Oral Answers to Questions

Jeremy Lefroy Excerpts

Wednesday 18th March 2015 Commons Chamber

[Justine Greening]

Much of our work in the occupied Palestinian territories focuses on providing basic services, including education. At the Cairo conference one of the main concerns of donors was the need to end the perpetual cycle of violence, reconstruction, then destruction and violence and the need for more reconstruction. I agree with the hon. Lady that this cannot continue ad nauseam.

[Jeremy Lefroy (Stafford) (Con)]

T4. Last month my hon. Friend the Member for Congleton (Fiona Bruce) and I had the honour of meeting Eileen Lodge, who has committed 60 years of her life to working for the poor and sick in Nepal. Does my right hon. Friend agree that the work of her Department would be impossible without the dedication of hundreds of millions of people, of all nationalities, who serve in difficult and dangerous situations, often for little or no financial reward?

Ebola

Jeremy Lefroy Excerpts

Thursday 12th March 2015 Commons Chamber

[Justine Greening]

The hon. Lady asked, understandably, about the four other health care workers. They are now in the process of being flown home, purely on a precautionary basis, and will be dealt with at the Royal Free hospital and the Royal Victoria infirmary in Newcastle.

I had a chance to meet some of the orphans from this crisis when I was in Sierra Leone just before Christmas. They were of all ages, of course. Some of our work is to help UNICEF to provide the psycho-social support that they need and to keep the orphanages going. We are also helping to provide dedicated centres where children can be looked after safely if their parents go to community care centres to be tested because they are concerned that they have Ebola; if the parents end up being taken into care, they cannot look after their children.

There are huge child protection issues. I can reassure the hon. Lady that we are mindful of them, and mindful of the need to work not just with the Government of Sierra Leone but with civil society and the NGO sector to make sure that they are properly addressed.

The hon. Lady asks about the extent of our commitment. The £427 million that I have talked about is essentially the money that we are spending on providing ongoing support, including what we have already done, which has now cost more than £200 million. Over the coming months, we need to keep supporting the beds and the safe burials and all the very practical work that we are doing—social mobilisation, talking to communities—and also put in place a budget, which is about half the increase, for the initial planning on early recovery. We are steadily shifting our strategy to ensure that we have the capacity on the ground still to cope and deal with Ebola and get to zero. That is the principal objective that we have to meet, while transitioning to look at how we can safely open schools and hospitals and deal with some of the issues that the hon. Lady talks about in relation to communities.

The helicopter support has been absolutely vital. The road network is part of the development progress, but there is no doubt that fantastic work has been done by the Merlin helicopters. I had a chance during my trips to Sierra Leone to get to know some of the pilots—I was there regularly enough—and they have been working round the clock. I want personally to say a massive thank you to them. They were incredibly impressive and have really put in the flying hours over the past six months. The civilian helicopter provision will ensure that we can continue to get around Sierra Leone rapidly and that the district-level response is working effectively, which is why we have kept it in place.

On the important point about ensuring that, frankly, we get the international community to step up to the plate, particularly as recovery takes place, we are indeed investing a lot of time and effort in lobbying. The Brussels conference, which happened a couple of weeks ago, was absolutely key in really making sure that we got international focus on the need to get to zero, avoiding complacency and starting to present the forward look at what those recovery plans will need. The $400 million part is really the initial absolute priority investment that is required to start the recovery process and kick it off. There will be a follow-up conference at the UN, which will be more focused on pledging. We have worked directly with the Government of Sierra Leone to talk to them about how we can ensure that their recovery plan is of good quality and essentially investable and prioritised, and we will continue to do all that work.

The hon. Lady also asks about the Ebola vaccine trials. In fact, we had some vaccines ready to go for phase 2 trials because the UK and DFID had already worked with the Medical Research Council and Glaxo Wellcome to help to support Ebola vaccines in the phase 1 trials. One of the learnings from my perspective is being clearer as an international community about what kinds of vaccine we want to have in stock at phase 1 stage, in order to be able to put them rapidly into phase 2, which is more expensive, if crisis hits. Also, streamlining the regulatory procedures is important, so that we can get the vaccines tested more rapidly when there is a real public health crisis element to them. Obviously, we all appreciate that the regulatory environment is there for a reason, which is to protect patients, but in this case, it was vital that we looked at how we could fast-track the Ebola vaccines. The trials have started in Liberia already. They are about to be started in Sierra Leone and Guinea.

On the number of patients, if anything we have a challenge, because fewer people are suffering from Ebola, but as the hon. Lady will understand, that is the patient population on whom we are testing the vaccines.

On WHO reform, I have had a chance now on a number of occasions to see Margaret Chan, both in London and, most recently, in Brussels. The UK has been a leading player, most recently in the special session on WHO reform, playing a constructive a role in helping us all to learn about how not only the WHO but the international community can better respond to such a public health crisis in the future.

[Jeremy Lefroy (Stafford) (Con)]

I join the Secretary of State and the shadow Secretary of State in paying tribute to all those who have tackled this terrible disease, some losing their lives in doing so—Sierra Leoneans, Liberians, Guineans and all others, including the British workers. I pay tribute, too, to the Secretary of State for the leadership that she has shown in this crisis. In a video conference which I chaired last month with the president of the World Bank and parliamentarians from affected countries, all stressed the need, which the shadow Secretary of State mentioned, to strengthen health systems. We also talked about the possibility of doing stress tests of those health systems, in the way that has been modelled for the banking sector, to ensure that they are robust enough. Parliamentarians all agreed on this vital point. Can my right hon. Friend assure me that the United Kingdom will continue to work with Sierra Leone and the Governments of the other affected countries over the coming months and years, and ensure that we do not leave them at this time of need?

