Tuberculosis

Jim Fitzpatrick Excerpts

Thursday 7th June 2018 Commons Chamber

[Jim Fitzpatrick (Poplar and Limehouse) (Lab)]

I am grateful for the opportunity to make a very brief contribution to the debate. It is a pleasure to follow the hon. Member for Banbury (Victoria Prentis), who made a very good contribution. There is a bit of controversy about the Government’s solution to bovine TB, but it is a very serious issue and it does need to be addressed. I congratulate the right hon. Member for Arundel and South Downs (Nick Herbert) on securing the debate, his excellent presentation of all the facts and the sterling leadership he has given the House on this issue over a considerable period of time. It is valued and valuable, and we are grateful for the amount of time and effort he puts into it. I thank the Backbench Business Committee for affording the time for the debate.

The right hon. Gentleman, in his presentation, said that the motion succinctly outlines the main issues, so I do not see any reason for me to repeat all the messages contained in the excellent contributions we have already heard and I am sure we will hear before the close of the debate. It will suffice if I just make a few points.

TB is the world’s deadliest infection with, as we have heard, 1.7 million deaths in 2017. The WHO declared it a global health emergency in 1993 and it has not diminished since then. The UK has a very proud record. DFID should be pleased with the respect and recognition it and the UK have received for helping to address the issue across the world. World progress, however, is slow. It appears that the comparison with funding for HIV/AIDS and for malaria does not stand up to scrutiny, and I will come back to that in questions that I will pose to the Minister in due course.

If I may, however, I will stray for a moment from infectious diseases to one of the world’s other huge killers—that is, road crashes—which has an even lower profile. Annually, 1.25 million people die on the world’s roads and 20 million are seriously injured. The figures for malaria—I am not diminishing this in any way, shape or form—show that 429,000 died from malaria in 2015, which is the last year for which figures are available, and 1 million died from HIV/AIDS. There were 1.25 million deaths from road crashes. The UN and the World Health Organisation have recognised that this carnage needs to be addressed and two specific sustainable development goals address just that issue.

The United Kingdom is a world leader on safer roads. We can be of great help to many countries. The fire and rescue service and fire industry charity Fire Aid, which I chair, delivers post-crash response equipment and training to 30 countries. We are engaged with DFID and the Department for Transport and I hope that we can strengthen those links in future, because we can contribute much more to reducing these awful deaths—many are children on the way to and from school.

As I mentioned, I have just a few questions to pose to the Minister. I would be grateful if she could respond later, and if not, I would be very happy to receive correspondence in due course. First, can DFID commit to working with partners to close the TB funding gap? Secondly, will UK embassies champion TB in all high TB burden countries? Thirdly, will DFID establish a specific programme for new resources for TB, as it has for malaria and HIV/AIDS? Fourthly, will the Minister make DFID’s overall investment in HIV, TB and malaria in each of the last five years available through the devtracker website?

In conclusion, east London has been the hotspot in the UK for TB for—forever probably, but certainly in recent years. As the right hon. Member for Arundel and South Downs mentioned, the number of notifiable TB cases was 5,000 in 2017, down from 8,000 in 2011. We are going in the right direction, but people still die from TB in the UK, so it is a domestic issue as well as a global one.

I am grateful to consultant physician Dr Veronica White and her colleagues—she is a TB specialist at Barts and the Royal London NHS Trust—for all the work that they do in east London and to help the UK’s efforts, and for her briefing. I am also grateful to Alysa Remtulla from STOPAIDS and Janika Hauser from the all-party group on Global Tuberculosis for their assistance in producing briefings for all of us for this debate.

This is a hugely important issue. I echo the request to the Prime Minister—I think I signed the letter that the right hon. Member for Arundel and South Downs circulated last year—to attend the high-level global meeting. She will need relief from Brexit at some point. This would give her the perfect antidote by letting her concentrate on something on which I am sure the whole House will agree. It will give her the opportunity to take her mind off what is happening here and between us and the Commission.

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[Sandy Martin (Ipswich) (Lab)]

It is a real pleasure to follow the right hon. Member for Kingston and Surbiton (Sir Edward Davey) and all the other speakers. I fully support the motion and all the actions that it calls for. Much has been said about the urgency of ending the scourge of tuberculosis abroad, but I want to focus on what we can do here in the UK to help to stamp out TB among our citizens. If we are going to champion the fight against TB in countries where the prevalence is far greater, but where the general economic situation is far poorer, how can we hold our heads up when England still has one of the highest rates of TB in western Europe? That is from the Public Health England report of this March, so I apologise to colleagues from other nations of the UK—no doubt the figures are similar there.

Of course I support research into the causes and prevention of TB. Of course I support our programmes abroad to help to reduce the millions of deaths in less developed countries. Of course I support the search for new, more effective drugs, but we already know some of the causes, and the lack of effective policies on poverty and homelessness in our country make our commitments to eradicating TB abroad look—how shall I say this?—inconsistent. Public Health England is doing many of the right things, such as improving access to testing and diagnosis, but if we look for the reasons for the 20-year rise in TB rates in the UK from the mid-1980s to the early years of this century, the causal factors are not hard to find.

Some of the policies of the present Government, and, indeed, all Governments since the 1980s, have not helped. First, there is homelessness. Whether the homeless person was born in the Marshall Islands or in Margate, we know that if they are sleeping rough they are far more susceptible to infection and far less likely to seek treatment. Thirty per cent. of people in this country with TB do not seek treatment for more than four months, even after the symptoms have started, and during that time they are infecting the people around them. A very high proportion of those people are marginalised, without easy access to healthcare and without the motivation to seek it. We can try to work with homeless people, and I was delighted to hear about the London find and treat team, but how much better and more effective it would be to eradicate homelessness, and especially rough sleeping.

Secondly, there is our attitude to immigrants. It is yet another outcome of the hostile environment that so many immigrants suffer from diseases and do not have the information or the confidence that would enable them to seek help. Three quarters of TB sufferers in this country last year had not been born in the United Kingdom. That does not mean that they brought the disease with them, but it does mean that we do not do enough to inform immigrants to this country of the healthcare that is available, and do not give them the confidence to seek help from official organisations, including the national health service.

[Jim Fitzpatrick]

My hon. Friend is making a very important point. A matter that attracted quite a bit of controversy about 10 years ago was the number of people coming to this country as refugees or asylum seekers, from sub-Saharan Africa in particular, suffering from TB. The question to NHS England at that point was, should they be screened on entry? There was sensitivity about whether that was discriminatory and whether it was the right thing to do. It now appears that there has been an adjustment to the attitude of NHS England, which is screening people much more effectively. We need to let people know that they are carrying the disease and we can help them, but that means that we need to check them as they come into the country. There is great sensitivity about that, and I am not sure what the current position is.

[Sandy Martin]

I thank my hon. Friend for his helpful intervention. I would fully support a screening programme to help people who have TB and do not know it to receive the treatment that they need, and I cannot understand why anyone would be opposed to that. However, we are not just talking about people who were infected when they arrived; we are also talking about immigrants in this country who have contracted TB and who are afraid to go to the national health service, or do not know how to do so. Unless all UK residents can trust the major public institutions in our country, we are endangering ourselves. I urge Her Majesty’s Government to carry out a serious study of the take-up of health services by first-generation immigrants, and what can be done to remove the hurdles.

I fully support everything that has been said about the need to eradicate TB throughout the world, but let us also do something to remove the beam in our own eye, and deal with the poverty and marginalisation that prevent us from eradicating it here in the United Kingdom.