (Kate Green), and the hon. Members for Congleton (Fiona Bruce) and for Stafford (Jeremy Lefroy) for their excellent contributions. As time is short, I will not go over territory that they have already covered. I am sure the Minister will address the points that they made in his reply. As I said in the previous debate, it is important that DFID shows global leadership on this issue to ensure that a key part of our development objectives, both as a country and through our partnerships in multilateral organisations, relates to people with disabilities.

I want to share a couple of stats with the Minister. An Australian Agency for International Development study found that only around 3% to 4% of people with disabilities actually benefit from current international aid programmes, despite the fact that one in four households has a disabled member. For far too many disabled people, having a disability means they will never get an education, never go into employment and never live independently.

In developing countries, 90% of disabled children never attend school. Sadly, the education goal in the millennium development goals will not be met, because as Handicap International notes, 19 million disabled children globally still do not go to school. It was only in late 2013 that DFID announced that schools built with its funding would have wheelchair access. Will the Minister say how many experts on disability currently work in DFID? The recently published framework, which we welcome, says that the central disability team has more than doubled. How many people who define themselves as disabled work in this team? The same goes for the disability expert group.

Real expertise and resources will be needed to ensure that the framework becomes a reality, as the Committee Chairman said, so although I welcome the framework, I would like to see disaggregated costs on a programme-by-programme basis, showing how this will be funded. This is a 12-month framework, so its success will need to be measured within a year. How will DFID act on its commitment to develop indicators and other mechanisms that allow it to track its investments, particularly as regards the promises set out in the disability framework? This will include being able to see exactly how disability is being included in DFID programmes; how many DFID programmes are collecting data on disability; the extent to which DFID staff have the capability to include disability in their work; the extent to which DFID is able to engage with multilateral partners in this area; and what UK development non-governmental organisations funded by DFID are doing on disability.

This year will be critical in setting the foundations so that DFID can set ambitious targets on what can be achieved in the following years, post the one-year framework. DFID should guarantee that all services and infrastructure that it helps support is fully accessible for people with disabilities, including schools, hospitals and water and sanitation facilities. That needs to go far beyond physical accessibility to ensure that all forms of communication and information are also accessible, including to those with motor, sensory and mental health issues.

The Committee recommended that the Government include more disabled people and groups in the design, development and delivery of programmes. What steps are being taken to include a representative portion of disabled people, so that they are involved in programme development? How many people have been employed under the guaranteed interview scheme so far? On that point, I welcome the Government’s setting that scheme up and congratulate them on doing so. That scheme means that any disabled individual who meets the minimum requirements will be guaranteed an interview. I also welcome the promise to develop guidance for training staff. Which DFID staff will undergo training? Will they be staff at all levels? Who will perform the training? Will disabled people be involved in giving that training?

On the important matter of engaging with disabled people’s organisations, obviously many of those will already have a working relationship with other arms of Government, including the Department for Work and Pensions, so what work is being done by DFID and the DWP to try to help build those relationships?

As my hon. Friend the Member for Stretford and Urmston would testify, many disabled people’s organisations have a difficult relationship with Government because of some of the changes coming through on welfare reform. How do we make sure that the difficult elements of the relationship do not impact on the positive work that the Government and DFID can do with those organisations?

The Committee Chairman mentioned stigma and discrimination, which are key issues for disabled people and their families, especially in relation to their going into employment or education. What work will be done to develop our education programmes, to try to tackle some of the cultural barriers and the stigma? That will not happen overnight. It will require work over many years. It is worth considering supporting not just people with disabilities, but their carers, as we do in this country. What work will be done in developing countries to ensure that we support carers?

We should not fall into the trap of thinking that only elderly people have disabilities. Many young people have disabilities as well. Indeed, there will be many young carers, so how do we support them? A child with a disability is three to four times more likely to be a victim of physical or sexual violence. Violence against women and girls with a disability is of particular concern. What will DFID do to ensure that programme staff include gender-sensitive disability staff?

On private sector development, of course we welcome the desire to have more people going into work, but according to Sightsavers, 80% of disabled people are unemployed in developing countries. As we look to develop the private sector, what specific work is being done to encourage people with disabilities into employment? What support are we giving the private sector to encourage people with disabilities to come into employment? Do we have any figures on how many disabled people have been supported into employment by the work that the Department has done regarding private sector development?

