Universal Health Coverage

Debate between Jim Shannon and Alistair Burt

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.

Syria

Debate between Jim Shannon and Alistair Burt

Monday 11th March 2019 Commons Chamber

[Alistair Burt]

I am grateful to the hon. Lady and I commend those who took part in the march and others. From the beginning of the conflict, we were clear about what had sparked it: the conduct of the regime and the way in which a desire for reform in Syria—not the removal of the President—was met with violence, and we remember the killings of children. That turned peaceful protest into something rather different. I am sure that several Members have seen the evidence collected by those who escaped from Syria with photographs of what had happened under regime control. Most recently, the regime itself has started to produce the death notices of those who had simply disappeared to provide some evidence of what happened.

There are therefore two issues. One is, as the hon. Lady said, to draw attention to the horror of the regime’s treatment of women—her comments on that are accurate and well documented. Secondly, as well as drawing attention to that and making the case that a regime that conducts itself in such a way cannot expect anything from its people, we need accountability. Although the physical conflict in Syria may come to an end, we must continue to press for justice for those who have been so ill treated. The UK has contributed £9 million since 2012 to various accountability mechanisms and NGOs that gather evidence and assist victims. We also support the independent UN commission of inquiry’s investigations into human rights violations and abuses in Syria. We will continue to do that. A line cannot simply be drawn under what has happened to the Syrian people. The abuse of women should not be forgotten.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his hard work and commitment, which many in the House and further afield deeply appreciate. He knows that and I want to put it on record.

One and a half million Christians have fled Syria to Lebanon and Jordan during the war. Three things need to be done for those Christians to return home. They need new safe homes; they require employment opportunities, and they desire freedom of worship in their churches, which need to be rebuilt and restored. What has been done to deliver those three absolutes so that refugees can have the confidence to return?

[Alistair Burt]

I am grateful to the hon. Gentleman for his comments. As we have discussed in the House previously, the requirements of the Christian community in Syria for safety and protection are shared by any other community there. We have been at pains to impress upon the region that no minority community feels safe unless there is a sense that the state will protect them so that they do not have to rely on individual militias. That is a long, slow process, but we are working steadily at it and we continue to contribute to everything that will provide for greater state controls, particularly in Iraq. In Syria, the process will be longer. Elements of the Syrian community were not disturbed by the regime’s control, while others were. Our general support for the fair and just implementation of the rule of law is clear.

I also commend my right hon. Friend the Foreign Secretary’s review, led by the Bishop of Truro, on Christian persecution. It is another opportunity for contributions to the subject and new ideas. Ultimately, the protection of all protects any community, and the UK is right to insist on that.

Nazanin Zaghari-Ratcliffe

Debate between Jim Shannon and Alistair Burt

Monday 7th January 2019 Commons Chamber

[Alistair Burt]

Sanctions are in place in relation to a number of figures in Iran—the Islamic Revolutionary Guard Corps in its entirety, and others—on human rights grounds. That course of action has already been taken by the United Kingdom.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Hampstead and Kilburn (Tulip Siddiq) on bringing this matter to the House and giving us a chance to participate. I also thank the Minister for his endeavours on behalf of everyone involved, but Nazanin Zaghari-Ratcliffe in particular.

Nazanin had threatened to go on hunger strike. She was then informed that her weekly phone calls to her child and her family would be withdrawn. That is undoubtedly the final straw, which demands that we do more to help her. Does the Minister not agree that it is the latest low blow against this British mother, and is completely unacceptable?

What more can be done to help Nazanin Zaghari-Ratcliffe? Can the UN help, for instance, or could other countries with which we have contact use their influence?

[Alistair Burt]

No one understands compassion better than the hon. Gentleman, who articulates it so clearly in the House on so many occasions.

We still think it best to handle this issue in a bilateral way, which is how we deal with a number of dual nationality cases. We do have contact with the system in Iran, and we are continuing to pursue that. We are very disappointed by the present circumstances, and we are deeply concerned about the humanitarian aspects—both Nazanin’s separation from her child and the current restrictions on medical care, which must be lifted as soon as possible. We will continue to press for that, using all our contacts bilaterally.

Ukraine-Russia Relations

Debate between Jim Shannon and Alistair Burt

Tuesday 27th November 2018 Commons Chamber

[Alistair Burt]

I am not aware of any plans to change any of the deployments that have been planned and considered. Of course, while we must continue to do exactly what we have said we will, no one is looking for any escalation in these circumstances.

[Jim Shannon (Strangford) (DUP)]

Ukraine-Russia relations have deteriorated to an all-time low. There have been evidential reports of the persecution of Christians in eastern Ukraine, occupied by Russia. Pastors of churches have gone missing and nobody knows their whereabouts, and churches have been desecrated and destroyed. I ask the Minister gently: has he had the opportunity to highlight and raise these issues with Russia, and to confirm support for Ukrainian citizens expressing their faith and worshipping their God in the way they wish to?

[Alistair Burt]

I am grateful for my hon. Friend’s question; no one could be a more determined supporter not only of the rights of Christians in other countries, but of freedom of belief and religion for all, which he champions. The United Kingdom believes that Russia must uphold its obligations under international humanitarian and human rights law, and we call on Russia to release immediately over 70 political prisoners detained in Russia and Crimea. I will ensure that his comments about minority faith prisoners and detainees are conveyed to the Minister responsible.

Idlib

Debate between Jim Shannon and Alistair Burt

Monday 10th September 2018 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his response to the urgent question. There is a strong and significant evidential base to show that Assad has given the green light to the gas attacks. I am certain that, as the Minister has said clearly, the Foreign and Commonwealth Office is doing everything diplomatically possible to prevent gas attacks, which would have an impact on innocent women and children. As the noose closes around Idlib, what additional aid and practical support will the Minister’s office make available to deal with what will undoubtedly amount to massive casualties?

[Alistair Burt]

Without going into detail, I say to the hon. Gentleman that whatever preparation can be made is being made. We are conscious of the risk, and as I indicated earlier, we are also conscious of the fact that should there be an attack, disinformation would be spread about it. We want to make every preparation possible to save lives and treat people should it become necessary, and that is certainly being done by providing the supplies that are available in the area.

Yemen

Debate between Jim Shannon and Alistair Burt

Monday 11th June 2018 Commons Chamber

[Alistair Burt]

Very few UK citizens are involved in the aid programmes; my right hon. Friend the Secretary of State has had a meeting on that, and they have been given the same information as others on the availability of leaving. Obviously, the circumstances of UK aid workers is a matter of priority, as are those of other aid workers. That is why we issued our warning notice.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his response. What talks are taking place between all those involved in Yemen’s daily life? Coming from Northern Ireland, I recognise the importance of all sides being engaged in talk-talk, rather than war-war. Where is the peace process?

[Alistair Burt]

The peace process is in the hands of the UN special envoy, Martin Griffiths. Since his appointment in March, he has been working hard to get through to both sides and find a way in which he can put a proposal to them. I understand that he is coming back to the UN Security Council shortly to do just that. It is possible that the events that are currently going on might concentrate minds and assist that process—we earnestly hope so.

Hezbollah’s Rocket Arsenal: Southern Lebanon

Debate between Jim Shannon and Alistair Burt

Wednesday 6th June 2018 Westminster Hall

[The Minister for the Middle East (Alistair Burt)]

Thank you, Sir Christopher, for calling me to speak and, as always, it is a great pleasure to serve under your chairmanship.

First, I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate, and other colleagues on their interventions and other contributions. I also congratulate my hon. Friend on the thoughtful and detailed way in which he set out the concerns, based on the report, “Hizballah’s terror army: how to prevent a third Lebanon war”, by the High Level Military Group.

According to sources in the region, Hezbollah’s military capability has grown significantly since the start of the Syrian civil war. I do not have precise figures to respond to my hon. Friend with, but reports suggest that Hezbollah could now indeed have as many as 100,000 rockets, including hundreds of advanced rockets with a range of up to 300 km. That is deeply concerning and a clear threat to the stability of the region. The premise of my hon. Friend’s debate is entirely correct and fully well founded.

