House of Lords
Thursday 30 January 2020
Prayers—read by the Lord Bishop of Gloucester.
The following Act was given Royal Assent:
Direct Payments to Farmers (Legislative Continuity) Act.
Major Trauma Centre: Westminster
To ask Her Majesty’s Government whether they have any plans to establish a major trauma centre in the immediate vicinity of Westminster to treat casualties in the event of any terrorist attack in the area.
My Lords, the NHS has well-tested plans and capability for responding to a terrorist attack and treating casualties. The attacks in London and Manchester in 2017 tested our capability. London has four major trauma centres where casualties will be triaged and treated, and this will include casualties from an attack in the vicinity of Westminster.
My Lords, I thank the Minister for her reply. Is she aware that thousands of people come into Westminster, including tourists from all over the world, people coming to work here, the police, demonstrators and both Houses of Parliament? Are we not a special case? Would it not be very good to have a special trauma unit at St Thomas’ Hospital? When there is a lockdown, we cannot move in Westminster.
My Lords, I pay tribute to all the brave members of the public, the NHS and Members of this place who so often have responded incredibly bravely when terrorist attacks occur. We owe a great debt of gratitude to all those individuals who do not think of their own lives in responding to protect others.
On the noble Baroness’s specific question about our capabilities in responding to risks that occur, we have a specific arrangement that has been put forward with the trauma network. The decision about the location of the trauma centres allows full geographic coverage while ensuring that the full package of care is available for patients when they come forward, which includes treatment for burns, orthopaedic injuries and neurosurgery. I know the noble Baroness knows there are four major trauma centres located in London at St Mary’s Hospital, St George’s Hospital, the Royal London Hospital and King’s. They are all adult and children’s major trauma centres and are all approximately three miles from Westminster.
More importantly, we have specialist ambulance capability in responding wherever an attack may occur in London. We can be very proud of the response that we have seen not only from the hazardous area response teams but from the tactical response units. Those responses have been in very short order and have meant that, although these were appalling incidents, their impact was much reduced.
My Lords, a study published in the Emergency Medicine Journal found that NHS hospitals seem in many ways unprepared for terror attacks, with half the doctors unaware of emergency plans and just over one-third aware of what to do personally if a major incident is declared. I thought the Minister’s answers were brilliant and very reassuring, but what action are the Government taking to ensure that all doctors receive education on their hospital’s major incident plan as well as an abbreviated version of their own particular role?
The NHS develops its plans in each hospital according to the Government’s national risk register and its planning assumptions underpin this. The security services then evaluate and publish the current threat level to the UK from terrorism and the NHS is made aware of any change to this, so that it can react accordingly. In addition, we provide training for paramedics for terrorist attacks, as I have mentioned. We have the hazardous area response team, comprising specially trained personnel to provide ambulance response to particularly hazardous or challenging environments, including following a terrorist attack. London also has the tactical response unit, which is designed to work as part of a multiagency team with police and fire services to respond to firearms incidents. In the most recent attacks, the response time for paramedics was within seven minutes. We have recently agreed to increase the number of marauding terrorist attack and chemical, biological, radiological and nuclear trainee paramedic responders, and we will have a minimum of 240 responders in each ambulance trust.
My Lords, I welcome the Minister’s reassurances. Is she aware that in London last year 265 fewer members of the public attempted CPR on people nearby whose hearts had stopped? Does that not suggest that it would be more help to the people who work in and visit this building if we invited St John Ambulance to come to us again to deliver training on CPR and wider first aid interventions?
As ever, the noble Baroness makes a very sensible suggestion about wider CPR training. I will take up that point.
My Lords, with the closure of the fire stations in Victoria and across the river in Lambeth, is the Minister comfortable that the firefighting support for Westminster is adequate?
My noble friend raises an important point. Ambulance and specialist response teams have very tried-and-tested ways of working with the fire and rescue and police services to make sure that they preserve life during potential terrorist attacks. We can be very confident in that response, especially given their performance during recent events.
My Lords, London has some of the finest emergency services and best-equipped trauma centres in the world. The real problem is the deadly vacuum between the terrorist attack and the arrival of paramedics. Specialist and military experts have developed citizenAID, a free app with a proven record that gives ordinary people the ability to give life-saving first aid without prior training or equipment. Will the Government promote citizenAID nationally? London needs it now, as does the Parliamentary Estate.
The noble Lord makes a very sensible suggestion to look at ways in which we can encourage individuals to save lives. It may be appropriate in situations other than terrorist attacks and I am happy to look into it.
My Lords, many people think that St Thomas’ has a trauma centre and are very surprised when they hear that it does not.
I thank the noble Baroness for her comment. I think I have made the point that there is a trauma network across London to ensure full coverage for trauma across the city and enable individuals to get the best trauma service, wherever they may be.
Nursing and Midwifery
To ask Her Majesty’s Government what plans they have to celebrate Florence Nightingale’s bicentenary and the World Health Organization’s Year of the Nurse and the Midwife in 2020.
My Lords, the Government are working with the Chief Nursing Officer for England on plans to celebrate the bicentenary of Florence Nightingale and those in the nursing professions. Plans include supporting the Nursing Now campaign across the NHS in England. The Chief Nursing Officer is also working in partnership with the Florence Nightingale Foundation to plan many activities, culminating in an international conference organised by the foundation and the Burdett Trust for Nursing in October 2020.
My Lords, I thank the Minister for that reply. This year is a chance to celebrate the legacy of great nurses and midwives of the past such as Florence Nightingale, notably, but also great figures such as Mary Seacole and others in this country and elsewhere. It is also a chance to celebrate today’s nurses and midwives, and thank them for what they do. In passing, I am delighted to be wearing a piece of the new nursing tartan, designed by Scottish nurses and commissioned just last month. However, this is also an opportunity to look again at nursing and midwifery, recognising how far the professions have developed in recent years and that they perform a very wide range of roles, all with customary care and compassion.
Nurses are true health professionals in their own right, no longer handmaidens to doctors—if they ever were—and have the potential in the future to do even more. With that in mind, I ask the Minister two questions. First, what plans do the Government have for investing in training and increasing the numbers of advanced nurse practitioners? Secondly, what plans do they have for reversing the decline in community nurses, school nurses and health visitors in this country, who will play such a vital role as services move more towards the community?
I thank the noble Lord for his important question. I am envious of his tartan and I definitely identify with his praise for nurses, who work long hours and serve the most vulnerable at the moments of their greatest need. To answer his specific questions, as part of the NHS people plan, we are committed to supporting career development for nurses, which includes supporting a diverse range of careers. An example would be the advanced practitioners within multi-professional teams. This is an important point that the noble Lord raises. We are also developing a plan for district and community nurses to work with healthcare providers, practitioners and higher education institutions. The plan will set out how we will grow the community nursing workforce, which includes mental health and learning disability nurses, and it is expected to be published later this year.
My Lords, might my noble friend not mark this important bicentenary by enabling those nurses who have been in the profession for, say, five or 10 years to have their student loans written off, given that the cost to the taxpayer of not doing so will be greater? The write-off in 30 years’ time for the taxpayer will be £1.2 trillion in cash terms, so why not help the profession and the taxpayer by doing this now?
The noble Lord has made this point before and I have taken it back to the department before. He will know that we are providing additional financial support to nurses, including the maintenance grant of £5,000 in non-repayable funding, with specific targeted support of £3,000. However, I am very happy to take back his proposal once again, as we have an upcoming Budget.
My Lords, is the Minister aware that the Royal Statistical Society is celebrating the election of its first woman fellow, Florence Nightingale, and that nurses play a very considerable part in the collection and processing of data that matter for public health, and all our health?
Yes, indeed. As the noble Baroness will know, Florence Nightingale was perhaps one of the earliest and most notable statisticians. She is a great role model for those young women who wish to go into STEM careers. One way in which we wish to mark this bicentenary is with the Nightingale Challenge, which calls for every employer of nurses globally to provide leadership and development training for young nurses and midwives in 2020. The aim is to have at least 20,000 nurses benefiting from it in 2020, with at least 100 employers taking part.
My Lords, it is right that we have congratulated nurses and celebrate them but it is also the year of the midwife. It is important that we celebrate the progression in midwifery. Midwives are often much less publicised for the work they do within the community. What plans are there for celebrating midwifery specifically during this year?
We are of course conscious that we need to support midwives, especially as we look to raise standards in midwifery. Specific plans are being developed by the Chief Nursing Officer, Ruth May, which will ensure that all parts of the nursing profession, including midwives, will be focused on. These will be brought forward shortly.
My Lords, given Florence Nightingale’s genius for exploring and combining very disparate fields of study and practice, including the worlds of healthcare and faith, will Her Majesty’s Government and the Minister join me in commending the work of parish nurses, who now bring health and healing to more than 100 communities around the country, complementing the work of both the NHS and social care agencies?
I absolutely agree with the right reverend Prelate on this issue. He will know that the long-term plan is committed to supporting and developing community care. Parish nurses are a key part of that, but so is the development of social prescribing, which we have committed to rolling out. I know that parish nurses work hand in hand with this programme, so I am pleased to agree with the points that the right reverend Prelate has made. We will also want to think carefully about how we can support the work that he is doing.
My Lords, the Minister mentioned the reimbursement of fees, which has been reintroduced. For non-mental nurse training, is this scheme as generous as that which was discontinued a couple of years ago, or do we reimburse only about 50% of the fees?
The scheme is more generous than the previous scheme.
My Lords, until a few years ago, community nurses looked after the whole population in the area in which they worked. Lately, they have looked after only children up to the age of about five. Is it planned for them to go back to looking after the community as a whole, which is an important part of their work?
The noble Baroness is very knowledgeable about this. She is right that when we strengthen community practice, it is important to have a holistic approach. That is exactly what underpins the ICS having a much more joined-up approach to social care, general practice and mental health. It is what lies behind developing a holistic people plan. Such an approach will come forward when this is published.
European Union: Trading Arrangements
To ask Her Majesty’s Government what plans they have to offer the European Union a new treaty, subject to World Trade Organization jurisdiction, which would continue the United Kingdom’s existing trading arrangements with the European Union.
My Lords, the Prime Minister’s deal set out in the political declaration the framework for a comprehensive and ambitious free trade agreement with the EU. We will of course leave the EU tomorrow, and we will then begin discussions on securing a new relationship.
My Lords, I am grateful to the Minister for that reply, but I would have thought that the Government may need something like this if the going gets rough in the forthcoming trade negotiations. For the record, will the Government confirm their recent Written Answer saying that, if we end up trading on normal WTO terms, EU exporters will pay us some us some £14 billion per annum in new tariffs whereas ours will pay Brussels only some £6 billion —an annual profit to us of some £8 billion per annum? Would this offer not therefore be generous to the EU and, if accepted, get rid of the Irish border problem, the need for much of Operation Yellowhammer and masses of lengthy trade negotiations? Would that not be cheap at the price?
I thank the noble Lord for his interest in these matters, but the whole point of a free trade agreement is that it is an improvement on WTO terms. The reason that many nations around the world want to adopt them is that people do not want to get into paying tariffs and quotas, which are an impediment to free trade. We are confident, given the agreement and the political declaration, that we can reach an ambitious free trade agreement with the EU before the end of the implementation period, and that is exactly what we will be doing.
My Lords, I thank the noble Lord, Lord Pearson, who has managed to bring back the noble Lord, Lord Callanan, who had already taken his leave of us last week—well done. I thank him also for his support for continuing the same trading arrangements with the EU as we have now. We agree. The problem is that the Government want to break alignment, and if you break alignment then you cannot have tariff-free, easy trade. Is not the noble Lord, Lord Pearson, right on this one occasion?
It is of course always a pleasure to be back in front of this House. By my rough calculation, this is my 50th Oral Question in front of your Lordships, who are always extremely inventive in the points they raise. The noble Lord, Lord Pearson, is right that we want to have a free trade arrangement with as little friction as possible. We accept that we are leaving the single market and customs union, we are not going to go for the dynamic alignment that the Labour Party is urging on us, and within those constraints we want an ambitious arrangement with as few frictions on trade as possible.
My Lords, will the Minister provide the noble Lord, Lord Pearson of Rannoch, who thinks that the UK can keep existing trade arrangements with the EU, with a list of clubs—gentlemen’s, sporting, golf, dining or whatever—that allow people to resign and stop paying the subscription fee but still enjoy all the benefits and advantages of membership?
I will leave the noble Baroness to have her own conversation with the noble Lord, Lord Pearson, about the benefits or otherwise of various clubs that the two of them might wish to be part of.
Not the same one.
Can my noble friend think of a club which the two might wish to be part of?
I thank the noble Lord for his question. I suspect that the answer is that they are both part of one of the most exclusive and enjoyable clubs in the whole of London, in this House.
There will need to be a disputes resolution body to resolve disagreements between the EU and the United Kingdom. The Government’s position, which I understand, is that it cannot be the European Court of Justice, but what body is going to perform this task?
I thank the noble Lord for the close interest he takes in dispute resolution. Perhaps he should be declaring an interest, with his long experience of both litigating for, and resolving disputes with, Her Majesty’s Government. Of course, he raises an important point. He is right that it cannot be the European Court of Justice, and we will want to discuss with our European partners a proper, independent arbitration process for any disputes that arise, although we hope that none will.
My Lords, at the time of the referendum, Boris Johnson, now our Prime Minister, assured voters that frictionless trade would continue. That has now been completely forgotten, and he has said recently that we have to accept that there will be barriers to trade as part of what we have to get used to. Is the Minister’s commitment on dynamic alignment the same sort of possibly short-term commitment as that which Boris Johnson made three years ago?
No, our commitment is that we will not be entering into a process of dynamic alignment; we think that decisions on future laws governing this country should be made in this Parliament, and we will not be subcontracting that job to the European Union.
My Lords, I understand the Government’s position on dynamic alignment, but have they made an assessment of the cost to exporters of the additional controls and checks that will be required once we are no longer committed to such dynamic alignment?
We have not concluded the future relationship yet, so we do not know what impediments or otherwise there will be to free trade. Our aim and ambition is to make sure that there are as few impediments as possible. We want unfettered access to EU markets, as indeed the EU will want access to our markets—that is the whole point of having the discussions. We will be seeking to secure an agreement without any tariffs or quotas and with as ambitious a relationship as possible, and I hope we will have the support of the Liberal Democrats in doing that.
House of Lords: Appointments
To ask Her Majesty’s Government what plans they have to review the criteria for appointments to the House of Lords.
My Lords, the House of Lords Appointments Commission is an independent, advisory, non-departmental public body. It plays an important function in vetting appointments for life Peers to ensure the highest standards of propriety.
My Lords, could the Minister tell your Lordships whether the criteria for appointment of political nominees to your Lordships’ House are exactly the same as those for independent Cross-Bench Peers? If not, why not?
My Lords, as the noble Lord knows, there are various established criteria for appointments to your Lordships’ House, whether distinguished service in a particular field or the potential contribution that the individual can make to the work of your Lordships’ House—or, indeed, both those things—subject to vetting for propriety. I come back to that point because it is central to the issue he has raised. All nominations are subject to independent vetting for propriety by the House of Lords Appointments Commission before appointment. That must underpin any future consideration of this matter.
My Lords, the issue of appointments to your Lordships’ House goes right to the heart of any reform we would see for this place. The Minister will be aware that your Lordships’ House has supported two methods of reform: first, ending the by-elections for hereditary Peers, as proposed by the noble Lord, Lord Grocott, with the overwhelming support of this House; secondly, the report of the noble Lord, Lord Burns, on how to reduce the size of the House and bring some balance into appointments. The only reason why we have not had any reform is that it has been blocked by the Government. In the light of the new commission that the Government intend to set up, can the Minister tell me whether he, the Leader of the House, the Chief Whip or any senior member of the House of Lords leadership team have discussed with the Prime Minister the Burns report and ways to take this forward?
My Lords, these are matters under discussion. The Government have not yet decided what will be in the scope of the commission, as the noble Baroness knows, and whether that will include the role of the House of Lords. We will make an announcement about that in due course; the point of my saying this is that the two processes could go side by side rather than together.
My Lords, could the Minister spell out for us exactly what vetting for propriety entails?
My Lords, regrettably I cannot do that as I do not have the privilege of being a member of your Lordships’ Appointments Commission, so ably chaired by the noble Lord, Lord Bew. I will write to the noble Baroness, having consulted him.
My Lords, in view of the Question of the noble Lord, Lord Tyler, on reviewing the criteria for appointments to the House, could we carry out such a review to establish why, given the Liberals’ performance at two general elections, we have ended up with more than 100 Liberal Peers?
My Lords, I would think the Liberal Democrats’ adherence to the principle of proportional representation should raise various questions in their minds on that issue.
My Lords, this House is, I hope, aware that since 2000, the Green Party has won in general elections between 1.8% and 4.3% of the vote, yet my noble friend Lady Jones of Moulsecoomb and I make up less than 0.3% of the membership of this House—I am aware noble Lords may think we are more. Will this be addressed and reviewed for the Green Party and other underrepresented parties?
My Lords, we have all welcomed the arrival of the noble Baroness to this House and her contribution to it. As she knows, the Conservative Party manifesto committed to looking at the role of the House of Lords and to reviewing the relationship between the Government, Parliament and the courts in a constitution, democracy and rights commission. Inevitably, swept up in that will be the kind of question about representation she has posed.
My Lords, the Minister may remember that I was in the coalition Government as Lords Minister responsible for attempting to put a scheme for Lords reform through this House. He may recall that the level of enthusiasm for reform from the Labour Front Bench, as well as from many on the Conservative Back Benches, was moderate to say the least. If we are moving towards reform, does the Minister now accept that the only way we can form a consensus is on a second Chamber which is largely elected on a regional and national basis for a long period?
My Lords, as I said yesterday, the Government believe that it is important for citizens in all parts of the United Kingdom to feel connected to the legislature and politicians and for there to be trust in our democratic institutions. That is one reason why we have committed to establish the commission that I referred to. However, the issue of regional representation is almost certainly germane to any consideration of the role of this House.
But, my Lords, would the Minister accept that there has been concern and support for reform of the role of the appointments commission, particularly putting it on a statutory basis and making explicit the criteria against which it judges applications? Does he accept that, at a time when we are trying to recreate trust in our institutions, the casuistry of the different criteria for assessing appointments to the Cross Benches and those nominated by the political parties causes problems regarding suitability and capacity to participate in the work of the House, and that it would be helpful to have very similar criteria for both sets of appointments?
My Lords, I recognise the noble Baroness’s concern on this matter and I shall ensure that the points she makes are fully considered.
My Lords, may I take the noble Earl back to the question from my noble friend on the Front Bench about the Burns committee report? That report had significant support in this House and is focused on taking reform forward without the need for legislation, using what one might call the natural processes already available to us. Is the leadership of the House pressing the Prime Minister to take seriously the recommendations of the Burns report?
My Lords, I think we can all agree that our numbers in this House need to reduce. However, in the light of the Government’s commitment to review the role of your Lordships’ House, with all that that en tails, it is difficult for me to go further as I cannot pre-empt the conclusions of that review.
Wuhan Novel Coronavirus: UK Citizens
Private Notice Question
To ask Her Majesty’s Government what measures are in place to contain the Wuhan novel coronavirus (WN-CoV) in the United Kingdom and what plans are in place from British citizens returning from China and other affected areas.
My Lords, the NHS is always ready to provide world-class care to patients, whether they have a common illness or an infectious disease never seen here before. As a precaution, we are asking anyone in the UK who has returned from Wuhan in the last 14 days to self-isolate. The FCO is working to make available an option for British nationals to leave Hubei province.
My Lords, I thank the Minister for her response and for attending the House at short notice. It is essential that the Government be robust in their messaging and that remedial actions be taken to reduce the possibility of fear through ignorance. They should consider all eventualities, including whether, in the extreme, core elements of government should be placed in lockdown. Would the Minister study and consider replicating the helpful advice that came out of the Canadian ministry of health regarding what citizenry should do in all circumstances, with dos and don’ts?
I am very happy to look at the advisory from the Canadian Government. I hold in high regard the CMO from that nation, whom I have met. The action that this Government have taken in putting in place enhanced measures at ports and giving advice to nationals has been proportionate but robust. So far, we can be pleased that all of the 131 cases tested for in the UK have been negative.
My Lords, I underline the support from these Benches for the plans for organised quarantine. Both the medical evidence on the incubation period and the limited evidence of spread from people not yet showing symptoms highlight the need for this. Keeping evacuated people together is important. We also strongly support the recognition by government that dealing with this is a top priority, and give our praise and thanks to the medical, public health and NHS staff who are working hard to ensure that preparations are in place in the UK.
Can the Minister explain a little more about the evacuation arrangements and what discussions have taken place? What discussions has the UK had with the World Health Organization on difficulties with evacuation? Can the Minister advise what action the Government are taking to ensure the safety and welfare of British nationals stranded in Wuhan due to the delay in evacuation if they are unable to board a flight as they display symptoms of the virus? Those who make it on board will have to sign contracts agreeing to the 14-day quarantine at an NHS facility on their return to make sure that they do not have symptoms of the virus. What staffing resources will be available to carry out quarantine and screening procedures? What happens if various people refuse to sign the contract? Clearly, these teams will be of great importance in preventing the spread of the virus to the UK. I look forward to the Minister’s response.
I thank the noble Baroness for her extensive questions. We are doing everything we can to get British people in Wuhan safely back to the UK. A number of countries’ flights have been unable to take off as planned. We will continue working urgently to organise the flight to the UK as soon as possible. We are working with British nationals who wish to leave and we are developing a package for them once they arrive. The plane will have medical staff on board to assess and manage the passengers; obviously, this is on the direct advice of and with support from our Chief Medical Officer, who has specific expertise in this area. A team from Public Health England and the NHS will meet passengers, and any passengers who have developed symptoms will be assessed and transferred to NHS care, as appropriate. Asymptomatic passengers will be transferred to an isolation centre; we do not want to provide details on that at this stage. We are working with the Chinese authorities to unlock the issues to allow the plane to take off.
My Lords, more than 120,000 Chinese students study in the UK. Can my noble friend the Minister say what support and advice the Government are giving to both students and universities?
Public Health England is doing a superb job in providing very clear advice for all those who may be concerned—either those who have relatives in China or those who feel as though they have been exposed. I encourage anybody with concerns to look to Public Health England for the most accurate and up-to-date advice; it is updated on a very regular basis. That is the place to go for the most accurate and clinically validated advice.
My Lords, the Question from the noble Viscount, Lord Waverley, asked about British citizens returning from China and other affected areas. The Minister has concentrated her replies on Wuhan and Hubei province. Yesterday, Dr Michael Ryan, the executive director of the World Health Organization Health Emergencies Programme, said:
“The whole world needs to be on alert now, the whole world needs to take action and be ready for any cases that come, either from the original epicentre or from other epicentres that become established.”
What advice is being given to people coming from other countries where there are already reported cases?
The noble Baroness is quite right. At the moment, there are 5,974 cases in mainland China and 6,064 cases globally, and there have been 132 deaths. It is important to understand that coronavirus is a large family of viruses, ranging from the common cold to much more severe diseases, such as MERS. The data we have puts the mortality rate at about 3%, so the risk is comparatively low compared with SARS and MERS. I just want to say that at this point.
In terms of wider travel advice, the FCO is now advising against all travel to Hubei province and all non-essential travel to China, and is advising British citizens to leave if they are able to do so. Wider public health advice for those travelling around the region can be seen on the Public Health England website. It is very clear and detailed. Any further advice on travel can be seen on the Foreign Office website. We are co-ordinating very closely; indeed, there was a COBRA meeting on this issue just yesterday.
My Lords, can the Minister clarify that Public Health England is working closely with the other three public health departments in the UK and is taking the lead on this for people who are returning? Further, what is our strategy for Hong Kong, where nurses have said today that they will go on strike unless the borders between mainland China and Hong Kong are closed in order to protect the population?
The noble Baroness is quite right: all the public health authorities across the United Kingdom will work closely together to ensure clear co-ordination, as always happens on public health issues. On Hong Kong, we will be discussing those issues through the WHO, which met yesterday to consider whether WN-CoV should be declared a public health emergency of international concern. It did not declare a PHEIC yesterday, but it will meet again. If it does declare a PHEIC, we will of course review our recommendations. However, we should be confident about the actions that we have taken. They are measured, proportionate and based on the highest level of scientific and clinical advice available at this stage of the outbreak from the Chief Medical Officer and Public Health England. We will keep the situation under continuous review and report to the House as it develops.
My Lords, the Minister has emphasised that the arrangements will be for British citizens. If a British citizen is married to a Chinese citizen, perhaps with children who hold British passports, will the whole family, including the Chinese citizen, be eligible to come to this country?
We are currently holding discussions on this point and the Foreign Secretary has made representations.
My Lords, has any progress been made in developing a vaccine against this dreadful disease?
My noble friend has raised an important point. While the UK is one of the first countries outside China to have developed a prototype laboratory test for this novel disease, there is as yet no vaccine. The WHO is co-ordinating the research effort in this area and is producing an R&D road map. As a nation we are actively involved in this because we have particular capabilities here. We will be contributing to a co-ordinated global effort not only to improve the diagnostics but to develop vaccine capabilities.
My Lords, has the Minister seen the report this morning from the AFP saying that Russia has closed its borders with China? Does that not add to the need for the World Health Organization to declare this a world health emergency? Are we in discussions with it about that?
I think I have already made the point that we are in constant dialogue with the World Health Organization regarding all aspects of the response to this outbreak. That dialogue includes the declaration of a PHEIC, which would include a number of different elements, and the organisation is meeting on that today.
Contracts for Difference and Onshore Wind Bill [HL]
A Bill to make provision about the allocation of contracts for difference; resume the allocation of contracts for difference to onshore wind projects; and make provision about planning applications for onshore wind installations.
The Bill was introduced by Baroness Hayman, read a first time and ordered to be printed.
Elections (Candidates’ Expenditure and Nominations) Bill [HL]
A Bill to make provision about election expenditure by candidates and political parties and about nominations as a parliamentary candidate; to abolish deposits; to confer powers on the Electoral Commission; and for connected purposes.
The Bill was introduced by Lord Tyler, read a first time and ordered to be printed.
Right to Die at Home Bill [HL]
A Bill to create a right to die at home.
The Bill was introduced by Lord Warner, read a first time and ordered to be printed.
Higher Education Cheating Services Prohibition Bill [HL]
A Bill to make it an offence to provide or advertise cheating services for Higher Education assessments.
The Bill was introduced by Lord Storey, read a first time and ordered to be printed.
Devolution in England Bill [HL]
A Bill to require the Secretary of State to report on devolution in England.
The Bill was introduced by Baroness Janke, read a first time and ordered to be printed.
Joint Committee on Statutory Instruments
Food, Poverty, Health and the Environment Committee
Joint Committee on Statutory Instruments
In accordance with Standing Order 73 and the resolution of the House of 16 December 1997 that, as proposed by the Committee of Selection, the following members be appointed to join with the Committee of the Commons as the Joint Committee on Statutory Instruments:
Stirrup, L, Colgrain, L, Haskel, L, Morris of Handsworth, L, Newlove, B, Rowe-Beddoe, L, Scott of Needham Market, B.
That the Committee have power to agree with the Committee appointed by the Commons in the appointment of a Chair;
That the Committee have power to send for persons, papers and records;
That the Committee have leave to report from time to time;
That the reports of the Committee be printed, regardless of any adjournment of the House.
Food, Poverty, Health and the Environment Committee
That Baroness Ritchie of Downpatrick be appointed a member of the Select Committee.