Finally, disaster management, including the Ebola crisis, was mentioned in the previous debate; what specific action is being taken to make sure that rather than looking at vulnerable people as a whole, we consider protecting disabled people in particular during disasters? Disabled people are often left behind in a disaster. What specific measures on that are put in place in our framework? What specific training is given to people providing disaster relief to ensure that disabled people do not feel the biggest impact of a disaster?

As always, we would welcome a response from the Minister on all these points. I apologise for the number of questions I asked; it was due to the short time I had to speak. I would quickly like to thank the Committee for its report.

Oral Answers to Questions

Anas Sarwar Excerpts

Wednesday 5th November 2014 Commons Chamber

[Stephen Metcalfe (South Basildon and East Thurrock) (Con)]

2. What progress her Department has made on its work with the Ministry of Defence to tackle the Ebola crisis in west Africa.

[Anas Sarwar (Glasgow Central) (Lab)]

3. Whether pledges made by the international community at the “Defeating Ebola” conference in London on 2 October 2014 are being fulfilled.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

7. What steps she is taking to assist west African states in tackling the Ebola virus.

--- Later in debate ---

[Justine Greening]

I can. We can be very proud of the role the UK is playing: both the public’s response to the recent Disasters Emergency Committee appeal, which shows the British people’s generosity, and the work the Ministry of Defence is doing. I had the chance to see the Kerry Town facility as it was nearing completion a couple of weeks ago. It is opening today to treat patients and will save lives and stop the spread of the infection.

[Anas Sarwar]

The Secretary of State will know that the international community has a very proud record of making pledges when international crises happen, but a very poor record of delivering on the pledges. Given that every day delayed means more lives lost to the Ebola crisis, what pressure is she applying to the international community and all agencies to ensure that they deliver on their promises?

[Justine Greening]

The hon. Gentleman is right to raise these issues. The UN General Assembly and World Bank meetings were good opportunities for me to raise them, as was the recent EU Council, at which the Prime Minister successfully pushed to get more than £1 billion of support. We are now seeing many of the pledges made at the London conference come through. The most recent example is that the Norwegians will now be providing health care workers to help us operate some of those core facilities.

Syrian Refugees (Support and Aid)

Anas Sarwar Excerpts

Tuesday 29th April 2014 Westminster Hall

[Guy Opperman]

I endorse my hon. Friend’s point. We were lucky enough to go to the Nizip 2 camp, which is the gold standard of modern refugee camps, supported as it is by this country and others and by a multitude of aid organisations and charities. It is good at this point to say that we should make it clear that the work of the likes of Oxfam, Amnesty International and all the various charities involved is massively to be applauded. I am sure that the Minister will go on about the £600 million that this country is spending and I endorse and support that. That spending is popular in my constituency. Whether it is expressed by the churches in my constituency or at the pub quiz that I went to on Easter Sunday at the Feathers Inn in Hedley on the Hill, where they raised money for the Syrian refugees, there is a strong view that we are doing the right thing by supporting people in this way.

We saw in Nizip a strongly supported camp. My hon. Friend the Member for Huntingdon (Mr Djanogly) mentioned education. I went round the classrooms there, as several of us did, and saw how those involved were trying to provide education. I met Suleiman, a former engineer in Homs, who is now a teacher of year 6 and 7 children in the camp. He spoke movingly of the family members he had lost and of his desire, one day, to return, and about the difficulties of trying to provide education in a container or a tented camp on the Syrian border.

Aid is being provided outside Syria and I think that no one would dispute that this country is doing everything it possibly can in terms of the financial contribution and diplomatic and other efforts being made to ensure that the refugees, whether in Turkey, Lebanon or Jordan, are getting as much support as they can. We should make it clear that those three countries in particular have gone above and beyond the expectations of many and are to be supported and validated. It is noted that they have done a great deal to support the Syrian people.

I am particularly concerned about the situation inside—

[Anas Sarwar (Glasgow Central) (Lab)]

I congratulate the hon. Gentleman on securing this rather important debate. He rightly mentions the support in all our constituencies for the humanitarian assistance going to those outside Syria but of Syrian origin, and rightly mentions the lack of support inside Syria. I am sure that he welcomes the open letter today from humanitarian law experts, saying that there is no legal blockage to UN cross-border operations in Syria on a humanitarian basis. Would he support calls to the UK Government to back such operations?

