Queen’s Speech

Lord Crisp Excerpts

Thursday 28th May 2015 Lords Chamber

[Lord Crisp (CB)]

My Lords, I will use my few minutes to speak about international development. International development is, of course, intimately linked with foreign policy and is fundamentally about the UK’s place in the world and how it is perceived by other Governments and other peoples.

In what has been already described many times as a divided and dangerous world, the UK’s commitment to development is a force for unity and security. Those of us who travel in the poorer parts of Asia and Africa—and there are many in your Lordships’ House who do—know how well the UK and DfID are thought of by many people in those countries, so I first congratulate the Government on their continuing support for development. This is not just about money, although 0.7% sends a very powerful message of support, but about the golden thread that the Prime Minister has referred to of supporting civil society, commerce, the rule of law and so on. It is also about the fact that the UK operates with a degree more flexibility than other large donors—more as a partner while of course keeping proper processes in place.

This flexibility and sense of partnership are vital for the future and need to be further developed. This is happening in a world where power is shifting and to some extent splintering, as so many noble Lords have already said. New approaches are being developed that are more equal, less top-down, less about richer countries imposing solutions—less, if you like, of the West knows best and more about supporting local leaders, local ideas and local innovation, some of which we ourselves can learn from. We are moving towards a time of greater co-development beyond simple aid. As we help to strengthen other countries, we can also strengthen our own.

International development is not the only area where the UK plays this enormously positive and healing role in the world. The arts, science and sports are other obvious areas. I was very struck by the report on soft power produced under the leadership of the noble Lord, Lord Howell, with its analysis of the UK’s strength and its vision for the country as becoming the best networked country, with relationships in all parts of the world. That report rather underplayed the UK’s role in health. Depending on exactly how you calculate it, health is now the biggest industry in the world and the UK plays a massive global role. This is one area where the UK is truly a global power.

The APPG on Global Health, which I co-chaired in the last Parliament, commissioned an exercise to match the UK’s contribution to health globally across the four sectors of commerce, government, academia and the not-for-profit and philanthropy sector. It found, as you might expect, that the UK has a major impact in all sectors, overall coming second only to the US in impact, and doing better than the US in some areas. We will publish the report in a month’s time, with recommendations for maintaining and developing that role. My question to the noble Baroness is very simple: do Her Majesty’s Government recognise the importance of health being part of foreign policy, and what will they do to make it more prominently so?

Let me finish by returning to international development. The sustainable development goals, which we believe will be agreed in New York later this year, will be another force for unity and peace in the world. I want to make three simple points about them. First, during the process of developing them over the last three years, the great statement was that they should “leave no one behind”. I believe that needs to be absolutely central to everything that happens around the SDGs, and that the UK, like others, must ensure that this is not just a nice and pious statement. That means suggesting and ensuring that all the appropriate indicators are identified and measured, so that we have disaggregated data.

The problem is real. Who are the people who get left behind? They are the people you would expect: people with disabilities; women, often; ethnic and cultural minorities; rural populations. For the UK, meeting this commitment also means maintaining the recently launched and very welcome disability framework for UK aid, which has once again put the UK in a leading position globally.

Alongside that principle of leaving nobody behind, I hope and trust that the UK will strongly support the development of universal healthcare and universal health coverage around the world, helping countries to create their plans for doing so. That brings with it the recognition that it will involve a massive increase in the number of health workers needed globally. The UK has an extraordinarily good track record in the education and training of staff, and it could play an even greater part globally in that regard.

Finally, and much more specifically, I turn to a topic in respect of which I ought to declare an interest as the chair of Sightsavers. I request that the Government maintain and enhance the investment they have already made in the elimination of neglected tropical diseases. There is still an enormously long way to go. We have seen around the world many examples of diseases almost being eliminated, only to return because we did not go the last mile. It is fantastically important that we keep up that process. It is also one of the most cost-effective of all health interventions, dealing with diseases that afflict the poorest people. It is an area where the UK plays one of the leading roles in the world; its scientists, as well as its health workers, are making real change happen.

