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Grand Committee

Volume 798: debated on Tuesday 2 July 2019

Grand Committee

Tuesday 2 July 2019

Arrangement of Business


Academic Health Science Centres

Question for Short Debate

Asked by

To ask Her Majesty’s Government what is their policy and timetable for re-designating academic health science centres.

My Lords, I thank those other Members of the House, some of them very distinguished in health issues, who have put their names down to speak. Someone pointed out to me that if I were unfortunate enough to suffer a stroke, this would be the moment to do it.

I declare an interest as recorded in the register of interests. I serve as a non-executive member of the board of an AHSC—namely, King’s Health Partners, which includes King’s College London, King’s College Hospital, Guy’s and St Thomas’ and the South London and Maudsley NHS Foundation Trust. From 2009 to 2014, I chaired the board of King’s Health Partners.

I need not remind your Lordships what an exciting time this is for advances in medical science. The concept of academic health science centres offers a means to exploit those opportunities for the benefit of people locally, nationally and across the world. By bringing together great biomedical research institutions with outstanding teaching and clinical hospitals, it offers the opportunity not only to trial advances in medical science but to bring them to fruition for the care of patients.

Apart from the United States, which pioneered the concept of AHSCs, the United Kingdom is perhaps the country best equipped to make the most of those opportunities. In London and our great academic centres, we have ground-breaking research universities: colocated with long established and world-famous teaching and clinical hospitals. In 2009, the NIHR accredited the first five AHSCs: three based in London, one in Cambridge and one in Manchester. In 2014, following a further competition, they were reaccredited and a further one in Oxford was added. The accreditation was for five years and is due to be renewed in 2019.

It is important to recognise that this was simply a structural initiative. No extra money was provided and the institutions remain fully within the state sector. King’s Health Partners is the AHSC which I know best. This year, we celebrated our 10th anniversary. I believe that our achievements over that time, stimulated by the AHSC initiative, have been impressive. Brilliantly led—indeed, driven—by its chief executive, Sir Robert Lechler, assisted by a small but outstanding team, the reach of King’s Health Partners has been remarkable.

As I said, the underlying concept of AHSCs is to bring together frontier-breaking research with teaching and clinical care. Sir Robert approached this in King’s Health Partners by establishing 22 clinical academic groups, embracing the full range of medical specialties and bringing together from the four institutions the leading members in each.

King’s Health Partners has a number of assets which have assisted in making the most of those opportunities: two NIHR biomedical research centres, which provide unparalleled facilities for experimental medicine and in which 600 clinical trials are current at any one time, covering more than 3,000 patients; the leading research institute in the country in psychiatry, psychology and neuroscience, colocated with the leading hospital in the care of mental illness, which has enabled advances to be made from the increasing recognition of the links between physical and psychological illness; and a diversity of population in south London, where the widest range of physical and psychological conditions give unique opportunities for research and treatment.

In addition to the advances made in individual specialities, King’s Health Partners has pioneered a number of other advances. As a response to the ever-increasing demands on health services, it has pioneered the concept of value-based healthcare and preventive measures, not least through the concept of the vital five factors in the prevention of disease—blood pressure, obesity, mental health, alcohol intake, and smoking habits—which have been promulgated through KHP’s academic health science network in south London. This work will make a real difference in reducing future demands on the health services, as well as giving people the prospect of happier and healthier lives, and is of course a key plank in the long-term plan for the health service.

At a recent seminar to celebrate the 10th anniversary of the AHSC, we had presentations of some of the advances made in patient care over the last 10 years that have made a major contribution to the life prospects of patients. They include: treatment for Hodgkin’s lymphoma avoiding the side-effects of radiotherapy in children; advances in the application of naloxone for heroin addicts; genetic treatment to reduce inheritance of breast and ovarian cancer; separation of the elements of cannabis so that the benign element can be used in patients; a new approach to recognition and treatment of prenatal eclampsia; MRI recognition of scar tissue to assist life-saving treatment of heart attacks; and improvements of means to prevent rejection in organ transplantation. On top of that, we can be immensely proud of the contribution that British science has made to dealing with the Ebola epidemics in Africa. There is so much going on that it is impossible to cover it all in one speech—for example, exploitation of the opportunity provided by informatics to join up patient records across our health system.

