NHS: Overseas Doctors

Baroness Hayman Excerpts

Tuesday 8th May 2018 Lords Chamber

Asked by

[Baroness Hayman]

To ask Her Majesty’s Government how many overseas doctors recruited to work in the National Health Service have been refused visas to enter the United Kingdom in the last 12 months.

[The Minister of State, Home Office (Baroness Williams of Trafford) (Con)]

My Lords, no application for a medical practitioner role that is on the shortage occupation list, which is based on advice from the independent Migration Advisory Committee, has been refused a tier 2 skilled work visa. The Home Office publishes regular visa statistics. However, the Home Office visa case working system does not capture the profession of the applicant. That information is captured on the tier 2 visa application form, and to provide it would require a manual check of our records.

--- Later in debate ---

[Baroness Hayman (CB)]

I am grateful to the Minister for the detail there but it does not actually answer my Question. I have some figures from NHS Employers, which says it knows of at least 400 cases of qualified doctors from overseas who have been offered jobs in the NHS but not been allowed in because of the lack of being in a designated shortage occupation and the pressure on tier 2 visas. When the NHS is short of thousands of doctors, applications from EEA doctors are diminishing and the NHS is actively recruiting overseas, what possible logic can there be for the doctors whom it has recruited then to be turned back and denied visas by the Home Office? Last week the leaders of 12 medical colleges, the BMA and NHS Employers wrote to the Home Secretary asking him to take action to end this ridiculous and indefensible situation that damages patients. Will the Government act now?

[Baroness Williams of Trafford]

My Lords, there were quite a few points in that question. The noble Baroness’s first point was that there are 400 cases of doctors overseas who have been denied visas because they are not on the shortage occupation list. Therein lies the point: the shortage occupation list is arrived at with advice from the Migration Advisory Committee regarding those occupations that cannot fill the demand within the NHS. If we expand some of the doctor numbers that are not on the shortage occupation list, we are in danger of pushing out some of those other professions that we do need and that are on the shortage occupation list. We need to think about this in the round.

Benefits: Two-Child Limit

Baroness Hayman Excerpts

Monday 26th March 2018 Lords Chamber

[Lord Bates]

The noble Baroness is absolutely right to say that there are elements for disability and for severe disability regarding children, and those need to be protected. We maintain the assessment of the effectiveness through a number of different means, such as the households below average income survey, the universal credit data that we collect and the data on the benefits cap. As I said in answer to the right reverend Prelate, some very vulnerable people are impacted by this change, and we want to monitor it very carefully to make sure that they are protected.

[Baroness Hayman (CB)]

My Lords, the Minister mentioned exemptions in one of his answers. Many of us all around this House thought an exemption had been made and an assurance given in the case of kinship carers. We were therefore very surprised and distressed to learn of the case of a young woman who became a carer for her bereaved siblings and then later had a child herself, and became a victim of this policy. In the House on 11 December, the noble Baroness, Lady Buscombe, said this case,

“and this policy is being considered as we speak”.—[Official Report, 11/12/17; col. 1374.]

Could the Minister give us an update on that consideration?

[Lord Bates]

In respect of the kinship carers, that was a decision of your Lordships’ House when the legislation was going through, and of course we uphold that principle. However, here we are talking about cases where there is a third or subsequent child and the initial two places have been taken by either their own children or other children. The noble Baroness is shaking her head and obviously I respect the approach that she is taking. If we could talk about the specifics of the case afterwards, I will certainly make sure that it is taken up with colleagues.

Yemen

Baroness Hayman Excerpts

Tuesday 7th November 2017 Lords Chamber

[Lord Bates]

The second question from the noble Lord is slightly easier to answer in terms of the fact that the missiles being fired were Iranian. Clearly, the Kingdom of Saudi Arabia has a right to express concern about that and to seek to stop supplies of those ballistic missiles coming into the region. On the appeal, we know that the UK is either the second or third largest bilateral donor into the region—but, sadly, there is a funding gap of $1 billion from the UN appeal. We will use our position at the UN and in the quad to call on all countries to step up to what is one of the greatest humanitarian crises not just at the moment but in recent history.

