NHS: Global Health

Lord Dholakia Excerpts

Monday 20th December 2010 Lords Chamber

[Lord Dholakia]

My Lords, I thank the noble Lord, Lord Crisp, for securing this debate. I had a quick look at his biography, and three areas stand out: his experience of the National Health Service, his involvement as a fellow of the Institute for Healthcare Improvement and, above all, his political interest in the developing world. It should come as no surprise that he has chosen global health and medical education for this short debate. No longer can we simply concentrate on learning about what is appropriate for the health of people in the United Kingdom; we have to take into account post-war migration and our interdependency with other nations. We also have to accept that the process of globalisation crosses the geographical boundaries of all nations.

The globalising economy relies increasingly on the skills of people wherever they are available, and international migration is a key factor in ensuring that Britain benefits from this phenomenon. I shall give an analogy. Climate change is not restricted to a single nation. Last week we dealt with the outcomes of the Cancun climate conference. For the first time there is an international commitment to,

“deep cuts in global greenhouse gas emissions”.

Here is a recognition that a nation cannot act alone. The Medsin UK response on global health acknowledges that the health of people in every nation is interconnected. A global health approach seeks to understand how individuals and population health are determined by global, as well as local, factors.

I realised the need for an international dimension to training when some years ago my wife and I had returned to rural Sussex following a visit to India. After some days, despite having taken malarial precautions, my wife developed a fever. The local doctors could not make a diagnosis and her condition deteriorated. She thought that despite all the precautions she had contracted malaria, and decided to take her temperature at regular intervals. The results demonstrated that she probably had malaria. The doctors were not convinced and took her blood to look for parasites, but they did not find any as they took it at the wrong time of day. She remained undiagnosed and decided to treat herself. She obtained medication and worked out the appropriate doses and timing of the medication. I am pleased to say that, after six weeks of being ill, she made an almost instant recovery.

Let me say that many medical colleges have recognised the need for global health issues. My daughter, who qualified at St Bartholomew’s Hospital Medical College, decided to go to Brazil for her elective experience. She was fortunate during that period not only to spend time in the cities of that country but to work in the Amazon rainforest, which brought home to her the realities of a broader aspect of health, including the impact of poverty on the health of deprived communities.

There are a number of factors that we need to take into account. I urge the Minister to look at the broader determinants identified by Medsin UK: health financing, human rights, migration and environment. I am tempted to criticise the Government’s points-based system of immigration, but I shall refrain from doing so. Suffice it to say that the treatment of overseas doctors by the previous Administration was shameful; we continually moved the goalposts, and many of them suffered serious hardship when having to return to their country of origin.

The present cutbacks in university funding at about 6 per cent, which was announced today, are likely to impact on medical colleges. There is already evidence that some universities will no longer be able to afford training in certain disciplines. It is vital that knowledge is shared with countries abroad. Numerous good practices have been developed in countries such as Taiwan from which we can learn. India is making tremendous headway in providing medical tourism. It is also providing medicines at a much lower cost than we do in this country.

I am delighted that the noble Lord who is to follow me today is contributing to this debate. When I visited Ethiopia, there were those in the healthcare professions who valued his knowledge and advice. That, to my mind, is the acceptable face of our contribution to the third world.