European Union (Referendum) Bill

Lord Crisp Excerpts

Friday 10th January 2014 Lords Chamber

[Lord Crisp (CB)]

My Lords, my personal view is very straightforward: we are inevitably and intricately linked with Europe, and we need to work out our future in it through negotiation. I am also very clear that change is needed; I agree with my noble friend Lord Turnbull about the range of issues that need to be tackled in our relationship with Europe. There may be a place for a referendum in that process but I would not start with one. There will be consequences of doing so, as many noble Lords have spelt out today.

However, in the course of this debate I have been very impressed by the points that have been made about the will of both the Commons and indeed a significant part of the public. The noble Lord, Lord Strathclyde, spoke about the House having the power to defy the will of the Commons but asked whether it has the authority. The noble Lord, Lord Kakkar, spoke about us having that power but having the tradition of exercising it maturely. In some ways, I was most impressed with what the noble Lord, Lord Owen, had to say, and if I may summarise it to him, although he is not in his place, it was that there is a political inevitability about the process of having a referendum and we should get on with it—there was a political dynamic in place. I have some sympathy with that. Let us have the real argument, not these shadow ones about process.

Scrutiny has to happen, though. As a Back-Bencher, I rather feel—“resentment” is not quite the right word—slightly taken aback by what I think I am hearing: that we may discuss the Bill but may not put forward amendments or vote on them, which seems to be a very peculiar position for us to be in, particularly when there are two very clear issues that need to be scrutinised. They are the most fundamental points about any such Bill, which are, put simply: what is the question, and who gets to vote? Those are the two that have come up from a number of people. On the point about who has the right to vote, the noble Lord, Lord Oakeshott, raised an interesting point about the position of the 1.5 million British citizens living in Europe, which clearly needs debate and discussion.

With regard to the question, I have not yet heard what is wrong with the independent Electoral Commission’s version of the question. I have heard that there is not time to discuss it but I have not actually heard what is wrong with it. Parliament needs to have a good reason to overrule a group of independent experts which it has set up to advise it, and we need to understand what that good reason is if we are to go ahead with the question that is currently in the Bill. Very simply, my view is that we need to respect the will of the Commons and there is an inevitability about moving towards a referendum, but we need to have the power and the time to scrutinise these important issues and get answers.

Commonwealth

Lord Crisp Excerpts

Thursday 17th October 2013 Lords Chamber

[Lord Crisp (CB)]

My Lords, I wanted to take part in this debate more to listen than to speak, and I have been wonderfully rewarded so far. I come at this as rather a newcomer to the Commonwealth, or to the issues of the Commonwealth, although, of course, I was born a Commonwealth citizen. A lot of people in this country do not pay a great deal of attention to the Commonwealth. I have been paying attention to it only since I started working in health in Africa in the past few years. I shall say a few words about health, following my noble friend Lord Kakkar.

My first point is about links. As the noble Lord, Lord Luce, said in his excellent speech, there is a kaleidoscope of links between our country and all the Commonwealth countries. I was in Uganda yesterday for the launch of the Uganda UK health alliance, which brings together about 200 British organisations working in health in Uganda. The speech given by the Minister of Health there was very much about our shared legacy, our friendship and what we can do together and the future. Anyone who works in health in Africa will be aware of the painful legacy of colonialism that is still there, but the mood music is very much about the shared future that we have together.

If, in Uganda, there are 300-plus links between hospitals, schools and churches, all working on the desperate health problems of countries like Uganda, we can see how many links there are around the world and how important they are. I chair Sightsavers—its proper name is the Royal Commonwealth Society for the Blind—so am involved with a great deal of other links around the world. I was delighted to hear what the noble and learned Baroness, Lady Scotland, said about the Queen Elizabeth Diamond Jubilee Trust and its approach to eliminating some of the avoidable blindness in the Commonwealth. That would be a most remarkable impact.