[Baroness Hayman (CB)]

My Lords, it is almost exactly a year since the Disasters Emergency Committee —I declare my interest as a trustee—launched its Yemen crisis appeal. That raised £24 million and was aid-matched by £5 million from the Minister’s department. UK agencies and their partners have worked unstintingly and reached more than 1 million people, but they have done so against extraordinary operational difficulties and access and security challenges. I wonder whether the Minister can tell me how in the current situation he assesses the safety, the security and the ability to operate of UK agencies, and will pay tribute to the courage and commitment of people doing this humanitarian work on the ground.

[Lord Bates]

I am happy to do that, and to pay tribute to the work of the Disasters Emergency Committee in raising such an amazing sum from the generosity of the British people in response to this humanitarian crisis. The support that we have been operating on the ground has been provided to UNICEF to address malnutrition. Oxfam, Save the Children, ACTED and CARE are also based there to tackle food insecurity. The Yemeni Humanitarian Pooled Fund is operating there, as is the World Food Programme and the UNHCR. It is worth reminding ourselves of the number of humanitarian workers who have lost their lives in serving their fellow citizens. Yemen is one of the most dangerous places for them to operate in, but people are putting their lives on the line to save their fellow human beings. That should give us some hope if it can be extended to the warring parties.

Sierra Leone: Ebola

Baroness Hayman Excerpts

Monday 30th October 2017 Lords Chamber

Asked by

[Baroness Hayman]

To ask Her Majesty’s Government what assessment they have made of progress in the recovery of Sierra Leone from the effect of the Ebola outbreak; and what assistance they are offering the Government of Sierra Leone in the recovery effort.

[Baroness Hayman (CB)]

My Lords, I am grateful for the opportunity to introduce this debate tonight and to the other noble Lords who will be speaking, albeit too briefly. I declare my interests as set out in the register, and add that my husband chairs an international NGO active in Sierra Leone.

It is almost exactly three years to the day that the Disasters Emergency Committee launched its appeal for the victims of the Ebola outbreak in west Africa, the first time DEC had ever launched an appeal for a health emergency. The disease was raging throughout Guinea, Liberia and Sierra Leone. In August, an international emergency had been declared, and the UN was warning that if the epidemic was not brought under control before the end of the year we would face a global crisis.

The initial international response to the outbreak was desperately slow and inadequate, but the seriousness of the situation was eventually grasped. Epidemiologists and medical staff poured into the affected areas from all over the world. Community mobilisers in those countries worked tirelessly to break down the distrust of official advice among those most at risk and to persuade communities of the need to change burial practices in particular. International NGOs rose to the challenge of working in areas completely new to them, such as safe and dignified burials and contact tracing of potential patients. The UK sent 1,500 military personnel to Sierra Leone to implement a national emergency response centre under the guidance of that country’s President.

I went to Sierra Leone in February 2015 and saw for myself both the terrible devastation that the disease was causing and how effectively the UK, as international lead partner, was working through our NGOs, DfID staff, brave NHS volunteers and the outstanding work of the then high commissioner, Peter West. I will never forget what I saw during that visit and there is much that I could say tonight about the outbreak and the response to it, but I want to concentrate on the future and how the UK can support Sierra Leone going forward. However, it is important to acknowledge that the developed world was never interested in Ebola until this outbreak brought the disease to its TV screens and, potentially, to its borders. The reason that there was no vaccine, no rapid diagnostic test and no effective treatment for Ebola was not because haemorrhagic fevers are particularly complex or difficult diseases to treat. It is because they are, fundamentally, diseases of the poor. We often call such afflictions “neglected tropical diseases” but actually they are the diseases of neglected peoples. In our shrinking global world, we need to understand not only the moral imperative but also the self-interest in spending more resources and effort on finding solutions for these diseases. In this context I particularly welcome the setting up of the Ross fund to nurture British research. In London and Liverpool we have extraordinary centres of excellence and scientific expertise and we should support them.