[Justine Greening]

Yes, I can. The Ebola crisis has shown why the work that we do in development is so important. We saw that countries in parts of west Africa that had better developed health care systems were able to withstand this unprecedented Ebola outbreak. However, in the case of Sierra Leone and Liberia particularly, which had experienced terrible civil wars and comparatively recently come out of them, although their health systems had dramatically improved, they were still at a nascent stage and were unable to withstand such an unprecedented outbreak. I can assure my hon. Friend that the UK will play a leading role, particularly in our relationship with Sierra Leone, which is unique.

I join my hon. Friend in paying tribute to the bravery of the Sierra Leonean community, who were the ones on the front line, many of them volunteers, who ran towards the crisis and were part of the effort to tackle it, at the very time when most people would have wanted to run in the opposite direction. They were overwhelmingly the ones who helped get the crisis under control, but I am proud of the UK effort in supporting that.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Wednesday 4th February 2015 Commons Chamber

[Justine Greening]

I agree it is important that we play our role in the refugee crisis and provide refuge to people affected by it, which is precisely what we are doing. On helping children where they are—the overwhelming majority of children affected are still in the region—we are working hand in hand with the Lebanese Government to ensure that there is the capacity for children to get education. There is more to be done, but we can be proud of the leading role played by the UK.

[Jeremy Lefroy (Stafford) (Con)]

On the visit to Jordan and Lebanon by the International Development Committee last year we saw the huge amount of work that those countries are doing to support children affected by the conflicts. What is the Department doing to ensure that the children of Jordan and Lebanon do not suffer because of the huge burdens placed on their public school systems?

[Justine Greening]

We are working directly with both those Governments to ensure that our programmes help not only Syrian refugee children but, particularly in Lebanon, a host of children who were in school but perhaps did not get the textbooks they needed. We have provided a much broader package, and it is important that host communities are helped to cope with the strains that the refugees are putting on them.

Sustainable Development Goals

Jeremy Lefroy Excerpts

Wednesday 28th January 2015 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

I refer Members to my entries on international development in the Register of Members’ Financial Interests.

I am delighted that we have this opportunity to debate the sustainable development goals, which are incredibly important. Since 2000, the eight millennium development goals have achieved amazing results. My right hon. Friend the Member for Eddisbury (Mr O’Brien) and my colleague on the International Development Committee, the hon. Member for East Lothian (Fiona O’Donnell), spoke about malaria. Since 2000, there has been a fall in the number of malaria deaths per year from over 1 million to about 600,000. That is still far, far too many. Nevertheless, several million people, mainly women and children, are still alive today because of the results of the work that has been done through the MDGs. I congratulate this Government on increasing the amount spent on combating malaria from £150 million a year to approximately £500 million this year, in fulfilment of a commitment made in the Conservative party manifesto. That was a direct result of the millennium development goal. If it had not been there, this would not have happened.

The twin goals of the World Bank are, by 2030, to eliminate absolute poverty and to promote shared prosperity and thereby reduce inequality. Those goals are absolutely vital. This afternoon, the International Development Committee had the honour of questioning the Secretary of State for our report on jobs and livelihoods. In evidence to the Committee, the Department has said that the world must create 600 million new jobs not by 2030, but by 2020, which is the end of the next Parliament should it run for a full five years. For me, that is the major challenge that the world faces, and so many of the sustainable development goals are pertinent to it, which is why I will concentrate on it today.

Without peace and governance—goal 16—there is no prospect of sustainable development or of creating those jobs. Let us remember that Somalia is improving at the moment thanks to the work of the peacekeepers from Uganda and Burundi, each of which has lost hundreds of its soldiers in that effort, and that some of those soldiers have been trained by the United Kingdom. Peace and governance are therefore absolutely critical.

Jobs and livelihoods are referred to in goals 1, 2 and 8, particularly in relation to agriculture, which sustains so many hundreds of millions of people. It is vital to give priority to the work on jobs and livelihoods. I congratulate the Secretary of State and her predecessor, the right hon. Member for Sutton Coldfield (Mr Mitchell), on doing so, and I also congratulate the previous Government, who set out on that course.

Following on from that work must come taxation, which is mentioned in goal 17.1, because only through fair taxation can we provide the revenues to bring about the public goods necessary for sustainable development.

Health systems have quite rightly been mentioned. We have recently published a report on them. It is vital to ensure that the direct work done on malaria, TB, HIV and neglected tropical diseases is reflected in horizontal work across health systems. We must not forget about strengthening health systems while we are tackling diseases.

[Kate Green]

Will the hon. Gentleman take the opportunity to note the importance of investing in and supporting mental health services in developing economies?

[Jeremy Lefroy]

That is absolutely critical, and I entirely agree that it must come out in the SDGs.

Goal 4 deals with education, without which people will not be in a position to fill the jobs and create the wealth needed. My constituency neighbour, my hon. Friend the Member for Stone (Sir William Cash), has done sterling work in piloting through his Bill on gender equality. I was delighted to hear the Secretary of State say in Committee today that it looks as though we are spending roughly 50% of the international development budget on women and girls. It would be great to have that confirmed for the record.

