Universal Health Coverage

Jim Shannon Excerpts

Wednesday 10th July 2019 Westminster Hall

[Alistair Burt (North East Bedfordshire) (Con)]

I beg to move,

That this House has considered universal health coverage.

It is a great pleasure to serve under your chairmanship again, Mr Robertson, and to be here in Westminster Hall. I am pleased to have the opportunity to say a few words about universal health coverage.

Let me begin with one or two words of thanks. First, I thank Alison Stiby-Harris and, through her, all at Save the Children, which prompted me to seek the debate. I also thank all the colleagues who supported the effort to secure it, and the various agencies and supporters who have contributed to it through their briefings. Secondly, I thank the Library for its briefing pack, which of course is distributed far and wide—far beyond our boundaries. I thank Tim Robinson, Jon Lunn and Philip Brien for their contributions to it.

I also thank my former colleagues at the Department for International Development, who I know will have prepared the Minister for the torrid time he can expect this morning, and with whom I worked so joyfully before Brexit intervened. I thank them and all those they represent, here and around the world, for the immense contribution they make, not only to this area but to all other aspects of aid and development delivery. As I frequently told them and Foreign and Commonwealth Office colleagues around the world, life may be very difficult in some of the spots where they work, but without them things would be just that bit more difficult.

I will first set out the themes of universal healthcare and why I think it is so important, and then offer a few sobering facts and figures about where the world is, and point the way, with reference to what is being done, towards opportunities for the UK to continue to lead in this field, as I hope and believe it can. It is such a vast field that I cannot cover everything.

It is rather nice to start a debate, rather than to have the eight or 10 minutes at the end and have to respond to a veritable volley of questions from Front Benchers and others—not least the hon. Member for Liverpool, West Derby (Stephen Twigg), who we heard with great sadness will not be with us in the next Parliament. No doubt there will be plenty of opportunities to thank him for the contribution he has made. It is nice to have the opportunity to kick off a debate, but I will try to ensure that I do not abuse that privilege by going on until at least half-past 10, as I would love to.

Universal health coverage means that

“all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.”

That is the World Health Organisation definition, which embodies three related objectives. The first is equity in access to health services. Everyone who needs services, not only those who can afford to pay for them, should get them. Secondly, the quality of health services should be good enough to improve the health of those receiving services. Thirdly, people should be protected against financial risk, ensuring that the cost of using services does not put people at risk of financial harm. Universal health coverage cuts across all the health-related sustainable development goals, particularly SDG 3, and brings hope of better health and protection for the world’s poorest.

I am sure it is not difficult for us to explain to the British public why this topic has such resonance. Health is fundamental. Our nation’s commitment to a national health service, free at the point of delivery, is now such a staple of our lives that its principle needs little further emphasis. So it is around the world.

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. Gentleman on all he has done in the positions he has held, but it is good to see him leading a debate in Westminster Hall. Tuberculosis is the world’s deadliest infectious disease, killing more people each year than HIV and malaria combined. It affects the most vulnerable and marginalised—those with less money—and both the disease and the treatment have long-lasting consequences. Does he agree that it is imperative that we prevent rather than treat TB, since the latter leads to the emergence and spread of drug resistance, which is a real danger to individuals—especially the vulnerable—and to public health more broadly?

[Alistair Burt]

I am grateful to the hon. Gentleman for that intervention. He is a noble champion of many health causes, and of the rights of people across the world. TB is indeed a key part of the delivery of universal health coverage. I will cover it later in relation to our contribution to the Global Fund, but it is absolutely right that some of the diseases that we have begun effectively to marginalise in the United Kingdom are still a risk in many parts of the world, particularly for the poorest.

A healthy society is one in which children can fulfil their potential, mothers can give birth safely and the cruellest of preventable diseases, such as TB, can be tackled, with life and nation-changing impact, but to do this effectively, the world needs to tackle it collectively. Colleagues will know how important I hold collective multilateral activity by the world’s nations to be. As multilateralism seems under relentless threat from many quarters, universal health coverage reminds us that a common issue or threat is dealt with not by even the best-intentioned individual or bilateral action, but by pooling sovereignty and making collective effort, whether that is in vaccination, in the fight against HIV/AIDS, or in combating anti-microbial resistance. Collective effort also means creating partnerships between the public, private, and charitable and voluntary sectors, which all have a place. Efforts to exclude, or to advocate exclusivity for, one or other of those sectors need examining very carefully.

[Jim Shannon]

I thank the right hon. Gentleman for giving way again; he is being most generous. On collective responses, the UN’s high-level meeting on universal health coverage must build on the success of last year’s UN high-level meeting on TB and reaffirm the commitment to diagnose and treat 40 million people with TB by 2022. Does he agree that though our commitment to the Global Fund is a great first step by this Government and the United Kingdom of Great Britain and Northern Ireland, we need others to give the same commitment?

[Alistair Burt]

Indeed. Once again, the hon. Gentleman anticipates something I will come to later. Our 16% uplift in relation to the Global Fund is remarkable in itself, but of course it should be an example to others.

Efforts to build sustainability and to encourage and work towards health system strengthening around the world are really important. Although there will always be a need to respond to outbreaks or emergencies, basic healthcare and steady improvement are achieved not by continual external intervention, but by dedicated work to build, train and equip those who take national responsibility for their nation’s health. A DFID brief puts it as follows:

“Countries need strong health systems if they are to achieve Global Goal 3, and ‘ensure healthy lives and promote well-being for all ages’”—

that is SDG 3—

“and the target of UHC aimed at reaching the most excluded and living in the most remote locations, leaving ‘no one behind’.”

That determination to ensure that responsibility for health is rightly taken by a nation itself, and our view that our role is to enable such a transition in health to take place, helps us to explain in this country why UK aid and development assistance works, and why our commitment to spending 0.7% of gross national income is so important. Few question the role the UK plays in immunising millions of children around the world, including some 8 million victims of the war in Syria.