In addition, Hezbollah is also in direct violation of UN Security Council resolutions 1559 and 1701, which my hon. Friend mentioned and which stated that there should be no weapons or authority in Lebanon other than those of the Lebanese state and that only the Government of Lebanon were permitted to authorise the sale or supply of arms and related materiel to Lebanon. I will say more about our detailed support for Lebanon in a moment.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for giving way, and I congratulate the hon. Member for Kettering (Mr Hollobone) on securing the debate—I also apologise to him for not being here earlier to hear his full speech.

The Minister mentioned the 130,000 to 150,000 rockets. Is he also aware of the 50,000 soldiers, including reservists, that Hezbollah has? Does he agree that Israelis are entitled to be concerned about the relationship between Lebanon and the Hezbollah terrorists? Quite clearly, there is a connection between the two at this moment in time, so Israel has every right to have fears.

[Alistair Burt]

Yes, Mr Speaker—sorry, Sir Christopher. I am giving you an elevation there—in due course.

In response to the hon. Gentleman’s intervention, yes, the premise of the debate is correct; there is no argument about that here. Hezbollah is a dangerous and destabilising force. It sits on the northern border of Israel. Israel has every right to be concerned and to seek support in relation to dealing with that. That is what I would like to explain in terms of the United Kingdom’s relationship here.

I confirmed the United Kingdom’s support for the position in UN Security Council resolutions 1559 and 1701 when I was at the International Support Group for Lebanon meeting in Paris last December and at the Rome II ministerial conference on support to the Lebanese security forces in March. The joint statements that followed those meetings, which were agreed by a large cross-section of the international community, emphasised the role of the Lebanese armed forces as the sole legitimate armed force of Lebanon. I should add that Israeli overflights of Lebanon also violate UN Security Council resolution 1701 and contribute to increased tension in the area. The activity by Hezbollah risks triggering a conflict between Hezbollah and Israel on a scale far beyond that seen during the 2006 war. That could devastate Lebanon and further destabilise an already vulnerable region.

The UK has made clear our concern at Hezbollah’s destabilising actions in Lebanon and the region. We operate a policy of no contact with the entire organisation, and we have repeatedly condemned the group’s support for President Assad’s brutal regime in Syria.

Nazanin Zaghari-Ratcliffe

Debate between Jim Shannon and Alistair Burt

Tuesday 22nd May 2018 Commons Chamber

[Alistair Burt]

No.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answer to the urgent question. Does he not agree that the time has come to use all our diplomatic influence, and can he confirm what action we can take with our allies collectively to bring about an end to the brutal emotional and physical persecution—it is nothing short of that—of Mrs Nazanin Zaghari-Ratcliffe?

[Alistair Burt]

As always, the hon. Gentleman speaks from the heart, and his point certainly needs to be considered in this case. The humanitarian circumstances have been made clear to the Iranian authorities. This is a woman separated from her child some time ago. As the House knows, I have met the daughter and family in Tehran, and I am well aware of the circumstances. We make the case on the humanitarian basis as much as we can to indicate the pathway forward, and the UK will continue to do so in a manner that the House would expect and understand.

Libyan-sponsored IRA Terrorism

Debate between Jim Shannon and Alistair Burt

Thursday 10th May 2018 Commons Chamber

[The Minister for the Middle East (Alistair Burt)]

First, I thank my hon. Friend the Member for Tewkesbury (Mr Robertson) for securing the debate and echo the tributes paid to him by a number of Members for his long-standing commitment and work on this issue. I couple that with my thanks to all those who have taken part in the debate, many of whom have contributed to this issue over a period of time—for too long. Those include the hon. Members for Vauxhall (Kate Hoey), for Jarrow (Mr Hepburn), for Poplar and Limehouse (Jim Fitzpatrick) and for Strangford (Jim Shannon), my hon. Friends the Members for Romford (Andrew Rosindell), for South Suffolk (James Cartlidge) and for Beckenham (Bob Stewart), and the hon. Members for Glasgow North (Patrick Grady) and for Leeds North East (Fabian Hamilton).

This is a difficult debate. The ultimate justice and the basic facts are not in dispute among us. Without going into the answers to all the questions raised by the hon. Member for Leeds North East, which I will give him, the evidence is sufficient for us to speak today with confidence that Semtex and other materials supplied by the Gaddafi regime into Ireland and on to the mainland of the UK were responsible for IRA-based terror. The Government do not seek to dispute that in any way. There is also no dispute about the sympathy for victims, which has been echoed around the Chamber.

We are left with the complex issue of what to do. If this was straightforward and simple, it would have been sorted, but it is not. It joins one or two other issues that, in the past, have been considered almost too difficult to solve, and we may be getting into that sort of territory.

Let me say a little about the Government’s position, which will answer some of the questions raised, and then I will turn to some conclusions. At the end, I will give my hon. Friend the Member for Tewkesbury a moment to wrap up.

The Government have the greatest sympathy for the victims and their families, many of whom, as we have heard it eloquently put this afternoon, continue to live with the devastating physical and emotional consequences of these attacks. They are, quite understandably, determined to seek recompense for what they have suffered. It is right that we in the Government do our utmost to help them seek a solution, and we will continue to do so.

Today’s debate is timely. As a number of Members are aware, I have recently been in Libya to fulfil, I trust, that part of the Foreign Secretary’s commitment on behalf of the FCO to do what we can to be more visible and to tackle things directly. In my discussions with the Libyan Ministers for Foreign Affairs and for Justice, I explained that although victims of some other Gaddafi- sponsored attacks, such as the Lockerbie bombing, had received compensation from the Libyan authorities, victims of Gaddafi-sponsored IRA terrorism had not. I told them that victims, their families and the UK Government feel incredibly strongly about that and that the Government attach great importance to finding a resolution.

Just in passing, to answer the question why other people got compensation, it is not correct to say that the UK Government do not and did not negotiate on behalf of victims. The Government helped to secure compensation for the victims of the Lockerbie bombing and for the family of WPC Fletcher. Compensation was possible in those cases because of evidence that the attacks were planned and executed directly by the Libyans. While we are not formally espousing the claims of victims of Gaddafi-sponsored IRA terrorism, we do continue to impress on the Libyan authorities the importance of making progress on this issue, and we have done that where we felt it was possible to do so.

I urged the Libyan Government to demonstrate that they were taking these cases seriously, and I suggested that they consider meeting victims and their representatives to discuss a possible way forward. Both Ministers I spoke to expressed sympathy with the victims and their families. However, they also spoke of the many urgent political, security and economic challenges that Libya is facing. They made it clear that this is a particularly difficult time to discuss legacy cases and compensation.

I can assure the House, as Members would expect me to, that I made it very clear, as I and other colleagues have in the past, that this is a priority for the UK Government. I have since written to both Ministers to reiterate that and to reiterate further the importance of a meeting between Libyan representatives and victims’ groups.

[Jim Shannon]

I am conscious when I ask the Minister a question that he is a Minister who wants to give us the answer. If a bombing takes place that involves Semtex, one conclusion would be that it was an IRA bomb and came from Libya. If somebody is shot with an AK-47, it would be a good conclusion to draw that that was also the IRA and that the gun came from Libya, or, if it was a rocket-propelled grenade launcher, that that came from Libya. The instruments of war indicate where these things come from.

[Alistair Burt]

I am not in a position in any way to dispute what the hon. Gentleman says. There may well be some issues, if we look at compensation as a whole, about distinguishing between different groups, but that is a slightly different issue. However, we are clear what we are talking about here: there is enough evidence, and there will be victims of Gaddafi-sponsored terrorism Semtex who we can all be very clear about.

Oral Answers to Questions

Debate between Jim Shannon and Alistair Burt

Tuesday 27th March 2018 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

4. What recent assessment the Government have made of the effect on stability in the middle east of Iran’s ballistic missile programme.

[The Minister for the Middle East (Alistair Burt)]

We make clear our concerns about Iran’s destabilising regional activity, ballistic missile programme and support for the Houthis in Yemen. Increased dialogue, such as my right hon. Friend the Foreign Secretary’s visit to Tehran in December and my hosting of Deputy Foreign Minister Araghchi last month, enables us to engage Iran on these challenging issues.