Finally, as many Members have said—including the hon. Member for Stoke-on-Trent North (Joan Walley), whose work in this area I greatly respect—unless we tackle climate change, it will be impossible to live in a sustainable world and to create the jobs and livelihoods that everybody needs.

The motion calls on the Government

“to show global leadership on tackling the causes of poverty inequality and climate change.”

I am afraid that I cannot support the motion, because I believe that the Government are already showing such leadership under the Secretary of State and the Prime Minister, and with the support of the whole House.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Wednesday 17th December 2014 Commons Chamber

[Mr Swayne]

We have a deepening democracy fund through which we are providing support for those elections next year. With respect to the advance of Government forces, we are providing intelligence and direct tactical training to the Nigerian army. The elections themselves must be a matter for the Nigerians, but we are providing the funding and the technical support.

[Jeremy Lefroy (Stafford) (Con)]

We heard recently in the all-party group on malaria and neglected tropical diseases, which I chair, of a very important DFID programme to counter severe malaria in northern Nigeria. Can my right hon. Friend assure me that this programme will be continued and that efforts by Boko Haram to stop such development work will not be countenanced?

[Mr Swayne]

We are increasing our spend in northern Nigeria. Indeed, 60% of our spend in Nigeria is in the north-eastern areas, so I can give my hon. Friend that assurance.

Health Systems (Developing Countries)

Jeremy Lefroy Excerpts

Thursday 11th December 2014 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to serve under you, Mrs Osborne, and to follow the hon. Member for York Central (Hugh Bayley), who speaks with such knowledge and passion on these matters, and my two colleagues, my right hon. Friend the Member for Gordon (Sir Malcolm Bruce) and my hon. Friend the Member for Congleton (Fiona Bruce).

I was delighted when the Committee agreed to do a report on strengthening health systems, because the subject is not one that commands a great deal of attention. The report does not look at a particular country or disease, but instead seems more to do with bureaucracy than anything else, although that is not at all the case. As our report states, health systems are fundamental to the improvement of outcomes and self-sufficiency in health services in developing countries.

I hope that one of the sustainable development goals next year will be universal health coverage, which is impossible without strong health systems. Strong health systems are in place not only to provide better outcomes for life or to prevent morbidity and mortality, however important those things are, but to alleviate poverty, which is a direct responsibility of DFID. Strong health systems are also in place to increase fairness: if everyone has access to a health system, life chances are immeasurably improved. People who go to school and have worms are much less likely to be able to concentrate. If people have blinding trachoma, the consequences are obvious for their life chances. In so many other cases, disease brings not only disability—which we will discuss in the next debate—but an inability for people to fulfil their human potential. That is why health systems are so important to international development. In the Ebola tragedy in Sierra Leone, Liberia and Guinea, we have of course seen the consequences of weak health systems, to which my colleagues have already referred.

In this country, we have a unique thing to offer in the strengthening of health systems, which is our national health service. For all the brickbats sometimes thrown at the NHS—in my constituency we have had our difficulties, but I am glad to say that we are working through and overcoming them with the tremendous support of local staff and of the NHS as a whole—it gives us a system that is efficient, and acknowledged as such, and effective. It has its faults and failings, but it is not only chance that caused the Commonwealth Fund to put the NHS at the top of the league in an august company of health systems.

We have heard a little about the so-called problem of vertical as against horizontal programming in systems. I want to dwell on that a little. One of the things that people in our inquiry referred to was the great emphasis over the past 14 or 15 years, since 2000, on vertical programming, or disease-specific programming. The Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi and other programmes have all been successful, but there is always the risk that they will focus entirely or mainly on the disease without looking at how they can strengthen the health system within the country, which would bring far wider benefits than simply the elimination or reduction in prevalence of that disease.

I do not think this is an either/or question—that we need either vertical or horizontal programmes. Rather, it is a case of using both. I will give a couple of examples of interventions I have seen that were made through, and so reinforced, health systems. In June we visited Sierra Leone. I was privileged to go into a village on the peninsula near Freetown and see the results of the mass bed net distribution that was taking place—at a time, let us remember, when although Ebola had not reached a critical phase, it was beginning to become significant. That mass distribution of bed nets still went ahead, as far as possible, and did so through the existing health system, weak though it was. The distribution was effective: I went into homes where the new nets had been installed, and people clearly viewed them as being of great importance, particularly for their children and for pregnant women, who are the most liable to be affected by malaria.

Those mass bed net distributions, often through health systems, have resulted in the tremendous fall in the incidence of and mortality from malaria that we found out about this week from the World Health Organisation annual malaria report—I had the pleasure of chairing the launch of that report, in the company of His Royal Highness the Duke of York, in my role as chairman of the all-party group on malaria and neglected tropical diseases. Work by the global fund, DFID, and the US and many other Governments has probably saved around 4 million lives—mainly of young children and pregnant women—in the past 14 years. Even if we concentrate more on health systems and horizontal work, we should never let go of the gains that have been made. It is absolutely vital that we do not return to the situation we saw in the 1960s, and again in the 1980s, when, after a really strong effort on malaria, we let our grip on it go and saw a resurgence of malaria across the world. Vertical interventions are vital when they work through horizontal health systems as well.