I am sure that the other AHSCs can tell a similar story. The nub of it is this. Certainly on the basis of my experience, the concept of AHSCs has been an outstanding success. They promote a national asset in which the United Kingdom is a real world leader. They are a magnet for talent and worth investing in. At a time of severe pressure on resources, they make a major contribution to more cost-effective healthcare for our National Health Service. There is great potential still to be tapped.

Reaccreditation will provide both a stimulus and an opportunity. It would be cost effective if that were accompanied by a modest financial grant. We are talking of only a small handful of millions, which would make a big difference—chickenfeed in relation to the overall cost of the NHS. Therefore, I hope that in her reply the Minister will provide that encouragement, and in particular give us a firm timetable for the process of reaccreditation. King’s Health Partners has been preparing itself for that and is waiting for the signal.

My Lords, I thank the noble Lord, Lord Butler, for calling this debate on this vital topic. I also thank the Library for its briefing. I declare my interests both as a visiting professor at Imperial College AHSC, where I work with the noble Lord, Lord Darzi, and as a former Minister with responsibility for this area of policy.

The topic that we are really discussing today is innovation in the NHS and how we make the most of it. It strikes me that medical innovation is both our greatest opportunity and our greatest challenge. It is our greatest opportunity because for the first time we face the prospect of truly personalised medicines that could take hitherto untreatable and often terminal illnesses and cure them for life. We face the glorious fact that we in this country are responsible for huge amounts of medical innovation in our universities, our hospitals and elsewhere besides. However, it is also our greatest challenge because of the NHS’s reputation for adopting innovation, which, frankly, is not good, not least because there is huge pressure on database services to deliver the basics, meaning that many staff do not have the resources or the time that they need to adopt innovation. So at once innovation is our greatest strength but its adoption is our Achilles heel.

The Minister knows this better than anyone. She knows the importance of tackling this topic and resolving the tension. In the six months that she has been Minister she has already shown great resolve in this, both through the creation of the boosted accelerated access collaborative, and through her work on health data to take advantage of that opportunity and the launch of NHSX. Those are all crucial factors as we move towards the idea—a culture change, really—of thinking of the NHS not just as a health delivery organisation but as a research and development one too.

As the noble Lord, Lord Butler, alluded to, in this sense AHSCs are both a microcosm and an exemplar. They demonstrate, in one connected set of institutions, the ability to move from basic science in the lab all the way through to clinical application. I have seen the benefit of that myself when visiting UCL and the biomedical research centres at Oxford, where patients were among the very first in the world to have treatments for their cancers that had been invented in the labs just metres down the corridor.

I believe that redesignation is essential, not just to retain this excellence but, critically, to lead the system to a different and more research-oriented future. I speak from experience when I say that I know it has been the intention to redesignate, and I believe that that is still the case. I look forward to the Minister describing how and when that is going to happen. This time, though, I think we need to do it not just as a badge on these fantastic institutions but with a specific dual purpose with funding attached. The first of those purposes would be to prototype the bench-to-bedside approach and then to roll it out through the NHS. The truth is that we have fantastic adoption in some parts of the NHS but it is extremely patchy. I believe that AHSCs should be given a system leadership role to demonstrate what can be done and then work with other trusts to make sure that that can happen.

Secondly, as I have said, we in this country have one of the greatest opportunities that exist in the whole medical research realm through the use and the maximisation of value of our health data assets, something that we have discussed many times in this House, and using the wonderful technologies that we have in artificial intelligence—many of the leading-edge technologies are developed in this country—to apply them to the healthcare challenges that we face. That would not only give us the chance to change what happens for patients in the NHS but would retain our global leadership in this area.

I would very much appreciate hearing whether the Minister shares these ambitions for our AHSCs. I believe that through that redesignation, by giving them a turbo-boosted purpose and extra funding, they can lead the way for the future.

