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Health: Global Health Partnerships

Volume 690: debated on Tuesday 27 March 2007

asked Her Majesty’s Government:

What action they propose to take towards implementing the recommendations of the recently published Crisp report, Global Health Partnerships.

My Lords, the report of the noble Lord, Lord Crisp, highlights the valuable contribution that the UK can make to strengthening health capacity globally. The Inter-Ministerial Group on Health Capacity in Developing Countries, chaired by my colleague Rosie Winterton, will oversee the way in which this is taken forward. A small working group with representatives from the appropriate departments will undertake further analytical work to review the operational and financial implications of the report and suggest a phased approach for its implementation. We also have one immediate response, which is to commit £1 million over two years to help the Global Health Workforce Alliance to tackle the urgent need to find solutions to the lack of healthcare workers in poor countries.

My Lords, I thank the noble Baroness for that encouraging and helpful reply. Does she agree that this excellent report, based on an inquiry chaired by the noble Lord, Lord Crisp, contains a large number of recommendations, all of which require serious consideration? What action are the Government taking to enhance the opportunities for healthcare professionals in the developing world to undertake improved patterns of education and training? Further, can the Government give an assurance that the career progression of UK doctors wishing to work in the developing world will not suffer under Modernising Medical Careers? Finally, bearing in mind the crucial importance of collaboration between governmental and voluntary organisations, will the Government give their support to the Tropical Health and Education Trust, which is much concerned with this area?

My Lords, the Government warmly welcome the thrust of the noble Lord’s report. It is an excellent document and, as I said, we intend to act on the vast majority of its recommendations. However, we have to examine it in detail. The noble Lord asked me about doctors working abroad. We are looking at this carefully because while we want doctors to work abroad, we also want to ensure that that does not have serious repercussions for our own health services and that doctors’ careers are enhanced when they undertake such missions. On the issue of doctors in developing countries, we want to assist them to stay in their countries where that is possible. Finally, on the Tropical Health and Education Trust, I am afraid that I do not have an immediate reply on that but I shall look into it and respond to the noble Lord in writing.

My Lords, in response to my noble friend’s Answer, is there not a problem with brain drain professionals from developing countries? Even if they would like to go back, their working conditions when they return are so unfavourable that they are deterred. What can the Government do about that?

My Lords, it is indeed a problem. Inadequate health services in developing countries mean that doctors either do not want to train there in the first place or they do not want to return when they have trained in this country. They, like health professionals here, want to have a career. For that reason, DfID has provided £55 million over six years to fund an innovative emergency human resources programme in Malawi. The programme is helping to build up the health service there so that professionals will want to be trained there and to stay there. So far as we can see, there is evidence that fewer staff are leaving the service. We are now seeking to identify more remote areas for such an incentive package.

My Lords, will the department provide incentives and resources to primary care trusts and GP practices to cover for leaves of absence, particularly of doctors, midwives and public health specialists, who can be of particular assistance in the developing world?

My Lords, we are looking closely at that issue at the moment. We are aware of the problems. We want to ensure that doctors can leave when they need to, but we must examine that in detail. I will come back to the noble Baroness when we have a proper response.

My Lords, what are the Government doing to co-ordinate the work between different NGOs to ensure that they are not acting in rivalry with each other and that the wheel is not continually being reinvented?

My Lords, before I answer that question I must congratulate the noble Lord. He has a trust, the Swinfen Trust, which is cited in the Crisp report as a demonstration of excellence in the IT and telemedicine fields.

The Government are aware that NGOs need greater co-ordination. We are working on that in DfID, from a DfID perspective, but as this report relates to health matters I am sure DfID and the Department of Health will be looking at this issue and trying to co-ordinate NGOs better on the ground.

My Lords, does my noble friend agree that one of the best NGOs, which is well known throughout the world for developing health advocacy, is BRAC? Will she join me in congratulating in particular Dr Fazle Abed, who has developed this method? I hope that this is worthy of all our attention globally.

My Lords, BRAC is the most extraordinary NGO. I had the privilege of meeting the founder not long ago. He is a truly extraordinary man who is changing the face of the world, not only in Bangladesh but in places such as Afghanistan and in many developing countries. He certainly deserves our very warm congratulations.

My Lords, does the Minister recognise that there is a real need for doctors to go out to these developing countries and to be able to improvise? For instance, there is a surgeon in Nigeria who has mastered the art of improvisation. He operates by sunlight on ladies with fistulae because he has no electricity. He has to move the table around quite a lot during the course of the day, but improvisation—making do with the available resources—is a very important principle.

My Lords, improvisation, as the noble Lord has argued, is extremely important. I am sure we wish to look at ways of supporting such fantastic innovation. As I am in the business of congratulations today, I must congratulate the noble Lord on his work for Mercy Ships.

My Lords, is the Minister aware that the Tropical Health and Education Trust, mentioned by the noble Lord, Lord Walton, has particular expertise in, and knowledge of, the health services in Somaliland? Will she guarantee that in developing these global partnerships we will pay particular attention to the needs of Somaliland, which is an oasis of peace and stability in an otherwise very difficult and war-torn region?

My Lords, I give the noble Lord the undertaking that we will do so. Indeed, we will view Somaliland in terms of best practice.

My Lords, does the Minister agree that another good example is the Mildmay Mission Hospital in Hackney, which also has a hospital in Africa, and deals with very difficult cases of HIV/AIDS and dementia? I am sure those at the hospital would be delighted for her to visit it. It is most interesting.

My Lords, any examples of best practice, such as the one cited by the noble Baroness, are extremely important. I would be delighted to visit that hospital.

My Lords, will my noble friend support the work of the Health Protection Agency, which has so much to offer developing countries? It has all sorts of expertise in tropical diseases and the like, and does enormously good work.

My Lords, does the Minister agree that where the larger aid organisations so often go wrong is when they set up parallel health structures because they are frustrated with local government? Can she ensure, in the light of the Crisp report, that that will not happen under DfID?

Yes, my Lords. DfID is acutely aware of such parallel structures. DfID is looking at that issue, but I know that the UN body is also looking at it, because those structures cause problems for countries on the ground rather than provide solutions at some stages.