My second example is from Tanzania, where I visited a programme run by the Tanzanian Government with the support of Imperial college, London, and various NGOs, such as Sightsavers. The programme tackles neglected tropical diseases. Instead of looking at only one—lymphatic filariasis, for instance, or worms—it is tackling four of those debilitating diseases alongside each other.

In other parts of the world we find the use of pooled funds—for example, pooled health funds in South Sudan and Mozambique, the development partners for health in Kenya and the health transition fund in Zimbabwe. All are excellent examples of people coming together to strengthen health systems locally, showing that it is not simply about one person making their one vertical intervention, but everyone working to bring the money together and make the best use of it.

The WHO identified six key building blocks in health systems: governance, finance, the work force, commodities —mainly drugs—services and information. In all those areas DFID plays a major role. I pay tribute to NICE International, an organisation already referred to by the hon. Member for York Central. I was impressed by the presentation it made to the Committee and its evidence to us, and I am impressed by its work. It is an example of something that most people will probably not have heard of, but which is helping health systems around the world to learn from our experience and that of others to bring better health care to their populations.

We have already heard about the financing challenges. It is vital that developing countries live up to their commitments—in the case of African Union countries, the Abuja commitment to spend 15% of their annual budgets on health. At the meeting I referred to earlier, the leader of the African Leaders Malaria Alliance—she is a former Member of Parliament and Minister from Botswana—made the same point, saying that countries with endemic malaria have to step up to the challenge and cannot simply rely on donors to fill the gap.

Indeed, let us take malaria as an example. It would take $5.1 billion of investment every year to see the elimination of malaria within our lifetimes. At the moment, something like $2.9 billion is being given. To put that into perspective, $2.9 billion would run our national health service for a week. Another $2.9 billion—another week’s worth of national health service funding—would see the elimination of malaria in our lifetimes. Surely that is not too much to ask from both the Governments of countries with endemic malaria and the international community to eliminate a disease that even less than 200 years ago was rife in this country and within the past 50 to 60 years was still present and killing people in countries in the south of Europe.

The hon. Member for York Central covered the ground on the issue of the health work force extremely well, so I will not repeat his remarks, save to say that by some estimates there will be a shortage of 13 million health workers around the world by 2035. The estimated shortage at the moment is somewhere between 4.2 million and 4.5 million, although I would say it is probably more—another estimate I have seen is 7 million. Here we have worthwhile jobs and livelihoods that could be created immediately if the training capacity was there. We know the work is there, because there is a shortfall, yet we are not training enough health workers, whether in this country or elsewhere around the world.

Those are great job opportunities for young people. As I said in our evidence session this morning, I urge the UK Government to look at providing more spaces for training doctors, nurses and other health care professionals, so that our young people can enter those professions. I was shocked to see in a newspaper this morning that half of the schools in this country do not have anyone going for training as a doctor. That figure astonishes me. There must be several pupils in every school who would both want to undertake that training and be capable of doing so, yet it is not happening. Let us put our own house in order, while helping others as they do the same to theirs.

I will not dwell extensively on the other three pillars the WHO mentions—commodities, services, which are absolutely key, but are far too big a subject for this debate, and information—except to say that the supply of pharmaceuticals to rural outposts has been a real problem for many years. I remember visiting a place in Uganda where even basic malaria drugs were not available, yet those drugs were in stock in the central store in Kampala. It is not beyond the wit of man to get drugs out from Kampala, or any other capital city, to where they are needed. It takes a bit of leadership and imagination and, possibly, some work with the private sector, which often has the logistics to get the drugs out even if the Government do not.

I have a couple of specific points to mention. In our report, the Committee referred to the work of the health partnership scheme run by DFID through the Tropical Health and Education Trust. That is a tremendous programme, and I am glad to say that DFID has continued it and added another £10 million to its funding. Partnerships have already been created voluntarily, such as the one between Northumbria health authority and Kilimanjaro Christian medical centre or the King’s Sierra Leone partnership—there are many others, and most Members will have them in their constituencies. Those partnerships can receive support for their work training professionals on the ground in their own countries.

Finally, I want to speak briefly about health education, which we did not cover substantially in our report, but is vital. Community health education programmes can provide enormous benefits, particularly when they are not thrust upon communities. My wife ran a community health education programme in Tanzania for 11 years through a training of trainers programme, training up local people who were not health professionals to work with their neighbours on improving health in their families. The success, for a small amount of money invested, was enormous. It could be seen in the health outcomes. People improved the hygiene in their households by constructing toilets and things such as dish drying racks at very little cost, with great benefits for their children in particular, who were often the victims of diarrhoeal diseases.

In conclusion, I reiterate the importance of this subject. I am delighted that DFID takes it so seriously, but it must continue to do so. Health systems and good health are at the heart of every nation’s attempt to counter poverty and raise the livelihoods and well-being of its citizens.

[Anas Sarwar (Glasgow Central) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Osborne. I congratulate the Select Committee on International Development on its two fantastic reports, the second of which we will debate in a moment.