[Jim Shannon]

I thank the Minister for that response. Since the nuclear deal was signed some three years ago, Iran’s hard-liners have benefited from sanctions relief and the country has tested at least 23 ballistic missiles, while human rights abuses have continued unabated and Iran continues to finance terrorist proxies and regimes in the region, including Hezbollah in Lebanon and Hamas in Gaza, so does the Minister agree that the nuclear deal has not yet curbed Iran’s regional aggression, and how does his Department intend to rectify that?

[Alistair Burt]

The hon. Gentleman’s question neatly encapsulates the dilemma in relation to Iran and its future. On the one hand, it has adhered to the provisions of the Joint Comprehensive Plan of Action—to that extent, that issue of the development of a nuclear weapons capability is being dealt with—but on the other hand Iran’s activity still causes great concern. We do engage with Iran directly on those issues and they are known in the region. We believe there are better ways for Iran to demonstrate its relationship with the rest of the region, and we look forward to that.

Oral Answers to Questions

Debate between Jim Shannon and Alistair Burt

Wednesday 17th January 2018 Commons Chamber

[Alistair Burt]

As the House knows, we constantly challenge the Palestinian Authority in relation to anything that might encourage or glorify violence. I can assure the House that we ensure that no payments are made to those who have those connections. We do all we can to encourage the Authority to understand that naming places after those who have been involved in terrorism does not contribute to the peace process.

[Jim Shannon (Strangford) (DUP)]

T2. Will the Secretary of State conduct an independent review of DFID aid delivery mechanisms in Iraq in order to evaluate reports that UK aid is not reaching vulnerable religious minorities?

[Alistair Burt]

We look very seriously at any such allegations. There is a constant review in the Department to ensure that some of the challenges that come in on religious discrimination are evidenced. I challenge the agencies as well, and we will continue to do this. We do not have evidence of significant discrimination, but we are always on the lookout for it.

UK Victims of IRA Attacks: Gaddafi-supplied Semtex and Weapons

Debate between Jim Shannon and Alistair Burt

Thursday 14th December 2017 Westminster Hall

[The Minister for the Middle East (Alistair Burt)]

It is a particular pleasure to serve under your chairmanship in a debate such as this, Mr Gapes, knowledgeable as you are of foreign affairs. You will know the issue extremely well, so it is good to see you in your place.

I thank all hon. Members for their contributions. I particularly thank my hon. Friend the Member for South West Wiltshire (Dr Murrison) for securing the debate and, through him, all the Members of the Northern Ireland Affairs Committee for their continuing commitment to supporting the victims’ cause in Parliament. I thank other colleagues for their pertinent contributions today, which give plenty of food for thought.

As the hon. Member for Bishop Auckland (Helen Goodman) was gracious enough to acknowledge, when we look back at the past and the opportunities that might have been missed, this is not a great chapter for any Government, but it is important to remember that these events were not brought about by the British Government; the report refers to a period of time when Gaddafi was supplying weaponry to the IRA. I gently say to my hon. Friend the Member for Strangford (Jim Shannon) that it was not the Libyan people taking action against the people of Northern Ireland or the United Kingdom. It was Gaddafi following his own determination and his political beliefs at the time, and that makes it difficult when we are talking about retrospective balance between those who were victims of Gaddafi in Libya and those who were victims of Gaddafi here. I visited Abu Salim jail. I have seen the place where Gaddafi machine-gunned about 1,200 people in an act of revenge for some attack on his regime. Part of the instinct behind the communal fund, which we will come on to, is to recognise that the people in both places suffered under that man. That is why attempting to find a way to recognise that in a manner that benefits all victims has been so important.

[Jim Shannon]

All Members who made a contribution mentioned the conversation that the United States Government have had. They made a very clear distinction. Why can we not make the same distinction? I respect the Minister greatly, and he knows that, but I have to speak on behalf of my constituents in Northern Ireland. The US Government have done it. Why do we not do the same?

[Alistair Burt]

Perhaps I can come on to the United States situation a bit later. Distinctions between types of victims are difficult, and I will come on to that a little later on. First, let me put something on the record in relation to our current policy. I recognise the force of today’s debate, of the conversations that the Foreign Secretary has had in my presence, and of the discussions that I have had as well. This is a difficult area of policy, and it may not be finally settled.

I would like to take the opportunity once again to express on behalf of the Government sincere condolences to all those who have suffered as a result of the horrific attacks carried out by the IRA, and to all victims of the troubles. The Government want a just solution for all victims of Gaddafi-sponsored IRA terrorism, and we will continue to do all we can to make progress on that important but difficult agenda. The Government have raised the plight of victims of Gaddafi-sponsored IRA terrorism with the Libyan authorities at the highest level. The Foreign Secretary raised their cases with Prime Minister Sarraj during both of his visits to Tripoli, most recently in August this year. I intend to follow up on those conversations when I next travel to Libya.

Between 2010 and 2013, when I travelled to Libya I always raised the issue of compensation because it was a live issue back then. I raised it with either the then Attorney General or the then Solicitor General in Scotland—I cannot remember which—whom I got to know in relation to this matter. It was always on the agenda in the period of time after the fall of Gaddafi. The Libyan Government were obviously in a state of flux at that time, which of course has continued, hampering all our efforts, but it was important to put the claims on the record right the way through, and I sought to do so.

The Foreign Secretary and I welcomed our constructive recent discussions with parliamentarians, and I have recently met with victims groups to discuss their thoughts and concerns face to face. I very much hope that we can continue to engage openly and frankly, and I am sure that we will. That will give us the best possible chance of securing justice for the victims of these terrible attacks.

Clearly, the Libyan Government have a responsibility to deal with the legacy at the heart of the Gaddafi regime, as part of a broader process of national and international reconciliation and justice. The UK Government continue to impress upon the Libyan authorities the impact of Gaddafi’s support for the IRA, and we emphasise the importance we attach to responding to victims’ campaigns. We continue to judge, however, that engaging constructively with the Libyan Government remains the best way to make progress. As our response to the Select Committee report demonstrated, we maintain the long-standing policy of previous UK Governments not to espouse victims’ claims.

Hon. Members who took part in the recent meeting with the Foreign Secretary will be aware that that issue was discussed in some depth. They will also be aware that the Foreign Secretary committed the Foreign and Commonwealth Office to being more visible in efforts to support the victims’ campaigns and to ensuring that the issue remains a priority in our discussions with the Libyan Government. The hon. Member for Poplar and Limehouse (Jim Fitzpatrick) spoke about how that more visible attitude might be demonstrated. I am going back to Libya, for the first time in some years, early in the new year. We are actively seeking to explore the possibility of a meeting between the Libyan Minister of Justice and victims groups; we have recently written to the Minister about that. The meeting might take place in Libya, but that could be difficult, so it could be held in Tunisia or some other place. We are actively pursuing that idea as a way of doing something new and adding something new to the situation.

Questions were raised about whether we have abandoned the idea of a fund to compensate individual victims. We have carefully considered that option, but continue to believe that individual claims are best negotiated directly between victims and the Libyan authorities. We will continue to support victims to help to facilitate that, and we will raise their cases with the Libyan authorities at every opportunity. Even if the Libyans were at some point in the future to put aside money for the purposes of compensating UK victims, we believe that administering such a fund would be extremely difficult. There is currently no clear definition of a victim of IRA terrorism sponsored by Gaddafi as opposed to a victim of terrorism more generally.

Hon. Members who were present at the recent meeting with the Foreign Secretary will be aware that that issue was discussed at length. My impression is that at the end of the meeting we believed that, given the difficulties of drawing distinctions between different types of victims, the best kind of support would be a communal fund, focusing on community support, rehabilitation and reconciliation, that was available to all victims. It would not be confined to Northern Ireland, to respond to the concerns of the hon. Member for Poplar and Limehouse. It has not been drawn up in any way yet, but it would attempt to recognise the difficulty of separating one victim of the troubles from another, and to bring people together. Giving specific help to specific people who have been damaged, as the hon. Member for Strangford clearly described, would be an important part of it, so he would be providing something for his constituents, but in a communal fund that would be accessible to more people, rather than just through individual compensation.

