Health Systems (Developing Countries)

Debate between Hugh Bayley and Desmond Swayne

Thursday 11th December 2014 Westminster Hall

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

It is a pleasure to follow such a well informed, if interrogative, speech from my opposite number, the hon. Member for Glasgow Central (Anas Sarwar). I thank hon. Members for their constructive, measured, informed and, if I may say so, welcome criticisms. They stand in some contrast to those made in other proceedings that have taken place at Westminster today—although this debate is not about Ebola, it is certainly stalked by and informed by Ebola.

I am glad that the Chairman of the Select Committee, the right hon. Member for Gordon (Sir Malcolm Bruce), referred to the flags being out in Freetown, because I believe we have a record of which we can justifiably be proud. We have launched an operation with military precision. We have put 850 military personnel on the ground, in addition to the NHS workers whom I have already mentioned, to support 750 beds, of which 282 are for treatment and 468 are the key, important beds for isolation. We have isolation centres in which people can be isolated while we determine whether they have Ebola. Seven out of eight patients will go home after what was just a bout of fever, for example; the others will go on to receive treatment for Ebola. It is a remarkable operation, costing £230 million, of which we have already disbursed £125 million, and people should not be critical of it. In Kerry Town, we already have 52 operational beds.

[Hugh Bayley]

I strongly support what the Government and the military are doing, and tomorrow I will visit the Army medical training centre at Strensall to see the hospital that has been created there, in which people are trained to deal with infectious diseases such as Ebola in a tropical climate. It is not just UK military medical personnel who are trained in that centre; military medical personnel from other countries, including the United States, use it because it is a centre of excellence.

[Mr Swayne]

I hope the hon. Gentleman will convey the Department’s thanks to Strensall for the magnificent work it has done in providing build-up training to for many personnel before they deploy to Sierra Leone.

[Hugh Bayley]

indicated assent.

[Mr Swayne]

As I said, there are 468 key isolation beds. We are supporting more than 100 burial teams—both the logistics and training, and their fleet. That has had a remarkable impact on the incidence of the disease. As I said in an earlier debate, people are almost most infective once they are dead. Removing bodies and dealing with local burial customs has been one of the main drivers of the disease. In the western part of Sierra Leone, in which a third of the population lives, we are achieving 100% burial within 24 hours, which will make a key difference.

Of course, the criticism will be made that we acted too late; that we should have spotted the problem earlier. Hindsight is the most exact of sciences, but when the Committee went to Sierra Leone in June, it was not obvious that the problem was going to be of the scale we have now discovered. Actually, in January DFID had already begun refocusing our effort in Sierra Leone to deal with the emerging problem. In July and August we started to pump in more money to deal with that. I was making telephone calls, I think in the latter part of July, to the chief officers of UNICEF, the Office for the Co-ordination of Humanitarian Affairs and the World Health Organisation to try to ginger up their response. Many of those organisations are in need of reform. I have some sympathy for the World Health Organisation, which does not have at its centre the levers of power to bring about immediate change in the regions and countries in which it operates.

Equally, we must remember what was happening in the humanitarian community at the time. First, we were distracted by the terrible events in Gaza. Then, we moved swiftly on to rescuing people from Mount Sinjar, and all the time we had the ongoing crisis in Sudan. It has been a busy playing field for humanitarian organisations and workers to deal with.

Starting from where we are now, we certainly have a proud record. Clearly, there are lessons to be learnt, but, having looked at both the reports we are considering, there is no doubt that both Sierra Leone and Liberia are among the poorest countries in the world and that they were so even before they were struck by this disaster. Our aid reflects that: Sierra Leone remains one of the largest per capita beneficiaries of UK aid. In 2010-11 it received £51 million in bilateral aid, and £68 million in 2013-14. Owing to Ebola, I anticipate that that figure will inevitably fall next year—I suspect by about 30%—as a consequence of being unable to spend on the programmes we had identified. Of course, that will be completely augmented by the £230 million we are spending on Ebola.

I hope that 90% of our programmed spend on health will continue, but there will be instances where we will be unable to distribute bed nets in the way my hon. Friend the Member for Stafford (Jeremy Lefroy) described. There will be an effect on our programmes, but we will seek to minimise that.