I had the great pleasure of serving on the Committee at the start of this Parliament for almost a year and a half. Having worked with many of its current members, I can say that it is full of people who are dedicated to ensuring that we spread the values that we hold dearly in the UK around the world to maximise opportunity in the fight against poverty. Two of my former colleagues on the Committee—the right hon. Member for Gordon (Sir Malcolm Bruce) and my hon. Friend the Member for York Central (Hugh Bayley)—are retiring before the next Parliament. We all wish them both the very best for the future. The fact that both of them have used their last term in office to try to improve the life chances of the poorest and most vulnerable people in the world speaks volumes. The right hon. Member for Gordon has been a member of the International Development Committee since 1997, for which he deserves a special prize. I pay special tribute to the Department for International Development staff and health workers who have gone from the UK and elsewhere to help in the fight against Ebola and have risked their lives to protect the lives of others.

I am particularly pleased to be able to make the case for universal health coverage, as the Committee has done, given that the UK is a global leader on that issue. We should be the strongest global advocate for universal health care because our NHS is the envy of the world. It supports people from the cradle to the grave, and it is based not on people’s ability to pay but on their need. We should spread that health care model around the world.

In the current crisis in Sierra Leone, more than 1,600 people have lost their lives, and every week 200 to 300 people are dying and 400 to 500 people are becoming infected. That is a real and sad example of why sound health care systems are crucial. It also demonstrates why the UK and the Department for International Development are right to emphasise promoting private sector growth. Sustained economic growth, higher employment, strong infrastructure and other good development work can be lost in an instant during such epidemics.

Sierra Leone’s GDP growth has sharply declined, despite its positive growth in recent years. All its post-war achievements in the health, education, justice and employment sectors are in jeopardy. The Committee will know from its visits and from the testimonies it has heard that all the schools in Sierra Leone have been permanently closed, and there is a real risk of losing a generation. A generation of young people in Sierra Leone will never get the education they need to improve their life chances, get into meaningful work, break the cycle of deprivation, create a better life for themselves, their families and their communities, and create a better Sierra Leone in the process.

Let me compare three African countries with varied health systems. Sierra Leone, as my hon. Friend the Member for York Central said, has about 136 doctors and just over 1,000 nurses for 6 million people. That is the equivalent of one doctor for almost every 50,000 members of the population. Sadly, since November, more than 100 health workers, including five doctors, have lost their lives to Ebola. It is even worse in Liberia, which has an estimated 60 doctors and 1,000 nurses for 4.3 million people.

In contrast, Rwanda has more than 55,000 health workers for its population. The president of the World Bank, Jim Yong Kim, said:

“If this had happened in Rwanda we would have had it under control.”

That shows the difference that a meaningful health care system can have. It demonstrates that there is no substitute for adequate local health care cover. If there is no functioning health service, a single outbreak can turn into a global crisis.

[Jeremy Lefroy]

Will the hon. Gentleman also acknowledge Nigeria’s tremendous success in preventing the spread of Ebola? Some attribute that to the health systems built up through, for instance, the polio vaccination campaign.

--- Later in debate ---

[Mr Swayne]

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

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

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

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

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

[Jeremy Lefroy]

I am grateful to my right hon. Friend for giving way and for his powerful remarks. The Committee concluded that, after a period of terrible civil war, Sierra Leone had made tremendous progress and was on the cusp of being able to go much further, when the Ebola tragedy struck. Will he commit the Government to being there for Sierra Leone as it emerges from the Ebola tragedy and seeks to build on its recovery from that terrible civil war? This is not the time to give up, but to reinforce our co-operation with and support for Sierra Leone.

[Mr Swayne]

Absolutely, I give my hon. Friend that reassurance. We have already established the post-Ebola team to take that work forward once we have got on top of Ebola. Of course, it will have to consider how we develop the programme on jobs and employment opportunities.

I was as surprised as the Committee, and indeed the former Under-Secretary, at the lack of a programme for female genital mutilation, as highlighted in the report. It is not within my bailiwick to commit to such a programme, but I accept that the Department has placed great importance on that issue, as our girls’ summit earlier this year demonstrates.

Disability and Development

Jeremy Lefroy Excerpts

Thursday 11th December 2014 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Rosindell, and it is also a great pleasure to follow the hon. Member for Stretford and Urmston (Kate Green). I reiterate what she has just said, because we can learn from what we see of practice in developing countries.

I say that because one of the most memorable visits that I have ever made while I have been on the International Development Committee was to a hospital in Kabul that was run by the International Committee of the Red Cross. It was an outstanding place that cared for people with disabilities, substantially those who suffered from injuries caused by the conflict in Afghanistan. However, what was so remarkable about that hospital was that an extremely high percentage—the right hon. Member for Gordon (Sir Malcolm Bruce), the Chairman of the Committee, will correct me if I am wrong, but I think it was more than 90%—of the several hundred hospital staff, including the chief executive, themselves had disabilities. They were an outstanding group of people doing absolutely great work. Sometimes we in this country could learn from the way in which the ICRC had organised that hospital, so that people with disabilities were not just on the sidelines but were absolutely at the heart of providing services to other disabled people.

Disability is also a fairly personal issue for me, because my father was disabled. It was only after his death that I discovered that our family nearly emigrated to Australia because, as a disabled man, he could not find work in this country. Fortunately, at the last minute he became a clerk in holy orders; a church in London offered him the role and he served there for 25 years. However, it took him a long time to find that role, because in the 1960s disabled people were, to some extent, marginalised in this country. It is tremendous that we have moved on so far in this country, although we still have considerably more to do.