[Guy Opperman]

I certainly want the UK Government to do more. I have not seen that specific letter, but I take what the hon. Gentleman says. I would like the UK Government to do considerably more to enforce the resolutions and the law that operates to allow international aid through. I have received briefings from a number of organisations, including UNICEF, Oxfam, Amnesty International, Christian Aid and many more. Amnesty, for example, makes the case that the Security Council must ensure that resolution 2139 is effectively implemented by both the Syrian authorities and the armed opposition groups and that non-compliance should result in further measures being taken. Amnesty cites the application of sanctions and full arms embargoes against any groups suspected of human rights abuses. One has to question whether more should be done, and I will try to address that question in a second.

There are strong obstacles, and I accept and endorse that, in the statement by the Secretary of State for International Development and the Foreign Secretary on 14 March 2014, the UK Government made it clear that they condemn those who are stopping such aid getting through. But the reality of the situation is that the vast majority of the parties on the ground, primarily Assad but also some extremist and opposition groups, are preventing that aid getting through, and we need to consider the further steps that the Security Council promised if non-compliance persisted after 30 days. Those 30 days have been and gone on two occasions. The last report was barely a couple of days ago. Although there have been small successes—I cite the 9 April 2014 delivery of aid to a besieged neighbourhood in eastern Aleppo and other small examples of ongoing aid that is getting into Syria—the vast majority of aid is not getting through. The consequences are significant. Frankly, the parties that are still in Syria believe there is no prospect of survival and are therefore looking to leave. The reality is that there is effectively ethnic cleansing because people are being forced out by another means. To a certain degree, there is no need to kill those people. If those people’s lives can be made so unbearable that they are forced to leave, Assad and others will think that they are going to win.

--- Later in debate ---

[Lynne Featherstone]

This country has an honourable history of receiving asylum seekers, and I am pleased that the first refugees under the new scheme arrived in March. Our young people are going to fight in Syria with what I hope are misguided good intentions. The Foreign Secretary and the Foreign and Commonwealth Office have made it absolutely clear that such activity should not be embarked on, as it is dangerous beyond belief and can lead to no good for those individuals or their families.

A destroyed childhood is a destroyed life, and as the crisis rages on, an entire generation of children is being shaped by this relentlessly brutal war that has ripped away every bit of normality. That will have long-term, profound consequences for Syria, the region and further afield—we cannot afford to let those children become a generation lost to conflict. That is why, right from the start of the crisis, the UK Government have highlighted the plight of vulnerable children and focused on ensuring that they have the basics they need to survive.

In September last year, the Secretary of State for International Development helped launch the “No Lost Generation” initiative, which is designed to galvanise a global co-ordinated effort to provide Syrian children with the education, protection and psycho-social support they so desperately need. Slightly off topic, but not very far off topic, is our work in Sudan. The loss of 20 years of education to the children of Sudan has affected the recovery there. As can be seen from the problems that Sudan is experiencing, a lost generation is something that we cannot afford.

Earlier this month, the Secretary of State convened a high-level summit to underline the critical need for renewed financial and political commitment for the “No Lost Generation” initiative and announced a further £20 million of funding for it, bringing the total UK support to £50 million.

[Anas Sarwar]

The Minister is rightly outlining some of the humanitarian assistance, particularly for children, happening around the Syrian conflict. Will she break down specifically what support there is in Syria? What additional support can go into Syria within the legal framework?

[Lynne Featherstone]

I will come to that. It is important to recognise the impact the refugee crisis is having on the host communities, which is why we are working with partners to ensure that host community needs are incorporated into all programmes. If the host communities are not supported, only the refugees are getting support, which causes all sorts of knock-on problems. The UK also gives £12 million of funding to targeted programmes to meet the specific needs of host communities.

Conditions inside Syria continue to drive the refugee crisis as neighbouring countries’ capacity to support growing numbers of Syrian refugees is limited. We are working hard to ensure that more aid is delivered inside Syria. The UK has allocated £249 million to partners to provide assistance to all 14 governorates of Syria. That is delivering food for approximately 380,000 people and helping to supply drinking water to more than 1.4 million people.

--- Later in debate ---

[Lynne Featherstone]

Indeed. I do not doubt my hon. Friend’s access to it; I am merely explaining that it was to have been released officially later today.