My Lords, I am grateful to the noble Lord, Lord Butler of Brockwell, for initiating this important debate. As he did, I took part in the debate nearly nine years ago introduced by the noble Baroness, Lady Finlay of Llandaff. I was a non-executive director at King’s at that time and an independent panel member of the National Institute for Health Research. I was going to say a bit about King’s but I think the noble Lord has covered that, and I will spare the rest of the company. However, I chaired consultant appointment panels for a number of years, and it was clear from the calibre of applicants, all with research and international experience, that the AHSCs were expected to provide an atmosphere in which they could work and flourish.

My first question to the Minister is: given the internationalism of the best clinicians, how will the Government ensure the flow of talent needed and maintain that standard? In her speech to the Association of British HealthTech Industries last month, she said that,

“we must be relentless in our drive to ensure that the UK maintains its place at the cutting edge of health innovation”.

Only yesterday, in repeating the Statement on the NHS long-term plan, the Minister referred to,

“more investment in research and innovation”.—[Official Report, 1/7/19; col. 1270.]

Does she consider £39 million sufficient to maintain AHSCs as centres of excellence? The Government have enjoyed a lot of good will from these institutions and structures. I wonder whether it has now worn a little thin.

The noble Baroness, Lady Finlay of Llandaff, is sorry not to have been able to take part in this debate; she is on her way to Bangor—I am sure that there is a song about that somewhere. She indicated that what she regards as the jewel in the crown could be in jeopardy. Grants are so hard to come by that we are not growing our next generation of researchers. What action is being taken?

I want us to be able to compete on the world stage to attract the best consultants, researchers and innovators and, of course, to keep pharmaceutical companies here in the UK, but this is ultimately all about people. Perhaps I may give two examples from King’s. The CAR-T, or chimeric antigen receptor T-cell, to which the noble Lord, Lord Butler, has referred, is treating adult patients with lymphoma. Mike Simpson, a 62 year- old solicitor from Durham, was one of the first to receive the treatment. He said:

“I’m incredibly grateful for being given the opportunity to have this therapy … I describe it as my L’Oréal treatment… because I’m worth it”.

King’s College researchers, along with Cambridge University, have identified why arteries harden and how a medication used to treat acne could be an effective treatment for the condition. Trials are due to start shortly. I am sure that such exciting and positive developments sometimes help us forget the shortage of, and growing need for, skills in the health service, but we should feel proud of them and ensure that they continue. I hope that the Minister can answer my questions.

I, too, thank the noble Lord, Lord Butler, for initiating this debate. Given the number of people who will no doubt speak on behalf of different academic health science centres, the Committee should take it as read that I believe that they are all doing excellent work, because I want to explore one or two other areas.

On the need for a 21st-century research-led healthcare system, there is no political discord whatever—I think that we all agree on that, full stop. When the noble Lord, Lord Patel, managed to get the words “research led” on to the statute book during the passage of the Health and Social Care Act 2012, it was remarkable because it created a journey to which I think we all aspired.

There were some excellent signs. The early establishment of some academic health science centres during the years of the Labour Government was positive. In 2014, it was good to see the redesignation of six of them, five of them being in the “golden triangle” and the other in Manchester. I believed that was exciting but hoped it would pave the way for more. Why is there excellent research only in the south-east rather than elsewhere in the country? So far, that expansion has not transpired. If we simply go ahead and redesignate those already there, what will happen to my area, Yorkshire and the Humber? Are we saying that there are no initiatives worthy of designation in Yorkshire and the Humber or the north-east? Surely not. I hope that the Minister will take that on board.

My first plea in any reaccreditation exercise is to include areas that have a strong track record of collaboration between academia and research. In so doing, please use the opportunity to simplify structures that Peter Drucker once described as,

“the most complex in human history”.

Drucker was interesting, but it cannot be right to have differing governance, finance, clinical and political structures in each of the organisations, most with scant involvement of the people they serve. I have a great deal of time for Drucker but he had not looked at the rest of the health research landscape when he made his comments. As Professor Ovseiko argued in 2014, in a superb article on improving accountability through alignment, unless our model of competing structures for research, education, patient care and funding is radically streamlined we will not realise the huge potential for improved patient care that lies within our grasp.