I will focus on two aspects of this debate. The first is jobs and livelihoods. I have already mentioned the hospital in Kabul. However, 1 billion jobs are required in the world in the next 10 years, so sometimes the temptation can be to think, “Well, it’s difficult enough to create jobs and livelihoods for people who are able-bodied. How on earth are we going to be able to do so for people who are disabled?” But that is absolutely not the point. The point is, as the DFID framework recognises, that the issue of disability must be integral to every programme; it must not be an add-on. If we just leave things as an add-on, they will be parked in the “too difficult” place; we will be so engaged with the sheer process of trying to create jobs and livelihoods that anything on top of that will be too difficult to deal with. That must absolutely not happen.

The second aspect I will focus on is prevention. I chair the all-party group on malaria and neglected tropical diseases. We referred to NTDs in the first debate today. They affect the poorest people on this planet—something like 1.4 billion people in the course of a year. By NTDs, I mean worms, the so-called soil-transmitted helminths, Guinea worm, lymphatic filariasis—sometimes known as elephantiasis—onchocerciasis and trachoma, leishmaniasis and indeed leprosy, which my hon. Friend the Member for Congleton (Fiona Bruce) referred to. In fact, NTDs not only affect the poorest people and cause morbidity and sometimes mortality, but they often cause disability. And they are eminently curable, or at least eminently preventable, often by very cheap interventions.

That is why I was thrilled that the last Government decided to make NTDs a priority, and this Government, through the London declaration on NTDs in January 2012, has continued that work, providing, I think, £240 million in total, including the money committed by the last Government, over a four-year period. I ask the Minister to ensure that that commitment to the prevention and treatment of NTDs is continued, because it has a huge impact on disability and the prevention of disability.

HIV/AIDS is another area where a lot of progress has been made, particularly in negotiations over the use of drugs, so that they are made available at a cheap price and so that countries’ health systems can afford to provide the antiretrovirals that were not available in the past. That must continue; there must be no let-up in the fight against HIV/AIDS or in providing support for sufferers in developing countries. There can be no two-tier world where we in the west have access to drugs that people in developing countries cannot access.

The Chairman of the Committee has talked about road safety. I am glad that in 2010-11 the Government had what I think was a change of heart on the provision of funding for road safety and decided to continue that funding. We were delighted about that, because the number of deaths on the roads in developing countries is enormous; it is in the millions. There are also tens of millions of disabilities caused by road accidents. I would like to hear from the Minister what progress is being made to ensure that all road programmes, whether we are talking about main trunk roads or rural roads, have a strong road safety component built into them.

When the hon. Member for York Central (Hugh Bayley) and I were in Dodoma a couple of weeks ago, we met the Tanzanian Minister responsible for rural roads and DFID staff who were implementing an excellent rural roads programme in Tanzania. The point we made was that when roads, even rural roads, are in a poor state, people can travel on them at perhaps 10, 15 or 20 kph. If someone causes an accident on those roads, they might cause some form of injury. However, if roads are upgraded so that people can travel at 60, 70 or 80 kph along them, and if children—indeed, everyone—along the route are not educated about what is happening and the danger that the road now poses to them if they treat it as they did when it was full of potholes and only traversable by vehicles at 10 kph, we will see a tragic rise in injury and death from something that at the same time is bringing development. I ask the Minister to comment on that.

Finally, there is the question of armed violence. I have already referred to the violence in Afghanistan, which has caused so much disability there and, of course, among members of our brave armed forces who have been injured there. However, there are many conflict states in which DFID is rightly engaged and spending up to 30% of its budget. I stress the importance of this issue, and ask what work is being done, or continuing to be done, to ensure that the kind of things that cause disability, such as improvised explosive devices, are dealt with, because conflict is probably one of the single biggest causes of disability. With that, I conclude my remarks.

Oral Answers to Questions

Jeremy Lefroy Excerpts

Wednesday 5th November 2014 Commons Chamber

[The Prime Minister]

First, I agree with the hon. Gentleman that what has happened at Milford Haven is very disappointing. We will continue to work with the company concerned and try to find employment opportunities for all those who work there. With regard to Tata Steel, Clydebridge employs around 90 people and, as he knows, is an integral part of the Long Products division. We took action in the Budget to support heavy industry, and we are working with Klesch Group and with the Scottish Government. It says that it is taking this on as a going concern and that due diligence has started. I think that the right thing to do is to work with the Klesch Group to try to ensure that its plans are to maintain that company. What we need overall is a situation in this country in which the steel industry continues to grow, as it has been doing under this Government.

[Jeremy Lefroy (Stafford) (Con)]

Q14. On behalf of my constituents, may I offer my sympathy to the families of those killed and to those injured in the tragic factory fire in Stafford last week, and may I also praise the wonderful response of the emergency services? UK exports to countries outside the European Union have gone up by a remarkable 22% over the past three years, including transformers, generators and financial services IT systems from my constituency. Will the Prime Minister look at whether the support given by UK Export Finance could be increased, particularly for small and medium-sized enterprises?

[The Prime Minister]

First, let me join my hon. Friend in offering condolences to the families of those killed in the fire in Stafford; we must get to the bottom of exactly how it started. In terms of supporting exporting companies, a very important part of our long-term economic plan is ensuring that we get more small and medium-sized companies exporting. As he will know, we have increased the budget for UK Export Finance and made available export contracts for small and medium-sized enterprises worth over £1 billion, and we will continue to work with those companies, including through the GREAT campaign, which is opening up new markets for British products to ensure that more of our companies choose to export.