[Alistair Burt]

Let me respond as best I can to those two comments. I take the hon. Gentleman’s point about the meeting, but my sense is that there would be sufficient victims and victims’ representatives who would be prepared to take part in such a meeting. It would not be an unmoderated meeting and, of course, I would expect us to be there in some form, whether through embassy officials locally or senior officers from here; in those circumstances, there would probably also be a Minister. I do not think it would be appropriate to ask a Minister from another state, unconnected with all this, to deal with the issue without one of our Ministers being prepared to support those who had come from the United Kingdom. I am sure that we could handle that, but I accept his point that for some people such a meeting would be too difficult and not possible.

In relation to the hon. Gentleman’s other point, there is no suggestion that because the fund has not yet been created or put together, it would be confined to one place rather than another. If the point is to find something that will benefit victims wherever they have been, it must of course apply to mainland UK as well as Northern Ireland. I do not think that those in other countries have had to make an individual distinction between a victim of Gaddafi-sponsored terrorism and a victim of a terrorist atrocity from another source. That is something that we find difficult and, as we have discussed, we all understand those difficulties.

[Jim Shannon]

To follow on from the point made by the hon. Member for Poplar and Limehouse (Jim Fitzpatrick), it is quite clear to me, and I suspect to everyone in the Chamber, that if someone was blown up by Semtex, or there were an explosion in which Semtex were used, it was Gaddafi-inspired and sponsored terrorism. If they were shot with a bullet from an AK47, that was Gaddafi-sponsored terrorism. If they were shot by a self-loading rifle, an SA80 or something different, that certainly was not Gaddafi-sponsored terrorism. If we want a factual, historical way of collating what has taken place, I suggest that the weapon or bomb used is an indication of where it came from and its intention. It is therefore easy to diagnose. Forgive me, but I see it very simply. If someone was blown up with Semtex in London or shot by an AK47 rifle in London or anywhere else, that is Gaddafi-sponsored terrorism.

[Alistair Burt]

I understand the hon. Gentleman completely. It is not difficult to make a distinction based on cause of death, but is he saying that there would be a different system of compensation, and that someone who lost their life in circumstances identifiably traced to Gaddafi would have access to one fund, but those who died in other circumstances would not? That is what successive Governments have found difficult, because the impact of the loss of life due to a terrorist incident is the same, whatever the cause was. It would be difficult to have a fund that distinguished victims and gave some victims and their families access to something that others are denied.

[Jim Fitzpatrick]

It is patently unfair that some victims may not get compensation and others would. The distinction we are drawing, in the absence of a UK fund to compensate victims of terrorism per se, is that the Libyans have paid other Governments in other countries money to compensate their victims. Apparently, we have not been making the same efforts to get Libyan compensation for our victims. If we can get that for the victims who can be identified, let us get them compensation. The British Government ought to be looking after the other victims of terrorism, as I hope they do, from whichever source the terrorism outrage comes.

[Jim Shannon]

rose—

[Alistair Burt]

I am happy to take the other intervention if it is on the same topic.

[Jim Shannon]

The hon. Member for Poplar and Limehouse (Jim Fitzpatrick) has clearly hit the nail on the head. The United States Government made the distinction. There is a way of making the distinction. They did it and have shown us how to do it, and I suggest that we do the same. They have done it, and so can we.

[Alistair Burt]

Of course, in the particular case of the Lockerbie victims, the UK Government intervened directly to secure compensation. However, as we have discussed, individual compensation is being pursued through private claims, and we have sought to facilitate that work through our contacts and everything we have done in relation to that. We still believe that that is the most appropriate thing to do, and that is why we deal directly with the Libyan authorities. We have approached individual compensation differently. The allocation of the compensation fund illustrates the difficulty of individual compensation, but of course if such claims are successful, that deals with that issue. However, as successive Governments have done, we have supported the individual pursuit of claims rather than doing on it on a Government basis. That is different from those who have chosen to do it another way—that is quite right. That is the process we have chosen, and that is the process we are continuing to support.

World AIDS Day 2017

Debate between Jim Shannon and Alistair Burt

Tuesday 5th December 2017 Westminster Hall

[The Minister of State, Department for International Development (Alistair Burt)]

It is, as always, a pleasure to serve under your chairmanship, Mr Hollobone. I thank the hon. Member for Cardiff South and Penarth (Stephen Doughty) for securing this important debate to commemorate World AIDS Day. I thank all hon. Members who contributed; this subject unites everyone in the House, including my hon. Friend the Member for Aberdeen South (Ross Thomson), the hon. Members for Ealing, Southall (Mr Sharma), for Strangford (Jim Shannon), for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), for Stockton South (Dr Williams) and for East Lothian (Martin Whitfield), and the two Front-Bench spokesmen, the hon. Members for Dundee West (Chris Law) and for City of Durham (Dr Blackman-Woods). They asked a range of questions. In the time available to me, I will not be able to cover them all, but in the time-honoured way, my Parliamentary Private Secretary has very kindly got a note of everyone who is here, so I will cover the questions I do not answer by way of letter. I will make sure the answers get out there.

This is an opportunity for colleagues to reflect on where we have got to. I am grateful to the hon. Member for Cardiff South and Penarth for mentioning the Lord Speaker, who did so much when he had the opportunity to do so, and the haunting quilt. It was particularly noticeable when there was the odd square of anonymity because somebody still did not want to reveal something. I think of the pain behind that expression, of what people have been through in the past, and of what some people still go through. The fact that they are unable to talk about it, when for many of us it has become much easier to deal with and talk about, is a measure of the pain behind some of those issues.

None of us has the experience of the hon. Member for Stockton South. We all noted his work in Uganda, where he used his commendable skills in the best possible way. I still remember visiting AIDS orphans in South Africa with my daughter at a time when it was very clear that the babies could not be kept at home because of the shame and stigma attached to the disease, so they were just dispatched. I remember thinking that the nurses looking after them were making an extraordinary contribution. The afternoon that we saw them, my daughter and I said we did not know what we could do in life that would possibly be as valuable as the love that those people demonstrated towards those children. That was 20-odd years ago. Time has moved on and we are doing so much more.

Let me reflect a little on the progress that has been made, which colleagues mentioned, and then answer some of the tougher questions that come the way of a Minister. It is all part of the day job, even for an issue on which we are all broadly moving in the same direction. I commend the hon. Member for Cardiff South and Penarth for his speech, and the work of the all-party parliamentary group on HIV and AIDS, which has achieved so much over the years. I thank him for advance sight of the questions in his speech. It was much appreciated.

We have come a long way since the first ever World AIDS Day in 1988. We now have 20 million people with access to potentially life-saving HIV treatment—a big improvement on the year 2000, when less than 1% of those in need had access. We can be very proud that the number of new infections in children has also dramatically declined. It is important to put on the record the UK’s contribution to those achievements. Colleagues have been generous about that, and of course it covers Governments of all persuasions. The UK continues to play its role. We are proud to be the second-largest international funder of HIV prevention treatment and care. That work is impossible without our partners, through which we invest. Our contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria helped to provide more than 11 million people with antiretroviral therapy by the end of 2016. Our significant pledge of £1.1 billion to the fifth replenishment of the global fund will now help provide enough life-saving antiretroviral therapy for 1.3 million people living with HIV.

Our investments in research and support to Unitaid help improve access to medicines, diagnostics and prevention for those affected by HIV in low-income countries by bringing promising new health technologies to scale faster and more cheaply. The hon. Member for East Lothian was right to raise the importance of carrying on with such research. We must also recognise UNAIDS for its continued leadership of the global HIV response, for pushing for ambitious global targets to stop new infections and to ensure everyone living with HIV has access to treatment, for protecting and promoting human rights, and for producing the data we need for decision making.

Civil society with its links to communities and people living with HIV also has a critical role to play in leading the social movement for prevention, championing the rights of the most at-risk populations and those living with HIV, providing care and support services to communities that others are simply unable to provide, and—vitally—holding Governments to account.

[Jim Shannon]

In our contributions, some of us have recognised the good work of Churches and missions across the seas and at home. For the record, does the Minister too recognise the importance of their input physically, financially and emotionally into making the changes?