Middle East Peace Plan
My Lords, with the leave of the House, I shall repeat in the form of a Statement the Answer given by the Minister for the Middle East and North Africa to an Urgent Question in another place. The Statement is as follows:
“As the Foreign Secretary made clear in the Statement on Tuesday, the Government welcome the release of the United States proposal for peace between Israelis and Palestinians. It clearly reflects extensive investment in time and effort. A peace agreement between Israelis and Palestinians that leads to peaceful coexistence could unlock the potential of the entire region and provide both sides with the opportunity for a brighter future.
Only the leaders of Israel and the Palestinian territories can determine whether proposals can meet the needs and aspirations of the people they represent. We encourage them to give these latest plans genuine and fair consideration and explore whether they might prove a first step on the road back to negotiations.
The United Kingdom’s position has not changed. Our view remains that the best way to achieve peace is through substantive peace talks between parties, leading to a safe and secure Israel living alongside a viable and sovereign Palestinian state, based on the 1967 borders, with agreed land swaps, Jerusalem as the shared capital of both states and a just, fair, agreed and realistic settlement for refugees.
Our first priority now must be to encourage the United States, Israelis, Palestinians and our partners in the international community to find a means of resuming the dialogue necessary for securing a negotiated settlement. The absence of a dialogue creates a vacuum, which fuels instability.”
My Lords, the only way to achieve peace in the Middle East is a two-state solution negotiated with the consent of both sides. I note that the Government have welcomed this proposal, but surely it is striking that it has been published after consultation with only one of those states. If we are to find a diplomatic resolution, the Palestinian Authority must be involved in the process. Does the Minister agree that the involvement and consent of Palestine is vital for any agreement?
My Lords, the noble Lord raises an important point, and I believe I have covered that in part in the Statement I have just repeated: the UK’s
“view remains that the best way to achieve peace is through substantive peace talks between parties, leading to a safe and secure Israel living alongside a viable and sovereign Palestinian state, based on the 1967 borders, with agreed land swaps”
“Jerusalem as the shared capital”.
My Lords, this plan goes contrary to international law. It is an annexation plan and would give the Palestinians no control over their borders, water or security, no port and no airport—to mention just a few points. Yet the Government’s press release—I notice the Minister has added a few words to the end of it—welcomed this as “a serious proposal” that should be given “genuine and fair consideration”. How can the Government claim that in leaving the EU we will be better placed to fight for the rules-based international order and human rights? If annexation goes ahead, what will the Government do to protect international law?
My Lords, the noble Baroness suggested that I added certain lines. Just for clarity I should say that, as she knows from her own experience, that is not how government works. I have stated the Government’s position, which again restated that, as far as we are concerned,
“the best way to achieve peace is through substantive peace talks”.
She is right to raise concerns about annexation. We have always retained and sustained, and I reiterate again, that any annexation of any lands would be against and contrary to international law.
Can the Minister confirm absolutely clearly that this proposal involves further annexation of Palestinian land? Is there any other part of the world where the Government sanction annexation of neighbouring territories or even countenance it? Further, although he repeats the commitment to a two-state solution, as all Ministers of all parties have, can he confirm that this latest proposal manifestly makes any possibility of a two-state solution almost impossible?
My Lords, as the noble Lord rightly says, I have stated what the United Kingdom’s position is, as is entirely appropriate. This proposal has been put forward by the United States. Like any peace proposal or peace plan, it is worth consideration. It has been described as a first step. I agree with the noble Lord that, as I have said before and continue to say, any settlement between the Israelis and the Palestinians has to be credible, has to be accepted and must involve consideration by both sides. We hope the current proposal on the table means that the Palestinians will also seek to engage on this, but as I have reiterated, from our perspective this is a first step.
My Lords, I share some of the reservations that have been expressed about the position that the Government have taken, but could I ask for clarification on two points? First, some press reports have said that the proposals actually double the land available to the Palestinians. Where is this extra land coming from? Is it just the bits in the desert bordering Egypt? Secondly, do the Government actually approve of the annexation of the Jordan Valley, thus cutting Palestine off from Jordan?
My Lords, I will not go into the specific details of the plan. I have stated what the UK’s position is. On the reported annexation and the plan for the Jordan Valley, the position of Her Majesty’s Government is very clear: the unilateral annexation of any lands is against international law.
My Lords, the Minister said that he hopes this will be the basis for taking forward discussions. Has there been any indication whatever from the Palestinians that they are willing to take forward discussions on this basis?
My Lords, I can share with the noble Baroness that my right honourable friend the Foreign Secretary spoke with President Abbas on these proposals earlier this week. I understand that my right honourable friend the Minister for the Middle East is also meeting the Palestinian representative. I hope that they will engage with the proposals. Like the noble Baroness, I have followed the statements they have made thus far, but as I have said before, we hope that this plan is a first step and will engage all communities towards the final objective of two viable states.
My Lords, is it not difficult for the Government to maintain what is essentially a position of neutrality on this matter given our responsibilities under, for example, the Balfour Declaration? The truth is that this is neither a peace plan nor a two-state solution. It is a fait accompli in favour of Mr Netanyahu, as demonstrated by his public response to it in the White House. It is an annexation not just of land on which illegal settlements have been based, nor of the Jordan Valley, but of the Golan Heights, all of which is contrary to international law. Why do the Government not give a robust response in favour of the principles of international law—the kind of response we gave when Mr Putin annexed the Crimea?
My Lords, on the point about annexation, the noble Lord mentioned the Golan Heights. When the United States made that statement in support of Israel, we made our position clear: we are against annexation, which is against international law. I reiterate that annexation of any territory unilaterally is against international law.
My Lords, it is a strange phenomenon that so many noble Lords are quick to reject the proposals. What do they know better than the Egyptians, the Saudis, the Bahrainis and the UAE, who have all welcomed the proposals? That is a promising sign, but most notable is the statement from Qatar. So often in the rejectionist camp, Qatar is now calling on the Palestinians and Israelis to sit down together. What efforts is my noble friend making with the Palestinian leadership to encourage them to sit down and talk rather than reject the initiative as, sadly, they have done too often in history?
My Lords, my noble friend is right that certain parts of the Arab world share the objective of the plan’s being a first step. Countries have made statements according to how they view it. On the issue of engagement with the Palestinians, and I have said, we hope that the Palestinians engage on the first step of the proposals. We are making efforts. As I said earlier, my right honourable friend has spoken to President Abbas, and we will meet the Palestinian representative to London later today.
My Lords, it would be no exaggeration to say that this proposal is controversial, but it is certainly not the endpoint. It is not even the beginning of the end, nor the end of the beginning. It being on the table might be the beginning of the beginning of a process. Surely both sides can discuss it, at the very least. Does the Minister agree that objecting from the outset, as the Palestinians have done, is not terribly helpful?
My Lords, I am coming to the beginning of the end of my time. Noble Lords have repeatedly and rightly raised issues; I am sure that we will return to this plan and the wider issues across the Middle East. It is important that there is something on the table. Countries across the region have sought to give due consideration and, as I said, this is not the UK plan but an American plan. The United Kingdom position, of a viable two-state solution with a shared capital in Jerusalem, has not changed.
My Lords, surely Her Majesty’s Government should be not neutral on this issue but on the side of peace. The period since the Oslo accords has been littered with missed opportunities, generally involving the Palestinian Authority’s refusal to engage. Everyone in this House with any influence on the Palestinian Authority should urge it to engage in this. A large part of the Arab world is behind this, and Her Majesty’s Government should do their best to facilitate this important peace process.
My Lords, I assure my noble friend that we are on the side of peace. I share his belief in the importance of all parties engaging. We are doing our utmost to ensure that the Palestinians engage with this proposal, but as I said, it is an American plan, which we believe to be a first step.
Motion to Take Note
That this House takes note of recent developments in the field of gene editing, and its status in scientific research around the world.
My Lords, I open this debate in a spirit of inquiry and concern rather than as an expert with well-established views. I do so because I am a journalist, not a scientist. The field of gene editing is developing so widely across the planet and so deeply in the range of applications that it is time to back the calls of many scientific institutions to extend the debate beyond the medical and scientific fields, where, until recently, any degree of concern has been concentrated. It is time for everyone to know what is going on.
Before I get to the meat of the matter, here for a start is an issue raised by two charities, Genetic Alliance UK and the Progress Educational Trust, once they knew about this debate. In the interests of clarity, they have asked for the phrase “genome editing” to be used consistently in this debate, rather than simply “gene editing”. They warn against too often using the term “CRISPR”, a process of genome editing pioneered since 2012, as if it were the synonym for gene editing in general when there are several other techniques. Having explained that to your Lordships, for the purposes of this debate, and because it was used in its title, I shall refer to gene editing.
Last December, a Chinese scientist was convicted of practising a medical procedure without a licence to do so. He was sentenced to three years in prison and fined 3 million yuan. He is He Jiankui, a name now familiar throughout the world of gene editing. He had researched and produced, through the use of CRISPR, the genomes of what have since become two little girls. What is more, he declared that he had done so at an international genome editing conference in 2018. The world of biogenetics was appalled and flew into an explosion of panic and outrage. The welfare of the little girls is not a matter of public record—not yet.
Last November, I was invited by the Royal Society to chair a debate called “The Quest for the Perfect Human”. Its four panellists were people steeped in the science and application of gene editing and each was familiar with CRISPR. One, Dr Rodger Novak, was co-founder in 2013 of CRISPR Therapeutics. Another was Professor Robin Lovell-Badge of the Crick Institute, where many of its 110 labs are allowing scientists to analyse gene function and disease processes. Professor Lovell-Badge is also a member of the World Health Organization Expert Advisory Committee on Developing Global Standards for Governance and Oversight of Human Genome Editing. More of that later.
Intervention in a person’s genes for the sake of medical benefits is a technique that was always on the cards once the human genome project was declared complete in 2003. However, science is a constantly flowing river and, before then, interventions such as IV fertilisation had resulted in the first IVF baby, Louise Brown, being born as long ago as 1978. From the late 1980s, scientists in the UK were developing pre-implementation genetic diagnosis—PGD—a process whereby parents with a serious inherited disease in their family can avoid passing it on to their children. This technique is approved in the UK by the Human Fertilisation and Embryology Authority.
Time moves on, and in June 2013 the UK Government agreed to develop legislation that would legalise three-person IVF as a treatment to eliminate mitochondrial diseases that pass from mother to child—it is called MRT—and the 2015 mitochondrial donation regulations, allowed under the Human Fertilisation and Embryology Act 1990, made this possible with parliamentary consent.
I mention this background to indicate how genetic procedures are becoming more and more common in modern medicine and to place gene editing and its direction in that context. As one of the panellists said at the Royal Society debate, a line drawn in the sand gets washed away by the tide of change. Perhaps prompted by Mr He Jiankui’s extraordinary announcement, in 2018 the UK Nuffield Council on Bioethics published a report which concluded that
“though there may be many individual objections, there exists no categorical ethical objection to planting genome-edited human embryos.”
Given that, as I have outlined, existing UK law already allows limited editing of genomes in human reproduction, the eventual wide acceptability of editing to prevent the transmission of serious diseases and to eliminate them from the germline appears likely in the near future.
That being so, a number of ethical and social issues need to be considered. Before setting them out, let me summarise the present state of law around the world concerning gene editing. No country explicitly allows human germline genome editing, but many have no prohibition on it either. In the UK these matters are, as I have indicated, the concern of the HFEA, which requires all such matters to be done under licence. The August 2017 issue of Nature first reported on the American use of gene editing in humans. In response, George Annas, director of the Center for Health Law, Ethics and Human Rights at Boston University School of Public Health declared that
“the scientists are out of control.”
What makes a big difference to all this is the speed of scientific developments and the availability of editing techniques that are precise, affordable and easy to apply. We know that many are being used successfully under licence in the treatment of rare diseases. Their availability around the world makes their use, official or unofficial, likely to spread. CRISPR is the most well known. When CRISPR was first announced, the acronym received 19 million hits on Google, 5,000 articles were written, 28,000 patents were taken out and, as we know, two babies were born. The prospects for the future of medicine and the human race are huge: 8 million babies are born each year with genetic defects and most will die quite soon. The potential for doing good is enormous. There is talk, for example, of being able to eliminate sickle cell disease entirely, and families blighted by the possible inheritance of Huntington’s can look to gene editing permanently to delete the aberrant gene from their germline. Work is also being done on type 1 diabetes.
In this country, the Government set up the national genomic healthcare strategy last February to improve existing services for those with rare diseases, with the NHS offering genome sequencing as part of its service. One in 17 people in this country—6% of the population —will be affected by a rare disease at some point in their lives. That is 3.5 million people in the UK and 30 million across Europe. It is because so many new techniques are in use or imminent that it is important to confront the broader ethical and social dilemmas.
Is it ethical to change for ever a human germline to eliminate from human history certain patterns of inheritance? There have been calls for a moratorium, or at least a pause. How can and should the world control this? In the wake of Mr He Jiankui’s announcement, the World Health Organization has set up a committee of experts to look at the governance of the process and to create a framework that will consider the risks, benefits and various models of regulation—hard laws, soft laws and so on. How can any regulation be policed? With the techniques cheap and available, who is to stop rogue operators, or even biohackers, seeking to make such changes? How might a political tyrant one day make it serve his or her interests? The WHO report is expected this spring.
Another major consideration arises: what is to be considered an illness and who decides? Is deafness an illness? Should we be seeking to wipe it out? Is autism an illness? Many of those who belong to such communities would not think so. The offspring who result from gene editing have no say in the matter, and the consent of the patient is one of the major principles of medical practice. Who has the authority to rule on such a matter, and what form would any such ruling take? Would it be a total ban or would there be conditional permissions? Who is to write the framework, and should it be universal or local?
Another matter is social justice. To whom will this new facility be made available? Will it be acceptable for rich countries to forge ahead, leaving behind poorer countries that cannot afford such developments? Will rich individuals be able to benefit while the poor cannot? Who will have the right to refuse such treatment and to whom? The project risks widening, in an ever new and devastating way, the differences between rich and poor, and dividing the human race into subsections worthy of some futuristic science fiction. Indeed, such fictions have already been written—Huxley’s Brave New World, Kazuo Ishiguro’s Never Let Me Go and plenty of others. The imagination of our novelists is running ahead of the science.
The debate that I chaired at the Royal Society was called “The Quest for the Perfect Human”. In the course of that evening, the word “eugenics” came up—the science of perfecting the human race. It was used merely as a touchstone of the worst that could be imagined, but it is why I initiated this debate.
I have spoken of what I know and what I have heard. The first is very little; the second I may have oversimplified—I stand to be corrected by experts. However, as these techniques become more widespread, what has emerged—from the considerations of the World Health Organization to those involved in this work at the Francis Crick Institute and in university research institutions across the world—is the belief that the public must be brought on board. I hope that the Government are taking to heart the concerns that exist about this exciting but fundamental change in how science is about to shape, irreversibly, the human race. I beg to move.
My Lords, I thank the noble Baroness for initiating this debate. Although I agree with much of what she has said, I have a different viewpoint of how the science might develop. It is right and proper that society decides what science output to control and whether it is right for society to benefit from it if it harms society.
Perhaps I may start from a different angle. This is a story of another time—of a plausible future 20 or 30 years from now—in which the human experience of life and health, and perhaps even who we are, will unfold unlike anything we have known hitherto. In future, citizens will learn early in life, through a combination of intelligence gathered from their smart accessories, embedded devices and more accurate information from genetic testing, their predisposition to disease—whether they are heading towards disease, depression, dementia or any other condition.
More importantly, they will have a choice of an exit strategy. They will be able to choose a familiar route of medication, behavioural change or lifestyle change, or they might choose novel treatment paths. Those predisposed to disease will be able to have their risky DNA removed or altered. Those with neurological conditions might be treated with brain implants, and even cognitive function might be restored by a cling-film-like membrane or hair-like wires inserted into the brain to restore neuronal connections.
Brain implants are already in use in tens of thousands of patients with epilepsy, tremors, seizures, Parkinson’s disease and even some conditions related to mental health. If such treatments were effective and safe, who would not choose them to divert the course of their illness? Yet our genes and neurons are more than origins of our illness; they are also part of our substrate, our being, our humanity. Would manipulating them risk altering who we are?
Yet we cannot stop science and scientific developments that may make people’s lives better. As humans, we have been shaped by our discoveries: stone tools, fire and its control, eye glasses, electricity, antibiotics, nuclear physics, organ transplants, in vitro fertilisation and the internet, to name but a few.
Yet there is something different—some may say exciting—about gaining mastery over our DNA and brains. Our complete set of DNA, its molecular code and how it is expressed give rise in each and every one of us to a singular life. In modifying DNA in human cells, we turn them into living drugs. Since 2003, over a dozen gene therapy treatments have been approved to treat cancers and other disorders, of the eyes, blood and neuromuscular systems. The technology holds promise for countless cures.
Jennifer Doudna, who is known for her work on CRISPR-Cas9, says that, in less than 30 years,
“it will … be possible to make … any kind of change to any kind of genome”.
Because of the power of the technology, she and many others have called for a moratorium on germline editing of the human genome.
Developments in somatic editing of the human genome are quite different. This is not germline editing. Genome editing and somatic editing hold out great promise for the treatment of diseases caused by genetic mutations. There are over 75,000 genetic mutations that cause inherited diseases. Unlike in germline editing, the changes made in somatic editing are not passed on to future generations.
Several CRISPR-related therapies are in early phase trials for somatic genomic editing: editing patients’ T cells for treating cancers; boosting foetal haemoglobin in sickle cell disease; editing donor cells to treat non-Hodgkin’s lymphoma; editing photoreceptor cells to treat inherited blindness. Even in the UK, there are trials related to somatic genome editing; the CRUK-AstraZeneca Functional Genomics Centre does much of the work. The UK was the first in Europe to make CAR-T therapy, as it is today, available to cancer patients.
There is still a lot of science to be done to make these treatments safer and more effective. This will happen as more new technologies develop. CRISPR-Cas9 is not now likely to be used; it will be replaced by more accurate baseline and intermediate editing, which target a single nucleotide. ACGT nucleotides make up the amino acids of DNA. The transfer of one A instead of a C may cause a mutation and a disease; editing that into a normal sequence would cure the disease permanently.
Newer technology for base editing and prime editing, as I mentioned, holds much more promise. Germline genome editing in embryos to create genetically modified people is different, and ethically fraught. In my view, there should be a global moratorium on this for at least five years; it would not include a moratorium on research, because we can learn a lot of science from research into germline editing which may help in other areas.
There is a need for better regulation. We are lucky in the United Kingdom that we have a regulatory authority that can exercise this function to regulate practices that might be unethical, including research on embryos. The authority has granted one licence for research on genetically modified embryos. It may grant others if it is satisfied that they are necessary. But there are gaps that need to be filled. Hence, I ask the Minister to address this.
When the Human Fertilisation and Embryology Act was enacted, it was in the context of the science then, but now things have changed because the technology and the science have advanced to a point where it is not just human embryos that we can modify. It could be done on gametes produced outside the body or in vivo to gametes, so there is a need to change the Act so that it meets those changed circumstances. The definition of a woman has also changed, with trans women and other issues, so we need to look at the legislation so that it meets the current status.
The second aspect is that, as the noble Baroness has already mentioned, we need to have a wider consultation with the public such as the Government had before mitochondrial transfer was legalised. That took three years of experts and patients’ panels looking at the evidence. I hope the Government will do that with genomic editing.
My Lords, I warmly congratulate the noble Baroness on introducing this debate of great importance. I admired her for suggesting that it was in the spirit of inquiry and concern, not as an expert; I echo her comment. The joy of this place is that we have many distinguished scientists and clinicians as well as many distinguished ethicists among the Lords Spiritual and many others, so this is the right place to discuss this critical subject.
I shall quickly declare an interest as a member of the international advisory council of Chugai, a research-intensive Japanese pharmaceutical company involved in a pioneering genomics analysis programme. I have not discussed this debate with the company, incidentally.
All are aware that nearly every human ailment has some basis in our genes. The recent advancements in genomics are among the most impactful and exciting developments in medical research. Research using genome editing is enabling significantly improved diagnostics and treatment of a range of diseases including cancers, diabetes and cardiovascular disease.
I want to go back 40 years to when I published a paper in the Journal of Child Psychology and Psychiatry on the management of families with Huntington’s Chorea— now called Huntington’s disease—an incurable inherited neurological disorder that severely damages co-ordination and mental abilities, often resulting in psychosis. At that time there was no way to predict who carried the gene until it was manifest in deteriorating symptoms and, inevitably, a prolonged and deeply distressing death. It was a family secret, a taboo subject. However, as life-changing genetic medicine has developed, remarkable progress has been made, as has just been suggested, such that we can now perform genetic testing on high-risk individuals before the onset of symptoms. Pre-implementation genetic diagnosis now allows us to test embryos produced using IVF in order to prevent those with HD genes being implanted and, consequently, prevent the offspring inheriting the disease. Just last year uniQure announced a clinical trial for a gene therapy solution, AMT-130, which aims to utilise a harmless virus to add extra genetic code to patients’ neurons to make them produce a chemical that lowers the mutant Huntington protein. This is the first AAV to enter clinical testing for the treatment of Huntington’s disease—a wonderful example, but just one of many, of the benefit that genome editing may bring.
My second phase in this topic was as a member of the Medical Research Council under the distinguished leadership of a former Leader of this place, Earl Jellicoe. Some 35 years ago there was great excitement about the work at Cambridge—involving Sir Keith Peters, the Regis Professor at Cambridge, a man who I have recommended for a place in this House more times than I have had lunch but, I am afraid, without success—that led to the establishment of the Sanger centre, which in 1992 became the Wellcome Sanger Institute. Those were early days. Never then did I anticipate the phenomenal scientific progress that the next 30 years would bring.
Part of my purpose, and a prime concern during my National Health Service work, was to bring our great research universities together with the great teaching hospitals to protect, enhance and develop our scientific and medical research—a great strength in the UK where we see ourselves as a global leader. As we leave the EU, it is all the more important that we protect and enhance our competitive strength, in which biomedical sciences are a leader.
There has been great leadership at the Department of Health and Social Care. Jeremy Hunt launched Genomics England. Given its vast potential, it is vital to see the UK in a leadership position. I pay great tribute to Sir John Chisholm, Jon Symonds and many others who have served there. The House will be aware of the excellent work the organisation has undertaken through the landmark 100,000 Genomes Project since the organisation was launched in 2013. The project, which saw the full genome sequencing of 100,000 patients with cancer or rare, infectious diseases, places the UK at the cutting edge of genomic science.
Similarly, I pay tribute to the last Chief Medical Officer, Dame Sally Davies, a wonderful woman who I know really well. I am delighted to say that she is now the first female master of Trinity College, Cambridge. She worked on many causes—antimicrobial resistance, obesity and much else—but showed real leadership on genome sequencing. She has earned vast admiration. One of her research areas was sickle cell disease, so she really knew the patient cost of that. As CMO, she called for a gene-testing revolution in the hope that whole genome sequencing would become as common as blood tests and biopsies. It may cost around £700 a patient, but it can improve diagnosis and care for a majority of patients, allowing doctors to tailor treatments to each patient’s needs.
While the patients who participated in the 100,000 Genomes Project all gave full consent for their biological data to be sequenced, there are still some who are troubled by the implications of this technology for their privacy. Dame Sally has always said that the data can be stored securely and anonymised, but I well appreciate this point. One of my greatest battles in my health role was a fight with the insurance industry, which would weight clients, if they had an HIV test, as though they were HIV positive. I felt passionately that this was so counter to public health, and I am pleased to say that it changed its policy in the end. However, anxiety about what will become of patient information is real and genuine.
The NHS Genomic Medicine Service continues to develop. The leadership shown by Jeremy Hunt has been taken up by Matt Hancock and there is a great deal of potential. Like others, my concern is regulation. The first Bill that I took through the House of Commons in my own right when I became Minister of Health was what became the Human Fertilisation and Embryology Act. Coming back to the points made by the noble Baroness, Lady Bakewell, public debate on that was so important. Hysteria and misinformation are quite different from rational, evidence-based logic and the problem is always how to communicate that, so I was delighted to hear about her recent conference. At that stage, we were trying to spread information. The noble Lord, Lord Winston, who is in his place, was very much part of the campaign at that time, as were many others.
There was a real danger that we would not get the Bill through the House of Commons. I think the noble Lord, Lord Alton, was also there at that time. The Bill got a bit hijacked by the abortion debate. As ever, debates in the Lords were critically helpful and important. I remember drawing frequently on many of the Lords’ comments to take the work forward. Subsequently, I invited the noble Baroness, Lady Deech, to chair the Human Fertilisation and Embryology Authority, which she did magnificently. It has been said by the noble Lord, Lord Patel, and others that there have been light years of change since then, including MRT and much else.
The difficulties that we now need to consider are profound. I ask the Minister: how will we show leadership in regulation, nationally and internationally? It is complex and confused. It was 12 years from Louise Brown to the Human Fertilisation and Embryology Authority. How does he see the future?
My Lords, I add my own congratulations and gratitude to the noble Baroness, Lady Bakewell, on securing this timely and important debate. Unlike my noble friend Lord Patel and other noble Lords yet to speak, I am not a scientist. However, I have vivid memories of following the Human Genome Project with a mixture of excitement and awe as I realised its huge potential for good. I have been equally impressed by the many recent developments in gene editing, including the 100,000 Genomes Project and CRISPR-Cas9, which we have heard about, and their implications for the prevention or treatment of diseases such as cystic fibrosis, muscular dystrophy and cancer.
As our Library briefing makes clear, the benefits for personalised, precision human healthcare in particular could be enormous. The Church of England is supportive of what is going on, especially in the UK, which is leading the way. But, as always with progress of this kind, as we have already been reminded several times, several ethical considerations need to be taken very seriously and have already been mentioned. It is to those that I will now refer, given the generally accepted need of an ethical framework for all this work.
First, there is clearly a need to distinguish between research and its clinical application. Just because we have discovered that we can do something does not necessarily mean that we should do it, for a variety of reasons. In both research and application, it is essential to establish margins of risk for the participants. In the case of research the participants are of course embryos which, according to the HFEA code of practice, need to be granted “proper respect”. That respect is not easy to define but it means that they should never be viewed simply as commodities for experimentation or a means to an end. The 14-day limit for research on early embryos plays an important role here, since that is when the so-called primitive streak begins to appear.
Where clinical procedures are concerned, the participants will include donors, prospective parents and, above all, prospective children, as well as their eventual offspring. We need to consider every aspect of their well-being, including the psychological and social. At the moment, it really is not possible to know how subsequent generations of children might be affected by gene editing in their parents and grandparents. Interactions between genes might not come to light for several generations, so we need further research into the interrelatedness of genes before the clinical application of genome editing is likely to prove universally efficacious or safe.
Also, as we were reminded by the noble Lord, Lord Patel, there is a further distinction to be drawn between somatic or non-reproductive cells and germ or reproductive cells, as the Medical Research Council and others have made clear in the past. Human somatic gene editing does not present any novel ethical dilemmas but human germline genome editing has been aptly described as the bioethical equivalent of splitting the atom. This means its clinical application requires a very nuanced ethical approach. In particular, we need to be aware of unexpected outcomes and unintended consequences, such as deleterious changes in social attitudes; for instance, in our approach to disability and the stigmatisation of individuals.
As our Library briefing points out, there is also the danger—the noble Baroness, Lady Bakewell, referred to this—of facilitating eugenics or designer babies. The current consensus is clearly that such practices are ethically unacceptable. This raises the further ethical issue of human enhancement. The borders between treating illness, enhancing health and enhancing human performance and attractiveness are fairly porous, as we already know from periodic scandals in the world of sport. That needs more exploration before genome editing becomes a widespread clinical reality. So too does the question of social disparity, especially if clinical genome editing is to become primarily available through the private sector, as with IVF. This certainly needs to be adequately analysed and addressed. It was of course one of the two principles which the Nuffield Council on Bioethics insisted upon when commenting on the ethical acceptability of gene editing.