Ebola

Jeremy Lefroy Excerpts

Wednesday 5th November 2014 Commons Chamber

[Stephen Phillips]

Of course I agree with my hon. Friend. I shall be dealing with the question of diversion of resources shortly, but I can tell her now that one of one of the great concerns is that funds are now being directed towards Ebola that were formerly used to deal with other health problems in the affected countries.

Significant sums are undoubtedly being channelled through non-governmental organisations, as they have to be, for the simple reason that there is no infrastructure in the region that is sufficient to cope with the outbreak, or with the funds that are being channelled to deal with it. However, we need to know that our money is being well spent, and it is not always clear that that is the case. For example, the International Rescue Committee, an NGO that is laudably trying to help the fight in Sierra Leone, is apparently charging the King’s Sierra Leone Partnership, another NGO, $5,000 a month for the use of each of its vehicles. Why? How can that sum be justified? How can the administrative costs associated with the unnecessary transfer of those funds be justified? Where are the funds coming from in the first place? I do not expect the Minister to be able to answer any of those questions tonight, but they demonstrate that we need to get a grip on the ground, and to ensure that in Sierra Leone, where we are taking the lead, moneys are being properly directed.

Another example is the medical and laboratory facilities that we have constructed in Kerry Town, which opened this morning. I understand that all the out-of-country medical staff are staying at an hotel called The Place. It is one of the most expensive hotels in Sierra Leone, perhaps the most expensive. Save the Children told me today that it has have negotiated a special rate, that rooms are being shared, and that it is necessary for its staff to stay there for reasons of hygiene; but is that really the best use of funds, and what alternatives were considered? I do not know, and if the Minister is handing taxpayer money to Save the Children, he will no doubt want to find out.

Let me turn to the UN Mission for Ebola Emergency Response. It has, I am told, 65 staff in Freetown. What are they doing? I know not and, it seems, neither does anyone else in the country. Here is what someone on the ground said to me in an e-mail:

“Their role is unclear, so far they are just eating money and trying to raise more. Not helping fight Ebola.”

What is needed are health workers, an issue to which I shall shortly come, not administrators spending money on salaries, allowances, accommodation and drivers.

The health systems of all the principally affected countries have been overwhelmed. It is frankly amazing that so many health professionals from here and other countries are prepared to risk their lives to help. They are the real heroes, but there are problems in this area as well.

The first is the disincentive to volunteering that is caused by much of the media coverage surrounding the outbreak. For tabloids to question whether Ebola might become airborne when all the virologists tell us that is highly unlikely is hardly helpful. This is not a film with Dustin Hoffman; it is a real-life situation where responsible reporting is required, including reporting how difficult it is to become infected by the Ebola virus in the absence of contact with an individual displaying symptoms.

Politicians are scarcely blameless. What sort of message, for example, do the Governors of New York and New Jersey think they send out to those who might volunteer by imposing unjustified quarantine requirements on asymptomatic patients which have no basis in scientific fact? What sort of message do the Governments of Canada and Australia think they are sending when they impose travel restrictions on those coming from west Africa which again have absolutely no basis in scientific fact? Cheap scaremongering politics at the expense of lives is not only counter-productive; it is just plain wrong.

Politicians in this country are not immune in this regard. The Minister will know that after British Airways took the unilateral decision to pull its west African routes—another decision which had no basis in medical or scientific fact—the only airline still flying directly to the principally affected countries was Gambia Bird, yet I understand that in early October the Government either ordered or told Gambia Bird to stop its flights. The World Health Organisation has been clear that international air travel is a very low-risk vector for infection, so why did the Government give that direction? Perhaps the Minister can tell us, because a difficult journey involving a long layover in Casablanca or elsewhere en route to the region is scarcely a compelling incentive to dedicated medical staff to volunteer to assist.

[Jeremy Lefroy (Stafford) (Con)]

I am very glad my hon. and learned Friend has mentioned the question of Gambia Bird, which I have raised in this House before, and I press the Minister to say in his reply when we are going to start to see flights resume from the UK to Sierra Leone. It is surely much better to have people coming into the same place, rather than coming around from various transit points back to this country or out to Sierra Leone?

[Stephen Phillips]

My hon. Friend is absolutely right. The point I was making, too, is that it offers a massive disincentive to those who want to go and help in the region.

International Development (Official Development Assistance Target) Bill

Jeremy Lefroy Excerpts

Friday 12th September 2014 Commons Chamber

[Stephen Doughty]

If the economy grows, it will do, of course. The crucial thing is that we are tying this to the state of our overall economy, but it is also setting a worldwide standard, and it is meeting a promise we made in the 1970s, and which, indeed, all parties in this House committed to.

We could give many examples. The right hon. Member for Meriden (Mrs Spelman) mentioned one from Malawi, and I have seen for myself the impact of effective aid led by the expertise in DFID, whether in Sierra Leone in tackling maternal mortality and the deaths of young children, and the impact we were able to make with a very small contribution and removing user fees for basic health care services; in our action to tackle malaria, on which the right hon. Member for Eddisbury (Mr O'Brien) did excellent work in his time as Minister in the Department; or through the education programmes we have funded, which my right hon. Friend the Member for Kirkcaldy and Cowdenbeath, the former Prime Minister, spoke about. There is also our work on HIV and AIDS, which I know many Members are very passionate about, and, indeed, our humanitarian work.