The current landscape defies logical examination. We now have academic health science networks in every region with a remarkably similar mission to the AHSCs, except that they have a budget. Some have close ties with their AHSC, if it exists—not so in Yorkshire and the Humber—some do not. They should surely be brought together within the AHSN using its organisational structures, which are already there and are being paid for by the taxpayer. What about the collaborations for leadership in applied health research and care—the CLAHRCs—of which I am currently chairman, which are soon to be replaced by another set of organisations, the applied research collaborations, for which I am a prospective chairman? Again, some have close ties with a regional AHSN, some do not. For good measure, how do we ensure that our remarkable research effort actually benefits all our citizens, not simply the regions where the organisations currently are?

Finally, money is essential in this. We have a host of small elements of money. We need this to be properly funded. The whole nation needs to be involved and to take this wonderful opportunity forward.

My Lords, I also thank my noble friend Lord Butler of Brockwell for introducing this debate so thoughtfully. I declare my interest as chairman of University College London Partners, one of the designated AHSCs, and professor of surgery at University College London. As we have heard from the noble Lord, AHSCs were first designated some 10 years ago, following the review by the noble Lord, Lord Darzi of Denham, at the 60th anniversary of the NHS. Their clear purpose was to overcome the two translational gaps: the one between a discovery and establishing a therapy in man, and the one between that and ensuring it can be used more broadly across a relevant population. As we have also heard, there has been huge success in achieving the two objectives of overcoming translational gaps 1 and 2 with great effect on outcomes for individual patients, performance in broad health economies and opportunities for wealth creation in our country. It should be borne in mind that the life sciences represent, after financial services, the second most important part of our economy.

The nature and complexity of innovation and the broader questions attending health systems have changed over that 10-year period. We are faced with demographic change and important fiscal challenge and restraint in health economies. It is broadly accepted that the adoption of innovation is critical if health economies are to remain sustainable. Organisations such as academic health science centres therefore have a pivotal role. As we have heard, successive Governments have recognised not only the potential role of these centres, but the broader question of innovation in health economies through the creation of other designations, such as AHSNs, collaborations for applied research, biomedical research centres and so on. As we come to this third designation for academic health science centres, the question for Her Majesty’s Government is: what specific purpose do they see for AHSCs in the changed landscape for innovation in our health economies? Where do the AHSCs sit in terms of these other structures and designations, how are they to be co-ordinated, and how will we determine their success? We also have to try to understand whether the designation of academic health science centres in the future will be attended by contractual obligations, as we saw recently in the redesignation of the academic health science networks. To date, each of the AHSCs has been able to perform effectively, but driving its own agenda determined by its own local priorities and regional, national and global opportunities. Will that be the case in the future?

There remains also an outstanding question about how government and arm’s-length bodies in the NHS propose to facilitate the most important opportunity for academic health science centres: that is, their capacity to mobilise data across complex health economies and bring those to bear, not only on drug discovery but on changing the patterns and application of clinical care, development of the workforce, and of course the utilisation of vital resource most effectively. Do Her Majesty’s Government propose to deal with this particular question of mobilising the opportunity for health informatics in redesignation of academic health science centres? Finally, as we have heard, these designations come without any funding. Is it proposed that, at the time of redesignation, some funding is provided to the AHSCs?

My Lords, I also thank the noble Lord, Lord Butler of Brockwell, for calling this debate on the future policy of academic health science centres. I declare an interest: I chair the Accelerated Access Collaborative, I am a non-executive director of NHS Improvement, and I am professor of surgery at Imperial College London.

As some in this House may recall, in 2007 I led a review of London’s healthcare—A Framework for Action —which recommended the creation of a number of AHSCs in the capital. That created significant noise nationally. Subsequently, in 2008 we published the NHS next-stage review, called High Quality Care For All, and the Department of Health, under the auspices of the NIHR, commissioned five academic health science centres nationally.