I remarked in opening on the huge potential for good that gene editing has, especially in the early prediction and diagnosis of certain diseases. I certainly believe that to be the case despite the ethical whirlpools which need to be negotiated along the way. Perhaps we also need to be wary of exaggeration and its attendant danger, genetic determinism. For instance, it has recently been proposed that all newborn children should be offered genomic testing. That in itself is fraught with ethical difficulties, from consent—who gives it?—through to subsequent applications for life insurance, although there is a current agreement on that.
Even more perplexing is the fact that many illnesses, such as cancer, dementia and heart disease, are not due to just one factor. As a recent article by Dr Phil Whitaker in the New Statesman points out:
“Numerous genes contribute to susceptibility and all interact in fiendishly complex ways with environmental and lifestyle factors. The risk estimates achieved by commercial genomics tests are no better (and may even be worse) than our current clinical judgements.”
That has been stated also by the British Society for Genetic Medicine. Even if the predictions are accurate, there may not be a lot that we can do about them apart from feel anxious, and we have more than enough anxiety around already.
We are asked in this debate to take note of recent developments in the field of gene editing. I for one am glad to do exactly that, with admiration for all the work that is going on, and enthusiasm, but not entirely without some ethical reservation.
My Lords, I declare an interest as a founder president of Progress. I take some objection to its attempts to change the nomenclature, as it did at the time of embryo research when it called the embryo the pre-embryo. I do not think that is particularly helpful; it will not really make much difference to how we handle the actual biology and the science.
I am an unashamed gene editor. I have been involved with gene editing in embryos for nearly 30 years and have a company, Atazoa, which has looked at different methods of modifying embryos. We have done that both in mice and in pigs, and not only in embryos but in sperm, so I feel that I have something worth contributing to this debate.
I am grateful to so many people for mentioning preimplantation genetic diagnosis, or PGD, which was invented in my own laboratory. Alan Handyside and I published that first paper, and the first patients are now aged 30, so there is already a technique for preventing genetic disease that has been pretty reliable. It is not absolutely reliable—mistakes have occasionally been made—but the advantage of embryo biopsy is that one is not fundamentally changing the embryo and any risk taken is therefore simply a failure of that patient to get pregnant. As far as we know, there are no epigenetic consequences; we do not think that it causes long-term ill-health.
As the Human Fertilisation and Embryology Authority has been mentioned, I should say that it admitted this week in answer to a Written Question that it has no follow-up on any of the issues currently important in embryology in IVF. So we do not know what happens to babies in the long term after egg freezing, and we have no follow-up on PGD or on a whole range of issues. Such issues are far more important than regulation of IVF, which is done quite inaccurately much of the time. Due to the finances, many private clinics are doing things that most of us in this House would regard as utterly disreputable, such as selling research treatments that have no basis. It is clear that there will always be that risk, just as there was with He Jiankui in Shenzhen University. We also have to say that any medical procedure can be misused; I do not think in vitro fertilisation, or even gene editing, are any worse. Of course, it is terrible for the child born irreparably damaged, who carries that gene editing through their lifetime and passes it on to the next generation—of course, it cannot be controlled in the future. The risk of gene editing in the embryo is of massive importance and it is therefore extremely valuable that we have this debate at least to put this online today.
A recent headline in the Times suggested that we can now eliminate genetic disease by gene editing. That is complete nonsense. We cannot eliminate hereditary disease because so many of these genetic defects will not be expressed in the genome of the parents being screened. In fact, many of these defects occur between the generations, at the time when the egg or the sperm is formed, during meiosis or at other times. The idea that we can eliminate hereditary disease is rather like the Tower of Babel: it is trying to be so ambitious that we lose sense of what our humanity is. That is really important and I will come back to it.
I have to say that we were criticised, in this House as well as elsewhere, when we produced the first pre-implantation genetic diagnosis and it was said that we were undertaking eugenics. If you go to YouTube, you can hear a recording of Anne Sofie von Otter singing “Wiegala”, a lullaby that includes the words “Schlaf mein Kindelein”—sleep, my child. It was sung by its composer, Ilse Weber, as she entered the gas chamber at Auschwitz carrying her child. She wanted to comfort the child, who was frightened, and she died in that gas chamber. We know that this happened, because there were eyewitnesses, and we have the score of the poem she wrote. That is eugenics, because her only fault was that she was Jewish—a 41 year-old woman with two children. There was nothing else and the science was misused. Science is always capable of being misused: it is not just Nazis, anyone can do it. This was done in China and it can be done in this country, as it can in Europe. Let us not forget that.
Regulation is not really the answer here. I shall come back to that, if I may. We have to differentiate between eugenics and reasonable medical intervention. It seems to me that eugenics is where you involve a population. When you are dealing with an individual, you think of the best solution for that family; therefore, sometimes you decide to put back an embryo that has had some mitochondrial change—which, incidentally, is not gene editing, but simply changing the spindle, and therefore rather a different process. Gene editing has not been done in this country. We gave approval for that, but gene editing is banned and should remain banned, in my view, because the risks are appalling.
CRISPR is not an accurate technique. It is the best technique we have yet devised, and far better than the techniques we were using, introducing viruses into embryonic cells, but it carries the risks of off-target mutations, of epigenetic effects, of possibly producing cancer, of misdiagnoses and of producing, as the right reverend Prelate pointed out, completely unpredictable effects. I greatly valued and admired his speech, which was an important intervention in this debate.
One of the concerns we must understand has to do with our humanity. If we went through enhancement, we might end up with the basic principle of ethics being completely confounded. We believe in ethics because, whether we are religious, scientific or humanist, we believe in the notion of the sanctity of human life. If we make a superhuman, what value has human life? Playing God is something we should do; it is not wrong to do that. Imitating God, making use of our intelligence to provide the best solution to things, is what we are empowered to do and should be doing. However, to try to imitate God in the way they did, for example, at the Tower of Babel, if that parable or lesson is right, is utterly inappropriate, in my view.
We have to recognise that regulation will not work; it did not work in China and it would not work in this country. You could not prevent somebody doing this out of hand. We must recognise that we have to collaborate. International law will not work, but having more scientists working together and understanding the ethical issues will. I bet that if Dr He had worked in our laboratory, he would not have done that experiment in China. He worked somewhere in the United States. He was not an embryologist, which was not very helpful, because he did not understand the ethical issues raised. That understanding is something we have to grasp more and more.
My Lords, it is impossible to follow that outstanding speech by the noble Lord, Lord Winston. I hope the House will forgive me if I focus on this subject as it applies to international sport.
It is interesting to reflect that 100 years ago in competitive sport the distinction was between the amateur and professional ranks. Today the focus is on the drug cheats who knowingly take banned performance-enhancing drugs to gain a competitive advantage. London was supposed to be the cleanest Games in history; statistically, they turned into the dirtiest. There were 116 failed tests at the London Olympics in 2012, beating the mark of 86 set in Beijing. Of those 116 athletes, 69 have subsequently been disqualified—more than triple the number caught doping at the 2004 Athens Olympics and, as your Lordships will know, only the dopey dopers are foolish enough to get caught during the height of the competitive season.
Thanks to the noble Baroness, Lady Bakewell, we have the opportunity in this debate to look to the future and focus on the next major challenge to clean competitive sport. The outlook is bleak, for the battle between sports cheats and testers is poised to enter a whole new era. The consequences of gene editing for performance enhancement in sport are real. That is why the World Anti-Doping Agency has extended its 2003 ban on gene doping to include all forms of gene editing. It already bans the use of genetically modified cells and gene therapy if they have
“the potential to enhance sport performance”.
The list also includes
“gene editing agents designed to alter genome sequences and/or the transcriptional or epigenetic regulation of gene expression”,
although, interestingly, the responsibility lies with the athlete, which is impossible if their gene editing eventually one day becomes somatic.
The field is advancing incredibly fast, in part due to the discovery in the Olympic year of London 2012 of an easier editing method, CRISPR, which has been referred to, and its subsequent sons and daughters. The challenge in global sport for the remaining years of the 21st century will move on to the consequences of fast-moving developments derived from gene editing, where genetically engineered athletes will be set against the untainted natural skills of the fastest, highest and strongest competitors on earth. At the heart of the debate will be therapeutic use, as opposed to performance enhancement, among athletes, as rightly referred to by the right reverend Prelate.
There will always be huge ethical hurdles to consider, as evidenced by the rogue Chinese scientist Dr He Jiankui, but for sure there will be others seeking to fill his research shoes and the possibility of hidden funding to attempt to create the perfect athlete, which, as the noble Lord, Lord Winston, noted, will be impossible. However, it will not be impossible to create enhanced athletic performance.
My call for an outright ban on the application of this science in the world of competitive sport does not mean that I am blind to the potential of gene editing outside sport. However, I caution on the reality of further laboratory work in this context. Genes have a significant role to play in sporting performance, but they will never deliver sporting glory on their own. Without the balance of genetic advantage, environment, coaching and training, there will never be gold medal outcomes.
Take the example of the benefit of altitude training. As elite athletes acclimatise to high altitude, they acquire more red blood cells, which allow them to carry more oxygen. When they compete at lower altitudes, they get a natural boost to the muscles when additional oxygen is available. This blood-expanding effect can enhance performance by up to 2%. While that sounds like a tiny improvement, it can be the difference between missing selection and a gold-medal performance.
As evidenced by David Epstein in his seminal book The Sports Gene, the celebrated Mäntyranta—the multi-gold medallist in cross-country skiing in Finland—had a genetic trait which led to an extraordinary blood cell count, measured at up to 65% higher than that of the average man. It demonstrated that even trace quantities of EPO could bring major performance advantages. Subsequently, in all, 97 members of his family were examined, 29 of whom had remarkably high haemoglobin —many were champions in cross-country skiing. The geneticist Albert de la Chapelle discovered that, of the 7,138 pairs of bases that make up the EPO receptor gene, a single base was different in the 29 family members who had unusually high levels of haemoglobin. Each family member, like all human beings, had two copies of the EPOR gene. But at position 6,002 in only one copy of each affected family member’s two EPOR genes, there was an adenine molecule instead of a genuine molecule—a minuscule alteration, but the impact was immense. The production of red blood cells ran amok. Here was a mutation beneficial for an athlete, but otherwise of little consequence.
Of course, natural examples such as this are extremely rare, and applying that science in the laboratory and finding the athleticism genes is extraordinarily complex and difficult. However, it is attractive to those who wish to cheat in international sport to achieve glory. This is the road that will be travelled by rogue sports geneticists to cheat the system, which we must block through effective regulation and legislation, both domestically and through international co-operation, however great the challenge. David Epstein went on to say:
“A persistent inability to pinpoint most sports genes doesn’t mean they don’t exist, and scientists will, slowly, find more of them.”
One conclusion we can all reach is that, despite the uncertainty surrounding the potential application of gene editing to competitive sport, its potential is real. It should have no place in competitive sport. As I have made clear, in the 21st century, cheating by means of performance-enhancing drugs is an issue of today, and it is an issue of tomorrow for those geneticists who will go to any lengths to corrupt the athlete, and, sadly, many nation states in search of glory, in one of the few sectors where some countries can gain national pride. Gene editing clearly has huge benefits, such as relieving the burden of heritable diseases. However, it has no place in the sports arms race if we are to protect the integrity of competitive sport between clean athletes and rejoice in fair competition between young sports men and women worldwide.
My Lords, the whole House will want to thank the noble Baroness, Lady Bakewell, for giving us the opportunity to discuss this hugely important topical but also morally important question, which raises grave issues regarding the science and ethics of what we might do, especially regarding eugenics, to which the noble Baroness referred. I particularly endorse the remarks that were made by the right reverend Prelate the Bishop of Carlisle and the noble Lord, Lord Winston, who made an incredibly important speech in our debate today, asking us to consider the wider issues that are at stake here.
The noble Baroness will have seen the response of the British Society for Genetic Medicine to Matt Hancock and his ambition to conduct genomic sequencing of healthy newborns. It says that that could be “problematic”, because the genetic code of a healthy newborn
“will only rarely predict future disease accurately”—
a point the noble Lord, Lord Winston, reminded us about. The society says that it is important that
“children are not tested for adult onset conditions if there is no effective preventative intervention or treatment in childhood. Issues such as sample and data storage, access and retrieval also require detailed scrutiny”.
“Such a venture therefore needs to be carefully researched, and the ethical and societal aspects require careful consideration before roll-out to the general population.”
However, other forces are at work. This morning, I sent a letter to the Minister, the noble Lord, Lord Bethell, from the Royal Academy of Engineering, as well as my response. I was dismayed to see the phraseology it used in talking about gene editing, citing factors such as
“economic activity and sustainable and resource-efficient solutions to the societal challenges faced in food, chemicals, materials, water, energy … and environmental protection.”
If applied to humans—which has yet to be excluded—I admit that the language employed in the academy’s letter sounds rather disturbing. For example, it uses words such as “exploiting”, “explosive”, “market pull” and “technology push” and “commercialisation and industrialisation”. The Royal Academy of Engineering’s report also focuses on commercialisation to the apparent exclusion of ethical discussion, apart from a glancing reference to consumer choices in clothing.
Reference has been made in your Lordships’ House to earlier debates on the 1990 legislation, the establishment of the Human Fertilisation and Embryology Authority and the use of mitochondria. It is important to say in the context of such debates that we should not tantalise or raise expectations unduly. During our debates in your Lordships’ House on mitochondrial replacement, we were told that there would be cures and that they would be imminent. What progress has been made on clinical use since the licences were granted by the HFEA? It is an interesting precedent in the context of today’s debate.
One of my last contributions as a Member in another place before standing down was in a debate on genetics and embryology. I said:
“Legislation cannot be value-free or ethically neutral. A dirigiste or disinterested approach—marketplace genetics—simply would not do.”—[Official Report, Commons, 19/7/1996; col. 1444.]
So I cheered when, in December 2018, the World Health Organization established an expert panel to develop global standards for the governance and oversight of human genome editing. Its consultation closes on 7 February.
A year ago, in an article in Nature magazine, 18 scientists and ethicists from seven different countries called for
“a global moratorium on all clinical uses of human germline editing—that is, changing heritable DNA (in sperm, eggs or embryos) to make genetically modified children.”
My noble friend Lord Patel referred to this point earlier; I endorse entirely his call for a global moratorium for at least a five-year period. The scientists warned against using tantalising arguments to justify the risks and pointed to unknown dangers, including attempts to correct or modify susceptibility to one disease and unwittingly opening the way to another. They said:
“It will be much harder to predict the effects of completely new genetic instructions—let alone how multiple modifications will interact when they co-occur in future generations. Attempting to reshape the species on the basis of our current state of knowledge would be hubris.”
They warned of
“marketing pressure to enhance their children.”
“Genetic enhancement could even divide humans into subspecies.”
They said that implications for
“future generations could have permanent and possibly harmful effects on the species.”
Very significantly, Jennifer Doudna, one of the two scientists jointly responsible for CRISPR-Cas9 gene editing technology, is cautious about its use in humans and calls for prudence. Her co-discoverer and co-inventor, Emmanuelle Charpentier, has far stronger reservations. She urges us to look for alternative approaches and, along with her colleagues, says that
“germline editing is not yet safe or effective enough to justify any use in the clinic.”
She says that, even with experience, study and future research,
“substantial uncertainty would probably remain.”
Against this background, around 30 countries currently have legislation that directly or indirectly bars all clinical uses of germline editing. Although a regulatory approach, which has been referred to, and an international treaty—perhaps mirroring those on chemical and biological weapons—is what I prefer, I recognise the challenge of securing such international agreement. Of course, UNESCO signally failed to create a legally binding convention outlawing human cloning.
However, we should at least attempt to secure voluntary pledges to prohibit the clinical use of human germline editing while a moratorium is in place. I like others’ suggestion of a global genome editing observatory to track developments and foster widespread debate. I welcome the Minister’s response to that proposal.
The urgency of tackling the wild west of marketplace genetics was illustrated by the way in which, in late 2018, the Chinese biophysicist. He Jiankui ignored ethical and scientific norms in creating the twins Lulu and Nana, who were referred to earlier. His use of gene editing on embryos was not a correction of any existing disorder but an attempt to immunise the twins against HIV—an attempt at enhancement that appears to have introduced novel mutations. On 4 December, the Guardian warned:
“China gene-edited baby experiment ‘may have created unintended mutations’.”
Initial approbation turned to condemnation; as we know, He Jiankui is now in jail.
The Chinese Academy of Sciences is to be commended for its robust and unequivocal condemnation of He’s activities, which, it said, represent
“a gross violation of both the Chinese regulations and the consensus reached by the international science community. We strongly condemn their actions as extremely irresponsible, both scientifically and ethically.”
I hope that the logic of that argument will be extended when we look at issues such as DNA profiling and, although it is wider than today’s debate, when we think about the million Uighurs incarcerated in Xinjiang, all of whom have had their DNA profiled. I wrote to the Minister about this; although it is outside the scope of today’s debate, I hope that he will reply to my points and place a copy of that correspondence in the Library.
As the noble Lord, Lord Winston, reminded us, this is a week in which we commemorate terrible events. In December 1946, the so-called Doctors Trial opened the eyes of the world to the way in which medics and scientists had committed appalling and vile crimes against humanity. It must always be our objective to ensure that good science and good ethics march hand in hand and always go together.
My Lords, like other noble Lords, I will talk mainly about gene editing as it relates to human reproduction, which is a highly contentious issue at present.
The UK recently completed a project to map the genomes of 100,000 individuals. When an individual’s genome has been mapped, therapies can be tailored to address their personal ailments, including cancers. An individual’s genetic information can serve to identify the precise nature of the cancer, then the cancer can be treated by means that are more subtle and less invasive than the surgery, chemotherapy and radiotherapy on which we have depended hitherto. In mapping an individual genome, one can also discover whether an individual is a carrier of a pathological recessive gene, such as those that give rise to cystic fibrosis, muscular dystrophy or sickle cell anaemia.
There is detailed genetic knowledge of many monogenic disorders. In such cases, gene editing might serve to alleviate the disease and prevent it being transmitted to future generations. Genetic editing, which is the topic of this debate, denotes the introduction of new genetic elements into organisms. It has been pursued in the laboratory since the 1970s, with plants and animals as the subjects. Hitherto, the major drawback of this technology has been the random way in which the DNA is inserted into the host’s genome. This can impair or alter other genes within the organism, which has disbarred its widespread use in humans.
Recent advances have meant that gene therapy can now be targeted more precisely. Among the novel techniques is CRISPR gene editing, which is based on a modified version of a bacterial antiviral defence system. This method allows DNA to be cut at a specific location, which is identified by the code incorporated in the Cas9 enzyme, which does the cutting. Then, the repair mechanisms of the cell can be relied on to mend the break and, at the same time, incorporate a DNA snippet or plasmid that has been introduced in the company of the Cas9 enzyme.
As we have heard, there are two types of gene therapy. In somatic cell gene therapy, the therapeutic genes are transferred into any cell other than a germ cell, which excludes sperm and egg cells. Such modifications affect the individual patient only, and are not inherited by offspring. In germline gene therapy, germ cells are modified by introducing functional genes into their DNA. The change will be passed on to subsequent generations.
Australia, Canada, Germany, Israel, Switzerland and the Netherlands prohibit human germline gene therapy. The techniques are regarded as unsafe and it is maintained that there is insufficient knowledge of the risks to future generations. The US, by contrast, has no controls regarding human genetic modification beyond the regulations that apply to therapies in general.
We need to consider whether the denial of germline therapy is a significant impediment to the application of genetic technology for the betterment of human welfare. For this, we need to look at some examples. We may begin by considering the case of a recessive gene such as sickle cell anaemia. Genetic editing might be used to eliminate the genes from the germline of a procreating couple, each of which contains a single copy of the gene. In normal circumstances, there would be a one in four chance that any offspring would inherit two copies of the faulty gene from the parents. This is a consideration that might encourage the couple to remain childless. However, there are several other recourses that are more obvious and familiar than gene therapy.
The parents might, for example, use in vitro fertilization to produce several embryos. After a few rounds of cell division, the cells of the embryos could be subjected to a biopsy. If any of them were found to be free of the faulty gene, it could be implanted in the mother. This recourse is described, as we have heard, as pre-implantation genetic diagnosis. Another recourse would be to use the sperm of a donor who has been shown to be free of the pathological gene. This would ensure that the offspring could not be afflicted by the disease, and that at most, they would inherit only a single copy of the recessive gene. Another possibility is an embryo donation to the mother using the ovum of a third party. The final recourse, which seems eminently practical and desirable, would be the adoption of a child.
Gene editing could in principle be used to the same end as pre-implantation genetic diagnosis. It would be possible to use techniques to correct, within the human embryos, the mutant beta-globin gene associated with sickle cell anaemia. The treated embryos would be grown in vitro and subjected to genetic sequencing to allow the selection of those in which the desired modification had been achieved, and one or more of them could be implanted. However, there seems to be no advantage in such a rigmarole in the case that we are considering.
A stronger case could be made for gene-edited conception where both parents have two copies of the recessive mutant gene. Another instance in which gene editing might be justifiable is where one of the parents contains two copies of a dominant pathological gene which is bound to be inherited, with ill effects, by any offspring. Sometimes, the affliction will be so severe that the individual is unlikely to procreate. However, some genetic diseases such as Huntington’s disease are not manifested soon enough to become obstacles to procreation.
Another theoretical possibility is to apply gene-editing techniques to the gametes—that is, the egg and sperm cells—instead of to the already-formed embryos. To my uncertain knowledge, albeit that I have been informed by the noble Viscount, Lord Ridley, on this matter, this is not part of the current repertory. However, there could be no avoidance of the need for a biopsy of the resulting embryos.
We have used modified sperm in pigs, as we have in mice, so it is certainly a possibility.
I have now learned something. However, we must now ask where this leaves us. The first point to be made is that the existing methods of gene editing are of insufficient accuracy to be used in human reproduction without the accompaniment of a rigorous pre-implantation genetic diagnosis. In such circumstances, they have no advantage over the existing methods of embryo cultivation and implantation, provided that there is a possibility of selecting a disease-free embryo.
A word should also be said about the eugenic fantasies that have accompanied the publicity surrounding recent advances in gene editing, notably the CRISPR technique. It has been suggested that they have created the prospect of breeding humans endowed with superior qualities of athleticism, brain power or other desirable traits. I believe that such fantasies can be dismissed. Notwithstanding the example given to us by the noble Lord, Lord Moynihan, the human qualities in question are the consequence of multiple genetic endowments. They are also affected by environmental and epigenetic influences, and such determinants are way beyond the reach of gene-editing techniques.
Finally, one is struck by the thought that the Cas-9 enzyme could be devoted to its original purpose, which is to defeat vital infections. Also, the bacteriophages against which it is naturally directed could be employed as substitutes for the human antibiotics whose efficacy is very rapidly declining.
My Lords, I thank the noble Baroness, Lady Bakewell, for introducing this debate with her usual clarity and for the extraordinarily powerful speeches that we have heard from noble Lords on all Benches, to which I have listened with great attention and interest.
In the past, I have had the huge privilege of being a member of both the HFEA and the Nuffield Council on Bioethics, and any contribution that I can possibly make to this debate is almost entirely indebted to that experience and what I learnt when I was a member of them. What first came out of my membership of the HFEA was a huge admiration for those working in the field of medical research. It is painstaking and exacting work, which I am sure the noble Lord, Lord Winston, can emphasise much better than me that for long periods can yield only disappointing results. Of course the results in recent years have been quite startling, as many of your Lordships have pointed out, so I will not repeat them.
The creative intelligence of the human mind in its capacity to discover and develop new forms of treatment for illness is a truly remarkable feature of what it is to be a human being, and a gift from the giver of all good things. Moreover, the Bible, if I am allowed to mention it, makes it clear that illness and disease are contrary to the will of the creator. They may for the moment be an inescapable part of being alive at all, but we are called on to alleviate pain and to cure illness whenever it is in our power to do so. It is remarkable how much in the Gospels is given over to stories of Jesus healing people. Using all our human ingenuity to overcome disease is not just what we want to do in our own interests as decent human beings, but from a Christian point of view it is co-operating with the work of a good creator.
All this may seem very obvious but it needs to be said because as we know, sometimes we hear accusations, particularly in the field of genome editing, that human beings have started to “play God”. It is not playing God, as the noble Lord, Lord Winston, emphasised, rather it is using our God-given gifts in the way they are meant to be used. According to the three great monotheistic religions of the world, we are made in the image of God. We are rational, creative beings able, within limits, to shape our human lives for betterment of our health and well-being.
That said, as all noble Lords have made quite clear, the cutting edge work now being done needs to be set firmly within an ethical framework. Every country in the world recognises this, including China, which recently took dramatic action to jail that maverick scientist. Within the overall framework of UK and European law, every research proposal now has to be approved by the appropriate research ethics committee. Furthermore, as we know, if it involves gametes, it needs to be licensed by the HFEA.
In relation specifically to genome editing, the Nuffield Council of Bioethics report of 2016 set out some important ethical considerations which it would be well worth continuing to take into account. That report was followed by another in 2018 that was specifically concerned with editing the genome of embryos, eggs or sperm; in other words, changing the genome not just of a particular individual, but for the benefit of future generations. This is allowed for research purposes if it is properly licensed by the HFEA, but it is not allowed in the UK for clinical application.
The Nuffield committee argued that it could perhaps be morally permissible on a case-by-case basis, provided that certain measures were first put in place. These are that there has been a sufficient opportunity for broad and inclusive public debate about its use and possible implications; that further research has already been carried out or needs to be carried out to establish standards of clinical safety; that the risks of adverse effects for individuals, groups and society as a whole have been appropriately assessed, and that measures are in place to monitor and review these. It adds that if it were ever to be permitted, it should be strictly regulated by the HFEA in the UK, introduced only in the context of a clinical study with monitoring of the long-term effects on individuals and groups, and that it should be licensed on a case-by-case basis. The two key ethical principles which have emerged time and again in this debate are that, first, they must be intended to secure and be consistent with the welfare of the future person; and secondly, that they should not increase disadvantage, discrimination or division in society as a whole. As we know, Huntington’s disease—with its devastating effects—is just one very obvious example where such a treatment would, if successful, be of immense benefit.
As we have heard, in principle it might prove possible not just to prevent a particular disease but for parents to have the genome of their offspring edited to enhance certain qualities. Suppose parents wanted their children to grow up muscular, clever, with blue eyes or whatever. That would potentially put those who pay for such editing in a position that might increase disadvantage, discrimination and division in society generally. The scientific community is quite rightly very cautious about the possibility of genes being used to enhance certain qualities.
In the light of these concerns, the council recommended, first, that there should be a widespread public debate—perhaps initiated by a government body—and, secondly, that without waiting for the report of such a debate, the Secretary of State for Health and Social Care should give consideration to bringing within the scope of licensing any heritable genome-editing interventions that currently fall outside its scope.
In the light of this debate, is there scope for a new House of Lords Select Committee—or, as I believe we are now meant to call them, an ad hoc committee—to deal with some of these issues? Some years ago we had a Select Committee for embryo research, which I had the privilege of chairing, with many distinguished scientists and philosophers who remain Members of the House.