We need to maintain pressure on the regime and its allies. We need to maintain our dialogue with neighbouring countries, regional partners and the opposition. As the resolution makes clear, we fully intend to take further steps if the demands it sets out are ignored; I accept that they are being ignored. We will return to the UN Security Council to consider further measures. It is vital to the credibility of the Security Council that it acts when its will is so clearly undermined. I have heard loudly and clearly the message that my hon. Friend wants me to take back to my Secretary of State and to the Foreign Secretary about applying more pressure and going back to the UN Security Council to say, “This is urgent. These people are in desperate need. We cannot wait for things somehow to resolve.”

Obviously, things such as humanitarian corridors have been looked at, but they are simply not feasible at the moment. It therefore behoves us to press the UN Security Council to take further steps to put pressure on the Syrian authorities and on the opposition. The Syrian authorities could certainly be seen to be arbitrarily blocking access to refugees, particularly in opposition-surrounded areas.

[Anas Sarwar]

Would the Minister support UN cross-border humanitarian operations?

[Lynne Featherstone]

There is a legal discussion going on at the moment. The UK Government agree that providing partial humanitarian aid cross-border without explicit regime consent is not unlawful in circumstances in which the regime is arbitrarily denying consent for humanitarian access across borders over which it has no control and in the light of the fact that the regime is employing starvation as a method of warfare, which is against international law, against its own people. Such aid, however, must fulfil the requirements of humanity and impartiality.

On whether the UN should give cross-border aid, humanitarian agencies should deliver aid by the most effective route possible to get aid to those who need it. A decision on the UN going across borders without regime consent must be taken after consideration of not only the legal arguments, which we are having now, but the security risks and the risks of regime retaliation against humanitarian operations in other parts of the country where we are getting access to those who are in need. There could be reprisals and then more difficulties created, so worsening the situation.

We continue to urge the United Nations to do all that it can to ensure that aid reaches those who need it. It is indeed a hugely frustrating and dangerous situation, and a desperate one. Although there has been an important step forward, the UN report to the Security Council on 28 March made it clear that obstruction of humanitarian operations is going on in violation of the UN resolution. That is why, as I said to my hon. Friend the Member for Hexham, I will take the message back loud and clear that the UK Government need to consider what our next steps will be to press the United Nations on what further actions it might take. Baroness Amos will provide further details later today, although my hon. Friend already has the details of her proposals—I cannot comment on why his information is better than mine. I assure him, however, that the UK will do everything possible to provide humanitarian assistance to Syrian refugees in the region and outside Syria. We call upon other nations to contribute their fair share in this humanitarian crisis.

I thank hon. Members for their interest and concern about such a desperate situation. The Department for International Development, working hand in hand with the Foreign Office, will continue to focus efforts on ensuring that humanitarian needs are being met, while working hard to find a political resolution to the Syria crisis—although seemingly not in the offing, that is ultimately the only way in which the region will find peace.

Question put and agreed to.

Oral Answers to Questions

Anas Sarwar Excerpts

Wednesday 4th December 2013 Commons Chamber

[Mr Duncan]

At the Lough Erne summit, the Isle of Man, Guernsey and Jersey agreed automatically to exchange tax information on the basis of the Foreign Account Tax Compliance Act. All the overseas territories have said that they will conclude similar agreements with the UK. A pilot in the EU is developing the practice further. If accounts are more open and less hidden, poor countries will be in a much better position to raise their own taxes.

[Anas Sarwar (Glasgow Central) (Lab)]

Large multinational companies are avoiding paying tax in developing countries. Having tax transparency here can help to increase the tax receipts in those countries. When will the Government come forward with firm proposals to introduce country-by-country reporting right here in the UK?

[Mr Duncan]

The UK is leading by example. We are taking action to put our own house in order on this issue. We have announced that the UK will introduce new rules that require companies to obtain and hold information on their beneficial ownership. That information will be held in a central, publicly accessible registry maintained by Companies House.

International Development (Scotland’s Role)

Anas Sarwar Excerpts

Wednesday 4th September 2013 Westminster Hall

[Anas Sarwar (Glasgow Central) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Davies. I am delighted to have been able to secure this important and topical debate, given the continuing humanitarian crisis in places such as Syria, Palestine, Burma and elsewhere, and what that means in the context of the upcoming referendum in Scotland. I am also delighted to have so many hon. Members from Scotland here, and I hope that they will take the opportunity to intervene during the debate.