AHSCs are organisations that hold a joint and equal responsibility for the delivery of healthcare, education and research. The combination of scientific method and clinical care has been seen as the fastest means of ensuring that scientific advances are translated into improvements in patient care. The establishment of the AHSCs in the UK was through a competitive process, as we heard earlier, judged by an international panel, and represented an attempt to regain this lost momentum. With no additional funding, the universities and their NHS partners in these five centres pledged to combine strategy, operations, and in some cases finance to deliver innovations in teaching, research and service delivery. Over the last decade, as we have heard, the AHSCs, with their BRCs, have made a significant contribution to translational research. Translation has typically either meant “bench to bedside”, meaning basic science to first in-human use, or “knowledge translation”, meaning uptake of new innovations. This brings me to the Accelerated Access Collaborative and its role in the NHS innovation landscape.

The AAC is a convening board bringing together NHS commissioners and providers, NHS arm’s-length bodies, industry, patient organisations and Government to ensure that the innovation landscape builds a strong pipeline of proven innovations that meets the service needs and to increase the adoption and diffusion of such across the NHS. The remit of the AAC has recently been expanded by the announcement of the noble Baroness, Lady Blackwood, to include six priorities: implementing a system to identify the best new innovations; setting up a single point of call for innovators, so they can understand the system and where to go for support; signalling the needs of clinicians and patients, so innovators know which problems they need to solve; establishing a globally leading testing infrastructure, so innovators can generate the evidence they need to get their products into the NHS; and overseeing a health innovation funding strategy that ensures that public money is focused on the areas of greatest impact for the NHS and our patients.

In light of all this, I see the AHSCs as having a unique and distinct contribution to make to the innovation ecosystem and the priorities of the AAC by providing a pragmatic testing environment, enhancing the uptake of innovation through their expertise in research methods, access to data and our great NHS clinicians.

The Accelerated Access Collaborative will work with the Department of Health over the next month to define further the role of the AHSCs and their future designation.

My Lords, I, too, thank the noble Lord, Lord Butler, for this debate. I am thankful to follow the presentation of the noble Lord, Lord Darzi; after all, he was the one who started the whole concept of the AAC. I am glad that the noble Lord, Lord Prior of Brampton, will follow me because he might be interested in what I have to say.

Hitherto we have all been supportive of the idea and the successes of the academic health science centres, so let me take a slightly radical view. If we are serious about how good our academic health centres are, we should look at models that really deliver the change. The noble Lord, Lord Darzi, mentioned teaching, research, innovation and clinical application, the key themes of the successful, leading research-based academic health centres in the United States. Are we saying that we have been serious in adopting this in our clinical practice, taking scientific inquiry into clinical application? Yes, of course we have started and have been successful.

In the United States, however, policy-making in healthcare involves a pluralistic approach. In our case it is the department of health that decides on the policy. If academic health science centres are to be successful, they need to be part of that policy-making. That has implications for us to be more pluralistic and for the academic health centres to be involved. For instance, if we agree that this is a good idea, the recognition of the distinctive nature and contribution of academic health science centres might greatly facilitate the development and implementation of policy in a number of areas. These include addressing the current crisis in clinical academic careers in the United Kingdom, growing and modernising the NHS workforce and meeting concerns over clinical governance.

There are, however, additional questions of interest to society that cannot be adequately framed in the absence of an academic health science centre concept. For example, what is the role of AHSCs in supporting government objectives for UK success in a knowledge-based economy—the so-called strategy for life sciences that we are now developing—in improving the impact of research, and in technology transfer? How can AHSCs leverage their academic resources to contribute to improved quality in the NHS? What is the social and economic contribution of AHSCs to local communities? Can AHSCs provide leadership in the development of new models of partnership working and the development of clinical networks? Even to pose these questions it may be necessary to develop a model that is unique to Britain.

Academic health science centres have hitherto been extremely successful. They need to be supported even more and included more in developing our policies.

My Lords, I should first declare an interest as chairman of NHS England and a non-executive director of Genomics England. I support the noble Lord, Lord Butler, especially and all the arguments other noble Lords have made.

I will begin by taking noble Lords’ minds back to 1980, when two Senators in the US, Senator Bayh and Senator Dole, passed the Bayh-Dole legislation, which forced universities receiving money for federal research to commercialise their IP. Until that day the IP had sat in the ivory towers of the universities and had not been exploited. From 1980 on we saw this extraordinary growth in Silicon Valley and, latterly, Boston as universities were forced to commercialise their intellectual property.