[Alistair Burt]

I do. The hon. Gentleman’s connections with Churches and Church movements not only in this country but worldwide are well known. Absolutely, that is an important point to put on the record because to some extent it sets the record straight about the commitment of the Church and Christian communities to this particular sort of work, which is important. In some parts of the world, only the Church network is there to provide social care across the board. We would all be the poorer without being able to support that.

Mention was made of the Robert Carr civil society Networks Fund, of which we are proud to be a founding member. I cannot give a further commitment at this stage—we are yet to announce it—but I recognise the issue and we will come back to say what the future funding position will be in due course. I have noted what colleagues have said.

There is also greater shared responsibility from low and middle-income countries. Domestic resources constituted 57% of the total resources for HIV in low and middle-income countries, which is a step in the right direction, but more needs to happen to build a sustained response. As good as that is, as all colleagues have said, there is much more to do, so let me deal with some of the questions I was asked.

In terms of the broad strategy, the UK’s ongoing HIV commitment is that we want to see AIDS ended as a public health threat by 2030. That is an important priority for us. We are proud to be the second-largest international funder of HIV prevention, treatment and care, as I have said, and as a leading donor we will use our influence to ensure that we collectively deliver on the global commitment—to end the AIDS epidemic as a public health threat by 2030—and that no one is left behind.

In relation to the gag, we will continue to show global health leadership by promoting and supporting comprehensive, evidence-based sexual and reproductive health and rights. We are the second largest donor for family planning assistance and we are the largest donor to UNFPA, the United Nations Population Fund, so we will skirt around issues raised by the gag.

On a new HIV strategy, the note I have states that the 2013 review of the UK position paper on zero infections identified the integration of HIV as the key strategic priority. We intend to continue that approach, rather than to develop a stand-alone strategy or conduct a further review. However, I have heard what the House has said, so let me reflect a little on that, as I will on the Youth Agenda point—whether HIV is included. It is not currently. Clearly, the Youth Agenda is a very important part of our strategy and we recognise, as all in the Chamber do, the significance of adolescent girls in particular and the related issues. Again, let me have a look at that to see whether we can say anything further about it. I will come back to colleagues in due course.

For women and girls generally, it was right to recognise the heightened risk. Empowerment of women and girls lies at the heart of our development agenda. DFID is supporting the generation of new evidence to improve outcomes for women and girls, including the development of female-initiated HIV prevention technologies, research into how gender inequality drives epidemics, and a particular focus on improving what works for adolescent girls in southern Africa.

The UK is also working with the global fund to increase its focus on girls and women, which I think is in accordance with the House’s wishes. Giving greater attention to women and girls is a shared priority for us and the global fund. With UK support, the global fund has embraced gender equality as being central to accomplishing its mission of ending the three diseases as epidemics, including it as one of its four strategic objectives in the 2017 to 2022 strategy. Between 55% and 60% of global fund spending directly benefits women and girls. That includes programmes to prevent gender-based violence and to provide post-violence services. The number of HIV-positive women since 2002 who have received services to prevent transmission of HIV to unborn children has reached 3.6 million, and we will continue to press on that.

Yemen

Debate between Jim Shannon and Alistair Burt

Tuesday 7th November 2017 Commons Chamber

[Alistair Burt]

My hon. Friend makes a good point. Sadly, there is appeal fatigue at present. Whether it is new issues such as the Rohingya or the pressures in northern Iraq with the fall of Mosul and Raqqa, as well as Yemen, it is true that efforts to raise money through UN appeals have been very difficult, which is why it is important that the United Kingdom keeps up its extraordinary record. I am proud that the United Kingdom has been such a donor, both bilaterally and through these appeals.

[Jim Shannon (Strangford) (DUP)]

There seems to be a softening of attitudes towards human rights in Saudi Arabia and, I hope, towards a more secular society. Will the Minister indicate whether he has had discussions with Saudi Arabia’s new leaders about resuming peace talks, using the scheduled meeting of the Foreign Ministers of the United Kingdom, Saudi Arabia, the United States, Oman and the United Arab Emirates on 14 November?

Oral Answers to Questions

Debate between Jim Shannon and Alistair Burt

Tuesday 5th July 2016 Commons Chamber

[Alistair Burt]

I am sorry to hear about the difficulties of my hon. Friend’s constituents. There is a provision within the regulations to enable patients who have serious difficulty in getting to a pharmacy because of the distance involved or the lack of transport to receive dispensing services from a doctor. Doctors should certainly not be blocking the addition of local pharmacies. If my hon. Friend writes to me, I can look into the matter in greater detail.

[Jim Shannon (Strangford) (DUP)]

Taking into account the immeasurable value that community pharmacies provide for some of the most vulnerable people in sections of our society, does the Minister agree that, when it comes to Government budgets, these dispensing services should be included in any ring-fencing that goes on around front-line services?

[Alistair Burt]

The hon. Gentleman’s support for these services is well known and what he says is right. The regulations do protect the more vulnerable, but when I next look at them, I will make sure that they fulfil his requirements.

Child Dental Health

Debate between Jim Shannon and Alistair Burt

Wednesday 3rd February 2016 Commons Chamber

[The Minister for Community and Social Care (Alistair Burt)]

It is a great pleasure to respond to my hon. Friend the Member for Mole Valley (Sir Paul Beresford) and his excellent speech. The House has been fortunate to benefit from his professional knowledge on a number of occasions. As a new Minister coming into office some nine months ago, I had an early meeting with him, from which I benefited hugely and continue to benefit. I am grateful for the way in which he put his case and for the heads-up in respect of what I might do and the speech that I might make to the British Dental Association in due course.

I am grateful that the usual suspects have been here to listen because of their interest in these matters, namely the hon. Members for Strangford (Jim Shannon) and for Nottingham North (Mr Allen). I thank my hon. Friend the Member for Battersea (Jane Ellison), who is the public health Minister, for being here, together with the Whip and the Parliamentary Private Secretary. I also saw the hon. Member for Dewsbury (Paula Sherriff), who has been to see me to talk about dental matters and who clearly cares very much about these issues.

I congratulate my hon. Friend the Member for Mole Valley on securing this very important debate about children’s dental health. Poor oral health in children and young people can affect their ability to sleep, eat, speak, play and socialise with other children. Other impacts include pain, infections, poor diet and impaired nutrition and growth. When children are not healthy, it affects their ability to learn, thrive and develop. To benefit fully from education, children need to enter school ready to learn and to be healthy, and they must be prepared emotionally, behaviourally and socially. Poor oral health may also result in children being absent from school to seek treatment or because they are in pain. Parents may also have to take time off work to take their children to the dentist. This is not simply a health issue; it impacts on children’s development and the economy.

It is a fact that the two main dental diseases, dental decay and gum disease, can be almost eliminated by the combination of good diet and correct tooth brushing, backed up by regular examination by a dentist. Despite that, as my hon. Friend has set out, their prevalence rates in England are still too high. Dental epidemiological surveys have been carried out for the past 30 years in England and give a helpful picture of the prevalence and trends in oral health. Public Health England is due to report on the most recent five-year-olds survey in the late spring.

There is a mixture of news, as the House might expect. The good news is that the data we have at present show that oral health in five-year-olds is better than it has ever been, with 72% of five-year-old children in England decay free. Between 2008 and 2012, the number of five-year-old children who showed signs of decay fell by approximately 10%. The mean number of decayed, missing or filled teeth was less than one, at 0.94. Indeed, the data suggest that, notwithstanding the All Blacks’ rugby success and their bone-crushing efforts on the field, oral health in children is currently better in England than in New Zealand. New Zealand’s data for children aged five in 2013 showed that the proportion who were disease free was 57.5% and that the mean number of decayed, missing or filled teeth was 1.88.

[Jim Shannon]

We have had a marked reduction in dental decay in children since the year 2000, as I said earlier in an intervention. With respect, Minister, I would say that we are doing some good work in Northern Ireland. The Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison) knows that I always say, “Let’s exchange ideas and information.” We are doing good work in Northern Ireland and we want to tell Ministers about it.