In 2016, I visited Sierra Leone again after the country had been declared free of Ebola. It was a pleasure not to see burial workers in protective clothing; not to have ones temperature taken at roadblocks or to have to wash ones hands at every building’s entrance; not to have a curfew and a palpable sense of fear wherever you went. However, the Ebola epidemic, like any natural disaster, left behind it a trail of destruction and long-term problems. These were not helped by the disastrous floods this year, where the vulnerability of the infrastructure and the communities in which many of Sierra Leone’s people live was graphically illustrated. The country was poor before Ebola struck and it reversed much of the progress that had been made after the civil war, some 50% of its population living on under $2 a day.

The effects of Ebola were devastating: 4,000 deaths; some 14,000 people either infected or believed to be so; children orphaned and schools closed. For many girls, their education was not only interrupted but completely ended. There was a spike in teenage pregnancies, much of it related to the exploitation of young girls in poverty by older men. Survivors are left with a range of health problems, and in some cases have suffered social stigma as, cruelly, did some of the Sierra Leonean heroes of the epidemic who worked on burial programmes. During the outbreak, health workers were 20 times more likely to be infected than the general population, and 220 lost their lives, a significant number in a country whose health service was already desperately underresourced. Vaccination rates fell from their high of 92% in 2013 and were still nearly 10% lower than that last year. During Ebola, maternal deaths increased by 30%, and newborn deaths by 24%. It is chilling to remember that maternal deaths in Sierra Leone are 100 times those in our own country. As far as the economy was concerned, in 2015 GDP actually fell by 21%. Major industries such as tourism were devastated, but the closure of markets during the epidemic meant that many small businesses also went to the wall.

In recognition of all these problems, the UK Government allocated £240 million to support the President’s recovery plan in Sierra Leone. The strengthening of health systems, as well as women’s education, health and empowerment have been high priorities. However, there are also a number of deep-rooted structural challenges that have to be faced. Next year, there will be elections in Sierra Leone and constitutional changes are proposed. I know from my visits to the Parliament there how underresourced it is and how difficult it is for MPs to act as a constituency advocates, particularly for the poorest in Sierra Leonean society. I hope that the Minister can reassure me that the strengthening of parliamentary democracy will remain a priority for the UK.

There is a specific issue on which I would be grateful for comments from the Minister. One of the main pillars of DfID support has been the Saving Lives programme, to which £150 million was pledged over five years and which focused particularly on improving the availability of reproductive, maternal, neonatal, child and adolescent health services by 2021. Several UK-based NGOs involved in these areas have flagged concerns to me about the management of that programme; about abrupt changes late in the setting of contracts; and about whether funding has been reduced and resources diverted to other areas. I hope the Minister can give me some reassurance about the programme and assurance that UK NGOs and institutions which have worked for decades in Sierra Leone will be supported by DfID in their future work.

One of the lessons from the Ebola crisis was how, in the end, the Sierra Leonean Government, international donors, NGOs and community groups worked effectively together to defeat the outbreak. In the long, hard slog ahead, not just to recover from the effects of Ebola but for Sierra Leone to become a thriving, successful, democratic country within Africa, that commitment to integrated and sustained effort will be necessary once again. I hope that our DfID representatives in the country and our high commission will take the lead in ensuring that sort of co-operation. Most of all, I hope that the Minister will be able to assure us today that Her Majesty’s Government are committed to working with the Government of Sierra Leone and other partners across a wide range of fronts: economic development and increasing the tax base; health infrastructure; water and sanitation; the empowerment of women; and, perhaps especially, the horribly high rates of FGM and what can be done to reduce them. I hope that Her Majesty’s Government will agree to commit the necessary resources to meet all those challenges, not just in the short term but for the sustained, long-term effort that will be necessary for success.

Overseas Development Assistance

Baroness Hayman Excerpts

Monday 3rd July 2017 Lords Chamber

[Lord Bates]

She is also on record as a passionate defender of the 0.7% target. That was in the Conservative manifesto; it was secured under a coalition Government and maintained under a Conservative Government, and it is something that we are extremely proud of. The fact that we have a 0.7% commitment does not mean that everything to do with reform should stop there. We want to make sure that every single penny and pound of that is directed to the people who are in the greatest need because we cannot afford to leave them behind when there is so much need visible around the world.