We have been much slower in the UK. Until recently, universities, particularly Oxford and Cambridge, were ivory towers. That has changed and the AHSCs are part of that change. We have developed an ecosystem in the UK that is both hard to replicate elsewhere and extensive. Whether it is the BRCs, the HSCs, the AHSNs, the Crick or the LMB, we have an extraordinary and competitive life sciences ecosystem. It is becoming even more competitive as we see the convergence of biology with data, statistics, computer sciences and artificial intelligence. That puts the UK in a very strong position.

Money comes into this. I have done the Minister’s job and I was involved at BEIS with the industrial strategy. Our problem is that our ambition is so low. Our ambition was to get up to the OECD average for research spending in five years—2.4% of GNP, at a time when the Germans were already at more than 3%. We have to argue for £5 million for a new LICRE digital application across London. We have to argue for £20 million or £15 million for a new dataset for people with polygenic risk scores, for example. We are fiddling while the rest of the world—China and the US—is putting huge resources into this. When I was working on the industrial strategy, I looked at countries as diverse as Singapore, Israel, Ireland and Switzerland, where there was active government involvement in research and industrial strategy. America is always seen as the land of small government, but the NIH is a massive funder of life sciences research.

I do not know how we can change the mindset of the Treasury and the British Government. The only good thing that might come out of Brexit, which I think is a universally bad thing, is that it will provide us with a big shot in the arm. Whether we put in the money through AHSCs or through other vehicles in our ecosystem—UKRI, the MRC, the BBSRC—I do not care, as long as we get more money into fundamental, basic research and support the translational research for the BRCs, the NIHR and the AHSCs. I am fully in alignment with the redesignations of AHSCs. Whether more money comes in through them or other parts of the ecosystem, we have a huge opportunity in life sciences. I know that the Minister supports that, too.

My Lords, I thank my noble friend Lord Butler of Brockwell for bringing up the matter of redesignating academic health science centres. As noble Lords know, the six NHS university health partnerships that have been designated by the department of health are Cambridge, Imperial College London, King’s Health Partners in London, Manchester, Oxford and University College London. I ask your Lordships and the Minister to look at a map, where you will see that Scotland and the north of England have been left out. There is a serious north-south divide. Both Newcastle University and Glasgow do some excellent work. Will the Government extend the list to include the north of England and Scotland, so that the work to research new treatments and to improve health education and patient care can also be promoted in these areas? That would help to alleviate the discrimination between north and south.

I declare an interest as president of the Spinal Injuries Association. There is a great need for research. Spinal injury causing paralysis is life-changing. Several bodies are raising money for this, on aspects such as bowels, bladders, pressure sores and sexual matters. Some of this research has links to some of the six partnerships on the list, but the ultimate aim is to find a way of joining the spinal cord. That needs global co-operation and the highest dedicated research, with hospitals and universities working together.

The disruption that Brexit is having on the NHS is evident. I have several reasons for being concerned about the £30,000 threshold, and universities may also have concerns. What assessment have the Government made of the impact of the £30,000 threshold on delivering research and on specific groups such as early-career researchers, part-time staff, technicians and other specialists working in the UK?

Many people with disabilities of all sorts live in hope that universities will find cures for their condition. It would be helpful if NICE were able to speed up its assessment of technology, which is increasing as research moves on at a great pace.

My Lords, I shall describe how I tried to enhance the co-operation and understanding between academia and hospitals by having all the trainees in a third of the south-east region spend a year or two on the academic side. In 1971, as professor of surgery at Guy’s Hospital, I started a comprehensive training programme that lasted until the trainees were appointed to a consultant post.

Several years were spent in district general hospitals and several years at Guy’s. The trainees experienced a wide range of surgical disciplines, including anaesthetics and intensive care. They also spent a year or two on the research side, including a year at Harvard. This gave them an involvement in research that they carried with them into their consultant work in the NHS. In addition, many of them became professors of surgery. The Guy’s Hospital training programme gave junior staff not only more comprehensive training but more security and a more stable family life. It also shared out the junior staff more fairly with the district general hospitals in a third of the south-east region. Most important of all, it encouraged young trainees to embrace academia early on in their career.

