My Lords, the UK’s £427 million response was fundamental to combating Ebola and saving countless lives. We are committed to learning lessons and responding effectively to future crises, and made a critical contribution to better understanding community engagement. Many UK nationals worked bravely alongside Sierra Leonean communities and health workers, and I pay tribute to their phenomenal work. Part of our £240 million economic recovery programme will help strengthen local health systems, and help communities to hold government to account.
My Lords, I am grateful to the noble Baroness for her reply and for her consideration of the report of the All-Party Parliamentary Group on Africa on lessons to be learned from the Ebola crisis, which will be launched publicly later today. Can she confirm that the Government accept the key finding of this far-reaching study: that, in order to ensure preparedness for future health crises in Africa, health systems should be developed horizontally, local leadership prioritised and investment concentrated at community level? Will the Government regularly monitor DfID’s health development programmes to ensure that they recognise and respond to these findings?
My Lords, I thank the noble Lord and the APPG for the useful and timely report, which draws attention to the importance of communities’ role in ownership and in delivering in crises. We agree that engaging with communities in the delivery of public health systems is essential. To provide stronger, people-centred health services that reflect their needs, we are looking at lessons learned from the crisis, and very much looking at the recommendations of the noble Lord’s report.
My Lords, will the Government acknowledge that, prior to the Ebola crisis in Sierra Leone, they were planning to cut support for health systems in that country? As the Minister said, they subsequently spent nearly £500 million tackling the crisis. Does she accept that if we are to have health systems fit for the future, we must maintain long-term commitments? Can we be satisfied that the Government have reviewed their policy, given the cutbacks that have been applied in sub-Saharan Africa in order to support the Syrian refugee crisis?
My Lords, as the noble Lord knows, we are currently undergoing bilateral and multilateral reviews. We will learn from that process where our future funding will go. To take the noble Lord’s point about concentrating on fragile countries, a number of the countries to which the noble Lord referred will be among the 50% that we are targeting in our support for conflict-ridden and fragile states.
My Lords, the noble Baroness raises an important point about causes, but these are lessons that we will learn as we review all the work that we ourselves, other agencies and the Sierra Leone Government have done. We are also undertaking a lot of research in this area, so I thank the noble Baroness for her question.
My Lords, I saw for myself at the height of the Ebola crisis last year and again on the return visit to the Parliament in Sierra Leone last month the value that communities there put on the work of the Minister’s department, the Foreign Office, NHS volunteers and international development agencies. One thing that they did not value was the suspension of direct flights to west Africa. Could the Minister look very carefully at that decision and not have a knee-jerk reaction in future? It did not stop people travelling from west Africa—it just made life a lot more difficult for volunteers and those going out and actually impeded public health screening, because people came back through a variety of routes rather than direct routes.
My Lords, is the Minister aware of the criticism that has been made by Save the Children of the UK’s NHS employment of 27 Sierra Leonean doctors and 103 nurses, which amounts to a subsidy to the UK of £22 million? Will the Government review the practice of using migrant nurses in the NHS?
As the noble Baroness will of course be aware, it is important that during the crisis we draw on the expertise of all volunteers and experts. We were very fortunate to have volunteers from the UK go out, but we also very much drew on local communities and are now building up their local capacities.
My Lords, does my noble friend agree that something that we can do from this country is harness the extraordinary strength of our scientific base, particularly with respect to tropical diseases—in particular, insect-borne diseases such as malaria and Zika, which also threaten people’s livelihoods?
My Lords, just to pick up on the point made by my noble friend, one problem is that there is no postgraduate training for those who want to specialise in the healthcare system in Sierra Leone to build a sustainable and resilient system. I have asked this question before, but the Minister did not respond directly to it. What steps are the Government taking, and DfID in particular, to support the royal colleges in ensuring that there is in-country professional development for healthcare workers?
My Lords, I am sorry if the noble Lord thinks that I did not respond, so I shall try again this time. We are supporting the strengthening of healthcare systems in Sierra Leone and other places. In Sierra Leone in particular we are investing £37 million to strengthen President Koroma’s recovery plan, which will help build up the strength and capacity of local health workers—and, of course, will look at patient safety.
My Lords, I understand that it is possible that Ebola will become endemic in some of the populations that have been affected in the recent crisis. Can the Minister tell us what assistance is being given to these countries to monitor their people and make sure that we do not have such a huge epidemic as we had before?
My Lords, I am pleased to say that so far we are now looking towards 16 March as being the zero-plus-42 days since the last outbreak of Ebola, but we continue to monitor. Sierra Leone has active surveillance activities. Throughout the communities, health workers, health facilities and community surveillance programmes are continuing, even though we are coming to a zero point.