[Baroness Hayman (CB)]

My Lords, the Minister referred to the prime aim of aid as economic development. We have discussed before in this House how economic development cannot take place without investment in health and in the empowerment and education of women. The UK is a respected global leader in many of these areas: malaria, neglected tropical diseases, maternal and child health, and the education of women and girls. Can the Minister assure the House that any changes that are made will not be to the detriment of continuing investment in the areas in which we have proved to be effective and successful?

[Lord Bates]

I can certainly give that assurance. In fact, health is one of the key areas in which we have been investing heavily. I know that the noble Baroness has taken a great interest in neglected tropical diseases. We announced a further £200 million for that cause, which is saving hundreds of thousands of lives, just a few months ago.

Brexit: United Kingdom-Africa Trade and Development

Baroness Hayman Excerpts

Tuesday 25th April 2017 Lords Chamber

[Lord Bates]

That is the reason we set up a cross-government programme including the prosperity fund to build economic trade and development. It is why we hosted the Commonwealth Trade Ministers’ meeting here last year. It is the reason the Secretary of State for International Trade is travelling round the world with his other Ministers, trying to put in place the groundwork for these trade agreements in future. We all recognise that free, unfettered trade is one of the best routes out of poverty ever known and we need to do more to encourage it so that people get the opportunity to come off aid dependency and into a self-sustaining economic future.

[Baroness Hayman (CB)]

My Lords, today is World Malaria Day. I do not expect the Minister to have read and digested the report published today, Global Britain and Ending Malaria: The Bottom Line, compiled by Malaria No More and Ernst & Young, but it sets out that malaria costs this country £765 million in lost trade opportunities with the most affected countries. Does he agree that investment in malaria control not only saves lives and improves the economies of the affected countries but is a major benefit to this country in terms of life sciences investment and boosting British trade?

[Lord Bates]

I am very happy to do that on World Malaria Day. I have not seen that particular report but the World Health Organization’s annual report, published in December, pointed to the fact that malaria-related deaths have reduced by some 60%, which means about 6 million lives have been saved as a result. That was why the Secretary of State announced in September that we will invest a further £1.1 billion in the global fund to tackle AIDS, TB and malaria, which is another demonstration of this Government’s commitment to the poor.

Neglected Tropical Diseases

Baroness Hayman Excerpts

Monday 3rd April 2017 Lords Chamber

Asked by

[Baroness Hayman]

To ask Her Majesty’s Government what is their assessment of progress made in combating neglected tropical diseases since the London Declaration made in January 2012.

[Baroness Hayman (CB)]

My Lords, tonight’s debate has been an extremely movable feast in terms of dates, times and length of speeches. However, at last, we are here and I am delighted to introduce a debate which has become, over the past five years, a standing item in the parliamentary calendar. I am extremely grateful to colleagues here tonight for their commitment to a subject which, before the London declaration of 2012, was very much a minority interest even among those who focused on health in the developing world.

Tonight I hope that we can do two things: first, that we can look back and record achievements in combating the 18 bacterial, viral and parasitic diseases brigaded in the WHO’s category of neglected tropical diseases affecting more than 1 billion people in 149 countries across the world, and that we can also look forward and recognise the major challenges that remain if we are to meet the targets set in 2012 in the WHO’s 2020 NTD road map and in the London declaration of the same year.

I know that colleagues are well aware of the toll that these diseases take on individuals and on human and economic development in the countries in which they live. These diseases result not only in half a million deaths each year; they also cause chronic disability, stigma and long-term ill health. They affect children’s development and pregnancy outcomes. They are the diseases of poverty and in themselves they perpetuate that poverty. As Margaret Chan, the director of the WHO, put it in that organisation’s latest report:

“NTDs thrive under conditions of poverty and filth. They tend to cluster together in places where housing is sub-standard, drinking water is unsafe, sanitation is poor, access to healthcare is limited or non-existent, and insect vectors are constant household and agricultural companions”.