In addition to the wealth of links that bind us all together, the Commonwealth is a truly remarkable organisation because it brings together rich countries, poor countries and fast-growing countries, and it is not geographically bounded. It is important to Africa. As my noble friend Lord Kakkar has already mentioned, the Commonwealth Health Ministers Meeting is one of the great meetings for Health Ministers in Africa. They see it as an opportunity to influence the agenda because they are sitting down together with rich countries and having a major impact. In parenthesis, I very much support the noble Lord’s proposal which was made there, and would be interested to hear what the Minister has to say about that.

The Commonwealth is also important to us on health. It gives us access to learning and development of all kinds of approaches to health around the world. It is based on a shared history and largely shared values. I say “largely shared values” because I am very conscious of the points made by the noble Lord, Lord Black, and others about, for example, the attitudes in some countries towards gay men and women, and to women in some others.

The single point I really want to make on this is that it is a rapidly changing world. We in the UK have our traditional ways of doing things, but we can learn from people without our resources—particularly in health—about how to do things differently, and how you use the community, to take that example from Africa, in things such as health and education in ways which we simply do not do in this country. It is in our interest to promote these links and the Commonwealth more generally, both for that self-interest and for our co-development with our partners in the Commonwealth.

Finally, I come back to the people-to-people aspects which the noble Lord, Lord Luce, mentioned right at the beginning of the debate. We underplay the Commonwealth. I am not at all unusual in not having thought much about the Commonwealth at all beyond, perhaps, the Commonwealth Games and a few other things like that. It has been, to put it slightly rudely, something that the enthusiasts have understood, and if you know about the Commonwealth you know about the Commonwealth. The profile needs to be raised in many different ways, as the noble Lord, Lord Luce, again said. With that comes the scope for greater shared growth and development in a wide range of different countries.

Older People: Their Place and Contribution in Society

Lord Crisp Excerpts

Friday 14th December 2012 Lords Chamber

[Lord Crisp]

My Lords, I, too, congratulate the most reverend Primate on his welcome, timely, wide-ranging and clear speech. I want to echo one particular point on the importance of public policy being geared towards maintaining dignity and capacity. This is really a definition of what I think of as healthy ageing. I am very glad to know that old age does not start until 62. In the light of the ageing population, I would like it confirmed that it will be going up one year for every year from now on. The figures are extraordinary. Our life expectancy has gone up by 30 years in the past century—that is three years a decade or about eight hours a day. It is a remarkable change that we are going through and that is why healthy ageing is so important.

I want to say three things. The first two are very positive and celebratory; the third is not, but together they are important and can contribute to a healthily ageing society. I am going to use health examples but they have wider relevance.

First, I learnt something very interesting about decision-making when I was a hospital chief executive. I used to attend ward rounds, which concern decision-making about individual patients. It is interesting to look at the dynamic. There is the contribution of the patients and their families and the contribution of the nurses. However, when you turn to the doctors you see the hierarchy in action. The students and the SHOs—the younger people—set out their ideas, which may sometimes be wildly off the mark. Then there are the registrars. In the days when I was chief executive, the senior registrar would be the person who knew absolutely the latest evidence on everything, drew their own conclusion and set it out for others. It almost always rested there. However, in about one in every 10 cases the consultant came in, perhaps because they had seen some pattern or recognised something that they may have seen 15 years previously. They provided another insight about not the latest research but history and knowledge. Perhaps in some ways it was about pattern recognition; occasionally, it was even about wisdom.

I learnt then what an excellent pattern of decision-making that is and what a good metaphor it is. We need the three sorts of knowledge and the different perspectives: the questing hungry sort of the young people, the central authoritative sort of the up-to-date people in the centre of their lives, and the different perspective of the experienced older people who have seen a lot. We need all those perspectives and we need to honour them all. We can too often miss out some parts of that collection.