It is vital that, during these difficult economic times, we recognise the fantastic work that the UK has done and continues to do in promoting and supporting international development. We are all rightly proud of that work. Let us not forget that the Department for International Development does exactly what its title suggests. Yes, one of its roles is to respond quickly to crises—to feed, to clothe and to provide emergency health supplies—but, crucially, it is designed to help and support developing countries to lift themselves out of poverty, grow their economies and create prosperity and opportunity for their own citizens. That is why DFID is a force for good in the world.

I have more than my fair share of criticism of the Government, be it on the economy or on welfare, but we must all recognise and pay tribute to the efforts of successive Secretaries of State to protect DFID’s budget. It is the perfect example of how we can maximise our impact by pooling and sharing our resources. It demonstrates the positive and powerful voice for change of the people of the United Kingdom—be they from Scotland, England, Wales or Northern Ireland—and the powerful voice that they have through their seat at the top table.

Who can doubt the UK’s positive influence on international development? Not only do we play our part, but we lead the way shaping global priorities, fighting poverty and creating opportunity. That is one example, among many, of how our collective voice is stronger—stronger in the UN, stronger in the EU, stronger in the G8 and stronger in the G20. Let us not forget that it was a Scot who, in 2005 as Chancellor of the Exchequer, got the G7 group of leading economies to agree to cancel up to 100% of the debt that was owed to them by developing countries. As a result, the debts of 18 of the world’s poorest countries to the World Bank and the International Monetary Fund were wiped out as part of a $55 billion package.

[Mr Iain McKenzie (Inverclyde) (Lab)]

I congratulate my hon. Friend on securing this important debate, and it is indeed a pleasure to serve under your chairmanship, Mr Davies. Does my hon. Friend agree that Scotland, if it were separate from the UK, would lose out on the UK’s experience and influence in the world to deliver such projects?

[Anas Sarwar]

I am coming to that point in a second. Everywhere I have travelled to while serving on the Select Committee on International Development—whether it was Palestine, Rwanda or the Democratic Republic of the Congo—I have seen Scots who work for DFID leading teams and leading the difference that the UK makes to some of the hardest-hit places around the world.

The same Scot who was Chancellor of the Exchequer in 2005 later, as Prime Minister, put tax transparency on the agenda for the G20 in 2009. Many hon. Members will have received correspondence from constituents asking them to support the Enough Food for Everyone IF campaign, which calls on leaders of the G8 countries to take concerted action against global hunger. I highlight that campaign because it recognises the instincts of internationalism shared by people from all parts of the UK, who want to make a difference based not on nationality but on need.

As part of the UK, we play a leading role on the board of the International Monetary Fund and the World Bank. The UK has far greater combined influence when we speak with one voice than we could ever hope to achieve by speaking in isolation. It is not merely our position of influence that is a force for good. The combined budget of DFID this year is £10.7 billion—more if other departmental spend is included—which is used to deliver real change, lift people out of poverty and intervene to save lives.

Scotland is not simply part of the delivery but at the heart of it. DFID’s historic Scottish headquarters in East Kilbride, in the constituency of my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Mr McCann), has had a 30-year presence and employs more than 500 people to fight global poverty. The East Kilbride headquarters has developed from a transactional and corporate support function into a core part of the Department with responsibility for bilateral and multilateral projects. I take this opportunity to pay tribute to the staff in East Kilbride, many of whom I have had the pleasure of meeting when I have visited, for the tremendous work they do.

As we have found in debates about defence, or about civil service jobs in Her Majesty’s Revenue and Customs, there would be no simple transfer of Scottish-based jobs or services to a Scottish Government if the country voted for independence. Such jobs serve the whole DFID operation, which would have to be disentangled. It is inconceivable that a continuing UK DFID would locate a third of its jobs in what would become another country. The inescapable fact is that those jobs are at risk. For the Scottish National party to suggest anything else would be merely an assertion not backed up by reality.

[Dr Eilidh Whiteford (Banff and Buchan) (SNP)]

The hon. Gentleman wants to spread scare stories yet again about what would happen in an independent Scotland. He may have noticed that the Scottish Government have operated a policy of no compulsory redundancies in the parts of the public sector for which they are responsible. That policy has sadly not been replicated in the rest of the UK. Would the Labour party support a policy of no compulsory redundancies for Scottish public sector workers?