Unsurprisingly, we think of NTDs primarily as diseases of the developing world, and that of course is where they take their highest toll. But poverty is not confined to those who live in poor countries, and cases of NTDs are found among the poor of even the wealthiest countries. In North America, there has been the emergence of Chagas disease in several southern states. In Europe, between 2007 and 2015 we saw outbreaks of chikungunya in Italy, France and Spain, of dengue in Portugal, of leishmaniasis in Greece and of schistosomiasis in Corsica.

The causes of these cases of emergence and re-emergence are not only poverty, but climate change and mass human migrations linked to the hundreds and thousands of people fleeing conflicts in Libya, Syria and Iraq. In Syria cutaneous leishmaniasis has reached hyper-epidemic proportions due to breakdowns in health systems and a lack of access to essential medicine, with tens of thousands of new cases annually. There is a real danger of introducing or reintroducing NTDs endemic to the Middle East and north Africa to Europe and beyond. All this highlights the global challenge of NTDs and emphasises the need to make progress in tackling these diseases of poverty in our interconnected world if we are to achieve the “ensuring healthy lives for all” sustainable development goal.

In the five years since the London declaration, we have made considerable progress. The bringing together of Governments, pharmaceutical companies, NGOs and researchers, scientists and doctors, has had profound results. Increased donations of essential medicines, targeted funding by international development agencies, private foundations and the domestic financing of NTD programmes by endemic countries are drastically improving the quality of life of millions worldwide. Almost 1 billion people were treated in 2015 alone. Thanks to the donations of several major pharmaceutical companies, billions of doses of drugs have been donated in the past five years so that by last year around 50 treatments were being delivered by mass drug administration programmes every second of the day. UK aid and the work of British institutions, NGOs and partnerships like the Liverpool School of Tropical Medicine, the Schistosomiasis Control Initiative, Sightsavers and the London Centre for Neglected Tropical Disease Research are all playing a critical role in implementing prevention and treatment strategies, and in generating evidence from operational and scientific research to inform efforts to achieve the 2020 WHO targets. Since 2013, four countries in central America have all eliminated river blindness and the misery that the disease brings, and last year both the Maldives and Sri Lanka were certified free of lymphatic filariasis. Great progress has been made and I am happy to pay tribute to the role that the UK Government have played both in their original support for the London declaration and through their ongoing leadership and financial contributions.

But we have to recognise that there are significant challenges ahead and “steady as she goes” will not deliver the targets set, particularly for soil-transmitted helminths. Mass drug administrations will need supporting infrastructure such as water and sanitation projects, additional interventions, including new medicines, and in particular, as I raised in the debate last year, new vaccines. We were then all anxious about Zika and focused on the need for prevention rather than cure. One of my questions for the Minister is whether DfID is considering broadening the R&D focus on NTDs to explore potential vaccines, given the research evidence that suggests several diseases such as schistosomiasis and soil-transmitted helminths will not be eliminated by mass drug administration alone.

In addition to vaccines, we need to continue searching for better tools across the board. We have new mapping tools and we understand better the burden of disease, but we will have to continue improving diagnostics, such as the new rapid diagnostic test, funded by DfID, for sleeping sickness. We will need to improve our strategies on vector control and, as in most areas of combating poverty, to do more on the education and empowerment of women and girls, which has a demonstrable effect on sustained access to clean water, sanitation and hygiene. Sufficient and safe access to water in turn helps to combat NTDs such as trachoma, schistosomiasis and soil-transmitted helminths.

While most of the targets of both the WHO and the London declaration understandably focus on interrupting transmission and infection cycles, we have to be aware that NTDs cause severe morbidity and lifelong disabling conditions such as blindness and disfigurement, which in turn lead to stigma and exclusion. So resources should also be directed towards improving the quality of life for people suffering from the consequences of these diseases and integrating services into existing health systems and ongoing NTD programmes. I hope the Minister can give us some information about the Government’s plans for NTD spending and how the NTD portion of the Ross fund will be managed and allocated, as this portfolio will be key to the delivery of UK aid to NTDs.