Secondly, there is the valuable role that older people can play, as has been mentioned by many noble Lords. The noble Baroness, Lady Bottomley, talked about B&Q setting up a store with older people and the noble and learned Baroness, Lady Scotland, talked about BMW in Germany. I want to give a health example called Grand-Aides, a name which is drawn from grandparents. It is an American idea but it is now getting global impact in a number of countries. Very simply, it is about involving older people in the healthcare team, sometimes part-time, with them coming in—properly trained, of course—at the healthcare assistant level. They have a unique capacity to contribute. As we know, work contributes enormously to people’s self-worth and to the dignity that the most reverend Primate spoke about. Older people also have the time and experience. Sometimes they can understand the little clues in the patterns of people’s lives that maybe other people cannot.

I also note from the House of Lords briefing that, in our own country, the people who retire earliest are very often in healthcare, which is interesting when it is in healthcare that we are going to see more need, over time, for more time to be spent with people. The real scarcity is going to be in the time of professional staff; it is not just about money. There are lots of other examples where people can contribute but the health one could be important.

Alongside all this potential and my previous two points, there is the sadness of what so often happens in reality. Other noble Lords have talked about poverty and disability, both physical and mental. I want to touch on loneliness and isolation, something that the noble Lord, Lord Glasman, just talked about. The number of people who live alone is terrifying and astonishingly large. It can be debilitating, destroying and numbing and is linked to ill-health and poor survival rates. I am reminded of Dr Doug Eby, from the Southcentral Foundation in Alaska, who says that with older people in particular, as with most of us, the primary diagnosis is social. You may be treating an elderly man for Parkinson’s disease, for example, but the fact that he may be isolated, not eating, not warm or not washing properly are the issues that have to be addressed and which are seen so often in our health service. We know that this isolation has an appalling impact on health and survival.

Other noble Lords have not yet mentioned some of the research on healthy ageing. It has been talked about in an instinctive way—about people wanting a meaningful existence, for example. However, the research from Japan, America and elsewhere shows that three things are the key to healthy ageing. First, there is getting into your 60s while healthy; secondly, there is having some meaning in your life, with something to do and the ability to contribute; and thirdly, there is having some kind of social life. All the evidence shows that those three things, coming together, contribute to healthy ageing. It reminds me again how privileged I and all noble Lords are to be in this best club in town with access to all three things.

In public policy, we need to explore much further the dynamic of healthy ageing. We need to understand healthy ageing and bring the three parts of my argument together: using the wisdom of older people—or shall we call it experience?—developing ways of bringing people into careers, and getting into caring and combating isolation.

In doing so, we also need to recognise the equity gap, an issue which has been so clearly raised by at least three noble Lords who have spoken. There is the gap concerning people from minority ethnic communities in this country, raised by the noble Lord, Lord Dholakia; the gap in equity itself, raised by the noble and learned Baroness, Lady Scotland; and the differences in healthy life, raised by the noble Baroness, Lady Greengross, who referred to 45 years of healthy life in the north of the country and 51 years of healthy life in the south. There is enough evidence here for us to start to create a sensible public policy about healthy ageing and bring together the research about getting into your 60s while being healthy, having a meaningful existence and having a social life.

This brings to me my last point, which is that this is also about political will, politics and power. I am agnostic on the need for a Minister for older people—or, indeed, a commissioner—but I was interested when an MP friend of mine told me the other day that, until very recently, older people were not of great interest politically because it was assumed that by the time you got into your 60s your political views were settled and, therefore, that you were going to be on one side or the other. However, she told me that that is now changing. It would be interesting to hear the views on this of the noble Lords on the Front Benches who will be summing up the debate: on how they see the future, how much they recognise the power of the grey vote and whether they see this having significant implications for policy in the future.