[Alistair Burt]

This is possibly the fourth or fifth invitation that I have received from my hon. Friend to come to see different things in Northern Ireland, and he is right about every one. He finds in me a willing ear, and we will make a visit because there are several different things to see. Where devolved Administrations and the Department can learn from each other, that matters, and I will certainly take up my hon. Friend’s offer.

In older children there are challenges when comparing different countries, because of how the surveys are carried out. The available data still show that we have among the lowest rates of dental decay in Europe, but despite that solid progress we must do more. There is disparity of experience between the majority of children who suffer little or no tooth decay, and the minority who suffer decay that is sometimes considerable and can start in early life. In this House, we know the children who I am talking about—it is a depressingly familiar case. We can picture those children as we speak, as my hon. Friend the Member for Mole Valley described in the sometimes horrific parts of what he told the House. The fact that we know that such decay affects children in particular circumstances makes us weep.

Public Health England’s 2013 dental survey of three-year-olds found that of the children in England whose parents gave consent for their participation in the survey, 12% had already experienced dental decay. On average, those children had three teeth that were decayed, missing or filled. Their primary, or baby, teeth will only have just developed at that age, so it is highly distressing for the child, parents, and dental teams who need to treat them. Dental decay is the top cause of childhood admissions to hospitals in seven to nine-year-olds. In 2013-14, the total number of children admitted to hospital for extraction of decayed teeth in England was 63,196. Of those, 10,001 were nought to four-year-olds, and so would start school with missing teeth.

From April 2016, a new oral health indicator will be published in the NHS outcome framework based on the extraction of teeth in hospital in children aged 10 and under. That indicator will allow us to monitor the level of extractions, with the aim of reducing the number of children who need to be referred for extractions in the medium term. Extractions are a symptom of poor oral health, and the key is to tackle the cause of that. Today I commit that my officials will work with NHS England, Public Health England and local authorities to identify ways to reach those children most in need, and to ensure that they are able and encouraged to access high-quality preventive advice and treatment.

The good news is that the transfer of public health responsibilities to local authorities provides new opportunities for the improvement of children’s oral health. Local authorities are now statutorily obliged to provide or commission oral health promotion programmes to improve the health of the local population, to an extent that they consider appropriate in their areas. In order to support local authorities in exercising those responsibilities, Public Health England published “Local Authorities improving oral health: commissioning better oral health for children” in 2014. That document gives local authorities the latest evidence on what works to improve children’s oral health.

The commitment of the hon. Member for Nottingham North to early intervention and the improvement of children’s chances is noteworthy and well recognised in this House and beyond, and of course he can come to see me. I would be happy to discuss with him what he wants to promote in Nottingham, which sounds just the sort of initiative we need.

Public Health England is also addressing oral health in children as a priority as part of its “Best Start in Life” programme. That includes working with and learning from others, such as the “Childsmile” initiative in Scotland, to which my hon. Friend the Member for Mole Valley referred. It is important that health visitors—I know that the Public Health Minister takes a particular interest in their work—midwives, and the wider early years workforce have access to evidence-based oral health improvement training to enable them to support families to improve oral health.

Public Health England and the Royal College of Surgeons Faculty of Dental Practice are working with the Royal College of Paediatrics and Child Health to review the dental content of the red book—the personal child health record—to provide the most up-to-date evidence-based advice and support for parents and carers. The National Institute for Health and Care Excellence has also produced recent oral health guidance that makes recommendations on undertaking oral health needs assessments, developing a local strategy on oral health, and delivering community-based interventions and activities for all age groups, including children. Community initiatives to improve oral health include supervised fluoride tooth-brushing schemes, fluoride varnish schemes and water fluoridation.

I agree with my hon. Friend that water fluoridation is an effective way of reducing dental decay. However, as the House knows, the matter is not in my hands. Decisions on water fluoridation are best taken locally and local authorities now have responsibility for making proposals regarding any new fluoridation schemes. I am personally in favour. I think I am the only Member in the Chamber who remembers Ivan Lawrence and the spectacular debates we had on fluoridation in the 1980s. He made one of the longest speeches ever. Fluoridation was bitterly and hard-fought-for and I do not think there is any prospect of pushing the matter through the House at present. I am perfectly convinced by the science and that is my personal view, but this is a matter that must be taken on locally.

Diet is also key to improving children’s teeth and Public Health England published “Sugar reduction: the evidence for action” in October 2015. Studies indicate that higher consumption of sugar and sugar-containing foods and drinks is associated with a greater risk of dental caries in children—no surprise there. Evidence from the report showed that a number of levers could be successful, although I agree with my hon. Friend that it is unlikely that a single action alone would be effective in reducing sugar intake.

The evidence suggests that a broad, structured approach involving restrictions on price promotions and marketing, product reformulation, portion size reduction and price increases on unhealthy products, implemented in parallel, is likely to have the biggest impact. Positive changes to the food environment, such as the public sector procuring, providing and selling healthier foods, as well as information and education, are also needed to help to support people in making healthier choices.

Dentists have a key role to play. “Delivering Better Oral Health” is an evidence-based guide to prevention in dental practice. It provides clear advice for dental teams on preventive care and interventions that could be delivered in dental practice and school settings. Regular fluoride varnish is now advised by Public Health England for all children at risk of tooth decay.

For instance, the evidence shows that twice yearly application of fluoride varnish to children’s teeth—more often for children at risk—can have a positive impact on reducing dental decay. In 2014-15, for children, courses of treatment that included a fluoride varnish increased by 24.6% on the previous year to 3.4 million. Fluoride varnishes now equate to 30.9% of all child treatments, compared with 25.2% last year. This is encouraging progress.

There are many measures that can and should be taken in order to reduce the prevalence of decay in children, but we recognise it is unlikely that we will be able to eradicate entirely the causes or the effects of poor oral health in children. This means that the continued provision of high quality NHS primary dental services will continue to be an important part of ensuring that every child in England enjoys as high a standard of oral health as possible. NHS England has a duty to commission services to improve the health of the population and reduce inequalities—this is surely an issue of inequality—and also a statutory duty to commission primary dental services to meet local need. NHS England is committed to improving commissioning of primary care dentistry within the overall vision of the “Five Year Forward View”.

Oral Answers to Questions

Debate between Jim Shannon and Alistair Burt

Tuesday 5th January 2016 Commons Chamber

[Alistair Burt]

Herbal products are slightly beyond my normal portfolio remit, but anything that assists in social care and makes people feel better and can add to their vitality and wellbeing is to be welcomed. I am sure in many local areas they are taken extremely seriously.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his response. Integration and improving care outside of hospitals is just one way we can revolutionise the health service. Will he outline any links his Department is exploring between reducing pressure on A&Es and using care provision outside of hospitals to facilitate reducing that pressure?

[Alistair Burt]

Absolutely, and a number of the pilots and pioneer programmes are doing just that. Early results from the living well programme in Penwith in Cornwall show a 49% reduction in non-elective admissions to hospital and a 36% reduction in emergency admissions to hospital. So the hon. Gentleman is right: better social care and better integration may have, and should have, an impact on hospital admissions and make sure people are receiving the most appropriate care in the most appropriate place.

Oral Answers to Questions

Debate between Jim Shannon and Alistair Burt

Tuesday 17th November 2015 Commons Chamber

[Alistair Burt]

I fairly regularly meet families and others who have had young people and older people in the system and where there is a difference of opinion about what might be done. Some of the stories are very distressing. Families will sometimes feel that people have not listened to them. There can be quite difficult clashes of opinion on occasion. Of course, any case that my hon. Friend wants to bring me I would be happy to see, but this is a perpetual issue. The important thing is always to listen to those who are closest to a problem. That is likely to be the best way forward. Even if there is a difference of opinion, if people feel that they have been listened to, there is a proper opportunity to explore what can be done.

[Jim Shannon (Strangford) (DUP)]

The autism numbers in Northern Ireland are growing. I understand that it is a devolved matter, but it is clear to me that three Departments have a responsibility: Health, No. 1; Education, No. 2; and Employment, No. 3. We need to ensure that the health of autistic children is looked after and that they have an education that prepares them for employment. Does the Minister have a strategy that takes all three Departments on board, and if so, is it shared among all the regions of the United Kingdom of Great Britain and Northern Ireland?