Next month, the WHO, Uniting to Combat NTDs and the NTD community will host a summit in Geneva to mark the fifth anniversary of the road map and declaration, and to plan for the future control, elimination and eradication of NTDs. I hope the Minister will make clear the Government’s commitment to that summit; that we will have high-level political representation at that meeting; and that we will have a commitment to further funding and continuing the task set five years ago. That meeting is an opportunity for us to continue our leadership with other donors in the philanthropic world and other national donors, and to work with the Governments of endemic countries to come together and once again commit to consigning these diseases of poverty to history.

[Baroness Buscombe (Con)]

My Lords, all noble Lords may speak for five minutes.

--- Later in debate ---

[Baroness Northover (LD)]

My Lords, I thank the noble Baroness, Lady Hayman, for securing this debate and, as ever, for opening it so effectively. I declare an interest: I am a trustee of the Malaria Consortium, a position that I took over from the noble Baroness.

[Baroness Hayman]

I shall not take up more time, but I did not declare my interests at the beginning of my speech, which I should have done. I therefore do so now: they are as recorded in the register.

[Baroness Northover]

I remember the huge excitement of the London meeting in 2012, when the UK, by that stage moving towards spending 0.7% of GNI on aid, as so long promised, was able to increase its commitment on neglected tropical diseases so substantially, by an additional £195 million. I was proud to be part of DfID’s ministerial team at the time and recall the amazing briefings that I was given by committed experts not only from the department but from the London School of Hygiene & Tropical Medicine—including on how you pronounce the names of all these various diseases.

As the noble Baroness has pointed out, NTDs affect more than 1.3 billion people worldwide and cause half a million deaths each year. They cause chronic disability, disfigurement, stigma and ill health. They disproportionately affect the poor and marginalised.

It is vital for delivering the SDGs that we address the NTDs. Of course, there is goal 3 on healthy lives, but it is much more than that. The SDGs aim to eliminate extreme poverty while leaving no one behind. It is the poorest and those with disabilities who are so often left behind. Tackling these diseases is part of the overall strategy of all the SDGs. In doing so, we need to focus on research, and here the London School of Hygiene & Tropical Medicine and the Liverpool School of Tropical Medicine have been so important, and the UK has had such strengths.

We need to make sure that treatments and preventive measures, such as vaccines, are coming forward and that we get them where they are needed. We need also to ensure that we have adequate surveillance. This is, of course, vital for understanding a country’s true burden of disease, as well as for securing and achieving intervention, detecting the last cases and, when and if we are in that fortunate position, making sure that there is no resurgence. I urge the Government to use their position as a leader in this area to encourage others to increase their own support. The noble Baroness, Lady Hayman, mentioned the upcoming summit in Geneva towards the end of April as a key opportunity for this. I, too, ask whether the Secretary of State will attend.

Like the noble Baroness, Lady Hayman, I want to ask about the Government’s Ross fund, announced by the former Chancellor in the autumn of 2015. It seems an absolute age ago, but it included £200 million to tackle NTDs. As far as I know, there have been no announcements yet relating to NTDs. Can the Minster clarify what is happening? It has also been flagged to those of us speaking today that leprosy remains a neglected disease, where others are no longer so neglected. Will the Minister comment on this?

I come now to the eradication of certain NTDs: it is fantastic that we have reached that point. We had the wonderful visit from President Carter last year—in 1986, Guinea worm disease affected 3.5 million people; now, it is almost eradicated. President Carter said that he hoped to outlast the last Guinea worm. I am delighted that the former President is still with us and I want to ask about those last Guinea worms. Have we almost reached that point and do we have any information on other NTDs which are on their way out?

Finally and most importantly, what assessment has DfID made of the effect of Brexit in this area? We know that scientists working in the United Kingdom come from many different parts of the world, but especially from the EU. What are we doing to encourage them to stay? How can we make sure that they know that the UK’s leadership in this area, as in many others, depends so much on them and that we are very grateful to them? I look forward to the Minister’s responses in this vital area, which is so important for the health of the poorest around the world, and where the United Kingdom has such a proud record.

East Africa: Famine

Baroness Hayman Excerpts

Thursday 23rd March 2017 Lords Chamber

Asked by

[Baroness Hayman]

To ask Her Majesty’s Government what assistance they are giving to those suffering from famine and acute food shortages in East Africa.