International Year for People of African Descent

Lord Crisp Excerpts

Thursday 13th October 2011 Lords Chamber

[Lord Howell of Guildford]

My Lords, there is a great deal of wisdom in much of what the noble Baroness, Lady Howells, has said. However, it is not right to say that the Government have ignored these matters. On the contrary, there has been massive, continuous and growing commitment to these issues. The only matter here is whether it is a practice in this country to recognise all the various UN days marking many issues over the years. That is not our practice, although we fully recognise all the aims behind these things and work at the United Nations to further the activities of the UN in all these fields. I would not for a moment dispute the analysis or the line of thinking that is in the noble Baroness’s question, but merely not marking these days in this country is not in any way connected to a lack of very strong commitment to all these causes.

[Lord Crisp]

My Lords, as your Lordships will know, the NHS benefited enormously from a great number of people of African heritage, particularly in the early days. Would it not be a good idea to use this occasion to celebrate this in some way and partly thereby contribute to improving the morale in the NHS?

[Lord Howell of Guildford]

My Lords, the noble Lord is absolutely right about the contribution and the value. He urges celebration, which should be in all our words, aims and activities, but whether a specific day is necessary as well I am not so sure. However, I make absolutely clear that we recognise everything that he said as being extremely valid.

Zimbabwe

Lord Crisp Excerpts

Thursday 10th March 2011 Lords Chamber

[Lord Crisp]

My Lords, I congratulate the noble Lord, Lord Avebury, on his powerful introduction to this debate, which sparked many other powerful speeches, including the remarkable maiden speech of my noble friend Lord Dannatt. I want to speak briefly about health in Zimbabwe. Our main discussion today is naturally about the political situation, rights and the rule of law, but I know that noble Lords will well understand the relationship of health in the short term and, perhaps more importantly, in the long term to the condition of the country. The reduction in health status that we have seen in recent years is as significant a deficit in the country as any other problem.

A healthy population is strongly connected to the economy, to well-being, to civil society and eventually to the rehabilitation and rebuilding of a healthy society. There have been some improvements over the past two years, but they follow a desperate decade of deterioration. Everywhere we can see chronic shortages in the supply of drugs and of staff, many people having fled the country, some of them coming here but a significant number going to their neighbours, poor morale and—that indicator of difficulties in the future—a reduction of and other problems in the education and training of health workers.

The result, as my noble friend Lord Sandwich said, is predictably awful. Over the past 18 years, maternal mortality has more than doubled, from 380 deaths per 100,000 births in 1990 to 810 per 100,000 in 2008. Translated into terms that are easier to understand, it means that one mother dies in every 120 births. The equivalent would be a mother dying every week in St Thomas’s Hospital across the river. These are awful figures. Over the past 15 years, life expectancy has dropped from the mid-60s to 44 years. The health status of the country has deteriorated very quickly.

As I said, there has been some improvement over the past two years, which can be linked to economic improvements in the country, but there is more to do. What I want to draw attention to in my remarks is the work and role of diaspora organisations and the many links that we have between the UK and Zimbabwe. From time to time, I am approached by groups of Zimbabweans who ask how civil society, as much as government, can help to support the rehabilitation and improvement of health in the country both now and, crucially, in the longer term.

Let me talk about one such group, Zimbabwe Health Training Support. Founded in 2006, the group comprises health professionals who are almost all from Zimbabwe, the others having strong links with the country although they come from the UK. Its role is to leverage the talent of the diaspora and to create sustainable links between this country and people in Zimbabwean organisations in order to support improvements in health.

Currently the group is supporting 10 Zimbabwean institutions across all parts of the country, regardless of politics, and working with organisations such as the Zimbabwe Association of Church-related Hospitals. Zimbabwe Health Training Support responds to need. Over the past four years it has trained 100 midwives with partners in the UK, including the Royal College of Obstetricians and Gynaecologists, and by drawing strongly on British talent has trained 16 people in emergency obstetrics The organisation is grateful for the support that it gets from the UK, recognising that some element of DfID money allocated to the country is going towards maternal and child health, as well as towards water and sanitation improvements. The group recognises that at the moment it can receive only a small grant from DfID to support its work but urges the department to pay more attention to helping it to support the training and education of future health workers in Zimbabwe, because that is what will be vital in the years to come.