My Lords, I join everyone in thanking the noble Lord, Lord Butler of Brockwell, for putting forward for discussion this important subject of the future of the academic health science centres. I thank the noble Baroness, Lady Masham, for asking: what about Yorkshire? I say that as a Bradfordian.

We could probably have done with at least another hour to do justice to this subject and indeed to the distinguished speakers who have taken part, such as my noble friend Lord Darzi. We have four ex-Ministers here, and then the Minister herself. It is all right; I have been in rooms like this with virtually everyone in the room knowing more than I do about the subject being talked about.

I think we would all agree that these health centres provide essential research in medicine, clinical trials, cancer treatments, mental and physical health integration and much more. At a time of such uncertainty regarding our collaboration with Europe colleagues to conduct health science research due to Brexit, it is vital that we have clarity on the next steps for the academic health science centres in the UK. I agree with the noble Lord, Lord Prior, about the lack of ambition regarding finance, funding and our position on research. I am not sure that I quite understood whether he thought that Brexit was a good or bad thing for the future of research, and I will come back to that.

I have declared in the register of interests that I am a member of the Camden Clinical Commissioning Group, so I am at the foothills of the NHS. However, I am aware of the research done by Moorfields and UCL on, for example, laser treatment for glaucoma, which is important to our CCG. The treatment is said to have had high success rates, with the research suggesting an annual saving to the NHS of £1.5 million in direct treatment costs, potentially rising to £250 million if the treatment proves beneficial for patients with later-stage glaucoma. In Camden CCG, we are proud that our area has many major research centres—Moorfields, UCL and Great Ormond Street—and regard our job as primary care commissioners as being to make sure that we co-operate with them.

I return to Brexit. One of the health science partners, the University of Cambridge, stated:

“Both the NHS and the UK life sciences industry desperately need clarity and certainty to plan successfully for Brexit, and time has almost run out”.

That was in March, but it remains true, and the Government must consider what solid solutions can be offered. If we fall out of the European Union at the end of October, that presents an enormous challenge to the centres. It makes it more important that they exist and receive sufficient funding, I agree, but the collaborations that need to be carried out across Europe and the world seem to become more difficult. I would like the Minister’s view on that.

My Lords, I thank the noble Lord, Lord Butler, for raising this question on AHSCs. I pay tribute to his work as the former chair and now non-executive director at the King’s Health Partners AHSC and to his speech setting out some of the achievements that have been delivered. This has been a supremely expert debate, so I feel somewhat cautious in summing up. I thank noble Lords who have spoken this afternoon about their work in AHSCs, notably the noble Lords, Lord Kakkar, Lord Patel and Lord Darzi, and my noble friends Lord Prior and Lord O’Shaughnessy, who have been so instrumental in developing the system to where it is today. This is a timely debate because, as many noble Lords said, we are developing policy options for AHSCs going beyond the current designation. As noble Lords know, it is due to end in December this year. I acknowledge that this is a tense time for AHSCs, which will now be thinking about planning their future strategy. I am grateful to the noble Lord, Lord Willis, for making the point that this is a cross-party issue and that there is wide agreement across the Chamber about the importance of AHSCs. I will say at the front that there is also consensus about the need to go forward to designation; the question is how we do that.

First, in response to some of the wider points that were made in the debate, I say that the Government recognise the critical role that health research plays not only in fuelling the life sciences sector, which is one of the most productive within our economy, but in driving up the quality of diagnosis, treatment and care in the NHS. We are committed to creating the best environment for clinical research and to achieving the ambition set out not only in the life sciences strategy but in the sector deals. This is the only sector to have two sector deals, and that is because of the quality of the sector and the relationship between research, industry and the NHS, which has developed into an outstanding ecosystem in the past few years. We have to pay tribute to the role that the NHS long-term plan will play in that, due in no small part to the leadership role of my noble friend Lord Prior.