[Baroness Hayman (CB)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as a trustee of the Disasters Emergency Committee.

[The Minister of State, Department for International Development (Lord Bates) (Con)]

My Lords, the scale of the humanitarian crises facing the world in 2017 is unprecedented. The UK is leading the way on the response, stepping up life-saving emergency assistance for those affected by food insecurity in east Africa, and calling on the international community to urgently step up its support before it is too late.

[Baroness Hayman]

My Lords, I thank the Minister for that reply and for the work that his department is doing. The humanitarian crisis in east Africa is, as the Minister said, of horrifying proportions, with 16 million people on the brink of starvation and cholera a growing threat. But lives are being saved as we speak thanks to the work of British humanitarian agencies on the ground in east Africa, funded by the £30 million that has been raised already in the DEC appeal. Will the Minister join me in acknowledging the generosity of the British public, who always respond very generously to appeals like this? The theme of the DEC appeal is “Don’t delay, donate”. Does the Minister agree that that is a message not only for individuals—who might think about their winter fuel payment, in fact—but for Governments? Will Her Majesty’s Government agree to continue to urge other nations to replicate the generosity that the UK has shown and to keep the UK contribution under review?

[Lord Bates]

I am very happy to do that. I also pay tribute to the work of the Disasters Emergency Committee in this instance. The immediate response to the crisis and the generosity of the British people in raising £20 million, which was then aid matched by DfID, is typical of the character of the British people, to which the most reverend Primate referred earlier, and their humanitarian concern for their neighbours. That commitment is there and is being built upon by the £100 million that has been announced for South Sudan and Somalia. We are keeping those numbers constantly under review because the situation is at crisis point.

US Overseas Aid: Global Gag Rule

Baroness Hayman Excerpts

Tuesday 21st February 2017 Lords Chamber

[Lord Bates]

We have to remain calm in this area. We know what the policy is and we have worked within this context before. The Secretary of State in her letter of 8 February to Stephen Twigg, the chairman of the International Development Committee, made it abundantly clear that our position is absolutely resolute in support of sexual and reproductive rights. We need to work with international partners. That is part of the constructive engagement which will take place at the London conference later this year.

[Baroness Hayman (CB)]

My Lords, is it correct that this executive order is not exactly the context in which we have worked before? There is a danger that it goes far beyond sexual health services and will affect services for those with Zika, TB and AIDS and maternal and child health services? Can I press the Minister a little further? As he said, his department has been very strong in the area of women’s health. Will DfID be supportive of the Dutch Government when they try to fill the gap and save women from some of the disastrous effects of this policy?

[Lord Bates]

We are certainly leading by example. We continue to be the biggest funder of organisations such as Marie Stopes. The noble Baroness is absolutely right to say that this measure is different, that it contains some different elements and that we do not quite understand how they work. That is why it is important to keep a good relationship with the United States Administration, particularly USAID, so that we can work through these issues and find out how we go forward in a way that does not put more lives at risk.

HIV Global Epidemic: Young People

Baroness Hayman Excerpts

Thursday 1st December 2016 Lords Chamber

[Lord Bates]

We will certainly do that. In fact, the areas of the world where we are seeing levels of infection increase are often in eastern and central Europe, where the issue is with injecting drugs. Good health promotion initiatives with that key population group are also important and are all part of the effort to eradicate AIDS.

[Baroness Hayman (CB)]

My Lords, the high rates of HIV infection among young women in Africa, in particular, reflect, at least in part, their powerlessness in terms of sexual relationships. Does the Minister agree that this accentuates the need for DfID programmes that focus on the education and empowerment of young women to be continued?

[Lord Bates]

That is absolutely right and it is what we are focusing on. I think I am right in saying that HIV is still the largest killer of adolescent girls in sub-Saharan Africa. We need to move much further in that area. That is why it is encouraging that the Global Fund is spending a large proportion of its money in low-income countries. At the same time, we need to provide better civil society networks and social networks that can help young people when those tragedies happen so that they can access treatment and antiretrovirals. As my noble friend Lord Prior will be saying, people can have a better quality of life here living with AIDS, and that should be more widely available in southern Africa as well.