I have two questions. First, in relation to somatic genome editing, is the present regulatory framework adequate or do we need something more overarching? Secondly, in relation to germline genome editing, should there be a moratorium or should it be licensed and strictly regulated? In this House there is clearly the strong view that there should be an absolute moratorium. The point is that this debate is not going away, and it would be very useful to have an authoritative body—a Select Committee from this House—to look at it very seriously and come up with a recommendation, either that there should be a moratorium or perhaps that it might be licensed by the HFEA on a case-by-case basis. I hope the Minister and his department will think seriously about the possibility of an appropriate committee.
My Lords, it is an honour to follow such a clear and persuasive speech by the noble and right reverend Lord, Lord Harries, with whom I fully agree. Like others, I congratulate the noble Baroness, Lady Bakewell, on securing this debate. Its title does not include the word “human”, so I will focus my remarks on genome editing in agriculture and the environment. I had a hunch that greater medical and ethical minds than mine would have addressed the human aspect by the time I stood up.
In contrast to the human case, it is absolutely vital that the UK Government signal their encouragement of genome editing in agriculture this afternoon. There is no clearer case of a technology in which we could and should take the lead, but in which we are and will be held back if we do not break free from the EU approach. That would be not a race to the bottom but the very opposite: a race to the top. For example, if we allowed the genome-edited blight-resistant potatoes developed at the Sainsbury Laboratory to be grown here in the UK, we would be able to greatly reduce the spraying of fungicides on potato fields, which happens up to 15 times a year, harming biodiversity and causing lots of emissions from tractors. That would be an improvement, not a regression, in environmental terms.
Although we have heard the Prime Minister champion this technology, we have not heard nearly enough from other Ministers so far. The technology has enormous potential to do good and less possibility of doing harm than the existing technologies it would replace.
The private sector is not in a position to champion genome editing in agriculture, because the private sector effectively does not exist in this space. Twenty years ago there were 480 full-time equivalent PhD-level jobs in agricultural biotechnology in the private sector in this country. Today there are 10. That is what has happened to that whole sector in this country. Until politicians signal a sea change, the private sector will shun the UK’s wonderful labs and the breakthroughs will be applied overseas, if at all.
In that context, let us not forget that—as others have suggested—Britain has a truly extraordinary record in biology, far above any other country’s and far more dramatic than in physics and chemistry. Here is a short list of the things that were discovered, invented or developed first on these damp little islands with 1% of the world population: the circulation of the blood, evolution by natural selection, antibiotics, the structure of DNA, DNA sequencing, the first test-tube baby, DNA fingerprinting, the first cloned mammal. I could go on.
Genome editing is an alarming exception. The early work is the result of work done in Spain, France, Japan, Holland, Finland and America, with not a Brit in sight. We are playing catch-up, but are well placed to get back in the lead if we only have the right encouragement. Here is another shocking statistic: last year three French scientists reviewed the patenting of CRISPR products in agriculture and found that, whereas America had taken out 872 patent families and China 858, the EU had taken out only 194. The gap is growing.
The July 2018 ruling by the European Court of Justice, in defiance of clear advice from its Advocate-General, was a disaster. It meant that genome-edited plants and animals are subject to the draconian, interminable and reputation-poisoning regulations that have killed genetic modification in Europe, despite its manifest environmental benefits. It also made no sense. The objection to GMOs was always that they include foreign genetic material. That is not true of genome editing. In many cases, it is impossible to distinguish a genome-edited variety from a conventionally bred variety with the same trait. Stefan Jansson from Umeå University in Sweden put it like this:
“Common sense and scientific logic says that it is impossible to have two identical plants where growth of one is, in reality, forbidden while the other can be grown with no restrictions; how would a court be able to decide if the cultivation was a crime or not?”
America sensibly went the other way, regulating the technology not by the method used but by the trait expressed. If you can make a potato resistant to blight, what matters is: is the potato safe, whether it was made by conventional breeding, gamma-ray mutagenesis or genome editing? In the EU, if you made this potato by gamma-ray mutagenesis, scrambling its DNA at random in a nuclear reactor, the regulations would say: “No problem. Go ahead and plant it; no regulations.” If you made it by the far more precise method of genome editing, in which you know exactly what you have done and have confined your activities to one tiny bit of DNA, you are plunged into a Kafkaesque maze of regulatory indecision and expense from which you will likely never emerge.
We need to hear from the Government that they will switch to regulating biotechnology by trait, not by method. The Science and Technology Committee, on which I sit, recommended this a few years back. It is a matter not just of environmental benefits but of animal welfare. In 2017, scientists at the Roslin Institute near Edinburgh announced that they had genome-edited pigs to protect them against a virus called porcine reproductive and respiratory syndrome, PRRS. They used CRISPR to cut out a short section from the gene that made the protein which gave the virus access to the cell, thus denying the virus entry. They did this without altering the function of the protein, so the animal grew up to be normal in every way except that it was immune to the disease. This means less vaccination, medication and suffering. What is not to like? But commercialising that animal in the UK is currently all but impossible.
Looking further ahead, the same scientists at the Roslin are now looking into how to control grey squirrels not by killing them, as we do now, but by using genome editing to spread infertility infectiously through the population, so that the population slowly declines while squirrels live happily into old age. This technique, called gene drive, will transform the practice of conservation all around the world, especially the control of invasive alien species—the single greatest cause of extinction among birds and mammals today. For those who worry that gene drive might run riot, it will be designed to last for a certain number of generations, not forever.
Looking even further into the future, genome editing will one day allow the de-extinction of the great auk and the passenger pigeon. To achieve this, we need to take four steps: to sequence the DNA of an extinct species, which we have done in the case of the great auk; to edit the genome of a closely related species in the lab, which is not yet possible but will not be far off with genome editing techniques; to turn a cell into an adult animal, which is difficult, but possible through primordial germ cell transfer, again pioneered at the Roslin Institute; and to train the adults for living in the wild, which is hard but possible.
If we do gene editing in Britain we will cure some cancers, improve animal welfare, encourage biodiversity and bring back the red squirrel. If we do not, then China and America, Japan and Argentina will still push ahead with this technology and will follow their own priorities, leaving us as supplicants to get the technology second-hand.
My Lords, I join many others in thanking the noble Baroness, Lady Bakewell, for initiating this important debate and for her very clear and informative introduction. I apologise for missing the first few seconds of it.
I also want to focus not on the medical issues but on the use of gene editing in crops, domestic animals and wild populations. In this I am indeed following the lead of the noble Viscount, Lord Ridley, although he might take it as given that my views are 180 degrees opposite from virtually everything he just said.
I will address this subject from three aspects. The first concerns the very sad fact that we will be leaving the EU on Friday night. We have seen the collective efforts of the European Union, together struggling for 30 years with this fast-moving field of endeavour. We saw 10 years of uncertainty until the European Court of Justice ruled in 2018 that directed mutagenesis techniques such as CRISPR, which we have been discussing, are to be considered GMOs under the EU’s GMO directive. However, it is important to point out some misinformation. The EU does not have a ban on GMOs. Around 70 authorised food and animal feed products come into the EU. That means thousands of tonnes of animal feed, soybean, rapeseed and maize. For the EU and for us, a safety assessment needs to be updated regarding the latest understanding of these imports, particularly on stacked events, where we might see interaction between the genetic modifications.
In the EU we currently have mandatory labelling and tracing that enables the public to know what they are eating and what they are getting. There is very strong evidence that that is what the public want and it is something we very much want to keep. Research is also allowed in the EU—I expect it will continue in the UK—provided there is no risk of contamination in the outside environment. We had a long debate about dynamic alignment. It is worth thinking about the fact that, from Saturday morning, we will share a land border with the EU. It will be very interested in what we are doing, because our decisions about genetic editing will almost inevitably end up affecting the EU.
The second area I want to address is the fact that gene editing can have unintended effects—and intended effects—that go much further than anyone thought they would: gene combinations, results and biological ramifications that were not intended. They can be significantly different from those produced by conventional breeding, including random mutagenesis. We need to have clear, close and tight oversight.
The noble Lords, Lord Alton and Lord Winston, made very powerful speeches reflecting on the interaction of science, politics, economics and society, and how those interactions can be deeply and horrendously toxic. On a perhaps lesser scale, the noble Viscount, Lord Ridley, spoke about ensuring that pigs do not catch a particular disease. Maybe that means that people will think they can house pigs much more closely together, in far more crowded conditions. What will be the animal welfare ramifications of that?
The noble Viscount also referred to gene drives—possibly some of the most frightening aspects of potential gene editing, and which are being widely explored in the laboratory at the moment. They are intended to achieve permanent genetic changes to the make-up of wild populations of animals and plants. It means that you release something that you cannot then call back. I guess I should declare my Australian origins here and say that we have very close and intimate understanding of what the release of the cane toad did and continues to do to Australian ecological systems. It was released and cannot be controlled.
For noble Lords who are interested in this area, I make specific reference to a recent report known as RAGES—Risk Assessment of Genetically Engineered Organisms in the EU and Switzerland—which came out last year. Although the noble Viscount suggested that EU regulations were far too tight, the report concludes that they are not nearly tight enough. It concludes that the European Food Safety Authority’s GMO panel’s
“implicit and unaccountable risk assessment policies … indicate that those assessments are far more likely to underestimate the range and severity of possible adverse effects, rather than to overestimate them.”
My third point is the question of how we approach the world and our management of it. Genetic editing, pretty well by definition, involves a silver-bullet solution: you address one aspect of one thing. That ignores the complexity. People say that if we modify just this one gene in wheat, it will become more drought resistant and then we will solve hunger. Problems of hunger, food security and the unhealthiness of our diet are not innately biological problems, but ones of society, poverty and our food system. The idea that you can take one step with one gene and make a huge difference to that is, I argue, entirely false.
I am very pleased to say to the Minister that we are now hearing from the Government about agri-ecological approaches in the Agriculture Bill. This is the alternative way to look at how we solve the huge problems we face with food security and hunger. The Government are focusing on the health of soils. These are the kinds of approaches we need to take, rather than simple silver-bullet solutions.
We also know that a huge percentage of the world’s food is produced by small farmers. Patented and costly tools produced by gene-editing technology are not the solutions to their problems. We know how fragile these apparent solutions can be when we look at the spread of herbicide resistance in weeds around genetically modified crops.
I conclude by reflecting on how complex human health and biology are. I have a personal interest in the human microbiome, some recent research into which has been looking at bacteriophages that live—I apologise to any noble Lord who is about to eat lunch—in your gut. The bacteria in your gut mostly exist as inactive prophages. Depending on the food you eat for lunch, they might be activated and that will change your microbiome.
This is complex and we have to tread very carefully. I stress that this is not an argument for doing nothing; it is an argument very much for science, research and caution. Things can be done, as we have recently seen with mitochondrial donation. We can make progress, but very cautiously.
My Lords, I congratulate the noble Baroness, Lady Bakewell, on securing this important and timely debate on developments in gene editing. She set the scene to allow the widest of debates. I think we can all agree that we have had an extraordinary, wide debate.
The noble Lord, Lord Patel, said that our genes are part of our humanity, yet we cannot stop science. There is much to be done to make it safe and effective. The noble Baroness, Lady Bakewell, the right reverend Prelate the Bishop of Carlisle, the noble Lord, Lord Alton, and the noble and right reverend Lord, Lord Harries, talked about the ethical and social justice issues that must be considered alongside scientific advance if we are not to slip into eugenics. I always learn so much from the contributions of the noble Lord, Lord Winston, and his outstanding speech summed up the dilemma very well as eugenics versus “a reasonable individual intervention”, which encapsulates the moral dilemma we have been discussing. The noble Viscount, Lord Hanworth, reinforced the need for a careful public debate and for clear regulation. The excellent speech by the noble Lord, Lord Moynihan, reminded us that athletes are always under pressure to find that extra advantage. I think many of us agreed that there is no place for gene editing in competitive sport. The noble Viscount, Lord Ridley, and the noble Baroness, Lady Bennett, rightly reminded us that we need to include agriculture and the environment in our debate—equally thorny issues to get right. Current parameters and frameworks should be reviewed and updated as science improves and takes us forward.
From the Liberal Democrat Benches, we echo many of the concerns about social and health injustices—for example, developing genetic techniques that might improve an embryo so that the child has enhanced intelligence, a longer life and so on. If that is available only to the wealthy, or in wealthy countries, how do we ensure that those not so enhanced are not at a permanent disadvantage that cannot be rectified? This is not fantasy. We know that when in vitro fertilisation became available, some communities used it to choose the gender of their child. We must guard against that.
I want to talk about genome editing and children with rare diseases. I thank the Library, the Francis Crick Institute, the Progress Educational Trust and, especially, Together for Short Lives and Great Ormond Street Hospital, for their excellent briefings.
Over 70% of rare diseases have an underlying genetic cause, and most, including all childhood cancers, present in childhood. Inevitably, our children and young people are disproportionately affected. These diseases are serious: one-third of children with a rare disease will not live to see their fifth birthday.
Treating rare diseases has been extraordinarily tough. It has been about the management of symptoms, often with severe side-effects that are hard for small children to understand and tolerate. There are some curative treatments, such as bone marrow transplants, but they rely on donors, and children must live with the risk of tissue rejection. As these children grow older, their symptoms may worsen, with many not surviving. The exceptional developments in genome editing and research, which noble Lords have already spoken about with such eloquence, can transform the lives of children with rare diseases. Genetic diagnosis can be achieved before symptoms begin to show. Early intervention to correct the genetic error could provide a long-term barrier to disease, sparing children from developing debilitating symptoms and suffering cumulative, irreversible damage to their bodies. Unlike treatments such as bone marrow transplants, the patient’s own cells can be modified, making the treatment perfectly matched, with no risk of rejection.
However, rare diseases that individually affect very small numbers, but collectively might affect millions, can struggle to attract research funding. Genome-editing technologies can be applied across a broad range of diseases and may therefore be more likely to attract funding. They can be adapted and applied to benefit isolated patient populations, but there is still a risk. The 100,000 Genomes project, delivered by Genomics England, a company owned and funded by the Department of Health and Social Care, was established in 2012 to sequence the 100,000 genomes from NHS patients affected by a rare disease or cancer. In December 2018, the project ended when the 100,000th sequence was achieved. The Health and Social Care Secretary, Matt Hancock, announced
“an ambition to sequence five million genomes in the UK over the next five years.”
In November 2019, Mr Hancock also confirmed his ambition to see all children receive whole genome sequencing at birth, saying that tests would be routinely offered to map out the risk of genetic diseases and offer predictive, personalised care. Today we have heard concerns about how this would operate without a clear moral and legalistic framework. What progress have the Government have made in achieving the Secretary of State’s ambition that all children should receive whole genome sequencing at birth? What assessment has the Minister made of the extent to which mapping genetic diseases can offer personalised palliative care for children with life-limiting and life-threatening conditions?
In July 2018, the noble Baroness, Lady Blackwood, spoke at the British Paediatric Surveillance Unit’s rare disease summer tea party. She said that
“seriously ill children who are likely to have a rare genetic disorder will be offered whole genome sequencing under the GMS.”
To continue cementing the UK as a world leader in genomics, in February 2019 she announced that the Government were
“developing a UK genomics healthcare strategy. I’m very pleased to say that the work is well underway, and the strategy will provide a clear, national vision, setting out how the genomics community can work together to make the UK the global leader in genomic healthcare.”
She went on:
“The strategy will be ready for publication this autumn, so watch this space.”
That is now last autumn. Can the Minister tell us how many seriously ill children who are likely to have a rare genetic disorder have been offered whole genome sequencing under the NHS Genomics Medicine Service? When does she expect the Government to complete the UK genomics healthcare strategy?
For rare diseases, genetic understanding is the key to getting this right. Our scientists and clinicians need infrastructure, technologies and collaboration. To develop effective gene-editing approaches, the UK must advance understanding of what, how and when genetic changes occur in a child’s development and how they cause disease. This will help to diagnose problems more quickly and accurately, and to understand which treatments are most likely to work for each child. Clinicians will be better able to predict the risk of genetic diseases and their progression, and to develop treatments such as genome editing, to eradicate these diseases.
Two years ago, Great Ormond Street Hospital became one of seven genomic laboratory hubs commissioned by the NHS to deliver the nation’s genomic sequencing. The initiative builds on the 100,000 Genomes project, in which the hospital played a leading role, as well as rapid genome sequencing techniques developed there that read an entire genetic sequence in a matter of days. This approach will underpin the development of gene-editing approaches.
The Zayed Centre for Research into Rare Disease in Children, based in Great Ormond Street, opened last year. It is the world’s first purpose-built centre dedicated to paediatric research into rare diseases. It has a six-room suite that adheres to strict requirements to manufacture therapeutic, gene-edited cells which can then be returned to patients. Facilities with this capability are extremely rare; there are no comparable labs elsewhere in the UK at present.
None of this will be achieved without proper long-term funding of research. The UK’s leading role in the European Union’s Horizon 2020 project must necessarily come to an end tomorrow, as we leave the EU. It is worth noting that in Horizon 2020, we contributed £3 billion and received £5 billion back in research grants. Because we lead research in many areas, we have been net beneficiaries. Can the Minister confirm that funding and research for genome sequencing will continue at least at the same level, to ensure that we continue to lead the world in genome research?
I close with a personal example. A family I have been working with for the last five years had a child with a rare disease that was undiagnosed. He died 18 months ago, aged 10, having been treated at Great Ormond Street Hospital. Just after he was born, he had his first gene test, but the cause of his multiple and profound problems could not be found. Just before he died, the hospital asked his mother if it could take another sample, as genetic testing had clearly moved on a great deal. This week, it identified the disease, which is extremely rare. Most children, if they survive the first three months, die within three years. Their son is an example to look at in the future, when caring for children born with this disease. The family are very proud.
My Lords, like all other noble Lords, I thank my noble friend Lady Bakewell for securing this debate. From listening to today’s thoughtful contributions and my own preparation, it is clear that the 2020s and beyond could be touted as the decade for genome editing.
When I was studying for my O-level in biology at the Ardrossan Academy in the mid-1980s, I remember thinking whether I would ever in later life need to know about deoxyribonucleic acid and the building blocks of adenine, cytosine, guanine and thiamine and how their pairing created a double helix of DNA. I now know that it was of great use.
This year’s Wolf Prize in Medicine was awarded to, as we heard earlier, Professors Jennifer Doudna and Emmanuelle Charpentier for their discovery of the gene-editing tool CRISPR-Cas9. The Wolf Foundation stated:
“This transformative technology has the potential to … revolutionize the fields of genetics, molecular biology and medicine.”
By acting as molecular scissors, CRISPR allows scientists to tweak, change or remove genes at a specific location. Doudna said:
“Over the next decade, researchers will continue to advance the use of CRISPR … to treat and in some cases cure diseases, develop more nutritious crops, and eradicate infectious disease.”
Obviously, this is an exciting time for those working in this field but, as noble Lords have mentioned, consideration must be given to the oversight of this science to protect people and society from any possible negative and unintended consequences. As Doudna stressed:
“We must work to ensure that the technology is responsibly applied to allow it to reach its potential and benefit millions”.
The process of genome editing can, as we have heard, lead to biological, medical and environmental benefits. This technology has the potential to help, treat and prevent human diseases. Illnesses such as heart disease and Alzheimer’s could be cured through genome editing. It also has the potential to deal with hereditary diseases.
This technology has also been trialled on food to determine whether it can help farming and crop resilience. Genome editing can, potentially, significantly improve the UK’s environmental footprint. The Commons Health Select Committee stated that the Government should
“require UK Research and Innovation to closely monitor the development of genome editing for potential obstacles to innovation”.
Can the Minister explain what steps the UKRI has taken to follow these recommendations?
In agriculture, genetic editing is seen by some as the answer to farming sustainability and crop resilience. The World Resources Institute has said that genetic modification is the key to feeding a growing global population in the face of warmer weather and scarcer water supplies. However, the effects of human interventions are not always predictable and food standards could be threatened. Like many other noble Lords who received it, I found that the National Pig Association’s briefing raised some interesting points in relation to this issue. It stated:
“We do not see this technology being the sole solution to the efficiency of pig production in the UK, but we recognise that it will be an important part of the solution.”
We all know that the US has a more relaxed approach to GM food and, although on a slightly different track, Professors Erik Millstone and Tim Lang have said that accepting products such as hormone-treated beef would be an “unnecessary and unacceptable risk” just to secure a future trade deal. Can the Minister outline the Government’s thinking on GM food in relation to any future trade deals?
The Prime Minister has called for the bioscience sector to be liberated from the rules against GMOs, as we heard from the noble Viscount, Lord Ridley, and the Conservative Party’s manifesto stated that it would implement science-led policy to improve the quality of food, agriculture and land management. Science-led, yes, but where do ethics and moral issues sit within that?
Clearly, this is one area in which the Government want to go it alone after Brexit, but it is not enough just to give the green light from No 10. We need a strong regulatory framework for this science to be ethically and commercially available. I agree with my noble friend Lord Winston that regulation alone is not enough; scientific co-operation will also be necessary.
So, as much as the benefits of genome editing could be of great help to many of us, the Government need to ensure they do not get ahead of themselves and consider all factors in genome editing before they continue moving on these medical practices. As the noble Baroness, Lady Brinton, and the noble Lord, Lord Alton, mentioned, in 2019 the Secretary of State for Health and Social Care announced ambitions to see all children receive whole genome sequencing at birth. I agree with the right reverend Prelate the Bishop of Carlisle and the comments of the British Society for Genetic Medicine, who advised that this could prove to be problematic as
“the genetic code of a healthy newborn will only rarely predict future disease accurately”—
again, an issue touched on by my noble friend Lord Winston. The BSGM later stated:
“Such a venture therefore needs to be carefully researched, and the ethical and societal aspects require careful consideration before roll-out to the general population.”
As my noble friend Lady Bakewell mentioned in her introductory remarks, in July 2018 the Nuffield Council on Bioethics published findings from an independent inquiry on the social and ethical use of genomic editing in human reproduction. This inquiry concluded that genome editing could only be deemed ethically acceptable on humans if two principles are satisfied. The first principle is that the interventions are intended to secure, and are consistent with, the welfare of the newborn child who may be born consequently to this practice. The second principle is that these interventions would uphold the principle of social justice and should not provoke social division, or marginalise or disadvantage groups within society. Do the Government agree with these principles? If so, what have they done so far, and what will they continue to do, to ensure that these two vital principles are consistently met?
So, like my warning to my children when they were younger—do not run while holding scissors—I encourage the Government to do the same, even if those scissors are molecular scissors rather than tangible ones.
My Lords, like other noble Lords I start by thanking the noble Baroness, Lady Bakewell, for calling this important debate and for instigating a broad discussion of complex themes around genome editing that deserve detailed analysis. I have followed her written and spoken career and note her important debate at the Royal Society and her excellent Radio 4 “Inside the Ethics Committee” programmes around this subject. I also thank my noble friends who have spoken here with great passion and experience today for their contributions. They say that in the other place the Minister is the person who knows the most about any subject, but in this place the Minister knows the least about the subject. I have never felt that aphorism to be more true than today, and I commend noble Lords on their remarkable experience and wisdom. My noble friend Lady Bottomley put it very well: this Chamber is filled with experts who have had a part in every aspect of this debate over many decades, and for that I thank them.
I am not immersed in this subject, as some noble Lords are, but I declare an interest as I know something of the ambitions for genome editing through my work as a trustee of the Scar Free Foundation, a medical research charity, where we hope a breakthrough will improve those blighted by unsightly or painful scars. I pay tribute to my noble friend Lady Blackwood in the Department for Health and Social Care and my noble friend Lord Gardiner in the Department for Environment, Food and Rural Affairs and to all those across Whitehall, Westminster, academia and industry who engage in this fascinating and broad subject.
It would be incorrect for any of us to consider the use of genome editing as heralding some sort of panacea. None the less, the opportunities posed to us by genome editing are quite incredible, and the Government are committed to seizing the opportunity but, as several noble Lords made clear, our work must be rooted in ethics and controlled by regulation, and that is where I will begin.
The noble Baroness, Lady Bakewell, and the right reverend Prelate the Bishop of Carlisle set the scene very well. I recognise the deep concerns of several noble Lords. My purpose is to reassure the Chamber that the UK has a robust, evidence-based regulation regime that is under rolling review to adjust to developments as they happen. It is true that UK regulators have adopted a pro-innovation regulatory approach but, as noble Lords have made crystal clear, it must be strongly rooted in public dialogue and ethical discourse. The Government’s efforts have created a safe space for UK innovators to develop cutting-edge, disruptive products that will transform the lives of people in the UK. This regime must be committed to upholding ethical values, personal safety and public acceptability. We rigorously test public attitudes to polarising issues such as human enhancement and social justice, which were mentioned in this debate, through engagement with the public because it is not just the science that matters but what we as a society want to do with it.
To find the right balance, we have committed to engaging world-class academics and expert groups such as the Progress Educational Trust, the Nuffield Council on Bioethics, and the Wellcome Trust, which were mentioned by a number of noble Lords including the noble and right reverend Lord, Lord Harries, the noble Baronesses, Lady Bakewell and Lady Brinton, the right reverend Prelate the Bishop of Carlisle, and the self-confessed and unashamed gene editor, the noble Lord, Lord Winston.
We are fully aware of the challenges presented by this technology and the anxieties it raises among some people. In response to the question about leadership asked by my noble friend Lady Bottomley, I say that we embrace our leadership role where necessary in the EU, the World Health Organization and the numerous emerging forums on this hot subject. For instance, in the wake of the revelations of germline editing mentioned by several noble Lords, the UK joined our counterparts from the US national academies to bring together a consortium on ethics at the World Health Organization. This consortium is currently accepting evidence on this issue. The deadline is 6 February, so I urge all noble Lords who can contribute to hit that cut-off date.
In response to the noble Lord, Lord Alton, and others who asked about a global observatory, I can tell them that we look forward to the World Health Organization report and the prospect that it may lead to the rollout of a global observatory.
As a number of noble Lords, including the noble Baroness, Lady Bakewell, mentioned, what happened in China is completely illegal in the UK, but globally standards and regulations differ, which is a challenge when it comes to the pursuit of ethical science, so Britain must have a clear and definitive voice. That is why we have set up the Centre for Data Ethics and Innovation to get the balance right. As a result of this leadership, a safe place has been made in the UK to turn our country into a renowned hub for genome editing, allowing us to attract and nurture businesses.
The noble Lord, Lord Patel, spoke persuasively for a commission based on the consultation on mitochondrial disease and regulations amending the Human Fertilisation and Embryology Act 1990. The noble and right reverend Lord, Lord Harries, suggested a House of Lords Select Committee. These ideas are worthy of consideration by the Government, and we will look closely at them. However, I emphasise that the issues brought up by genome editing are very broad, not specific, and we are already engaged in considerable public and expert consultation.
If we get the ethical framework right, the opportunities are enormous. The noble Baroness, Lady Bakewell, mentioned Louise Brown, the first IVF baby. I have Elizabeth and Rosalie, my two IVF babies, and very beautiful and bouncing they are too. Their embryos were screened. I remember the moment well, and I remember the ethical conversation I had with my wife before we went ahead with that. I take seriously the comments of the noble Lord, Lord Winston, about the need for follow-up research. It is on the mind of parents such as me around the world.
As a number of noble Lords mentioned, there are opportunities for genome editing to create new types of medicines for tackling a range of conditions and improving the lives of patients. Who could not be moved by the story of David Sanchez in last week’s “Storyville” on the BBC? He is a charismatic young boy with sickle cell disease who described his wait for advances in genome editing that could mend the single-digit mistake in his DNA and save him from a painful affliction and an early death. The noble Viscount, Lord Hanworth, my noble friend Lady Bottomley and the noble Baroness, Lady Bakewell, mentioned rare diseases, and I was struck that up to 17% of the UK population may be affected by diseases such as Huntingdon’s. That is why we are so excited by advanced therapies. An example is CAR-T treatments. They are new, personalised, precision medicines that work by taking immune cells from a patient, reprogramming and using them to target cancers within the body. That excitement is why the NHS moved fast. It is the first health system in Europe to agree full access to CAR-T treatments. That was achieved through the fastest product approval in the NHS’s 70-year history.