[Anas Sarwar]

In case you do not follow day-to-day Scottish politics, Mr Davies, you just heard the same old line that we get continually from the SNP about scaremongering. For members of the SNP, the definition of scaremongering is asking a question to which they do not have the answer. They do not know what will happen to the DFID jobs that I have mentioned, which is why the hon. Lady did not want to raise that point. Are we likely to have large bases of civil service jobs in France, Spain or Portugal, for example? Is the First Minister likely to locate a third of the jobs in the new Scottish tax service, which he launched yesterday, in Norway? No, he is not. He will base them in his own country, and the same principle applies to jobs in DFID.

[Dr Whiteford]

Will the hon. Gentleman give way?

[Anas Sarwar]

I will happily give way if the hon. Lady will make a point that is more relevant to the debate.

[Dr Whiteford]

The contradiction in the hon. Gentleman’s argument is that he has highlighted the positive role played by Scots all over the world, especially in international development, but suggested that in Scotland we would suddenly forget all that if we opted to join the international community as an independent country. Of course we would not. We would hope to work with DFID and with other countries to ensure that good development work continued.

[Anas Sarwar]

I agree with that point, and I will address it in a moment. The hon. Lady fails to understand that I am talking about 500 staff in Scotland who control a budget of £10.7 billion, which services the entire UK DFID programme, not Scotland’s share of it. It is not possible to escape from that dichotomy as the hon. Lady is, sadly, trying to do.

One reason why I am so proud of my Scottish heritage is the overwhelming sense of compassion that Scots have for those who are less fortunate than ourselves and the incredible passion we have for making the world a better place for everyone. According to a recent study by New Philanthropy Capital, people in Scotland give more to charity than those in any other part of the UK. That is not simply a Scottish value; it is a Labour value. By contrast, the SNP likes to paint a picture of independence in which, free from the shackles of the UK, Scotland can pursue its natural preference for progressive politics. Scotland does not need to look to an independent future to achieve a progressive contribution to international development. We can be proud of our progressive record to date as part of the UK.

[Dr Whiteford]

Before we all get too self-congratulatory, does the hon. Gentleman share my disappointment that the previous Labour Government failed to meet their 0.7% target? They have been shamed by the Tories, who met that target. All the missing aid over those years would have gone a long way to help people in developing countries by improving health, education and water and things that really make a difference.

[Anas Sarwar]

I seem to have pre-empted the hon. Lady’s intervention, because I was just about to say that Labour MPs from Scotland helped to secure majority Labour Governments in the UK that were committed to pushing international development high up the political agenda. Labour appointed the first Minister for overseas development. Labour established DFID with a Secretary of State in the Cabinet. Labour doubled and then trebled international aid. Labour secured debt relief. Labour set in place the 0.7% target that has been hit in 2013. We should be proud of that record, instead of trying to talk it down.

Scots can be immensely proud of their contribution to that record; millions more children are in school, mothers are giving birth safely and AIDS sufferers have access to life-saving medicines because of the decisions made by successive Labour Governments that Scots helped to elect. In Budget after Budget, and at international summit after international summit, a Labour Government fought on the side of the poor and the marginalised, transforming their lives for better and establishing Britain as a leading force for social justice in the world.

The UK has joined the select group of only five countries on the OECD’s development assistance committee that have reached the target of providing 0.7% of their national income in aid. It is worth noting that many countries the SNP holds out as examples of the benefits that accrue from independence are well below that target.

I care about reducing poverty and inequality not only in Scotland, but in other parts of the UK and across the world. Poverty has no respect for borders; I have yet to see an inequality that stops at a line on a map. That is why I recognise, as do others on the Labour Benches and, I am sure, right across the House, that pooling and sharing our resources across the UK is the best way of making a difference in the UK and across the world.

For me and the majority of Scots, our beliefs and compassion extend not just to people living within the borders of Scotland, but to people right across the globe. Members will be aware that a Scottish engineer, William Burton, developed one of the first drinking water systems in Japan. We all know the story of David Livingstone and about the close links that remain with Malawi. Those are just two examples, but fine ones, of how Scots have a long and proud history of making a difference in the world.

Scottish organisations are still making a difference today. DFID works with a number of leading Scottish charities to deliver its aid and humanitarian support programmes. It recently announced that Mercy Corps, which is headquartered in Scotland, and which is one of the top organisations specialising in disaster response, has been selected for a new UK rapid-response network. Another Scottish charity, the Global Alliance for Livestock Veterinary Medicines, recently received funding of more than £31.2 million from DFID and the Bill & Melinda Gates Foundation. Those are just two examples of the many Scottish organisations that work in partnership with DFID and deliver change around the world.