I conclude my brief remarks with two questions. First, thinking forward and at the right time, do the Government plan to provide specific support for rebuilding and revitalising the health sector in Zimbabwe? Secondly, in the short term, what support will they give to diaspora organisations, such as the one that I have talked about, which are working in the healthcare sector?

Health: Maternal Health

Lord Crisp Excerpts

Wednesday 12th January 2011 Lords Chamber

[Lord Crisp]

My Lords, I congratulate my noble friend Lord Patel on raising this issue and sparking this excellent debate. I also congratulate this and the previous Government on giving the priority that they have to this issue. The question is: why is more not happening faster? There are improvements but it is not fast enough. Three things come together here.

First, on the clinical issue, we have heard from clinicians in the Chamber and elsewhere that, clinically, people know what to do. Obviously, you can do it better but two other issues go alongside the need for good clinical leadership. Secondly, it is particularly about the resources of health workers and having more appropriately trained health workers. The third issue, which is the hardest to tackle, is the one that the noble Lord, Lord Jones, has just referred to: the matter of social issues. There are issues of women’s inequality, of women not being able to leave the house without a man’s permission, of women not having money of their own, of whether women are allowed to manage the finances in a family and of whether it is acceptable for young, underdeveloped women to marry and to bear children.

Those are all issues for the whole society, particularly for men, and it is interesting to see examples of countries such as Zambia where people actively work with the leaders, whether they are the spiritual or the traditional leaders of the country, to change social attitudes. It is my belief that you need these three things to work together in a country: clinical leadership, political leadership that will in part release the resources and civil society leadership, which embraces media and other aspects that have been referred to. What are the Government doing to make sure that those three issues are addressed together? I believe that doing so is what will make a difference.

Perhaps I might add one quick footnote on an issue that my noble friend Lord Patel raised in his excellent speech. There are many people in the UK willing and able to help provide support, from his own college and elsewhere. Can the Minister tell us what is being done to enable people to use their skill and good will for the benefit of dealing with this problem?

Queen's Speech

Lord Crisp Excerpts

Wednesday 26th May 2010 Lords Chamber

[Lord Crisp]

My Lords, in congratulating noble Lords on their appointments as Ministers, I warmly welcome the clear commitment to international development that I see coming from the coalition Government, despite the financial circumstances—and perhaps, even more importantly, because of them—and their clear determination to maintain and even enhance the leading role that the UK has played over the years. The UK has been a leading player in international development in recent years. It will be encouraging to see that supported and continued.

I will talk about health and development, and I will touch on foreign policy. I will make three points. The first is about health workers, the second is about using UK experience and expertise and the third is about links to global security. In all of this, I will stress the interdependence of rich and poor countries. This point should underlie all UK policy in this and other areas.

There is a desperate shortage of health workers. I was sorry to see that this point was not mentioned in the brief coalition statement on international development. It is mentioned strongly in the Conservative Green Paper of last year, and I hope that it will be returned to in subsequent policy documents. It should be one of the most important areas for international development. Health is very much about human contact. It is about access to the advice and knowledge that health workers can produce. Too often in poor countries, we see children dying of diarrhoea because nobody knows how to rehydrate them. We see a lack of immunisation. We see the dreadful problems, referred to by my noble friend Lady Flather, of pregnancy-related illness, injury and death. Some of these things are very simple for trained professionals to deal with, while others are complex.