We are ensuring that it is not only laboratory research to which the NHS has access. There are six licensed gene therapy products, including Kymriah, a cancer therapy, and Strimvelis, the bubble-baby therapy. More than 70 companies are developing advanced therapy medicinal products in the UK, such as Autolus, which looks at T-cell immunotherapy, and Oxford Biomedica, which looks at Parkinson’s disease. The noble Lord, Lord Patel, gave us an expert read-out on the progress of these sorts of initiatives. These businesses which productise research are exciting evidence of the success of our life sciences industrial strategy.
The noble Baroness, Lady Brinton, asked about the genetic screening of children. This is a huge subject, and I do not have time to delve into it in huge detail, but I reassure the House that the Government are starting with those with severe illnesses. Yesterday the Government announced that a pilot of exome sequencing would be extended to whole-gene screening and that we are hoping to process hundreds of cases a year, starting this year. The department is looking at ways of extending these trials dramatically.
The noble Baroness, Lady Brinton, also asked about palliative care. I reassure the House that the focus is very much on diagnostic and preventive opportunities, although there might be opportunities in pharmaco- genetics. She also asked about the genomics healthcare strategy. I reassure noble Lords that the aim is to have this published by the end of the year.
A number of noble Lords mentioned the economic opportunity presented by these medical advances. Advanced therapy companies already employ 3,000 people and that number is set to more than double by the end of 2024. Estimates are that this sector could be worth £10 billion a year to the UK by 2035.
A number of noble Lords mentioned government interventions. Since 2009, over £300 million of government investment has been committed to support commercial research and innovation in cell and gene therapies. Initiatives include the Cell and Gene Therapy Catapult and advanced therapy treatment centres. I shall give an example. As several noble Lords mentioned, the Medical Research Council is funding research into the earliest stages of human development. The team working on this research is based at the impressive Francis Crick Institute in King’s Cross—the first globally to embark on this sort of research. The work, which is ongoing, might help us better understand the development of embryos during pregnancy, and it is hoped that it will help to explain and prevent miscarriages.
An important point was raised by the noble Lords, Lord Patel and Lord Alton, and my noble friend Lord Moynihan. They suggested that it might be time for a moratorium on germline editing. I reassure the House that at present the researchers, the regulators and the Government are satisfied by the regulations as they are. However, the Government totally acknowledge that the Crick team’s research, and that of others in the future, might make suggestions for future reviews or a moratorium should the position change. The Government also acknowledge that those suggestions should be debated in Parliament and that they might lead to future regulation or legislation.
The tools of the fourth industrial revolution touch many sectors—too many to cover in this debate—but a number of noble Lords, including my noble friend Lord Ridley and the noble Baroness, Lady Bennett, mentioned agriculture. If the House will indulge me, I will take a brief moment to praise our fantastic British produce. It includes Welsh lamb and fantastic English wines that rival French champagne, and I need not remind the noble Lord, Lord McNicol, of spirits such as Scotch whisky which are renowned the world over.
As our climate changes, we may need to take steps to protect our food industry from warming temperatures or new pests and diseases. It is important that, should a time come where we need them, we have tools at our disposal and are sure that they will work. Genome editing and other technological advances can enable higher-yield varieties of staple crops so that we can feed our growing population or help our native varieties to withstand future conditions as our climate continues to warm.
As described by my noble friend Lord Ridley, the European Court of Justice has, regretfully, ruled that all genome-edited organisms should be treated as genetically modified. That is a shame. The Government feel that this ruling is neither scientific nor justified. As I have said previously, we would prefer a science-based, evidence-driven approach to regulation in this space, and we will revisit what regulations it might be appropriate to consider as the future landscape and our relations with the EU evolve in the coming years.
The Government are supportive of new applications for genome editing in other emerging fields that are too numerous to mention. However, I should like to refer to synthetic biology, which might allow us to make new medicines, fuels or other substances faster and more efficiently than ever before. For instance, we have seen the collaborative approach taken by government and industry in the development of the life sciences sector deals and the bioeconomy strategy. We have also seen groups such as the Synthetic Biology Leadership Council and a host of partnership programmes. The UK’s academic facilities in this exciting area of science are second to none, and they include the noble Baroness, Lady Bakewell’s very own BRIDGE Lab for genomic research at Birkbeck University.
The Government are proving their passion for science, having recently committed to double the science budget. I reassure the noble Baroness, Lady Brinton, that the manifesto at the last general election and the Prime Minister’s statement after his successful leadership election made very clear the Government’s long-standing commitment to budgets in this area. These will enable the best research to take place in the UK, create new jobs across the country and support sectors that are crucial to the UK economy.
By way of closing, I again thank the noble Baroness for proposing this debate. It has not been possible to answer all the questions, so I will endeavour to write. I am reminded that that includes writing to the noble Lord, Lord McNicol, on GM food and trade deals, and on UKTI’s work on identifying investments in innovation.
My Lords, before the noble Lord concludes, I pressed him during the debate to reply to the correspondence that I sent him about DNA profiling. Can he undertake to place that in the Library of the House when he has answers?
The noble Lord, Lord Alton, is entirely right. I shall be glad to write to him on DNA profiling. It is felt to be a little outside the scope of this debate but I will be glad to place such a letter in the Library, as requested. I thank each and every noble Lord who has spoken today for their contributions, and I look forward to this important subject being revisited in the future.
My Lords, when I proposed this debate, I knew that it would be a good one because, as the noble Baroness, Lady Bottomley, said, people in this House know stuff. It has been great to hear so many different points of view.
Speaking personally, it is rare to find myself in agreement with two bishops—an agreement that I wholly endorse. I have learned a great deal not only from the medical people here but about sport—perhaps, for me, the most surprising entry to this field of knowledge. I very much enjoyed and found interesting what turned out to be a spat about EU regulations between two of the speakers, but I suppose that we are all getting a little twitchy as we get towards the end of tomorrow.
It has also become clear that the dilemmas are proliferating—the moral dilemmas about children born with genetic diseases, the sport issues, which have not surfaced in my knowledge, and the Government’s ambitious plans for the genome sequencing of children. I think that there is a big issue around that that will be problematic.
Finally, I thank the Minister for his answers. He did not propose a strategy for making these issues more possible and more widely acknowledged by the public at large. I hope that that will happen some time soon. In the meantime, I thank him and all noble Lords for taking part.
Iran: Stability in the Middle East
Question for Short Debate
To ask Her Majesty’s Government what assessment they have made of the influence of Iran on stability in the Middle East.
My Lords, the question of how we in the UK should deal with Iran has been a constant struggle. We have leant over backwards to reach some sort of agreement with that country, and no one tried harder than our own noble Baroness, Lady Ashton, when she represented the EU in putting forward the Joint Comprehensive Plan of Action. It is a particular pleasure that she will be enlightening us in this debate. However, I fear that we have failed to get any reasonably acceptable response from Iran. We might try to blame President Trump for the failure, but it is clear that appeasement was not working terribly well before he backed out of an agreement that gave us, at best, a one-year delay to Iran’s nuclear programme, and which it repeatedly disregarded.
The catalogue of activities in which Iran is engaged should make the most compliant of negotiators pause for thought. We have only to look at its actions against the UK. The imprisonment of Nazanin Zaghari-Ratcliffe and many others, the recent detention of our ambassador, the capture of a British-flagged tanker in the Strait of Hormuz, the planned terrorist attacks in London and the continent, the cyberattack on our own Parliament a couple of years ago, and the burning of our flag do not suggest a country that is seeking to accept a deal from us any time soon.
Let us look also at how the regime is suppressing its own people. This is a country with a proud history of intellectual and social development, now brought to its knees by a rigid theocracy. Women remain second- class citizens and homosexual men are publicly hung. Its population is constantly suppressed in the most brutal ways. Imprisonment, torture and the hanging of hundreds of dissidents each year are now the norm; 1,500 demonstrators were killed in the November demonstration alone, according to the Iranian liberty association. It is these poor citizens who are suffering the most from the economic sanctions imposed on a country intent on pouring its money into developing nuclear arms and long-range missiles for itself, as well as arms for its allies in Lebanon, Gaza, Syria and now, deeply, in Iraq.
Hezbollah has taken over Lebanon and is heavily armed, with 50,000 trained troops and 100,000 missiles hidden in villages in the south, aimed at Israel and probably Jordan. Even more worryingly, Iran has begun fitting sophisticated guidance systems to its ballistic missiles so that they can pinpoint Israeli airports and strategic targets. In Gaza, Hamas is fully armed by Iran, while in Iraq it has managed to infiltrate a huge number of armed units and achieved what it was never able to achieve when Saddam Hussein was in power: it has largely taken over the country without having to fight any wars.
In Yemen, Iran is funding the Houthi rebels as they fire missiles at the Saudi Arabian capital Riyadh, its international airport and its oil fields. Saudi Arabia is now also on the front line against Iran. Finally, in Syria, which has descended into a completely failed state divided into several pieces, it is only by Iranian aid that the monster Assad has managed to survive in his subset of the country. So, now we have a Shia Iran that has taken over an arc of countries from the Gulf to the Mediterranean Sea, through Iraq, Syria and Lebanon. These countries are already extremely vulnerable, with young populations and high unemployment rates; Iran is taking full advantage of that vulnerability.
However, an even greater danger lies in Iran’s attitude to Israel, about which we should be most concerned. Iran has made no secret whatever that its intention is to see Israel wiped off the map. Its leaders repeat that message every week and we should not mistake that as any desire simply to support the Palestinians. Even if the Israelis and the Palestinians ever came to an agreement, leaving aside Mr Trump’s doubtful “deal of the century”, Iran would still keep up its animosity towards—and plan to remove—Israel. In truth, it seems to care little about the Palestinians; it just wants to get rid of the Jewish state.
Iran has its allies at the ready in Lebanon and Gaza and now, most worryingly from Israel’s point of view, in Syria, right on Israel’s northern border. So far, Israel has been surreptitiously reducing Iran’s military capacity there, but it is quite unclear how long that can continue. Israel is surrounded and feels besieged. We should know that all these threats are in addition to the prospect of Iran going all out to develop its nuclear bomb. Israel takes the threat from Iran very seriously indeed. Anyone threatening to wipe out the Jews, now at the press of a button—with the memories of Auschwitz so strong this week—is taken very seriously. Israel is on ready alert to respond to any attack, or even, equally dangerously, to pre-empt one with a devastating attack of its own. That way leads to a war across the rest of the Middle East and inevitably, much as we would like to keep out, we and the EU, as well as America, would be drawn in.
So, what should we be doing here in the UK? I have some questions for the Minister. First, I understand that we have halted the JCPOA agreement and put it into a dispute resolution mechanism, even though Iran has clearly stated that the agreement is dead and that it is continuing to enrich uranium beyond the 3.67% limit. Can we seriously believe Iran when it says that it is developing its nuclear power simply for peaceful purposes? I think not. It seems inevitable that Iran will be referred to the UN Security Council and further sanctions applied.
Iran gives no impression that it is a friend waiting to come in from the cold. Where are we up to with the dispute resolution process? And what about INSTEX, our trade agreement with Iran, set up jointly with other EU countries? I hope that our Government will think long and hard about any trade deals with Iran while it continues its belligerent stance, its sponsorship of terrorism and its inhumane treatment of its own citizens. What is the current situation with INSTEX?
Is there anything else that might induce the Iranian leadership to change its position? Alone, we have little chance, but we may be able to engage those who have greater influence. I think particularly of Russia and China. Are we in discussion with Russia about what pressure it may be able to bring to bear on the regime? Mr Putin’s recent invitation to our Prime Minister to join him in Moscow at a meeting of UN Security Council members could be an enormously valuable opportunity to discuss global issues; inevitably, that should include the threats to Middle East security and Iran’s role in them. I hope that our Prime Minister will accept this opportunity. Mr Putin certainly does not want a nuclear war on his doorstep. What about China? We have now done it a favour; perhaps it may be encouraged to reciprocate by exerting pressure on Iran. We need as many allies as we can get.
As far as Israel is concerned, we should of course continue to press Israel and the Palestinians to come together and reach some form of agreement—even though the Trump plan may not be the answer—and we should urge restraint on Israel as it tries to deal with the threats surrounding it. However, we have to face up to the fact that Israel will listen to such words of caution only if they are accompanied by our own full recognition of the nature of Iran’s threat. We should support Israel as it tries to work out how to deal with that threat, which is not only to Israel and the rest of the Middle East but, inevitably, to us too. What is the Government’s attitude to Israel as it faces up to the threats to its existence?
In a world where political wisdom and moral leadership are sadly in short supply, it is vital that we find a path to de-escalation in what has become a Middle East arms race. We are faced with many perils and I fear that Iran is inflaming rather than stabilising them. We should not be fooled into believing that we can isolate ourselves from the fallout.
I am delighted that so many noble Lords have agreed to speak, and I very much look forward to hearing their words of wisdom.
I thank the noble Lord, Lord Turnberg, for initiating this important debate. At the outset, I emphasise and support the UK’s stance and continuing efforts in calling for the de-escalation of tensions in the region. Further conflict is in no one’s interests, but Iran has to be held to account.
Reports of ongoing, widespread unrest in the Middle East continue, particularly over Iran’s involvement in Iraq. The protests in Iran have been mostly by working and middle-class demonstrators who were traditionally backers of the regime. They have also been centred on universities. Students want to see their country open up and offer opportunities—freedom of speech, equal opportunities for women and, above all, the stamping out of corruption and instability in their country.
With heavy US sanctions in place, Iran’s economy is spiralling downwards. Serious protests continue as we see inflation of 38.6% a year and depreciation of the national currency by about 60%. Freedom to demonstrate should be a fundamental right; for guards to fire live ammunition to quell protesters is abhorrent. It would seem that the country is at a crossroads; it can remain in economic isolation or take steps to de-escalate tensions and engage in a diplomatic path forward. Let us hope that Iran will take this path, as no one wants to see tensions in the Middle East escalate into war.
While Iran can offer plenty of weaponry, it is the women of Iran that I would like to focus on, particularly the future for girls and women and their right to an equal opportunity to engage in education, business and government. With regard to access to quality education in Iran, such obstacles and barriers double and triple for female students. With more than 80% of the nation living under the poverty line, there is no guarantee that Iranian children and young people can continue with their education. The number of girls who leave school far exceeds the number of boys, while the number of girls deprived of education is three times greater than that for boys. The UN also expresses concern about the increasing number of marriages of girls of 10 or younger.
Over two years ago the White Wednesday campaign began, in which brave Iranians wearing white headscarves or their own choice of clothing in public could be detained, fined or flogged for protesting. They also face discrimination in personal status matters relating to marriage, divorce, inheritance and child custody, and cannot obtain a passport or travel outside the country without the written permission of their husbands. I have listed many barriers for women to overcome. They must have equal rights.
Iran has choices to make: first, within the country, to remove barriers for women; and, secondly, to begin to take real steps in de-escalating tensions and adhering to the basic rules of international law, or to sink deeper into political and economic isolation.
My Lords, I thank the noble Lord, Lord Turnberg. Although America has withdrawn from the 2015 nuclear deal, I understand that our Government are working with European partners to find a way forward. However, how do the Government plan to address three key flaws in the deal?
First, the so-called sunset clause, which sees restrictions on Iran’s nuclear enrichment programme lifted after 2025, means that in five years there will be no obstacle to Iran seeking to develop a nuclear weapon. The second flaw is the lack of any restrictions on Iran’s development of its ballistic missile programme, with such missiles capable of being easily adapted to carry a nuclear payload at a later date.
Thirdly, there is an absence of any measures constraining Iran’s ability to fund terrorist organisations, such as Hezbollah, based in Lebanon. Hezbollah, which possesses a formidable stockpile of rockets and missiles, has made no secret of its desire to wipe Israel off the map, and, as the noble Lord, Lord Turnberg, suggested, Jordan is not free from that either. Last year it was revealed that in 2015, months after the Iran deal was signed, a joint operation between the Metropolitan Police and MI5 uncovered highly explosive material in north-west London, stored by radicals with ties to Hezbollah. Can the Government confirm that these issues will be discussed as part of any conversation on how to find a way forward on the deal?
Having proscribed Hezbollah’s military wing as a terrorist group in 2008, in March 2019 the UK Government declared Hezbollah in its entirety a terrorist organisation. Hezbollah is based in Lebanon. Founded with the aid of Iran in the 1980s, as well as being involved in Lebanese society through social services and active participation in politics, it also carries out international terrorist attacks and regional military operations—it is, in effect, an arm of Iran. In 2010 Iran provided Hezbollah with approximately $200 million, having transferred as much as $1 billion to the organisation between 2006 and 2009. Hezbollah is believed to possess as many as 100,000 missiles, 10 times its capacity during the 2006 war with Israel. What is the purpose of this armoury if not war on behalf of Iran?
Can the Minister assure us that all contributions to Lebanon are being assessed through rigorous parameters and that DfID resources are not being used by Hezbollah for non-humanitarian purposes?
My Lords, it is possible that the shocking and tragic downing of Ukrainian passenger jet PS752, with the loss of 176 lives, followed by a farrago of lies, denials and distortions will be Iran’s Chernobyl moment—a moment when another fundamentally flawed regime is exposed for what it is. The conflation of lies, denials and distortions, accompanied by bulldozers trying to plough up the evidence, was a vivid demonstration of the nature of a cruel and barbaric regime, unworthy of a great people and a great country. As widespread demonstrations have shown, this is Iran’s greatest existential crisis since 1979; it is a regime forced to kill hundreds of protesters and to terrorise thousands of others who show its true face. Khamenei and Soleimani are two sides of the same coin.
However, there are harbingers of change. Kimia Alizadeh, Iran’s only female Olympic medallist, has defected, while the country’s most popular actress told her 6 million followers on Instagram: “We are not citizens … We are hostages”. The sooner that the hostages —the people of Iran—are all freed, the better it will be for Iran and the rest of the world.
Last month I was in northern Iraq and Kurdistan, where I saw the Kurdish Regional Government attempting to build a pluralist and democratic society. That is endangered by a pincer movement of rekindled sleeping ISIS cells and by proxy Shabak militias funded by Iran. All over the region, Iran has destabilised countries, peddling a violent hateful ideology. Think of the consequences in Yemen, Syria, Lebanon and Iraq. Since its foundation in 1979 the Iranian regime has been based on two pillars: domestic oppression and the export of terrorism and chaos abroad. Since 2018, Iranian-backed groups of militants have fired over 30 rockets at US facilities in Iraq, including the US embassy in Baghdad, the consulate in Basra and military training facilities in Taji, Mosul, and Nineveh. Congress and the White House have repeatedly warned that this will not be tolerated for ever.
According to the Times, Iran attempted to build, or has built, a dozen underground missile silos in Syria and was doing the same in Iraq. In Lebanon it has over 100,000 missiles. As the noble Lord, Lord Turnberg, warned us in his excellent opening remarks, this remains Israel’s greatest threat. For 40 years Iran has supported acts of terror and been responsible for egregious violations of human rights, and we can be certain that it will not balk at carrying out more.
I have two questions for the Minister. A report in the Daily Telegraph revealed that Soleimani’s Quds force and Afghan mercenaries are secretly directing military operations in the north-west city of Idlib in Syria, despite a promise during peace talks not to attack that city. Could he give us his response to that, and to calls to proscribe the Islamic Revolutionary Guards Corps?
My Lords, I refer the House to my non-financial interests in the register. It is an honour to follow the noble Lord, Lord Alton. He was my MP in Mossley Hill, Liverpool. Although I left Liverpool soon after, his election had absolutely nothing to do with my leaving. I congratulate the noble Lord, Lord Turnberg, on this important and timely debate, although perhaps the title should have been “The influence of Iran on the instability of the Middle East”.
As we know, Iran is home to one of the world’s oldest civilisations. The country has a rich cultural legacy, reflected by its 22 UNESCO world heritage sites and its young, educated, business-oriented population. You have to ask why the population of Iran has taken the country down the road of supporting terror across the region and beyond. In relation to the JCPOA, the Foreign Secretary stated on 14 January that
“we are triggering the DRM because Iran has undermined the objective and purpose of the JCPOA, but we do so with a view to bringing Iran back into full compliance.”—[Official Report, Commons, 14/1/20; col. 897.]
Does the Minister agree with me that Iran has never, at any time, been in full compliance with that agreement? Perhaps a better question would be: what parts of the JCPOA agreement has Iran complied with? It is time to be tough because that is the only language that the leadership of Iran will understand.
My noble friend Lord Pickles recently called for the Government to proscribe the Iranian Revolutionary Guard Corps, and I support him in that call as Iran’s destabilising policy in the Middle East can be linked to its hostile policy towards the UK itself. Why is the UK desirous of a closer relationship with Iran while its nearest neighbours in the region are working to abate its influence?
As the noble Lord, Lord Turnberg, rightly said, many in this place, across the country and throughout the world marked the solemnity of the 75th anniversary of the liberation of Auschwitz this week. Yet Iran has openly and consistently expressed its willingness to commit another atrocity against the Jewish people and is actually pursuing the capacity to carry out that threat itself and with its proxies, including Hezbollah and Hamas. Does the Minister agree that pressure on Iran needs to be increased? It is indeed the biggest danger to Middle East stability in the world.
My Lords, I too am grateful to my noble friend Lord Turnberg for securing this debate. It is a very long time since I spoke in your Lordships’ House. Indeed, I was sitting where the Minister is, before I was whisked across the Channel into some kind of glorious exile. As noble Lords will know, during my time away, I led and chaired the negotiations with Iran for over four and a half years. In that context, I want to make just three brief points in the time I have.
First, one of the criticisms about the Iranian nuclear agreement—the JCPOA—is that it deals only with the nuclear weapons issue. If noble Lords reflect back to 2009, 2010 and the years that followed, the most pressing issue that we faced as a continent, and certainly in the region, was to ensure that Iran did not get a nuclear weapon. We had reason to believe it was months away from achieving that. This was, as I described it then, the boulder in the doorway that prevented us doing anything else about what Iran was doing in the region because we had to stop the possibility of a nuclear-armed Iran. When we negotiated that agreement —other criticisms have already been raised that I could address, but I do not have time—we did so believing that it was not the last agreement but the first. It was meant to take away the boulder to enable us to tackle issues, including ballistic missiles, but especially what was happening in the region.
That brings me to my second point. In my many discussions with leaders in the region, particularly the Prime Minister of Israel but many other leaders too—I pay tribute to the Sultan of Oman, who recently passed away—they were very clear that the region itself wanted to be in control of what happened, how negotiations might take place and what type of decision-making there might be. In my view, it is important that we recognise that we must allow the region to determine how best it wishes to move forward. That is especially true when you think about the chaos of Syria and Yemen, and of what is happening in Lebanon and Iraq right now.
My final point is about this country. This country has a long and proud tradition of diplomacy. I witnessed it at first hand many times when I was working in the European Union. I pay tribute to the team of diplomats and technical experts who worked on the Iranian nuclear deal. Sometimes, in this House and the other place, one might think that it was a bilateral agreement. But there were brilliant British people and others working throughout to get the agreement to the place that we did. I single out Sir Simon Gass, who is now chair of the Joint Intelligence Committee, for the work he did. Because we have that long tradition, I hope that as we look at where Britain should be in the future, we determine to try to use our diplomacy to work effectively in this region.
My Lords, I draw attention to my entry in the register of interests, particularly my chairmanship of the European Leadership Network. I thank my noble friend Lord Turnberg for securing this debate and I am honoured to follow my noble friend Lady Ashton, whom I admire greatly.
The recent escalation in the Middle East has not occurred in a vacuum. To understand it properly and honestly, we must understand the logic that drives Iran’s regional policies and recognise the geopolitical environment in which it operates.
Iran’s policies in the region are not exclusive to the Government who resulted from the 1979 Islamic Revolution. The strategy of supporting allied non-state actors and forces across the region spans at least six decades and can, in many ways, be seen as a continuation of centuries of imperial prowess. In the 1980s, this strategy morphed when conventional deterrence models lost hold and states began to review and test conventional deterrence structures, which, in the case of Iran, resulted in a marked and significant shift towards asymmetric deterrence, which I condemn as much as any other speaker. But we need to understand this if we are to deal with it properly.
This process continues. States across the region regularly re-test their red lines to re-establish deterrence, substantially increasing the risk of miscalculation and miscommunication. What we have witnessed recently between the US and Iran is but the most recent example of this. Tackled in isolation, Iran will not limit its regional influence and defences in the face of US or any other “maximum pressure”. For example, singling out Iran’s missile programmes ignores the fact that it is one of 11 countries in the region that possess long-range missiles. We need to recognise that more parties need to be brought to the table. Only region-wide approaches offer solutions to the region’s risks and confrontations.
We must accept that all regional states have legitimate security interests. This approach led to the landmark JCPOA nuclear deal in 2015, whose focus on the nuclear question was meant to be the stepping stone for future confidence-based conversations on other issues. Now we are in a completely different situation. We have to hope that the current pause in military escalation is not taken for granted and that the risk of war, which is genuine, spurs dialogue. Europe will pay a high cost for any regional conflict with Iran. Instability would fuel a potential resurgence of Daesh in Iraq and Syria, as well as new, larger flows of refugees, drugs and who knows what else. The E3—the UK, France and Germany—need to move beyond the JCPOA in their outreach with Iran and in their engagement with region-wide efforts, including those made by Iran, such as the Hormuz Peace Endeavor.
The European Leadership Network has been working extensively on Iran, in the context of the region, the nuclear deal and facilitating trade with Europe through INSTEX. On Monday, it released policy options for the UK and its partners to pursue in the coming weeks and months to help de-escalate tension on both nuclear and non-nuclear issues. I hope that Ministers will find time to review them, as they feed directly into the areas raised in this debate.
My Lords, it is appropriate on such occasions to mention that my hamsar is Iranian.
No region is more troubled that even when relations are friendly, mistrust reigns, and where rules are interpreted in different ways. I had occasion to pose a question this week to the Saudi Foreign Minister, Adel al-Jubeir. It was simply this: given that by anybody’s standards multiple challenges exist in the region at large, including the Palestinian issue, Israel’s right to recognition and security, Yemen, proxy relationships, Lebanon, the JCPOA, and Iran’s relationship with Saudi and others—all with the added complexity not just of the West but with the added dimension of Russia and Turkey—and that as past peace endeavours have not advanced with success, is there a priority list he might suggest that would have a drip-down beneficial effect on regional peace and stability, similar to that of a house built from a deck of cards crumbling? After reflection, the Minister’s response surprised me no end, and I commend him for it. In winding up, would our Minister consider this same question in order to ensure that the same is not being asked in 50 years?
Why have all endeavours thus far failed? What would be the easiest to implement? Are initiatives from outsiders ameliorating or hindering the process? Should the differing tracks be brought together or is piecemeal work the answer? Is it so impossible to believe that a line could be drawn and renewed focus placed on the positive side of relationship building, with differences put aside and the common denominators of tolerance, culture, religion, trade and security that befit ancient civilizations coming to the fore? Suggestions that came out of Davos of the potential for direct dialogue between Riyadh and Tehran are to be encouraged.