[Alistair Burt]

Yes. I could not have put it better myself. We have an autism programme board, on which sit representatives of the families of those with autism, which provides an opportunity to look overall at the Government strategy. The hon. Gentleman is right to say that it contains many different elements. For example, in relation to work, we have set out a challenge to halve the disability employment gap, because more people with disabilities want to take the chance of working. That must be done in the right way; we are working closely with the Department for Work and Pensions in relation to that, but things such as the autism programme board give a chance for families to be involved right across the areas where they might expect help and assistance.

Mental Health (Armed Forces Veterans)

Debate between Jim Shannon and Alistair Burt

Wednesday 14th October 2015 Commons Chamber

[The Minister for Community and Social Care (Alistair Burt)]

It is standard to congratulate the hon. Member who has secured the debate, but I really do congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron). This has been a very interesting 18 minutes, and my only criticism is that we should have had at least an hour and a half, or maybe three hours somewhere else, but I suspect that might happen. I also congratulate the hon. Lady on raising this subject at Prime Minister’s questions today. If she permits, may I thank her for her service to the NHS and those in difficulties and thank her husband for his service to the country?

I am delighted to be joined by the Under-Secretary of State for Defence, my hon. and gallant Friend the Member for Milton Keynes North (Mark Lancaster), who has also seen active service and we have just heard from my hon. and gallant Friend the Member for Plymouth, Moor View (Johnny Mercer). I say to them that there are times when their Minister feels very humble in that their collective experiences outrank mine very considerably. So I will do my best to respond to the debate. Because of the length of the initial speeches, I have slightly less time in which to do that, but that is all right because I want to make some changes to what I was going to say.

I should like to set out what the Government are doing. In doing that, I do not intend to suggest that what has come forward up to now is not valid, relevant, important or challenging to the Government. It would, however, be fair of me to put on record what is going on, although it is palpably not enough. If the hon. Member for East Kilbride, Strathaven and Lesmahagow, with her experience, needs more and if my hon. Friend the Member for Plymouth, Moor View, with his experience, needs more, then it is clear that whatever we are doing—good though it is, and better than it was—is not yet meeting the demands and the needs. It is also clear from the comments of other Members tonight that it is not yet meeting the demands of the House. My hon. and gallant Friend from the Ministry of Defence and I have listened carefully and there will be more to be said.

The Government are fully committed to continual improvement in the treatment of mental health conditions for veterans and the general public alike. We are rightly proud of the courage and dedication of our armed forces. For those who have been injured either physically or mentally, it is our duty to ensure that they continue to receive the very best possible care. As Members have already said, the vast majority of those leaving the armed forces do so fit and well, having benefited from their time in the forces. Members of the armed forces are not significantly more likely to develop mental health issues than those in other professions, but support and clinical care that are geared to the specific needs of veterans need to be available.

Armed forces and veterans mental health provision has vastly improved since the publication of the landmark report “Fighting fit” in 2010. The report was produced at the hands of my hon. Friend the Member for South West Wiltshire (Dr Murrison), who recommended that there should be 30 mental health professionals across England to provide services to veterans. With 10 veterans mental health teams in place across England, we now have significantly more than the 30 professionals recommended.

In deference to the position of the hon. Member for East Kilbride, Strathaven and Lesmahagow, let me now say a bit about Scotland’s provision. Scotland is proud of its commitment to improving mental health, including for veterans and their families. Visibility and awareness of mental health issues have substantially risen in the nation over the past decade. That echoes something that my hon. Friend the Member for Plymouth, Moor View said. There is greater awareness following long-standing campaigns against stigma. We have not gone as far as we need to go, but it is easier for people to talk now. For those with very difficult conditions, however, those are easy words, and it is still very difficult for them.

There is better public awareness of mental illness, suicide prevention and faster access to NHS services and other sources of help. Veterans and their families have unhindered access to all NHS services, enhanced by priority treatment where that applies. Evidence-based care and treatment are provided across community-based settings through support from primary care, with specialist or hospital in-patient services provided as appropriate.

In partnership with NHS Scotland and Combat Stress, the Scottish Government recently renewed funding for the provision of specialist mental health services at the Hollybush House Combat Stress facility in Ayr, for veterans resident in Scotland. The sum of £1.22 million a year over the three years to 2018 will fund a range of specialist clinical, rehabilitation, social and welfare support at the facility. Evidence-based treatment programmes include an intensive post-traumatic stress disorder programme; trans-diagnostic and stabilisation; and anger management programmes.

NHS Lothian secured £2.5 million of armed forces covenant LIBOR funding to support the commitment, and established Veterans First Point Scotland to work with local partnerships to explore how the strengths of the Lothian service could be delivered in other localities. Over the past year, work has been taken forward in 10 health board areas across Scotland to assist each local area to establish key partnerships, identify premises, plan requirements and recruit and select staff. This work continues, with the service in Tayside now open with others to follow.

I want to demonstrate that England, too, is recognising and trying to respond to the needs of veterans. Before I say a bit about that, may I thank the hon. Member for Strangford (Jim Shannon) for raising the issue in relation to the Republic? I do not know the answer, but I will find out. I recognise the point that he makes.

Underpinning all that I am saying is the demand for more research. There is some good research. The King’s Centre for Military Health Research has done some good work in identifying the categories of those who might be more at risk. Reservists and their particular issues came up, as did the other groups of veterans, particularly those who have been back for some time. There are ways of picking up those issues, and I will say a little more about that.

NHS England spends £1.8 million a year on mental health services for veterans including the 10 veterans’ mental health teams. Up to £18 million funding is in place to provide the Combat Stress six-week intensive post-traumatic stress disorder programme for veterans, with an additional £2 million of LIBOR funding being provided to Combat Stress to help veterans with alcohol problems, which is a key indicator of problems. Help for Heroes has received £2 million of LIBOR funding for its “hidden wounds” work, offering low-level improving access to psychological therapies services to veterans. Subject to the spending review, a further £8.4 million will be provided over the coming five years to help the most vulnerable veterans who have mental health problems.

[Jim Shannon]

The Minister mentioned LIBOR funding, and that is something that I have been pursuing through the Defence Committee and other ways. We have been seeking to have some of that LIBOR funding available for Northern Ireland to provide a rehabilitation centre for the many people who have served and who will continue to serve. None of that has been forthcoming to the Province so far. I understand that the Minister cannot give me an answer today, but perhaps he can look at the matter and come back to me.

[Alistair Burt]

My hon. and gallant Friend from the Ministry of Defence says that there is money available in a bidding programme and he will write to the hon. Gentleman and see what more can be done in relation to that.

I want to say two things as we run towards a conclusion. Many of the servicemen affected will of course be treated by the NHS in the course of ordinary medical treatment. The so-called talking therapies from the IAPT programme have been particularly successful. It is important to ensure that the particular needs of veterans are catered for in this programme. Work has been under way to ensure that that is done. The IAPT programme has been very successful. For the first time, we have standard waiting times and access targets. That will help veterans too.

Syria (EU Restrictive Measures)

Debate between Jim Shannon and Alistair Burt

Tuesday 21st May 2013 Commons Chamber

[Alistair Burt]

I repeat again, at the risk of riling the House, that we are not discussing whether the UK is providing weaponry. That point has been well made. The question of air cover has been discussed before. As the House knows, the Syrian air defences are not weak, and up till now no one has considered there to be a practical way of dealing with them, but part of what I will say is about all options being open. Lifting the arms embargo will increase the flexibility available to those who might need to protect civilians, or supply those who are protecting them, in the future. It offers that necessary flexibility, but no such decision has been taken.

[Jim Shannon (Strangford) (DUP)]

I recognise that the Minister is held in high esteem in the House for his response to humanitarian issues across the world. He refers to the relaxation of the arms embargo. One of the great concerns among Members is the 3.5 million refugees and displaced persons, many of them children. Can he assure people inside and outside the House that the provision of humanitarian aid—clean water, sanitation, clothing, food, blood, medicines—will continue and that the people who are really feeling the pain of this conflict will be helped?