As a former member of the International Development Committee, I have witnessed at first hand some of the fantastic work DFID has done, and is doing, in places such as the Democratic Republic of the Congo, Burundi and Rwanda. In 1998, DFID gave Rwanda £20 million to help improve the Rwandan revenue authority; on average, Rwanda now collects that amount once every four weeks. Currently, DFID is providing £348 million in response to the humanitarian crisis in Syria—a fact we should all welcome.

The hon. Member for Banff and Buchan (Dr Whiteford) mentioned the Scottish Government’s commitment, and it is commendable that they have committed £9 million of their budget to international assistance. However, as part of the UK, Scotland, based on its population share—if that is the calculation we choose to use—contributes about £900 million. We have influence over, and control of, a budget of more than £10 billion, alongside a seat at the top table at the IMF and World Bank. There can be few more bizarre arguments in favour of independence than the one that says, “Let’s turn our backs on this. Let’s walk away from a budget of billions and a Department that is a force for good across the globe, with the second largest aid budget in the world.”

I have no doubt an independent Scotland would want to ensure that it maintained Scotland’s proud record of providing international development support; of course it would—the people of Scotland would insist on it. However, it is not clear how that would happen, because on this issue, as on other issues, the SNP does not have a plan. All DFID’s good work is at risk. The contribution Scots make to meeting our global obligations would be cast aside at the altar of independence.

In a recent article for The Herald newspaper, the hon. Member for Moray (Angus Robertson) said:

“Independence offers us the opportunity to make Scotland’s place in the world one that meets the aspirations of our people.”

Well, I believe the aspirations of Scots go well beyond the nationalists’ blinkered, narrow approach. Are we really saying that we could have the same impact and the same budget and that we would require the same number of jobs with a fraction of the budget? Are we really saying that we would have the same influence across the world if we were standing in isolation, instead of sitting at the top table when discussions are had and decisions are made? Only the nationalists could believe so.

What would happen to the DFID jobs in East Kilbride in a separate Scotland? What would happen to Scottish charities such as Mercy Corps or GALVmed, which work with DFID to deliver its aid and humanitarian support programmes? Would staff working in East Kilbride have to relocate, or would they be made redundant? How much would it cost the Scottish Government to set up their own dedicated Department for International Development, or how much would Scottish charities in receipt of DFID funding lose? Crucially, how much would an independent Scotland spend on overseas development? Surely, after having thought about independence for so many years—for all its existence—the SNP would have answers to such basic questions. The sad reality is that, before, the answer to every problem was independence; now that the issue is independence, however, the nationalists simply have no answers.

Given that the Scottish Government’s international development fund is so small, by what amount, if any, would it be increased? What would be the implications for people in extreme poverty and for developing countries? Which DFID programmes would continue to receive funding in a separate Scotland? Which would have their funding reduced or cut altogether? Those questions cannot just be ignored—they must be answered.

Those are just some of the questions the International Development Committee hopes to find answers to in its inquiry about the implications for development following possible Scottish independence. I welcome that inquiry, and I urge all colleagues across the House—from all political parties and all parts of the UK—to engage with the debate.

Those are important questions for the Scots working for DFID in East Kilbride. They are important questions for the Scottish charities working with DFID or in receipt of DFID funding. Most of all, however, they are important questions for those of us who abhor poverty and the wasting of life chances, wherever they occur, and who recognise that our responsibility is not just to those in need in our own towns and villages, but to everyone in our global village.

--- Later in debate ---

[Mr Duncan]

I believe that the United Kingdom would be weaker without Scotland, which is a clear answer to the hon. Lady’s question; I regret that she has been unable to give a clear answer to mine.

[Anas Sarwar]

The Minister has hit the nail on the head. Five hundred people in East Kilbride service £10.7 billion of aid across the world. Would 500 people be needed to service £900 million of aid?

[Mr Duncan]

I will leave it to the Select Committee to analyse that in greater detail, but I point out, more generally, that the hon. Member for Banff and Buchan (Dr Whiteford) has been unable to give a clear answer, despite the illusion and impression that she is trying to convey. I ask her once again: does she, or does she not, guarantee the jobs of those in Abercrombie house should there be independence for Scotland?