The Saudi Foreign Minister’s response included a regional tour which emphasised the need for security, rule of law, good governance, women’s inclusion, recognising the high level of education and diverse innovation that exists—he particularly singled out Iranians’—the advances in opening new sectors of the economy and more. All this boiled down to one thing, however, and this was his core response: let the people win. Maybe this should become the central focus and approach to stability in the region: the people. Let the people win. I fully concur.
My Lords, I declare an interest as a member of the British Parliamentary Committee for Iran Freedom. I join all those who have thanked my noble friend Lord Turnberg for securing this timely and important debate. I say “timely” because of what we have read in the papers about what has been going on in that troubled country.
One reason I put my name down for this debate is that I want to hear the Minister’s reply to some of the questions posed so far—there will probably be more after. In the last 30-odd years, I and others in this Chamber have been pressing the Government to take a more realistic view of the inhumane and wicked regime that keeps the people of Iran under such oppression. Many years ago the then Prime Minister, Tony Blair, told the world that Iran was the greatest exporter of terrorism; through all the years since, those wicked mullahs have carried on bringing instability to the region. Their policies, internal and external, have been cruel and deceitful.
Within Iran, the oppression continues and the recent protests have led to an all-too-familiar pattern of murders and mass arrests. Innocent people who have only freedom in mind—freedom for democracy—are being cruelly mown down. Once again, the protests were put down by the Revolutionary Guard and others. I pay tribute to those people who made such a stand to try to change things in their own country.
Externally, we see the Revolutionary Guard getting its fingers into various other pies in the region. Other speakers have mentioned the countries where it is working; the external influence of the IRG and the mullahs is quite extensive. We have to recognise that and remember their history. Before we had the recent nuclear proliferation deal, deserted by the Americans, some of us remember the quartet plus one. After those talks finished, people thought they were a success. But President Rouhani went on record to say how he had duped and deceitfully misled us and other countries in those talks. We have to learn from the mistakes. This is the Rouhani from the 1988 massacre; the Rouhani who told Iraq what to do about the people at Ashraf and Camp Liberty. More recently, Iran’s fingers have got involved in Albania, where some of those people resettled after getting out of Camp Liberty. I hope that the Minister is able to speak with a louder voice than we have heard from the Government in recent years.
My Lords, I rise to speak in the gap to make three very brief and simple points. The first is that we, the international community, are gradually slipping closer to another war in the Middle East. This would be against Britain’s interests, economically and politically, if it were to occur.
Secondly, avoiding Iran becoming a nuclear weapons-capable power, with the means of delivering any weapons if it had them, must be a major objective of our policy and, surely, necessary to avoid triggering a nuclear arms race in the Gulf region. The best route to do that remains the JCPOA, difficult though it is to bring it back on the rails. It would need to be supplemented at some stage in such a way as to deal with the sunset provisions in some of its clauses.
Thirdly, stability in the Middle East will be achieved only if Iran is recognised and treated as a regional power in that area, along with others such as Turkey, Egypt, Israel and Saudi Arabia. This must be on the basis of all agreeing not to interfere in each other’s internal affairs, to respect borders and to work for economic co-operation. Achieving those three objectives will be possible only if they can be seen by all as requiring compromise—on policy and on behaviour. I hope that the Minister will say that achieving those three objectives remains part of our policy. I suggest that it should be the basis on which we move ahead.
My Lords, I too thank the noble Lord, Lord Turnberg, for securing this debate and for all his work in the region. I hugely respect his concern. It is also excellent to have a contribution from the noble Baroness, Lady Ashton, who, as EU high representative, played such an instrumental role in bringing about the JCPOA. As she put it, this agreement did not address everything, but it was a boulder in the door. As noble Lords have made clear, Iran has had a destabilising influence in the region, often through proxies such as the Houthis, Hamas and Hezbollah. There are also terrible human rights abuses in the country. That is why this agreement was so significant.
The plan, backed by moderates, was to show Iran that economic engagement and global moderation had benefits. Those benefits proved limited; nevertheless, Iran was judged to have adhered to the JCPOA, diverging in small respects from it only after President Trump withdrew American support. That is in itself a significant achievement. Now the US has assassinated Soleimani on Iraqi soil. He had blood on his hands, but that state assassination seems to have had the further effect of strengthening the hard-liners’ hold within Iran, so that they appear to be on course to do well in upcoming elections.
We all need to see stability, security and prosperity in a region in which instability results in the flow of refugees. Missiles capable of reaching Europe must concern us. Yet, now that Iran’s leadership has pledged to drive the US from the region, tension is increased even further. Can the Minister confirm that we agree with our European allies that it becomes even more important that we engage with Iran? Does he also agree that we need to try to build on the work of the noble Baroness, Lady Ashton, and our allies and not destroy it? I look forward to hearing what he has to say.
My Lords, I too thank my noble friend Lord Turnberg for securing this debate. The tension between Iran, the US and their allies, which culminated in the killing of Iranian military leader Qasem Soleimani earlier this month, has stabilised. I am pleased that this House is able to debate Iran, and the Middle East, at a time when we have realised that the immediate ambition of all actors is to avoid conflict. The people of the Middle East deserve to live in a peaceful, stable environment, free from the fear of imminent war. The UK can play a part in enabling such an environment by encouraging all leaders to interact through international institutions and to use these as our primary mechanism for defusing future tensions.
In the long term, we have a responsibility to support a framework which commits Iran to internationally recognised norms and formalises its relations with the West. The JCPOA is an opportunity to do exactly this. Regrettably, the agreement has disintegrated following President Trump’s withdrawal, the situation worsened by Iran’s violation of the uranium enrichment clauses. Although the JCPOA is not operational in its current state, we would be mistaken to abandon it altogether unless all other avenues have been exhausted. Can the Minister confirm what steps the Government are taking to resolve the present dispute, and detail the present status of the dispute mechanism?
If the JCPOA is to collapse completely, any replacement for the agreement may take years to develop and in the vacuum of a new deal, we increase the risk of conflict. Those who oppose the JCPOA have been scarce on the detail of what would replace it. Can the Minister explain exactly what the Government believe would differ in a future agreement, in order to gain the support of Iran and the US?
The immediate priority of the UK must be to encourage Iran to comply again with the present agreement, and to ask President Trump to return to the table. However, in the absence of any overnight miracle and a new agreement, we must also consider how we can maintain the present détente. There is a responsibility, which Iran must uphold, to international law, including the non-proliferation treaty.
In recent days and weeks, the Iranian Government have again used inflammatory language. We must make it clear that this is unacceptable and serves no benefit to the Iranian people, but we must also repeat our invitation for them to come in from the cold and work with the international community.
My Lords, I join all noble Lords in thanking the noble Lord, Lord Turnberg, for tabling this timely debate and for setting the scene in such a detailed and expert way, particularly on the challenges across the region. Perhaps I may say from the outset how much I welcome the contribution of the noble Baroness, Lady Ashton. The great advantage of your Lordships’ House, particularly for a Minister for Foreign Affairs, is that rather than look things up they can turn to many people—I look around at those who have taken part in our debate today—to provide expert insight on a particular situation, deal or issue. That is for the simple reason that they were there. Having the noble Baroness contribute to this debate is welcome.
As many noble Lords have said, the recent escalation in tensions between the US and Iran is deeply concerning. As the noble Lord, Lord Hannay, and others said, a conflict is in none of our interests—neither of Iran nor of any party within the region or the globe as a whole. However, one thing is clear: the world must recognise and understand Iran’s destabilising influence in the Middle East—I agree with my noble friend Lord Polak on that.
The United Kingdom has long recognised the need to prevent Iran developing a nuclear weapons capability, something that would significantly inflame tensions in the region. The Joint Comprehensive Plan of Action is the best means available to do that. It was the best means when it was first negotiated by the noble Baroness, Lady Ashton. The primary aim of the JCPOA was to prevent Iran developing nuclear weapons and it had achieved that aim. However, while the Joint Comprehensive Plan of Action remained the best means available to do that, it had its limitations—the noble Baronesses, Lady Ashton and Lady Northover, the noble Lord, Lord Palmer of Childs Hill, and my noble friend Lord Polak all talked of those limitations; for example, issues around ballistic missiles and the sunset clause. We also recognise the JCPOA’s strengths, which the noble Baroness, Lady Ashton, reminded us of. It has prevented Iran acquiring a nuclear weapon, which is an important pillar of the wider global non-proliferation architecture. The deal remains vital for our national security and the shared security of our partners and allies.
We have also held concerns about Iran’s activity in the region, including through the Islamic Revolutionary Guard Corps and the Quds Force, which was under the command of General Soleimani. That is why we will not lament his death. The noble Lord, Lord Alton, and my noble friend Lord Polak referred to the proscription of the IRGC. They will probably know the answer that I am about to give: that, while we do not comment on individual groups being considered for proscription, we keep a list of those proscribed organisations under review. I assure noble Lords that we have done just that. The noble Lord, Lord Alton, and others talked of Hezbollah. It is quite right that in 2019 proscription was extended to the whole organisation and not just the military wing. I think that that was a distinction that many found difficult to justify.
Recent escalation in the region, particularly around the JCPOA, has been deeply concerning, not just for the Middle East but for the world as a whole. The last thing the region needs is another conflict. Diplomacy and dialogue are required, as the noble Baroness, Lady Ashton, and the noble Lord, Lord Hannay, reminded us, and are the only way forward. I assure the noble Lord, Lord Hannay, among others, that the Government’s immediate aim is to de-escalate tensions. In the longer term, we want Iran to play a more transparent and constructive role in regional affairs—the noble Viscount, Lord Waverley, talked of Iran’s rich history in this respect—and to act in accordance with international rules and norms.
Iran’s influence on stability, or instability, in the Middle East is the issue before us today. As several noble Lords reflected, Iran’s size, its rich culture, its strategic location and, yes, its people—as the noble Lord, Lord Clarke, reminded us—are extremely important. It has been highly influential in the region for centuries, if not millennia. That is still the case today. Much of Iran’s regional behaviour should be seen through that lens. It is motivated by a desire to assert what Iran believes is its rightful place as a historically influential power. This explains Iran’s use of proxies in Iraq, Syria, Lebanon and Yemen. They serve to promote and protect what Iran sees as its long-term strategic interests in the region.
Since 1979, Iran’s outlook has sadly been shaped by a radical revolutionary ideology—the focus of the excellent contribution of the noble Lord, Lord Alton—with a number of crucial defining factors. Among them are a sense of self-reliance, forged during the horrific war with Iraq in the 1980s; a strategic rivalry with Saudi Arabia—the noble Viscount, Lord Waverley, alluded to that—and enmity towards Israel, mentioned by the noble Lord, Lord Turnberg, among others.
As the noble Baroness, Lady Northover, reminded us, one of the Iranian Government’s stated primary foreign policy aims is also to remove the US from the region. Without military means to do this directly, it has acted via proxies, deniable attacks and provocations. Let me assure the noble Baroness that we will continue to work with our European partners to see how we can bring pressure to bear on Iran. I say in response to other noble Lords that, yes, we will also be talking to the Russians and others who have influence over Iran.
More recently, and particularly since May last year, Iran has used activity in the region as a means to force the US to ease its policy of maximum economic pressure, a policy that Iran sees as economic warfare. It is important to distinguish these recent, tightly focused provocations from the established pattern of Iran’s behaviour, which is driven by its long-term strategic aims.
On the American policy of effectively bankrupting Iran and causing collapse within it, does the Minister agree that, far from it leading to its coming to a conference table, it is more likely to lead to a failed state lashing out and a possibility of conflict?
I was about to say that we do not agree with the policy of maximum economic pressure. I will come on to talk about INSTEX in a moment.
It is important that we place recent incidents in the former category of focused provocations. The attacks on shipping in the Gulf over the summer, on Saudi oil infrastructure in September—I was in Saudi Arabia just after that attack—and in Iraq in December triggered the recent cycle. All were designed not only to pressure the US, both directly and via its regional allies, to reconsider its approach but to show to the Iranian public, the region and the wider world that Iran would meet “maximum pressure” with “maximum resistance”. The gradual and systematic reduction in Iran’s compliance with the nuclear deal since May has had the same goal in mind, as the noble Lord just reminded us: to show resistance and force the US to change tack.
I assure noble Lords that we remain committed. The noble Lords, Lord Tunnicliffe and Lord Browne, asked about action taken by the United Kingdom. The UK engages closely with all countries in the region. We continue to do so with Iran; we continue to have our embassy there, notwithstanding recent pressures. Our continued diplomatic presence in Tehran is vital. Since 1979, we have chosen continuously to engage with Iran. Despite the many challenges in our relationship, this Government are convinced that engagement remains the best approach. I assure the noble Baroness, Lady Northover, that, together with our partners France and Germany, we remain committed to dialogue and finding a diplomatic way forward. My right honourable friends the Prime Minister, the Foreign Secretary and the Defence Secretary have all spoken to their counterparts in the US, Iran and across the region in recent weeks to stress the importance of de-escalation and a diplomatic track.
The United Kingdom remains committed to working with the international community—I hope that the noble Lord, Lord Browne, is reassured by that—to ensure that Iran abides by international laws and norms and is held to account for its destabilising activity in the region.
Following Iraq’s attacks on shipping in the Gulf, we joined the International Maritime Security Construct to uphold freedom of navigation. We fully understand the desire of the United States to re-establish deterrence and the need to shift the strategic calculation for the Iranian leadership by increasing the costs of Iran’s activity. We recognise the importance, as I said earlier in response to the noble Lord, Lord Turnberg, of working with Russia and China, both as parties to the JCPOA and as fellow members of the UN Security Council. We have been consistently clear on the need for Iran to return to full compliance with the nuclear deal. The JCPOA is a reciprocal deal, lifting sanctions in exchange for adhering to tough nuclear limits.
The noble Lords, Lord Turnberg and Lord Polak, asked about the dispute resolution mechanism. By breaking its side of the bargain, Iran left us no choice but to trigger the DRM. In doing so, we are seeking not to end the deal but to preserve it and to bring Iran back into compliance with its commitments. Several noble Lords asked about alternatives. The JCPOA is the only deal on the table and therefore it is important that we seek compliance and return to adherence by Iran. There is no intention currently to refer the issue to the UN Security Council or to seek the snapback of sanctions. Our side of the agreement also involves taking measures to facilitate legitimate trade with Iran and we will continue to support European efforts, including through the INSTEX trade instrument. We hope that this will give the Iranian people much-needed hope and access to goods. We welcome the decision of Belgium, Denmark, Finland, the Netherlands, Norway and Sweden to join.
My noble friend Lady Redfern rightly raised the issue of the rights of women and girls’ education. As she knows, my right honourable friend the Prime Minister has made girls’ education one of his primary objectives, but it is worrying for someone who looks after the agenda of women, peace and security to see the declining role of women within Iran and the suppression of women’s rights. It is important that we bring this to the fore. We regularly raise the issue of human rights, and as Human Rights Minister I assure my noble friend that I will continue to do so, both in multilateral fora and bilaterally through our engagement with Iran.
I thank noble Lords for their contributions. I will write to the noble Lord, Lord Palmer of Childs Hill, on his specific question about DfID and its operations in Lebanon. We have robust measures but I will write on the specifics. I shall conclude by agreeing with most, if not all, contributions made by noble Lords. Iran’s history, culture and strategic location mean that it will remain an influential regional player with legitimate interests across the Middle East. Our concern is with the way Iran seeks to pursue those interests. We have long-standing concerns over Iran’s nuclear programme, its missile proliferation activity and its support for proxy groups and militias across the region. Such support is in contravention of UN Security Council resolutions and in many cases against the wishes of the people and the Governments of the states in which the proxies operate.
Finally, I assure noble Lords that the UK will continue to call for a de-escalation of US-Iran tensions, we will continue to hold Iran to account for its destabilising behaviour, and we will continue to work in good faith with our international partners to persuade Iran to return to compliance with the nuclear deal. Ultimately, we want Iran taking her rightful place as a positive, constructive influence on stability in the Middle East. I assure all noble Lords that the UK is committed to working with all sides, including Iran, to achieve that goal.
Defence, Diplomacy and Development Policy
Motion to Take Note
That this House takes note of the role played by defence, diplomacy, and development policy in building a safer, fairer, and cleaner world.
My Lords, 2020 has begun with a flurry of national debates, on HS2, on Huawei and the 5G network, on the upcoming Budget, and on the implications of Brexit, which happens tomorrow, and, of course, we anticipate debates all year on immigration and the situation in our health service.
However, while our political debates may be dominated by domestic concerns, elsewhere in the world this year will also see the 75th anniversary of the United Nations and the 20th anniversary of the momentous UN Resolution 1325, which set out a programme for women, peace and security that has influenced work in that area ever since. COP 26 will take place in Glasgow in November and will try to recover the Paris climate change agreement from the rather disappointing summit that took place just before Christmas in Madrid. A summit in September at the United Nations will seek to energise a decade of action on the sustainable development goals and there will be other international summits and events around biodiversity and oceans, the global vaccine alliance and many other important issues. These international concerns should stand for us alongside those domestic debates as being at least of equal importance.
It was with that in mind that I was so pleased to see in the gracious Speech the Government’s commitment to undertake an integrated security, defence and foreign policy review “to reassess the nation’s place in the world, covering all aspects of international policy, from defence to diplomacy and development.” I was equally pleased to see that followed in the gracious Speech by the strategic objective set by the Government for these international relations of the promotion of peace and security globally. Your Lordships’ International Relations Committee, many other committees and many debates in this Chamber have contributed to the development of that international policy over many decades—particularly well, I think, over recent years. I am sure that today’s debate will include many distinguished contributions that will help illuminate decision-making on this review over the coming weeks and months.
I am particularly looking forward to the maiden speech of the noble Baroness, Lady Penn, whom I had the pleasure of working with some years back in southern Africa. I know from that her commitment to both public service and global concerns. I am looking forward very much to hearing her contributions today and in the future in your Lordships’ House.
This review may be overdue, but it is also timely. Tomorrow, we leave the European Union and we seek to put flesh on the bones of the concept of a new global Britain, but unfortunately, perhaps, that will be without answering in advance the question of the UK’s role in the modern world. How do we pull our strengths together to ensure that whatever strategy we have can succeed? Within that context there can surely be no doubt now, in 2020, that an integrated approach to defence, diplomacy and development is central to meeting the challenges we face in the 21st century.
In the UK we have, for two decades now, seen the progressive integration of our policy approach in government to defence, diplomacy and development. In the previous decades the then Labour Government established, for example, the Stabilisation Unit and created the Conflict Pool, pulling resources from the Foreign Office, the Ministry of Defence and the Department for International Development. It backed, at an international level, the responsibility to protect doctrine and a number of other initiatives to reform the international system to ensure that, for example, peacekeeping and peacebuilding at the UN worked hand in hand, rather than in two completely separate silos.
After 2010 the new Government, led by Prime Minister Cameron, Foreign Secretary Hague and Development Secretary Andrew Mitchell, took that further and put a decision-making mechanism in place, through the National Security Council, that gave the opportunity to put more flesh on the bones of this approach. Through DfID, for example, the Building Stability Overseas strategy was created. This included the commitment of a percentage of our development budget to working in conflict-affected and fragile states, and, ultimately, the UK’s participation in decision-making on the sustainable development goals in 2015, including the commitment to goal 16 on peace and justice as being central to any long-term, meaningful sustainable development. It was all part of the same approach and strategy.
This approach has been developed over the last two decades in the United Kingdom and we have used that commitment to try to influence the international debate, but I would say that we have not—until now, perhaps—refreshed that approach ready for the challenges of yet another decade. That is why I welcome this review so much. Look around us at the world today. None of the problems that we debate regularly in this Chamber and that we see having such an impact, not just in other places but here, too, can be solved without an integrated approach to international policy formulation. Whether it is the challenge of migration, which is so affected by conflict, climate change and extreme poverty, or the many examples of conflict—many of which take place today within borders but have implications way beyond them—or the climate emergency and its impact on not only migration and displacement but development and economic prosperity, in all these areas there are elements of the absolute need for security in the prevention of conflict and the preservation of our own security at home. There are elements that require real expertise from our diplomats here in the UK and those involved in the multilateral organisations and many critical countries around the world. Of course, our development budget contributes to trying to alleviate, prevent and deal with the causes of many of these problems alongside the diplomats and those who seek to defend us.
In that world of such complex problems, we see a changing multilateral balance: the United States increasingly looking to its own interests rather than the global interest; Russia increasingly influential again beyond its borders; and China emerging as not just an economic superpower but a diplomatic and development superpower as well. There is also the growth of regional blocs such as the African Union and ASEAN in south- east Asia, pulling together smaller countries that could be much more influential if they work closely together, not just on economic grounds but in the fields of diplomacy and development.
The United Kingdom is uniquely placed to intervene in this complex tapestry of international organisations, interests, challenges and debates. We may not be the number one most important country in the United Nations, but we have a seat at the top table. We may not have the biggest defence budget in the world, but we are influential not just in NATO but far beyond. We have a role in the G8. We still have an important role with our European partners, as we saw recently when the Prime Minister worked so closely with European leaders in dealing with the crisis around Iran, Iraq and the United States. We also have an influence in the World Bank and the Commonwealth network, which is so critical for our soft power around the world. Add to that the private businesses headquartered in the United Kingdom and our cultural and educational relationships around the world, and I would advocate that the UK is uniquely placed to promote the principles of diplomacy, development and defence working together to try to help shape a better world.
I shall raise four points as we move towards the Government establishing this review today, and I look forward to hearing what other Members of your Lordships’ House have to say during this debate. First, while it is important in principle to integrate the work of diplomacy, development and defence, having three departments working together strategically creates more impact than the individual departments would have working alone, or that two departments would have. The case for a separate Department for International Development is well made on all kinds of grounds, but it also gives that element of this integrated approach a seat and a voice at the top table in the National Security Council and elsewhere. The case for retaining a separate Department for International Development is not just about better spending and more effective aid but a better integrated defence, diplomacy and development approach in the United Kingdom, because all three would be represented at the top table in discussions.
We should ensure that in that approach we look beyond those three government departments and the Ministers that lead them to the other areas where the UK has influence—in effect, I suppose, DDD-plus. Looking at our cultural impact or the impact of our sporting teams and individuals, and the events that we host and contribute to, or the impact of our companies around the world, good and bad—and it can always be better—or the impact of our education system and the professional bodies that are housed in and led from the UK, in all these areas we can add to that approach and ensure that we have that impact and influence in every corner of the globe.
Secondly, we need to demonstrate in action what we talk about on paper or in ministerial committees. I will give three quick examples of that. We were one of the architects of the sustainable development goals. This year we are five years into a 15-year programme; we are far behind and the rest of the world is not in a much better place. We need to lead the way this year in upping our game and ensuring that the decade of action that is being launched this year for the period up to 2030 actually is action and that we are involved in it. We also need to take up every tool at our disposal and ensure that we do not just convene a COP 26 in Glasgow in November but lead the world in coming together in Glasgow to make meaningful decisions that are then implemented to tackle the climate emergency. Thirdly, if we put women, peace, security and some of the principles and actions that are central to that agenda at the heart of this review, we can help ensure that the debates and summits that take place this year on that agenda at the global level have a meaningful UK influence that makes a real difference.
The third thing I will mention is that we need to be brave in leading the debate for global multilateral institutional reform. We still have a global multilateral system that is pretty much based on a combination of the outcome of the Second World War and the following years that we now know as the Cold War. It is now 31 years since the Berlin Wall came down, yet we still have a system designed for that period rather than for the 21st century. The United Kingdom is uniquely placed to lead a debate on the role and structure of the United Nations, the role, aims and objectives of the other multilateral organisations, and the way in which new powers are brought to the top table, play a role and accept responsibility as well as rights. We should stop seeing the debate on reform of these multilateral organisations as being about the next speech, headline or summit, but about how in 10 years’ time we can in the way that people did in the 1920s and 1930s start to shape the next generation of institutions that will be more meaningful, rather than simply basing our reforms on the actions and decisions of the period from 1945 to 1989.
My Lords, the noble Lord referred to a safer and fairer world and the lead that the United Kingdom might play in global discussions on this. He talked about mass migration of people and the challenges of poverty and climate change. However, so far he has left out the most important single issue of the lot—the huge explosion in population. Does he believe that the United Kingdom should play a role in trying to get a better understanding of that problem and addressing it before it is too late?
If your Lordships will allow me to take a few extra seconds to deal with that point as well as finishing my own, I absolutely accept that the challenge of the growth in global population is fundamental to all these other issues and makes each of them even more complicated and difficult. That should not lead us to intervene just to try to restrict the growth in population; rather, we need to find new ways of supporting those nations with the largest population growth to secure jobs, opportunity, investment and progress for the people who live there. To me that is part of the challenge that we face. If I may include that under the umbrella of the need for more action on the sustainable development goals, I see population as one of the most important challenges that is addressed by those goals collectively.
My final point, which I will make very briefly, is that, in all of this, of course our membership of NATO and our relationship with our NATO allies is vital, not least because of the situation with Russia today. Our European partnerships and the Commonwealth are important, but in the 21st century this is perhaps a moment where we should be looking at new alliances and allies.
It seems that there are a number of important countries around the world that have a strong economy, a strong democratic system, the rule of law and a commitment to that globally, with which we could work more closely together. I would like to see the United Kingdom doing more to work with Japan, New Zealand and Sweden, stable democracies that are now emerging in parts of Latin America, Africa, and elsewhere in Asia, to build a global alliance for human rights, the rule of law, democracy and progress that can ensure that we not only talk the language of reform and do the right things in our own Whitehall system but ensure that we deliver the cleaner, safer and fairer world that we all want to see.
My Lords, I congratulate the noble Lord, Lord McConnell, on promoting this today, although I think he needed another 10 or 15 minutes to cover all the huge issues that we are addressing here. This is a further opportunity for your Lordships to make an input both into the forthcoming review of defence, diplomacy, development and so on that has been announced, and indeed to the strategic defence review. I assume that the grand review of our global strategy and foreign policy will come before the strategic defence review—in other words, we could have a strategy before we review it—but I have no idea which way round that will happen. It would not surprise me if they came the other way around; you never know.
I say that this is a further opportunity because we have already had two major reports from your Lordships in recent years: UK Foreign Policy in a Shifting World Order in December 2018, and Persuasion and Power in the Modern World back in March 2014, not to mention several books and other reports in between, all of which covered the issues which the review is supposed to look at. The UK in a Shifting World Order report from the International Relations Committee had 66 recommendations for action to reposition Britain in the totally novel international landscape into which we have now moved. So why we need a vast review again now beats me. Whitehall moves at tortoise speed; many of us would have thought that this sort of report was obvious 15 years ago and should long since have led to decisive action and changes.
I will choose six fundamental lessons from those reports and other conclusions quickly in my few minutes. First, we are now acknowledged as the number one soft power nation in the world, if we care to deploy this enormous resource, which we should do. Hard military power is of course necessary, but it will be used in the future only with other allies and coalitions of the willing, or in conjunction with soft power resources—so-called smart power. With soft power go soft management techniques, soft protection techniques and the soft economics of a global economy increasingly dominated by knowledge products and services in the digital age and by cyberspace, transforming the whole pattern of international trade.
Secondly, we must increasingly engage with and work with the great Asian powers. People go on about the need to reassert the power of the West but, frankly, that is a completely dated 20th-century concept. The great new 21st-century areas of growth and dynamism, the new sources of influence, wealth and trade, and the new consumer markets now lie outside the European Union and no longer exclusively in the Atlantic or western sphere at all. We have to secure good access to those markets, powers and groupings to survive.