It was also a privilege to be able to serve alongside people from DFID, the Ministry of Defence, the Royal Fleet Auxiliary Service and the Foreign Office, who worked on our response to the terrible Haiti earthquake many years ago. Disasters such as Haiti demonstrate exactly what is at stake. In addition to providing the immediate humanitarian response, we also need to address the underlying causes of vulnerability in those situations. That requires long-term, predictable and assured assistance from countries such as ours.

The argument about predictability has been put forward a number of times. Members have asked why we need the Bill, and why we need to firm up this commitment and put it into law. The reason is that the predictable assurance of effective aid in the long term creates an ability to move away from aid. If we can support countries in building up strong health and education systems and good governance, we will ultimately be able to move them away from needing development assistance.

This activity also helps to create a social contract in countries where people should be able to expect services such as health and education to be provided by their Government. Our assistance can get them over that hump. That is what happened in this country. Let us not forget that, many years ago, health care and education services were provided voluntarily, as charity, here before we moved to nationally funded systems. We can have a debate about how those systems should be handled in the future, but we have moved to those national systems with national standards and predictable, secure funding. That creates an expectation among the population and helps to further democracy and the overall quality of life in a country. We should never forget that. This is a fundamental point to be made to those who ask why we need this commitment.

[Jeremy Lefroy (Stafford) (Con)]

Does the hon. Gentleman agree that another important consequence of predictable funding is that, through DFID, we are able to support long-term programmes of research, particularly agricultural research and health research into much needed vaccines and medicines? Does he agree that those are global public goods?

[Stephen Doughty]

I thoroughly agree with the hon. Gentleman. I have seen many of those programmes at work, and we should pay tribute to those in DFID who work on them. DFID is a world leader in research on many of these issues, and we need to see long-term funding going into those programmes to enable us to come up with solutions for agriculture, for vaccinations and for other crucial areas. In the end, such solutions will remove the need for further support. We need the assurance for that funding, however, because if it is simply left to the whims and the day-to-day politics of this place and of other countries around the world, it could easily fall victim to the siren voices, which would ultimately do long-term damage as we would not be able to achieve the scale and effectiveness that we require.

Many right hon. and hon. Members have mentioned the importance of Scotland. It is exemplified by the fact that the Bill is being promoted by the right hon. Member for Berwickshire, Roxburgh and Selkirk and by the presence today of the Chairman of the Select Committee, the right hon. Member for Gordon. We must remember the impact that Scotland has had on these debates, not only here in the House but globally. I mentioned the impact of the Make Poverty History march in Scotland before the Gleneagles summit. That summit would not have taken place there if Scotland had not been part of the United Kingdom. The people of Scotland who feel passionately about these issues would not have been able to have that impact on cancelling debt, trebling aid and arguing for fairer trade rules had that summit not taken place in Scotland and had we not had leaders including our Prime Minister and Chancellor who were willing to stand up for those issues and respond to those campaigners.

Some of the most excellent DFID staff are to be found in Scotland, in East Kilbride. I have had the pleasure of visiting their offices. The right hon. Member for Gordon and my right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr Clarke) have rightly said that it would be a huge tragedy to lose them. In response to the hon. Member for Angus (Mr Weir), I would say that, yes, Scotland could have an aid programme—it already gives support to Malawi and other countries, and that is fantastic—but effective aid depends on scale. It depends on doing things together and working with institutions such as the European Union and the United Nations and with successful, long-established development agencies such as DFID. Breaking that up in order to set up a separate scheme and badge it in a different way would be foolish. It would be a sad ending for the hundreds of thousands of people who stood on the streets of Edinburgh in 2005.

The Bill is about investing in the future of some of the world’s poorest people. It is also about investing in our own common future. This is the right thing to do. It is about justice, not charity. It is about putting Britain on the world stage and doing the right thing.

--- Later in debate ---

[Philip Davies]

No, I will not.

I can mention two organisations in my constituency in that regard: Mpika Relief Fund does a fantastic amount of work helping people in Africa, and there is one in Burley-in-Wharfedale that does a similar job. They raise money for very worthwhile causes. I very much support what they do; I have even made donations to them in the past. What they spend their money on is much more worthwhile than these grandiose schemes that the Government come up with, where Ministers like to go out and say how wonderful they are because they are indulging their largesse everywhere. I prefer the smaller schemes that are run bottom-up from organisations like the ones in my constituency.

It might even be a good idea for the Government to offer tax relief for people who want to go out to other countries to help with particular projects. I would welcome that.

[Jeremy Lefroy]

It might help my hon. Friend to know that, actually, the gift aid from those kinds of donations is included within the 0.7% we are talking about, so that is happening at the moment.

[Philip Davies]

My hon. Friend is missing my point. I am not talking about gift aid on donations. I am talking about tax relief to help assist people who want to go out and do something practical themselves—who want to give up their job for a while to do something worthwhile. That would be a much more valuable and worthwhile thing for the Government to do than simply flex their muscles on how much they spend.

Because I am feeling in a generous mood, Madam Deputy Speaker, I will give way to the hon. Member for Wirral South (Alison McGovern), seeing as she is so excitable about intervening.