Burma (Human Rights)

Debate between Jim Shannon and Alistair Burt

Wednesday 8th May 2013 Commons Chamber

[Alistair Burt]

My right hon. and noble Friend Baroness Warsi takes these matters extremely seriously, and she has, indeed, pressed Bangladesh on this issue. She has taken this issue directly to the Bangladeshis. It is not a matter on which the United Kingdom can give a guarantee, of course, but I assure the hon. Lady that the UK takes very seriously the issues of access and recognition for refugees that are facing Bangladesh.

[Jim Shannon]

The Minister will be aware that Human Rights Watch produced a report that agreed that ethnic cleansing had taken place. Has he applied any pressure either through our Government or Europe to ensure that that report’s findings are made known and action is taken?

[Alistair Burt]

The Human Rights Watch report contained a number of disturbing and specific allegations, which we believe are backed up by comprehensive evidence. We are following up on them with the Burmese Government. If serious crimes have been committed, those who perpetrated them must be held accountable for their actions. We, too, take that report as extremely credible.

I had just reached the “but” point in my remarks about Burma. While recognising that some progress has been made, and having responded to that sense from colleagues, there is a but, and, as colleagues know, it is a big but.

As my right hon. Friend the Foreign Secretary made abundantly clear:

“The work of the EU in Burma is not remotely finished.”

There are many significant challenges facing the Burmese people, particularly on human rights and ethnic reconciliation. I thank my hon. Friend the Member for Enfield, Southgate and other colleagues who have spoken for again bringing to the attention of the House the many extremely concerning examples of human rights violations, and for further highlighting the urgent action that the Burmese Government, with the support of the international community, must take. I also thank the non-governmental organisations and others who are engaged in this difficult work, including some friends of ours, such as Ben Rogers.

The UK was one of the leading voices behind this year’s UN Human Rights Council resolution on Burma. The resolution recognised progress had been made, but highlighted Burma as a country of concern to the international community and extended the mandate of the UN special rapporteur for a further 12 months. It called on the Burmese Government to adhere to a number of pledges, including opening an in-country office for the High Commissioner for Human Rights and signing up to the international covenant on civil and political rights, which my hon. Friend rightly highlighted in his speech.

During a visit to Burma in December, the Minister for Asia, my right hon. Friend the Member for East Devon (Mr Swire), pressed senior Government Ministers there to make progress on both these points, as well as on the convention against torture and its optional protocol. We will continue to lobby the Burmese Government to ensure that they make progress against these and all their human rights commitments.

We continue to raise our concerns about human rights abuses in Kachin state. During the visit of my right hon. Friend the Member for Asia, he pressed the Burmese Government—[Interruption.] I should have said the Minister for Asia; my right hon. Friend’s constituency may be large, but it is not that large. He pressed the Burmese Government to ensure humanitarian access to all conflict-affected populations in Kachin state. The Department for International Development has allocated £3.5 million to support humanitarian needs in Kachin, making the UK the largest bilateral donor there. This aid is helping meet food security, shelter, water, sanitation, health, and bedding needs, and it is reaching conflict-affected areas. We continue to call for unhindered humanitarian access at every opportunity.

Sexual violence, which my hon. Friend the Member for Enfield, Southgate also rightly raised, is an issue that the Foreign Secretary has made a key priority. The British Government proactively lobby the Burmese Government on the rights of women, particularly the need to take measures to prevent sexual violence against women in conflict areas. My right hon. Friend the Minister for Asia raised this issue with Burmese Ministers during his visit in December.

We are also taking a number of targeted actions. We provide support to the Ministry of Social Welfare, Relief and Resettlement to fulfil the Burmese Government’s obligations under the convention for the elimination of discrimination against women, to which they are a signatory. We support legal assistance centres in Burmese refugee camps in Thailand, which can help support victims of rape to secure access to justice, and we work closely with the UN in Rakhine state to strengthen its work to prevent, and respond to, sexual violence there. Our embassy in Rangoon is exploring options to increase our engagement on this concerning issue.

Baha’i Community (Iran)

Debate between Jim Shannon and Alistair Burt

Wednesday 24th October 2012 Westminster Hall

[Alistair Burt]

The honest answer is that it is genuinely difficult to tell. It is a closed society and it is difficult to get information, but the objective information we get is not good. However, what it does have an impact on is the population. The UK is not so daft as to believe that the Iranian regime speaks for all the Iranian people. We monitor carefully what the Iranian people say to each other, on social network sites and the like. The Iranian people are a savvy internationally based people. They are actually more aware and concerned about their human rights position than perhaps they appear to be in relation to, say, the nuclear file and the nuclear issue. They are disturbed that there is a sense that as a good Muslim nation they are put in the dock for offences committed by their own Government that they feel very keenly about. Accordingly, although there may not be an impact every day on the day-to-day life of Baha’is or other minorities, the sense of outrage of the Iranian people is building up. That is why it is so important to raise such issues, for us to talk about them in Parliament and for us to do things through the international agencies—as I shall come to—in order to ensure this is known to the Iranian people.

[Jim Shannon]

In other countries of the world where there are more democratic societies, Red Cross would be able to visit prisoners in jail and give some help. Red Crescent is the equivalent in the middle east. Has contact been made with Red Crescent, for instance, to visit those prisoners if possible to see how they are getting on and whether they need help?

[Alistair Burt]

That is a good question to which I do not have the answer at my fingertips. I know that in some cases it has not been possible for Red Crescent to visit detainees, and occasionally Red Cross as well in appropriate countries, which is an offence against human rights. However, Iran’s human rights abuses make a pretty long list. I will inquire about that and write to the hon. Gentleman and copy it to the hon. Member for Belfast East.

As I have said, in the wider human rights situation, we do believe those human rights sanctions have an international impact.

The hon. Lady mentioned the annual resolution at the UN General Assembly being tabled by Canada. I can assure her that not only do we support it but we are actively lobbying for more states to support that resolution. That is again an example of the international condemnation that takes away the floor from Iran when it tries to claim that it has international friends and that it is only a select number of western countries and Israel that tend to be against it. This international condemnation gives the lie to that. In relation to the hon. Lady’s other concern, we will refer specifically to Baha’is in our intervention at the UN. We will make sure that is specifically on our agenda.

We actively lobbied for the appointment by the UN Human Rights Council in March 2011 of a UN special rapporteur on the human rights situation in Iran, Dr Ahmed Shaheed, with whom I have spoken a number of times. We will continue to support him in his crucial role of investigating human rights violations and seeking genuine engagement from Iran to address international concerns. His latest report, being presented today, and on which we will comment, further confirms our picture of a terrible situation for Iran’s Baha’i community.

The hon. Lady quoted the UN Secretary-General. I can do no better than say again myself that he said

“systematic persecution of members of the Baha’i community, including severe socio-economic pressure and arrests and detention”

are the substance of Iranian response to the Baha’i faith.

Escape of Taliban Prisoners

Debate between Jim Shannon and Alistair Burt

Tuesday 26th April 2011 Commons Chamber

[Alistair Burt]

The short answer to the hon. Lady is that I do not know, and she must forgive me for that. I will endeavour to get a written answer—to the best of our knowledge—to her as quickly as possible, so that it is public. The picture is more flexible, depending on what one sees as detention, official prison places and the like, but if the hon. Lady has asked successively we must get the best answer that we can for her, and I undertake to do that as quickly as I can.

[Jim Shannon (Strangford) (DUP)]

That was a very sober statement to the House. The indications are that it took eight months to dig the tunnels and 450 prisoners on their hands and knees probably upwards of 12 hours to escape—but nobody saw anything. We in the United Kingdom have many governors and prison people with experience and knowledge, so will the Minister offer that knowledge to the Afghan authorities to ensure that they can improve on what has happened?

[Alistair Burt]

Yes, indeed. I have already had that discussion with officials. The inquiry and investigation must be carried out by the Afghans as the sovereign power, but we do indeed have great expertise in all aspects relevant to the escape, and it is absolutely clear that it should be made available to the Afghan authorities. We will certainly be doing that.