The Commonwealth network, which the noble Lord mentioned—or the
“family of people in the truest sense”,
as Queen Elizabeth put it in her recent Christmas message—is one of several hugely advantageous routes into the new growth markets and high technology zones of Asia: that is, Asia Pacific, Asia south-east, Asia central and near Asia, and increasingly of course a changing Africa as well. None of this means turning our back on the great United States of America, always our friend. But it does mean a new and different relationship and new links with Asia, as it draws ahead not just in markets and growth but in technological edge—as we see all too clearly from the Huawei issue—and its influence in the Middle East, which we tend to ignore but which is powerful.
Thirdly, we have now entered a completely new phase of 21st-century networks in which we must engage: the revived Trans-Pacific Partnership, COMESA, the Pacific Alliance, the Regional Comprehensive Economic Partnership, the new ASEAN and even the Shanghai Cooperation Organisation. The old organisations are still important—NATO is our neighbourhood watch, and we have to stay on guard against Russia of course. But I must say that anyone who has seen the Bolshoi’s latest production of “Giselle”, which is probably the most stunning ballet production ever, should marvel at this manifestation of soft power and be reminded that we are not just up against a plain old-fashioned Cold War enemy; we will have to think much smarter to deal with that than we do at present.
Fourthly, and above all, we must make much better use of the enormous and modern Commonwealth network, although we are no longer at the centre of it. If, in this information age, soft power is increasingly becoming the means of advantage—promoting brands, reputation and interests and, hopefully, trade, as well as winning allies and subduing hostility—here for Britain is the soft power network to beat them all. There is no question of trying to resurrect Pax Britannica; that has long gone, as indeed has Pax Americana. We are just one member state out of 54, with plenty to learn from the others as they expand their trade and investment links, not just with us but with each other.
Fifthly, although the old ideological divides are almost dead in the new technological age, we must promote new and fairer forms of capitalism—socialising capitalism, if you like, to bring new wealth and status to billions of households and families across the planet.
Sixthly, some say we should merge DfID into the FCO to create one giant international departmental force. Frankly, I do not very much favour too much departmental juggling—although I have done quite a lot of it myself in the past—but I have no doubt that DfID and the FCO, and other departments, including the MoD, should work much more closely together on the ground than they do now, as global understanding grows of how aid and development and poverty alleviation and security really work and meld together, and where the real solutions lie. Certainly we need a combined effort to tackle the real global causes of global warming and ever-climbing carbon emissions, rather than just contenting ourselves with greening our own lovely country of Britain. Desirable though that certainly is, it does not necessarily lead to the tackling of climate change that is needed on a much bigger scale.
Once Britain has navigated through the present dangerous seas, the nation’s luck will be in—unless of course we throw it all away. Britain will be sitting plumb in the midst of the world’s best networks, both digital and real, and will be a safe haven, even more than it is now, for the world’s investors—and that will give us more power and capacity than ever to contribute to a safer, more peaceful and fairer world.
My Lords, my noble friend Lord McConnell reminded us in his opening remarks that few, if any, of the forces that will influence our common future on this planet respect or can even be bound in any form by national boundaries. We all know this but, unfortunately, many times we behave as if we do not, thinking that we can influence these things without partnerships across the world. I pay tribute to my noble friend, congratulate him and thank him for the way in which he has introduced it. I am honoured to follow the noble Lord, Lord Howell, another noble Lord who has a global vision—a perspective that he shares with us regularly and always to our benefit—and I thank him for his contribution.
We are at the start of a new decade, and tomorrow we leave the EU. Things are going to change—there is no doubt about that. The time is right to engage with the challenges posed by the announcement in the Queen’s Speech of an
“Integrated Security, Defence and Foreign Policy Review … covering all aspects of international policy from defence to diplomacy and development.”—[Official Report, 19/12/19; col. 9.]
But we need to live up to those words. In his contribution to the Queen’s Speech debate on 7 January, at col. 65, my noble friend Lord Robertson of Port Ellen described, in a few short sentences, by reference to the 1997-98 strategic defence review, the level of consultation that a proper review of this nature requires. As I recall, his wise advice attracted universal approval from your Lordships’ House, including from the Front Bench. Beyond approval, the Government have a responsibility to act on that advice.
Thanks to my noble friend Lord McConnell, we have two and a half hours of debate today, but that is insufficient by a long way for your Lordships’ House. On that point, surely it is not an unreasonable expectation that, in winding up, the noble Baroness the Minister can give your Lordships a clear undertaking that, at an early date before decisions are made, the Government will find time to debate the proposed review more fully so that Parliament has a proper opportunity to help to shape the review process. If she cannot do so and the Government do not find the time to do it, it will be difficult to avoid the conclusion that their talk about wide-ranging consultation is meaningless.
My noble friend asked an Oral Question about the proposed review, on 8 January, at col. 178. He was being a bit unfair to the Government; it was a bit early to ask the questions he asked, but they are on the record. I am sure that, in the intervening three weeks, the Government have thought about the review and are now in a position to give better answers to the questions he posed, because their answers then were all engaging but lacked substance.
Today, I intend to use my time to focus on the imperative of peacebuilding as the essential route to building a safer, fairer and cleaner world. From my experience of the views of those whom we charge with the responsibility of delivering our country’s hard power, I say without fear of contradiction that that view is shared by those very brave people. Since it was first coined—it was in the context of the Vietnam War, I believe—the phrase “We cannot do this by military means alone” is a common approach favoured by almost every senior military officer who has experienced the reality of modern conflict.
That was certainly the case when I served as Secretary of State for Defence; if anything, that phrase is even more pertinent in respect of the security challenges we face today. A modern nation must navigate all kinds of problems to be truly secure. This is truer when the risks and threats it faces emanate from abroad—as is the case with the UK, as confirmed by the constant assessment of threats that have informed successive national security strategies in this country. Almost all of the threats that we identify at any given time in these strategies emanate from abroad. Investing money in good governance, education, infrastructure and the alleviation of poverty directly will challenge the root causes of insecurity in the countries from which these threats emanate. The deployment of military force will often, at best, tackle only the symptoms. Our recent experience suggests that the deployment of military force, when it is not properly thought through, can and does make matters worse.
So, while ensuring that the resource commitment to defence reflects our ambition for our defence capabilities, the review should aim to create a paradigm shift in the way we think about peace. In large measure, that work has already been done for us. In the extensive work of the Institute for Economics and Peace, based in Sydney, Australia—the organisation which publishes the Global Peace Index—we will find a template for how to do that, which will assist significantly in helping to meet that challenge. Before I go any further, although this is not formally a registrable interest, I should make it clear that I not only admire the work of the IEP but have agreed to serve on its board of advisers. So I have an interest but not a formal one.
Using data driven-research—the data seldom lies—the IEP has developed metrics to analyse peace and quantify its economic value. For 13 years, it has been developing and publishing national indices, calculating the economic cost of conflict and violence, analysing country-level risk and both understanding and promoting positive peace. Its research is now used extensively by Governments, academic institutions, think tanks, NGOs and inter- governmental institutions, such as the OECD, the Commonwealth Secretariat and the United Nations.
The data, which is ideologically neutral, points to the value of policy interventions that create and sustain peaceful and resilient societies. Positive peace is associated with many social characteristics that are considered desirable, including—the evidence proves this—stronger economic outcomes, higher resilience, better measures of well-being, higher levels of inclusiveness and more sustainable environmental performance; in other words, an optimal environment in which human potential can flourish.
If reports are to be believed, this is just the kind of thinking that will be attractive to the Prime Minister’s principal adviser and which will push back against the growing narrative that we need to use our significant development arm for the purposes of our own interests exclusively. So we need to leverage it for trade purposes and other purposes.
Also, have we learned nothing? This is exactly where we were in the 1990s. As a result of a sustained approach to the use of aid in our national interest, we ended up with the national scandal of the Pergau dam. Thankfully, with a Labour Government, and through a series of steps culminating in 2002 with the passing of the International Development Act and the earlier creation of DfID as a separate government department with its own Secretary of State, the UK established a framework and a transparency to ensure no repeat of Pergau. If we take a step back from where we are now, we will end up back where we were in the 1990s, and that is back to aiding corruption.
My Lords, I too add my congratulations to the noble Lord, Lord McConnell, on securing this debate and on the admirable way he opened it, given the little enough time we have to debate these important subjects.
It is well understood that conflict and authoritarianism create an environment in which development and humanitarian conditions rapidly deteriorate, frustrating aid objectives and security interests at home and abroad. We should recognise that conflict, insecurity and authoritarianism are the leading causes of human suffering, human rights abuses and humanitarian crises. They allow organised crime to flourish, nurture violent movements and their terror tactics, thus undermining UK and international security. They impact on the promotion of women’s rights and gender equality, and undermine the rules-based order on which our security depends. They impede the efforts of international co-operation to tackle global issues such as climate change, migration and cybersecurity.
Uniquely, this integrated review faces a whole new range of issues brought about by our imminent departure from the European Union, and therefore the decisions taken in the review will not be effective just for five or 10 years, but potentially for generations to come—generations who will judge us harshly if we get it wrong. In this new Government, there has been much talk about a global Britain, a nation ready and able to take its place among the leaders in and of the world once again. Well, excuse me, I have never for one minute doubted the place the United Kingdom occupies in the community of nations, and I doubt that the average Brit has either. Our contribution as a nation to the advancement of democracy, culture, the humanities, the sciences and the rule of law is a matter of record, and the noble Lord, Lord McConnell, has spelled out our engagement at the top table very clearly.
What we need now are policies and institutions that adjust, redefine and manage our collective needs and aspirations in the 21st century. There are several policy documents, including the national security strategy, which increasingly emphasise the linkages between various aspects of policy, for example between peace and poverty reduction in the developing world, or between security, overseas aid and climate change. As the House of Lords Library points out, governmental structures reflect these linkages. They all have objectives to enhance the UK’s global influence using a range of tools. The new Government have yet to announce any changes to departmental responsibilities, but speculation abounds over whether DfID will be subsumed into the FCO. There is a very strong argument that delivery of the Prime Minister’s “compassionate global Britain” requires an independent Department for International Development led by its own Secretary of State.
The Department for International Development is the premier aid agency in the world and is recognised as such by many. No other comes close to it in terms of impact. The world’s foremost experts sit in 22 Whitehall, and their record speaks for itself: millions saved from disease; millions put through education; and millions of women empowered to lead their communities, as well as to control their own bodies and thus perhaps address the problems of overpopulation. It is right to suggest that the Foreign Office has been subject to decades of funding cuts, but the answer to a lack of resource is not as simplistic as putting DfID under the control of the Foreign Secretary or by merging DfID with the Foreign Office. You need defence, diplomacy and development working hand in hand to ensure that a global Britain is one that exudes the virtues of the UK and promotes our core values.
The FCO, DfID and the MoD have very distinct and different missions. That is not to say that the issues these departments work on do not complement one another. As the US General Jim Mattis famously told the American Congress:
“If you don’t fund the State Department fully, then I need to buy more ammunition ultimately.”
In order to effectively address catastrophic crises, international peace and security must be prioritised as a top-level objective of national foreign, security and defence policies, towards which all other aspects and tools of foreign policy, including trade, development diplomacy, need to contribute.
The ability to shape international peace and security is not held by government alone. Academics, businesses and think tanks have expertise that is relevant to the review. Non-governmental organisations have expertise in fragile contexts, drawn from humanitarian development and peacebuilding work in places where the government footprint may be small. Saferworld, RESULTS UK, Global Witness and Bond are some of the NGOs, to name but a few, which know this well. And the communities affected by conflict, including women and young people, often have the most sustainable solutions for addressing conflict. Their views are vital to informing the UK’s understanding. Our national security cannot be sustainably achieved if the security needs of unstable communities are not understood and addressed.
Given the Prime Minister’s intention to make this the
“deepest review of Britain’s security, defence and foreign policy since the end of the Cold War,”
the UK should include consultation where these groups and the UK public can participate. Only then can we have a long-term sustainable foreign policy that puts people and the planet at the heart of it. I implore the Minister to give us some clue about that in her response and to map out exactly what the Government plan to do in terms of allowing a full and proper consultation on these vital issues.
The way we act and the way we plan will provide a road map for how we will engage on the world stage over the next 50 years. We need a bolstered, fully funded Foreign Office working hand in hand with an independent Department for International Development, led by its own Secretary of State, supported by a strong and robust defence programme. That is how we can deliver a global Britain, and we need to get it right because our children and our grandchildren demand it.
My Lords, the noble Lord, Lord McConnell, gave us an admirable review of a complex and interlinked series of issues that we face as we leave the EU. He has got us off to a very good start and offered us a tempting menu of dishes to choose from. I will focus particularly on the “safer world” part of the menu.
I am very much looking forward to hearing the maiden speech of the noble Baroness, Lady Penn; she is almost there. She brings expertise on development in Africa and recent, up-to-date experience from the very heart of government, which will be a real asset to us. Although we may be a slightly select group in the House today, I promise the noble Baroness that we will be appreciative and attentive to all she has to say.
Since the start of this year, we have begun to see the outlines of what a post-Brexit foreign policy will be like for this country. I offer three pointers that I think are already clear. First, we will find ourselves aligning with our European friends more often than with the US on international foreign policy issues. In many ways this is not surprising, because we are in the same geography and are the same size as our European partners. That was very clear in the Johnson Government’s first international security crisis, the killing of Soleimani by the Americans just after Christmas. The strongest and clearest statement made by the British Government in that crisis was the joint declaration by the Prime Minister, Chancellor Merkel and President Macron. That rightly emphasised the importance of preserving the Iran nuclear deal and a dialogue with Iran and signally failed to make any reference at all to the US strike, still less condone it.
On the so-called US peace plan for the Middle East, I studied in Hansard what the noble Lord, Lord Ahmad, had to say earlier today. He tiptoed around the minefield with admirable dexterity, but the message was clear: we have always supported the European position that there needs to be a genuinely negotiated two-state solution. The US plan is light-years away from that.
Our proposed digital services tax is along the same lines as France’s and has run into the same sort of criticism from Washington.
As the noble Lord, Lord McConnell, says, as the year advances the Glasgow climate summit will loom larger and larger on our international agenda. There, again, we will work closely with European countries to build a consensus, and I fear the US may be one of the obstacles to achieving that.
Secondly, while it is true that we will often make common cause with European partners, we need to make sure that the tensions with Washington do not cut across the absolutely fundamental defence and security partnership with it. That will be a real challenge when we come to a free trade agreement, because it will be far more difficult than Ministers have already told us to find ways of achieving an agreement with the Americans that is at the same time acceptable to British public opinion in sensitive areas such as food security. We will have to ensure that that does not sour the wider relationship.
One area in which we should work closely with the Americans is the future of NATO, to give a clear and convincing answer to President Macron’s challenge that the organisation is brain dead. I do not believe it is, but we need to do some serious thinking about its role, purpose and narrative in the world, which are moving on rapidly from their post-war origins, as the noble Lord, Lord McConnell, said. A NATO reflection process is under way, and the British and Americans ought to be providing real thought leadership on that.
My third pointer to the shape of foreign policy to come is that we will constantly be caught up in the wider US-China competition for global influence, particularly in the high-tech area. That was the real story behind the sharp disagreements over the last few days on Huawei. I do not believe it was ever really about national security. We have all now seen the painstaking work done by the world-class National Cyber Security Centre. From what I understand, the technical communities on the two sides of the Atlantic were never far apart on how we could manage the risks. The problem was that the British issue of how to find a British solution to our own circumstances became a political football between the China hawks in Washington and the Chinese technology industry.
The weakness of the American position struck me all along: it did not have an American solution to the 5G problem to offer. Its increasingly strident efforts to influence the British Government’s own decision went too far and became counterproductive. I pay tribute to Britain’s National Security Council for taking a calm and measured decision despite the noises off. This is not the last time we will find ourselves caught up in this competition. Outside the EU, I am afraid we will be all the more vulnerable to the kind of lobbying and arm-twisting that is bound to go on, as we have to reconcile our interest in trade and investment with our wider values and security objectives.
Those are the three pointers I offer your Lordships. Plotting a way through these minefields would be easier if we knew where we were going. The old narratives—of a bridge between Europe and America, or of Tony Blair-style liberal internationalism—are more or less played out, as Dean Acheson might have said. We need a new vision for Britain in the world. It has to take account of the fact that this country is international by instincts and interests, but we also need a real honesty about where our influence can best be deployed. We do not need declinism, if there is such a word, but we do need honesty.
Of course, as noble Lords have already said, we have huge assets to deploy. Our Armed Forces are world-renowned, as are our soft power assets. I have argued before in this House for full resourcing of the Foreign Office. I will not make that case again, but I will touch briefly on three other important vectors of influence in the world.
I agree with other noble Lords about the value of maintaining DfID as a fully fledged department of state. It is having a good afternoon here, actually. I have worked very closely with DfID, including as Permanent Secretary. I have great respect for its professionalism. I know that it is held in high regard around the world. Co-ordination between DfID, the MoD and the FCO should happen in the National Security Council, but I would not tinker with DfID’s position in Whitehall.
If we were the French and we had a cultural promotion arm as effective as the British Council, we would double its budget. If we had an instrument for the promotion of our culture and language half as powerful as the BBC, we certainly would not be squeezing its funding and obliging it to shed jobs.
We need to look to where we have assets and make the most of them. It is a moment for hard strategic thinking about Britain’s role in the world and where we are trying to go. That should be the starting point for this integrated defence and security review, which I welcome. As the Minister knows, I had a modest role in the 2010 review. It is time to refresh it. We have in our National Security Council the right forum to produce the kind of global comprehensive view that the noble Lord, Lord McConnell, offered us in opening the debate.
My Lords, it is an honour to speak after the noble Lord, who is such an expert in the area we are discussing, although I am not sure whether to thank whoever put today’s list together or explain to them the impact that it has had on my nerves. I wish, though, to thank the noble Lord, Lord McConnell, for calling this debate. As he has already noted, we met nearly a decade ago in Malawi, a country that I know he has close links to from his time as First Minister of Scotland and since. I was there working for the Tony Blair Africa Governance Initiative. I reassure your Lordships that I am not confused about which side of the Chamber I should be sitting on, but I hope that that spirit of working across parties is something I can continue in this place.
Indeed, the thread that binds my previous roles together is not a tribal attitude to politics but a belief in the good that government can do. From working with the noble Baroness, Lady Featherstone, in the coalition Government to launch the consultation that resulted in marriage equality; working with the Governments of Malawi and, before that, of Sierra Leone to help to drive the vital projects for their development; and, most recently, working with such a talented team in Downing Street to deliver changes such as the energy price cap, a record NHS spending settlement and, alongside the noble Lord, Lord Woolley of Woodford, developing the first ever race disparity audit in government, I hope to have in some way helped to advance that good. I plan to continue to do so from my new role in this place. I look forward in particular to contributing to forthcoming legislation to implement the essential work done by Sir Simon Wessely’s review of the Mental Health Act, and will support the landmark domestic abuse Bill, which is the culmination of so many years of work not just by government but by so many up and down the country.
Another common thread across my career has been the presence of wonderful female role models. First and last among them was my boss in No. 10, Theresa May. Theresa’s advice to many young women wanting to make a difference was: always be yourself, do things your own way, and never give up. I also take on the mantle of baby of the House from a succession of talented women, most recently my noble friend Lady Blackwood, and before that my noble friend Lady Bertin. I take a moment to congratulate my noble friend Lady Bertin on the arrival of baby Edward eight weeks ago. She may no longer be the baby of the House, but she will always hold the record of being the first lady Peer to have had a baby while being a Member of this House. As thoughts have turned in recent weeks to potential reforms to this House, I am sure it will want to consider the introduction of proxy voting for new parents, as has been done in the House of Commons.
Another inspirational woman in my life was Kate Gross, the first CEO at the Africa Governance Initiative, and a firm believer in the good that government can do. When Kate was diagnosed with bowel cancer and had to step back from her work, she encouraged people to write her their news. Her reply to one of my missives about my studies at that time has stayed with me:
“Politics, and public life in general, needs more good women.”
It was followed by a strict instruction to take her words seriously,
“and repay me by doing some interesting and awesome things.”
Kate died on Christmas Day 2014, aged 36, leaving behind her husband, Billy, and her twin boys. I hope to honour her instructions while in this place. It is with Kate’s words in mind that I turn to the topic of this debate.
That Christmas, I was back in Sierra Leone, temporarily working for AGI again, as it supported the Government there in their fight against Ebola. The UK’s contribution to that fight is a great example of the issues which we are debating this afternoon. Over 750 British troops, alongside the RFA “Argus”, which was carrying three helicopters, were deployed to provide crucial logistical support, including building treatment centres and ensuring safe burials. Our scientists supported emergency research to understand the spread of Ebola and help to develop a vaccine to defend against it. Our NHS staff volunteered on the front line of Ebola treatment centres, saving lives and preventing further spread. Our diplomats worked to co-ordinate the international response. Our aid budget helped to fund not only that response but the economic recovery that had to come once the outbreak was over. Five years on, just last week we hosted the UK-Africa Investment Summit in London, bringing together UK and African businesses and Governments as they announced commercial deals worth billions of pounds and more aid money to unlock further investment and create thousands more jobs.
The UK’s response to Ebola demonstrated the importance of our ability to draw on multiple capabilities —defence, diplomacy and development—to keep the UK safe and simply do the right thing. In that light, and as we look forward to the integrated foreign policy, security and defence review this year, I would like to ask one question of the Minister and seek one reassurance. The question is: are the Government undertaking an updated national risk assessment, and will they publish an updated national risk register in advance of the review? In 2017, the United States national security strategy assessed great power competition, not terrorism, to be the primary focus of US national security. Our own national security capability review in 2018 took account of the resurgence in state-based threats. A clear assessment of this Government’s current view on the range of threats to our security, including over a longer-term strategic timeframe, would help to inform the contribution of experts, including those in this House, to that review. The reassurance is that, as the review is undertaken, the Government will think holistically about how to draw on all our capabilities to deliver a more effective single strategy, while acknowledging the importance of their independent strengths, expertise and leadership. We cannot deter state aggression or contribute to peacekeeping efforts without a world-class military, but the fight against climate change or anti-microbial resistance can be won only through diplomatic efforts and by supporting a different path of development. We cannot counter the terrorist threat without expert intelligence agencies and co-operation with our allies, but the ideologies that breathe life into those terror groups cannot be challenged without political stability and a path to prosperity that can provide an alternative offer of hope.
I close with some words of thanks to those who have made me feel so welcome since I joined this House: the doorkeepers, all the staff, and my introducers, my noble friends Lady Evans of Bowes Park and Lord Taylor of Holbeach, who have helped me navigate through this place with gentle guidance and, always, a smile. I thank your Lordships for making me feel so welcome, and for listening to my first utterances in this place with patience and good humour.
My Lords, it is a great pleasure and a privilege to congratulate my noble friend Lady Penn on her excellent maiden speech. It was accomplished, intelligent, erudite and demonstrated the huge knowledge that she is going to bring to your Lordships’ House. I first met her when she came to interrogate me on Scottish politics when I was at Harvard. I ended that interview far more nervous than she was when entering the Chamber today, I am sure. We are very lucky to have someone with her knowledge of government, not only from working in the Home Office and the cockpit—Downing Street—but with NGOs and other international development agencies. Her thoughts and wisdom will make a huge contribution to your Lordships’ House.
I thank the noble Lord, Lord McConnell, for bringing this important debate before your Lordships’ House, not least because I was not able to speak in the debate on the gracious Speech. I shall focus on two areas: the importance to the entire United Kingdom of the review the Government are undertaking, and the specific importance of Britain’s ability to continue on a joint departmental basis to bring stability to fragile states.
Today, on the eve of leaving the EU, I welcome the Government’s commitment to a full root-and-branch review of what “global Britain” will mean for security, international aid and foreign policy. Too often over the past three years, “global Britain” has only been shorthand for many as to what our economic and trading focus is to be in a post-Brexit world. The Government’s review will, I hope, provide the opportunity to ground the phrase “global Britain” in the idea of Britain being a respected force for good in the world.
While we were in a pre-Brexit world—can we believe such a thing ever existed?—your Lordships’ Select Committee on Soft Power and the UK’s Influence identified the importance of smart power, which was an integration of our focus, utilising all departmental avenues and ensuring, importantly, that we have a clear sense of ourselves as well as a clear focus on all that we want to do in the world.
As part of having a sense of ourselves, I would urge the Government to consider in their review the importance of Britain as a force for good in binding the United Kingdom together. Increasingly, with inevitable strains and demands being put on our United Kingdom, it is important that the entire country has a sense of pride and security. The institutions through which many people still identify pride in the United Kingdom are the serving Armed Forces, our excellent diplomatic network and our internationally respected international aid commitment. These are all key foundations of the integrity of this country. To be the only country in NATO that meets both its 2% defence spending commitment and its 0.7% international aid commitment should instil pride in all of us. It would be unwise to in any way destabilise this national pride through a desire to rebrand or undermine any of our previous commitments.
I hope my noble friend the Minister can reassure me that any changes arising from the review will be judged not only by costs but by a sense of Britain being a force for good in the world. If not, I fear we could undermine some of the key bonds that keep our United Kingdom together. I also ask the Minister that any review also consider how all parts of the United Kingdom may feel part of the new integrated security, defence and foreign policy review. We have heard already from the noble Lords, Lord McConnell and Lord Ricketts, about the importance of COP 2020 being in Glasgow this year, demonstrating that the whole United Kingdom is part of that global Britain.
Secondly, I would like to focus on our role in international development, its role in ensuring stable and self-sufficient states and how priorities must be maintained in a post-review environment. Like other noble Lords, I am aware of the chatter about departmental mergers as Whitehall moves into a clear delivery mode following Brexit. However, I would be concerned if we were to undermine DfID’s footprint in Whitehall through merger. The importance of a Secretary of State in Cabinet and—dare I say it to the noble Lord, Lord Ricketts?— a Permanent Secretary in Whitehall should not be underestimated.
I will now turn to the safer part of the Motion of the noble Lord, Lord McConnell, and refer specifically to the importance of state stability. For global Britain to be recognised as a force for good in the world, it must be the market leader in supporting fragile states and building stability and resilience in them, which we know are the best ways to promote development and reduce poverty and inequality. We also know that the days of an appetite for the traditional model of liberal peace-building in an interventionist, military- traditional mode are clearly behind us—because of not merely the problems of past interventions, but international cynicism over western countries making such interventions.
Development requires a stable platform that can be achieved only by peaceful political solutions. The work of the Stabilisation Unit and the Conflict, Stability and Security Fund is essential to ensure that the UK has a nuanced security and development policy and is prepared to use defence capability to avoid humanitarian disaster; probably more importantly, it is also there to help avoid the root causes of destabilisation and war.
To be successful, our interventions must have at their core the creation of participatory stability in countries. To be inclusive, that will require dialogue with all actors in conflict states and destabilised states. Much of this work has to be done at the grass-roots level to build confidence in a solution that will allow the kind of stability required for economic and public policy development.
To do that will require Britain to be seen not only as a force for good but as a fair player, with the eradication of human misery as our primary purpose. Britain cannot do everything, of course, but strengthening failing states is the most cost-effective way of building towards self-sufficiency in many parts of the world. It is no accident that 50% of our foreign aid is spent in fragile states. That is because fragility produces the requirement for foreign aid investment. By introducing stability, we will do much to make a safer, fairer world and, importantly, further to establish and augment Britain’s reputation around the world.
My Lords, I add my welcome to the noble Baroness, Lady Penn. On the grounds of age alone, she is a most welcome addition. I am an ex-Chief of the Defence Staff and was well turned 60 when I arrived, but I still feel slightly intimidated by this place, so she is in good company.