Moving from the personal to the general, I will say that we will not achieve the millennium development goals without more health workers in these countries. I am not talking about the same staff mix as you would have in the UK. This is not about many more doctors and nurses. It is about massively increased numbers of community workers—people trained to mid-level, nurses with extra skills that allow them to do Caesarean sections—and some more professionals. It is not about just transferring our model abroad. Nor is the problem simply one of migration. In the UK, we have benefited from large numbers of people from poorer countries coming to work in our health system. However, the best estimates show that over the past 35 years, 135,000 people who first had some health training in poorer countries have come to richer countries. That is a big number, but the need is for somewhere between 1 million and 1.5 million more in sub-Saharan Africa. Dealing with migration will deal with only part of the problem. In that context, I congratulate this and the last Government on the fact that the World Health Assembly last week passed a new code of conduct on health migration, to help to manage the problems that come from that.

The biggest issue is getting more people trained. It is about helping people to be trained in all those areas, whether they are community workers, mid-level workers or fully trained professionals. That must be part of the wider set of policies to retain, support and employ them. Training them is something with which we in the UK can help.

I turn to our expertise and experience. If the Government want to put a greater emphasis on getting more health workers into poorer countries, they can do so in many ways. One is simply to give more priority, with their partners, to the issue. PEPFAR, the President’s Emergency Plan for AIDS Relief, has made a commitment to train 60,000 health workers over the next five years. It can ensure that all its programmes embrace the need for more health workers. It can also use the extraordinary experience, expertise, tradition and history that we have in the UK of training health workers. Still today, our royal colleges and other institutions are part of the training and accreditation systems of health workers around the world. We have a great tradition and history to build on. We also know that there is great willingness among health workers in the UK to help. Can we not do more to put this together? Can we not make something of all the small-scale efforts that are happening in the NHS and in the universities? I refer to places like King’s in London, which is working in Somalia, or a hundred NHS organisations that have links with African countries. They are only part of the solution, but a valuable part.

I also acknowledge a point made by the noble Lord, Lord Howell, about how much the world is changing. I spend a lot of time in Africa, and I see that poor people with creativity, without all our baggage of history and without our resources, can innovate. They can teach us things that we need to know about how to run health systems. I have written about this. I note that the private sector is starting to develop ideas along these lines. GE Healthcare, for example, has identified a number of products that it has developed in poorer countries for translation into richer countries. McKinsey, the management consultancy firm, has also identified that many of the greatest innovations in healthcare today are developing and being created in poorer countries. This is a win-win situation.

I turn finally to security. At its simplest, building relationships and partnerships and links across the world will help. We see it all over Africa, where there are many strong links. Before I started to work in Africa, I did not think that the Commonwealth was terribly important. I now understand how important it is in forging the links between this country and many countries in Africa and elsewhere. We also know that poor health services, and poor services generally, foster discontent. We know that there is great unfairness in how health resources are shared—unfairness about patents and about how drugs and health workers are shared around countries—which builds tensions. On the positive side, we also know that health can improve the economy, that an improved economy can build stability in a country, and that health can play a bigger part in future in the Government's plans for post-conflict resolution and reconstruction.

On global security, there is the question of the risks of disease. We know that new diseases will develop in the poorest countries. They will develop where health systems are poorest. It is in our interest that those countries have reasonable health systems, so that they can protect the security of the world and not just of themselves. That is why I echo other words of the noble Lord, Lord Howell: international development is about not just moral imperative but enlightened self-interest. He talked earlier about mutuality and respect. When we put this together, we are in this together. We should be talking much more about co-development and not just about international development, where we are seen as doing things to and for other people.

On a personal level, I shall be seeking discussions with other Members of your Lordships’ House to see whether there is a need for an all-party group on global health. There are many specific groups which deal with specific issues but nothing as yet that looks at all the issues that join us together globally in health terms, at our interdependency and at promoting thinking and appropriate policies.

Finally, I urge the Government to do three things: first, to embrace the notion of interdependence and the linked point of co-development as underlying policy, taking further the previous Government’s work on Health is Global as their global strategy; secondly, to embrace and promote the need for more health workers—do not let people die for lack of simple advice and help—and, thirdly, to use the experience and expertise here in our universities and health service, as people are ready to play a role and people are ready for a lead.