Soft Power and the UK’s Influence (Select Committee Report)

Lord Kakkar Excerpts

Tuesday 10th March 2015 Lords Chamber

[Lord Kakkar (CB)]

My Lords, I, too, congratulate the noble Lord, Lord Howell of Guildford, and his Select Committee on producing a marvellous report and on having secured this important debate. I also join other noble Lords in congratulating my noble friend Lady Wolf of Dulwich on her very impressive maiden speech. In so doing I remind noble Lords of my declarations of interest as the UK Business Ambassador for Healthcare and Life Sciences, chair of University College London Partners and treasurer of the All-Party Parliamentary Group on Global Health.

It is quite right that this impressive report should touch on health and healthcare because there is no doubt in my mind or in the mind of my noble friend Lord Crisp that it represents an important area of soft power for our country. The reasons for this are clear. Every country in the world, whether it represents a developed or a developing economy, faces similar challenges when it comes to meeting the healthcare needs of its citizens. Those challenges are reflected most clearly by changing demographics in terms of ageing populations, more people living with chronic disease, higher expectations among citizens throughout the world that they should be delivered a reasonable standard of healthcare and that they should have access to it, and that it should be delivered fairly, effectively and safely.

There are also important political consequences with regard to delivering healthcare and, indeed, not delivering it. In our own country, we saw during the run-up to the Scottish independence referendum that when the question of healthcare in terms of the future of the National Health Service was introduced into the debate, particular anxieties were generated and, as a result, there was an impact potentially on the thinking of voters with regard to whether or not they felt confident about the Union separating. This, of course, is also the case in many other countries around the world.

The report of the Select Committee tends to look at health in terms of providing healthcare opportunities through DfID overseas aid funding, and that is an important element. But as we heard from my noble friend Lord Crisp, it is not the only way in which we are able to contribute to healthcare more broadly and, through that global contribution, increase our influence and the respect that other nations around the world have for our country and therefore for our soft power. The All-Party Parliamentary Group on Global Health has commissioned some work to look at this question. As my noble friend Lord Crisp set out, the group has identified the need to look at the question of influence in healthcare not only in terms of state overseas aid funding to other countries, but across a number of domains and sectors.

When we look at the contribution made by the state, while we have heard an awful lot about the BBC in this debate, one of the most important institutions in this country that commands global respect is the National Health Service. Of course, the health service is open to criticism at times around perceptions about its delivery in our own country, but globally the concept and the philosophy of the National Health Service—providing a healthcare system that is free at the point of delivery; that is, universal access to healthcare—is a very powerful principle that is deeply appreciated and respected throughout the world. As we have heard, the NHS ranks number one in terms of the efficacy and efficiency of its delivery when compared with 10 other healthcare systems, including that of the United States and some of our European partners.

Beyond the National Health Service and the important work that the Department for International Development does in the area of healthcare, being the second largest funder of bilateral healthcare engagements around the world, at £1.2 billion in the most recently reported financial year, we have the important contribution that is made by our university sector. This is sometimes under-recognised not only broadly, but also by the sectors in healthcare themselves, and I think that it is one of the reasons why so few healthcare organisations, universities and others contributed evidence for the Select Committee to consider. However, we have four of the top 10 universities in the world in biomedicine. We have heard about our academic output. We have 1% of the world’s population, but some 12% of all citations for biomedical research. We have many thousands of students from overseas who are studying medicine and dentistry in our 33 universities delivering medical and dental degrees, and of course we have a large number of postgraduate courses not only in medical subjects but also in nursing and in the professions allied to healthcare. These provide important training opportunities for people throughout the world.

Our commercial sector is also vitally important. Two of the largest pharmaceutical companies in the world are based in this country, but they operate in at least 200 countries around the globe. Between the two, they employ something close to 200,000 people and they play a vitally important role in our economy, contributing a net surplus of some £21 billion a year. They also, by and large, are providing interventions, therapies and innovations across the world, many of which were discovered here, that are affecting the lives of millions of other human beings day in and day out. That brings great credit to our nation. Then we have the charity and NGO sector which comprises many thousands of organisations. It contributes an investment of around £7 billion of investment abroad in healthcare projects.

I would now like to build on some of the comments made by my noble friend Lord Luce. There is an ideal opportunity and outlet for us to take forward all of this knowledge, expertise and ability to improve the lives of so many people around the world through the network of the Commonwealth. I should like to declare a further interest here because I have been working with the Commonwealth Secretariat in the establishment of a potential new initiative in healthcare—something that might become known as common health. It seeks to build upon the opportunities provided by modern technology platforms and thus create the world’s largest community of healthcare professionals—doctors, nurses and others—who have the responsibility and the privilege of looking after a third of the world’s population. Through modern mechanisms of communication and sharing, we seek to ensure that advances in knowledge and the most appropriate ways of providing clinical care are promulgated to isolated communities and to practitioners working single-handedly with few opportunities easily to learn from each other and thus develop themselves professionally over their careers. That problem might be overcome through such a network created within the Commonwealth and supported through the recently relaunched Commonwealth Enterprise and Investment Council. It will allow all opportunities for funding to be brought to bear in order to create the largest opportunity for communication and education among Commonwealth healthcare professionals. This will be strongly supported by UK institutions and therefore is a further representation of our potential soft power in this area.

I will finish with two important examples of where a focus on health has had a profound impact on our country’s global standing. The first is in the area of dementia, where the Prime Minister, using the opportunity of the presidency of the then G8, decided to put an international dementia strategy at the heart of G8 thinking. Dr Dennis Gillings was appointed to the position of World Dementia Envoy, and he has been able to move throughout the world, bringing parties together and helping other Governments to focus on dementia and the devastating impact that it will have in the coming years. Some 35 million people around the world are suffering from dementia at the moment; it is estimated that by 2050, the number will be more than 115 million. The appointment of an envoy will ensure that a global research effort to find new therapies to prevent and treat dementia could—and will—be established.

The second example is in the area of antimicrobial resistance. Increasingly, antibiotics, which have played such an important role in improving human health in recent decades, will become useless and ineffective. Through another initiative launched by Her Majesty’s Government, there is now a global task force, led by Mr Jim O’Neill, looking at the problem of antimicrobial resistance, trying to focus global healthcare research attention to this important problem that, if not addressed, will cost some 10 million lives by 2050 and will have had an accumulative cost of some $100 trillion to the global economy. These are very important representations of our country’s global contribution and a manifestation, therefore, of our soft power.