I am delighted to make a small, short contribution to this important debate. I am moved to do so primarily because of concern that a debate that talks about the integration of defence capability into diplomatic and development policy may run the risk of obscuring defence’s prime purpose. In making this point, nothing I have to say fundamentally parts company with the words of my former boss—and I hope, therefore, friend—the noble Lord, Lord Browne of Ladyton. I start by emphasising that I absolutely support the idea—not new—that the available spare capacity of the Armed Forces should be beneficially employed on such things as pre- and post-conflict stabilisation operations, capacity-building tasks and peace-support operations.
I also recognise that there will inevitably be times of crisis, both at home and overseas, when it will be entirely appropriate to employ the Armed Forces to help resolve such crises. I spent much of my active career involved in crisis response, whether it was Ebola in Sierra Leone, hurricane relief in the West Indies, providing Olympic security or eliminating foot and mouth disease. Armed forces are highly useful assets.
As an aside, I was often surprised that wider government did not always recognise that the most important capability that the Armed Forces contributed to any crisis resolution was an ordered system of command and control, and I firmly believe that any integrated review of defence and security would do well to recognise our national deficit in the standing architecture of command and control for domestic crisis.
However, I go back to my main point. The beneficial involvement of defence capability with the softer skills of diplomacy and development should not detract from the primary function of the Armed Forces. Our primary purpose is complementary to, not permanently integrated with, soft power. This is a subtle but important difference. Increasingly, defence capability has a significant role to play in ameliorating some of the security risks that emanate from what are termed the new vectors of threat, particularly in the new domains of space, cyber and so on. However, the major contribution of defence, in the current and foreseeable global context, is to provide the effective deterrence that buys time for diplomacy and development to do their job in helping to remove the potential causes of conflict.
I stress again that, at the tactical level of integration, defence can and should support diplomatic and development goals, but we must not slip into the somewhat deluded mindset that starts to make such activity the raison d’être for armed forces. We should constantly be mindful that defence is built on a subtle paradox: the more capable it is, the less likely it will be called upon to be used. That is especially so when, given that we currently live in relatively peaceful times, we might slip into the belief that, in some remarkable way, peace has somehow become naturally occurring. That is not something that I recognise.
The only other marker that I would lay down at this point is: whatever the outcome of the forthcoming review, defence should not be left in the difficult situation where the capability it purports to have bears little relationship to the available funding. There is nothing more frustrating or demoralising than to be institutionally underfunded and yet not be allowed to admit it.
My Lords, I too thank my noble friend Lord McConnell for securing this debate and for his splendid introduction to it.
There is no doubt that our nation needs to reassess its place in the world. We need to alter the country’s core strategic assumptions to better prepare for a more unpredictable and competitive future. The linkages between globalisation, climate change and geopolitical competition must be better understood in the upcoming foreign, security and defence review if the United Kingdom is to prosper and secure its national objectives and interests into the 21st century.
The UK is not a superpower like the United States or China, but it is a global power, unlike Japan or Germany. Not only has Britain’s history been global but its maritime tradition, its deep belief in free trade and the mindset of its people mean that it is outward-looking, and many think tanks around the world over the last 12 months have assessed the UK as the third most powerful and influential country in the world.
That of course relates to the UK’s soft power—the English language; the BBC World Service; its academic excellence, with world-renowned universities; its scientific excellence; the arts; sport; its geographic position on Greenwich meridian, courtesy of the Navy, which makes it very handy for the City; the rule of law and globally respected legal system; and so on. As an aside, I believe that we need to be very focused on ensuring the survival, and indeed growth, of the World Service and BBC Monitoring in any future BBC funding debate.
Equal to, if not more important than, soft power is the hard power that backs up that soft power: nuclear weapons; a globally deployable military capability, with proven willingness to use it; world-class intelligence services; and membership of military alliances. Soft power is as nothing without hard power in any geopolitical context. Does the Minister agree?
Historically, it was our nation’s military power that ensured that, with the United States, we were able to put in place, post World War II, a rules-based system for world order that has lasted to the greater good of the world until fairly recently. That rules-based order is now under challenge, particularly by authoritarian regimes. Military power also ensured that we were a permanent member of the UN Security Council, alongside the USA, the Soviet Union and China, and our military power was a critical part of winning the Cold War. Therefore, military power is important geopolitically.
We are in the process of leaving the EU and the review will need to assess what impact that has on defence and security. Personally, I think that it will make almost no difference to our military security and have only a minimal impact on our broader security, but of course it necessitates a review of our nation’s global alliances, how we sit in that world and what our posture is.
As regards nuclear, I have an area of concern. There has been a steady dismantling of the myriad treaties, primarily between Russia and the USA, that tried to limit the numbers and types of nuclear weapons and enhance confidence-building measures. Apart from the more general nuclear non-proliferation treaty, which will be reviewed in April and May, the only one remaining is the New START treaty, which will lapse in 2021 with nothing in its place.
The lack of dialogue between Russia and the US when both are spending trillions on updating and producing new nuclear wonder weapons—those that do not sit in any category previously looked at—is chilling. Both countries now seem to be of the opinion that nuclear weapons can be used for warfighting, which is madness. The situation is dangerous. Does the Minister agree that, as a nuclear power, we can have some influence on the dialogue to get things changed?
The immense growth in threats from cyberattack in our increasingly digitised world must be confronted, and utilised for our own ends—indeed, we sometimes do this. We should embrace the fourth industrial revolution, maintaining our leads in AI, quantum physics and mathematics, but ensuring that our research, which we are very good at, is then put to practical use and applied in all aspects of our lives and wealth.
Clearly, these changes have an impact on warfighting but they do not do away with the need for kinetic effect. Cyber is not an easy way to cut defence spending as, I am afraid, some in the Treasury and the National Security Council seem to think; rather, it will add to cost. There are a number of other key strategic factors. We are responsible for 14 overseas territories worldwide; we still run global shipping from London—for example, the IMO and all the insurance teams are based here; and we are the biggest European investor in south Asia, south-east Asia and the Pacific Rim, with consequent benefits to our balance of trade.
It is therefore not surprising that we need a maritime and global strategy. To help the UK compete more robustly against authoritarian competitors and, indeed, to create stability in failed and fragile states, both defence and diplomatic spending need to be made more efficient and then increased to levels akin to those of the past—as during the Cold War, for example. It is only in that way that we will make the world more stable, safer and all the other things that noble Lords have spoken of trying to achieve.
We can no longer continue cutting defence spending while hoping that we, and the world, will stay safe. We should invest in science, engineering and technology, which are of course strategic resources. We should clearly articulate where there is a need to maintain a sovereign capability; for example, in telecommunications —as highlighted by the current issue over 5G—energy supply, nuclear submarine and shipbuilding, aircraft manufacture and cryptography.
Military power is an enabler. Without the stability provided by military forces in many parts of the world, the aid agencies cannot work; indeed, the noble Baroness, Lady Penn, mentioned this issue in her maiden speech. Diplomacy and foreign aid need to work hand in glove. We learned this lesson too late in Iraq and Afghanistan. It was our military capability that enabled us to stabilise the situation in Sierra Leone well before the Ebola virus and then move that poor benighted country along the road to recovery.
Finally, I turn to a case where defence and diplomacy did not work together—an object lesson in what happens when defence is cut in an arbitrary way to make government and Treasury savings targets. In 1981, it was decided to pay off the south Atlantic patrol ship HMS “Endurance” to save some £16 million over a five-year period, because defence was having to take huge cuts. We now know that that decision was seen by President Galtieri as the green light to invade the Falkland Islands. While we saved £16 million, the subsequent war cost our nation £3.5 billion and 300 lives. That is what happens when you get defence spending wrong.
I look forward to the review that is unfolding and hope that this House will have a considerable input.
My Lords, grateful thanks are due to the noble Lord, Lord McConnell, for tabling this Motion, and I congratulate the noble Baroness, Lady Penn, on an excellent maiden speech.
There is today much talk about merging the machinery of aid and diplomacy, and it is legitimate to question whether such a coming together would significantly improve either development aid or foreign policy. We have a profusion of terms: cultural diplomacy, public diplomacy, cultural relations, hard and soft power and, of course, smart power. Despite some confusion as to what each approach actually means, there is no doubt that international relations are increasingly important as nations become ever more interconnected and interdependent. Our world is changing rapidly, and today no nation can measure its power by the size of its military might alone.
If the intention is to foster durable relations using the vehicle of soft power, the essential component is that the input is both wanted and/or needed and is durable. Ill-judged inputs are counterproductive. However, the foreign policy of a donor nation may not match the expectations of a recipient country and therefore not result in improved cultural relations. There is always the danger that policies designed to placate the domestic audience may in fact undermine the soft power potential. This is why it is important to distinguish between foreign policy objectives and cultural relations. The former at the extreme could look like propaganda, while the latter at the least might simply encourage friendships between individuals and groups.
In Sri Lanka the British Council runs an innovative programme to encourage and support young entrepreneurs, especially in the field of social enterprise. I met several successful young people, each of whom had been involved in setting up local and regional programmes to harness energy and resources for community development. This constitutes an independent soft power approach that is likely to have long-term benefits, including contributions to the growth of civil society, economic well-being and respect for the UK as a nation. I suggest that this is different from promoting the export of goods and services. So we might arrive at a definition of soft power or cultural relations as “the mutual exchange of culture between peoples to develop long-term relationships, trust and understanding for the purpose of generating genuine good will and influence abroad”.
The unique advantages of soft power as an instrument of influence lie precisely in its differences from political power. NGOs are often able to cross the border between national cultures and, as a result, cultural relations grow organically without government intervention. Cultural relations at their best have long-term vision and goals, eschewing short-term convenience and political advantage. The active intervention by Governments and/or diplomats in such cultural links changes their nature and may undermine the reputation and credibility of a given cultural programme.
However, how the UK interacts more broadly with the rest of the world has to shift, if only because of radical changes in the shape of nations and their interactions with one another. These include digital empowerment, the growing role of protest groups, the complexity of modern trade supply chains and accelerated urbanisation. These factors combine to shake up the existing international balance of power towards the rising economic and political importance of non-western nations. Following Brexit, we will enter a wholly new world of competing blocs and protectionism. Turkey, Russia and Iran all actively seek to extend their areas of influence, and a looming confrontation between the USA and China and the EU is likely.
The fact that the overseas development budget now nears £14 billion per year while the Foreign Office budget has gradually tightened has perhaps prompted questions about the role of diplomacy and aid in fostering a more humane and safer world. Should more of this generous aid be employed in furthering the UK’s foreign policy? Given that trust in people generally runs ahead of trust in the Government, the promotion of British industry and commerce, while not antithetical to sustained development, will have the impact of soft power only if it matches local perceptions and is accompanied by components such as adequate training, maintenance and longer-term impact evaluation.
The greater government investment and involvement, the greater the tendency to deliver propaganda. After all, states do not really have friends, only interests. Mixed diplomacy on the face of it seems to be an excellent approach, but is it? My view is that it blurs the distinction between soft power and political diplomacy. A recent survey of 30 countries shows the UK to be in second place on the list of soft power outreach—pace the noble Lord, Lord Howell, who said it was first; it has slipped a little—having ceded first place to France in recent years. The USA, however, is decreasing its influence. As we all know, the US State Department’s Bureau of Educational and Cultural Affairs runs a wide number of overseas programmes, including exchanges, tours and exhibitions, which are subject to oversight by the Secretary of State, the White House and Congress. Inevitably, therefore, all cultural exchanges will be inherently influenced by state policy objectives.
So if we make a distinction between traditional diplomacy and soft power and at the same time acknowledge that changes in approach are urgent, where does that leave the FCO’s priorities in helping to create a safer and fairer, not to mention cleaner, world? It is suggested by many who research these matters that we first need to understand soft power and how it relates to hard power. In turn, there has to be a shift in the mindsets of those who design foreign policies to fit in with reshaped global politics. Soft power encompasses cultural strengths and diversity, and success will come only from a long-term commitment. Therefore, embassies need to be “super-facilitators”, supported with the resources to include enhanced language training for diplomats, expertise in social media and a thorough grounding in the political and cultural contexts in which diplomats are called to work.
The UK already has an overriding advantage in that it is so deeply connected to the Commonwealth, especially through the CPA, a uniquely valuable network. These links are not always fostered to their full advantage as partners in soft, hard and smart power initiatives. We also have the British Council, the BBC World Service, as many have mentioned, a massive development budget, and a £1.2 billion Conflict, Stability and Security Fund. We should be a prime mover in strengthening the network of international relations, using both soft power and more sophisticated diplomacy.
My Lords, I thank the noble Lord, Lord McConnell, for securing this debate and for his long-term commitment to these issues. I also congratulate my noble friend Lady Penn on her maiden speech. I look forward to seeing the amazing things that she will do during her time in this House and the collegiate way in which she will undertake her work.
In this debate, I will restrict my remarks to the way in which nations develop and how we have observed that safer and fairer nations are actually built. I hope that this might provide some interesting thinking to feed into the Prime Minister’s welcome review.
How a person, community or nation develops along the pathway from poverty to prosperity has long been a concern of mine. From my time spent living in the Walled City in Hong Kong to my current role at the Legatum Institute—I refer to the Members’ register of interests—the question of how a nation builds a safer, fairer and more prosperous society has challenged me greatly. At the Legatum Institute, we have undertaken a piece of work entitled How Nations Succeed. We have analysed which nations, over a 60-year arc, have built fairer and safer societies from a starting point of fragility, such as Colombia, and which, with exactly the same starting point, have struggled to do the same, such as Nicaragua.
From this work, we have observed a number of lessons, but noble Lords should not worry—I will reference only three. As we have heard this afternoon, the number one need for any country is self-evidently to deliver security, peace and stability for its people—hence the safer world element of this debate. However, there is also a need to strengthen the social contract between a Government and their citizens. What can they really expect of one another? Then there is the need to create a positive environment for investment and to improve conditions for enterprise and flexible labour markets, all of which ultimately lead to a fairer society.
Noble Lords will be grateful to know that I will not unpack these one by one. However, what is interesting to note here is that there is not a clear connection between the development of a nation and the distribution and focus of aid to it. To put it simply, what we have observed is that nations that receive aid but do not take responsibility for their own development do not thrive on a national scale, even if some of their people benefit in the short term. However, nations that take responsibility for their own destiny drastically outperform the development of those reliant on foreign assistance, regardless of their starting point.
Against this background, let us first look at the issue of security and the creation of a secure foundation for a nation. No nation will be able to make the transition into a safer and fairer world without first delivering safety and security for its people. Stable governance, free from violent conflict and upheaval, is an essential requirement for development, as we have seen over the years in, say, Botswana. Countries need safety and security, effective governance and a stable political environment to thrive. It is therefore no coincidence that poverty is concentrated in high-risk settings. Some 87% of people who currently live in extreme poverty are in countries where security in all its forms—political, social or environmental—is fragile.
Globally, we are seeing the first welcome signs of increased safety and security following a trend of declining safety and security. This is crucial to establishing greater fairness. The relationship between wealth generation and security is essential, as we have heard. A nation with a basic level of safety and security is much more likely to create the conditions necessary for producing wealth, or fairness, for its citizens.
As nations transition from violence to stability, the next important step is to strengthen the social contract between a Government and their citizens. Our research shows that the strength and health of institutions has a stronger relationship with social well-being than aid in the long term; this points to where the greatest development leverage is likely to be in future. Improving the quality of institutions can stimulate increased economic well-being and thereby increased fairness. In the long term, the quality of institutions therefore has a substantial impact on social well-being, while the integrity and accountability of government is strongly related to the sort of fairness outcomes we long to see in the developing nations, in people’s health, education and living conditions.
This is because with stable Governments and institutional trust comes the ability to foster a positive investment environment. In our research, we have observed that the opening up of the world’s economies has led to an extraordinary reduction in the number of people in poverty. Absolute poverty rates have fallen; the proportion of families living on less than $1.90 a day has more than halved since 2000, and it continues to fall. We must not forget that the greatest anti-poverty achievement in the history of mankind has actually happened in our lifetime. Mainstream economists on the left and right, and in the centre, agree on the central role that free trade, property rights, the rule of law and entrepreneurship have all played in creating a fairer world. In our focus on aid, we must not hinder or constrain this metanarrative that is changing the world faster than any aid programme could.
The final lesson we learned when analysing how nations succeed is that countries which have developed over the last 60 years, such as Indonesia, have done so across multiple fronts concurrently: strengthening their institutions, growing their economies and improving the well-being of their people. This has seen a decrease in mortality rates across all age groups and a growing life expectancy. Our research shows that in living conditions and education, 85% of countries across the world saw an improvement over the last 10 years. Education systems are affording more people the opportunity to learn, with higher enrolment rates at each learning stage. Women are spending more time in school on average, for example in a country such as Mauritius. These improvements to living conditions, health and education foster communities and nations that are resilient enough to weather the challenges that an unpredictable world can provide.
There is significant food for thought in this debate, as we consider the way forward and the role that Britain should play in international development. If we are really focused on supporting the development of nations, do we need a conversation around how nations really succeed and develop? To build a compassionate world, we should certainly focus on providing assistance at times of crisis, famine and flood. Stability is absolutely the basis on which all prosperity is predicated. But if we really want to learn from effective models and use our defence, diplomacy and development to support emerging nations, should we work with the instincts of a nation where it is committed to development? Across all fronts, the nations that have forged the pathway from poverty to prosperity have worked to attract the people, ideas and capital that they need to succeed.
It is a pleasure to follow the noble Baroness and her positive remarks. Who would not sign up for a debate with positive aspirations such as we would expect not only from the noble Lord, Lord McConnell, but perhaps from Scotland? I have certainly done so with enthusiasm. I congratulate the noble Baroness, Lady Penn, on not only her speech but her African experience and her cross-party approach, which is so important.
Bringing the three Ds together also reflects the current concern about the merger of two or three ministries. I will come to that later, but, first, I want to emphasise the role of international development. Whether you are confronted by starving children in Africa in an emergency appeal or are listening to reporters in the Middle East of the quality of Jeremy Bowen, you can be in no doubt about the extent of poverty and misery around the world. The media have done us a great service in bringing these issues home to us. The problem is that there are so many calls on our time that we have to be highly selective.
The United Nations Secretary-General, António Guterres, said in his 75th anniversary address last week that the world faces four looming threats to human progress: surging geopolitical tensions, the climate crisis, global mistrust and the downsides of technology. The background to aid and development seems more turbulent than ever and our separation from the European Union does not seem to improve matters, although of course with our development record we shall find our own feet eventually.
The 17 UN SDGs are our principal guidelines in a peaceful world. Although we have only 10 years to reach them, we have to thank the many UN agencies working tirelessly to achieve these goals and encouraging us to meet them. The indicators are still being revised and refined, but I was glad to read that refugees and IDPs, which, ironically, were omitted at first from the SDGs, are at last included.
I would expect poverty reduction to remain the primary focus of our DfID efforts, while we need to acknowledge the urgency of climate change. However, we cannot be too high-minded about leaving no one behind; it is more complicated than that. The state of poverty even in the least developed countries differs from place to place. It is hard to define, and we find that poor health and education as well as low economic growth affect families differently, since people live in different circumstances and come from varying social backgrounds.
To my mind, the key to poverty reduction is to identify the most practical channel of assistance, and here I pay tribute to the non-government sector in which I have worked. I was on the staff and board of Christian Aid for 17 years; I also worked with Save the Children, CARE International and Anti-Slavery International. Through these organisations, I had a lot of opportunities to see NGO work on the ground. I maintain that the quality of aid through NGOs is higher, and that is why DfID has supported them since the time there of the noble Baroness, Lady Chalker. They may not always meet an auditor’s definition of value for money, but they generally represent good value. As the noble Baroness, Lady D’Souza, said, they often provide access to remote or endangered parts of the world such as those talked about by the noble Baroness, Lady Stroud.
Emergency work falls into a different category, but will the Minister confirm that we are looking seriously at the means of working alongside ECHO in the coming years? It is the EU’s most effective channel of emergency aid and the UK has spearheaded much of its work in the past. Similarly, I hope she can confirm that the UK will continue to participate in the EU’s CSDP missions. I realise that the new Prime Minister would like to have a clean break tomorrow, but only by realigning ourselves urgently alongside our European friends and allies will we both defend ourselves and save lives on all these programmes.
Trade can of course be another form of development, and NGOs have long recognised this through the Trade Justice Movement, the Fairtrade Foundation and initiatives such as Divine Chocolate, which is part- owned by the cocoa farmers themselves. The UK-Africa Investment Summit demonstrated the importance of development and trade working together to ensure that British investments in Africa are accountable, socially responsible and directly benefit the poorest communities.
Turning to climate change, I was a little surprised that in the title of this debate the phrase “cleaner world” is used instead of “healthier world”. It is arguable that the climate change crisis is so urgent that it must dominate even the development agenda. I recognise the urgency of every Government’s response, but personally I cannot raise it above the level of development. It is in the least developed countries, of course, where the urgency is felt most. I welcome the UK’s support for the Ayrton fund, which focuses on new technology to tackle climate change in developing countries—I am sure the Minister is going to mention it—and the doubling of our International Climate Finance funding. This may have been a response, and I hope it was, to the International Development Committee’s report last year, which urged such action. I notice that this funding is substantially to assist small farmers and local communities. Will the Minister confirm that NGOs will qualify for this alongside private sector initiatives and the CDC, since they are often the best way of reaching local communities?
Returning to ODA and the integrated review, in the new era we need to celebrate global Britain and to me that means our role in international development. UK aid has made a huge difference across the African continent by getting more girls into school, tackling food insecurity and reducing child mortality. We must now build on the legacy of our development work. We do not diminish the experience that there is in Germany, France and other countries when some of us boast somewhat about the UK’s particular contribution. I am all in favour of the Conflict, Stability and Security Fund, which has proved a good example of joined-up government.
I know that the FCO does good development work on its own too, as the noble Lord, Lord Ricketts, will confirm, and of course we have heard about the MoD in Africa. But merging DfID with the FCO, or even having both departments run by the Foreign Secretary, risks dismantling the UK’s soft power and leadership on international development and suggests that we are turning our backs on the world’s poorest and on the greatest global challenges of our time: extreme poverty, climate change and conflict.
My Lords, it is always a pleasure to listen to the noble Earl in these debates, with his thoughtful and experienced comments. A common thread in the debate, so well presented by the noble Lord, Lord McConnell, has been soft power, as ably defined by the noble Baroness, Lady D’Souza. It has been a consistent feature in all the contributions, whether the focus has been on defence and security, development or diplomacy. At its heart, soft power is how the UK is perceived in the world, not how the UK perceives the world. The noble Earl said nice things about Scotland, where I live, and since I am speaking at a Burns supper tomorrow night in Inverness, I am reminded of the Bard:
“O wad some Pow’r the giftie gie us
To see oursels as ithers see us!”
It is quite remarkable how the world does see us—we start from a good base and in many respects it is because of the point made by the noble Lord, Lord McInnes. Our foreign policy, our diplomacy and development policy are a creature of all four nations, not just one. All have made contributions. He was referring to the excellent maiden speech by the noble Baroness, Lady Penn, and I was reflecting, as the baby of another Parliament when I sat in the Scottish Parliament, that the second Head of State, after Her Majesty, who spoke at the Scottish Parliament was Bakili Muluzi of Malawi. The Scottish links, historical and present, with development and supporting African nations are very strong indeed and I was so pleased to hear her refer to that. As a former baby myself, in a different place, I recall what Charles Kennedy once said to me: “Parliamentary babies and toddlers are to be seen and heard.” I hope that we will hear very much more from the noble Baroness in the House.
I think it has been consistent across the debate that we welcome the review. It is right to reflect on what kind of global citizen we are and should be, but, as the noble Lord, Lord Ricketts, indicated in referring, as others have, to the Foreign Secretary’s recent speech in another place, it is better to start with the direction in which we wish to head and then look at how we achieve that ambition. I hope it will be an open review and not just internal to the departments. We have seen references in the Foreign Secretary’s speech to global Britain—someone unkindly pointed out not long ago that it was a slogan in search of a strategy. If global Britain is to carry on through this review, it would be beneficial if it is not just about updating technology or the machinery of government but starts from the principal opportunities around the globe on which the UK can take leadership. It will fail if driven simply by how other departments can access DfID budgets.
As my noble friend Lord Chidgey indicated, another element to be cautious about is that the review will of course be led by the FCO and linked with DfID, the MoD and DIT working together. As other noble Lords indicated, the British Council and the BBC World Service are also of critical importance to the UK’s global presence. We were due to have the soft power strategy published; when the noble Lord, Lord Howell, ably led the International Relations and Defence Select Committee, on which I serve, we called for this to be published on a number of occasions. It would be helpful to know whether it is still intended to be published in advance of this review or whether it will be wrapped up within the review.
As my noble friend indicated, if we lose the single Department for International Development, with a Secretary of State, it would dramatically reduce our capacity in the world to be advocates for good. We are the only country in the G7 which has legislated to enshrine 0.7% on our statute book; we meet it and are a leader on it. If we do not have a Cabinet-level Minister to bang the drum around the world, that will diminish our ability to do so.
As the noble and gallant Lord, Lord Houghton, and others said in this debate, it is interesting to reflect that it is welcome to co-ordinate but not always preferable to integrate between departments. It is often good to be aligned, but often preferable not to be combined. Often our Ministers serve the UK best when they can come from a specific aspect of the UK’s position in the world rather than always believing that one HMG are good.
This leads me on to the development point. When the UK met its 0.7% target—which we have continued to do—I remarked in this House that, being in a broad cross-party coalition, as a Liberal I was very pleased because we had met the Liberal manifesto commitment. That commitment was given in 1970, and the assumption after the Pearson commission was that private sector and aid transfers would be met by 1975 and development would take track. It is because we are so far away from that that financing the global goals and other countries meeting their obligations are so important. That is why I was disappointed not to see any mention in the supporting materials of the Foreign Secretary’s speech or some of the background briefings that one of the core purposes of our review will be our contribution to meet the global goals and how we will work with other countries so that they can meet them.
The core element of our development budget has been reflected on by the Independent Commission for Aid Impact. In the autumn, it said in its review of UK aid from 2015 to 2019:
“The government has clearly signalled its intention to use the aid programme to pursue direct UK national interests, in particular, by helping to position the UK as a key trade and investment partner with frontier economies. While the pursuit of mutual prosperity is not necessarily in conflict with good development practice, the focus needs to remain on building long-term opportunities, rather than securing short-term advantage.”
I hope that that thrust is to be a core element of the review.
While I am asking for clarification, the noble Lord, Lord Howell, asked a relevant question regarding the timing of other strategies. I mentioned the soft power strategy; we are led to believe that there is an Africa strategy, but that has not been published; and there is likely to be an updated national security strategy. It would be helpful to know how all these will be linked. On Africa, this is important because one of the signature elements of UK development with regard to that policy was announced in August 2018, when Theresa May indicated that the UK was to be the largest G7 investor in Africa by 2022. That was to set the stage for the UK-Africa Investment Summit, which took place last week. I have seen no reference to that target, either in the Prime Minister’s speech or from the Government. It would be helpful if the Minister could confirm whether that target is indeed still valid.
I had mixed emotions this morning with regard to the impact of tomorrow on us. I walked across Parliament Square and saw 10 still, rather limp union flags hanging from the flagpoles. It might be just because of the angle at which I saw them, but they looked as if they were at half-mast, and were set against a grey, dreich sky. I think this is meant to be a celebration. However, I was cheered up because my destination was Chatham House, where I and the members of the International Relations Committee received a superb briefing on Africa and the opportunities there. If we are to be successful in the review and if our strategy is also to be successful, it will probably be seen in our relationship with the most exciting, growing, innovative continent on earth, and UK-Africa could represent all the best that could come out of this review.