This country is a world leader in health research, with a world-class science base and three of the top 10 globally ranked universities. As my noble friend Lord Prior said, we have an extraordinary life sciences sector, and we must be as ambitious as we possibly can be in driving it forward. We are investing more than £1 billion per year through the NIHR to fund research, skills and facilities to enable high-quality research. I can answer the noble Baroness, Lady Donaghy: about £100 million of that was invested in a range of training programmes, and we have also created the NIHR training academy so that we can think about how we link that to international training.

We must ensure that we protect the valuable collaborations that we have because that ensures that we have the highest quality clinical research in the world. The commitment to increase our R&D investment from 1.7%, which has quite frankly not been good enough, to 2.4% and beyond that to 3% was hard won from the Treasury. I know that because I was one of the first to campaign on this as chair of the Science and Technology Select Committee some time ago. I will be one of the first to join noble Lords across the Committee in campaigning to drive further and faster, as we must not only have this commitment from our leadership candidates—and I am sure that others will join us in that—but keep driving forward blue-sky investment and further investment through the people, programmes, centres of excellence and the NIHR. That is how we will have an integrated health and research system which is one of the best in the world, designed to transform scientific breakthroughs into life-saving treatments.

The noble Baroness, Lady Donaghy, is right that we should be proud of what we have already achieved. Between them, the existing AHSCs cover health research and education in a wide range of clinical disciplines including mental and physical healthcare, cancer, cardiovascular and inflammatory diseases. It would not be right it we did not pay tribute to some of that today. Noble Lords have already done that. While we do not fund the AHSCs specifically, of the 20 NIHR biomedical research centres, 12 are at the heart of these six AHSCs, representing more than £700 million of NIHR investment over five years from April 2017. This significant NIHR-funded research infrastructure is key to enabling its engines for world-class excellence in early translational biomedical research.

The existing AHSCs were designated based on recommendations made by an independent panel, which we heard about from the noble Lord, Lord Darzi. On the regional spread, I am afraid that the noble Baroness, Lady Masham, will be disappointed that they can be designated only in England, not in Scotland, but it is open to the new designating committee to consider the regional spread as that goes forward.

Over the past 10 years, the six AHSCs have facilitated the strategic alignment of some of our leading NHS providers and their university partners in world-class research and health education, leading to improvements in patient care and playing an important role in driving economic growth through partnerships with industry, including life sciences companies, which is one of our key priorities. It is through this strategic alignment that these partners have secured funding. An example is the £10 million funding from UKRI for a new centre for medical imaging and AI at King’s Health Partners as part of the industrial strategy challenge fund. The noble Lord, Lord Kakkar, spoke about the success of UCL Partners, which has, among many things, been leading on the adoption of a learning health system to standardise data entry. This has allowed seven CCGs to trial and support interventions into early detection of atrial fibrillation, which is a key priority of the long-term plan, and for primary care networks. Specific examples are the ways that we are going to change healthcare for individuals. Imperial AHSC has supported North West London STP’s integrated care record to bring together the health and social care information of 2.3 million patients in the sector, enabling the identification of patient cohorts and the evaluation of service developments.

London’s three AHSCs are collaborating through the MedCity initiative to grow the life sciences cluster of London and the greater south-east, working with the Oxford and Cambridge AHSCs. In Manchester—not in the south-east—the AHSC is working with the AHSN to align research and education into the health and social care priorities of the Greater Manchester population. A single blood test-driven decision aid for patients presenting with chest pain at the emergency department is being rolled out. Since June 2016, more than 7,000 patients have been treated using this tool and the diagnosis of acute myocardial infarction was ruled out in more than 99% of cases, with patients returning home within hours of their arrival in the emergency department. This is evidence of how the AHSCs have changed clinical practice on the ground. Additional data published today by the NHIR clinical research network shows that NHS trusts which are part of the six AHSCs have undertaken more than 3,600 clinical studies and recruited 148,495 participants in 2018-19.We know that other academic health science partnerships have formed, further strengthening the health research and health education interface in London but, as my noble friend Lord O’Shaughnessy said, we must ensure that the deep research base that we have in this country is matched by a health system that embraces innovation and translates research funding into improved patient care, so that innovators can develop, test and deliver those products that patients and clinicians need and so that examples such as those I have just given can be adopted.

We know that in the past the system has been too fragmented, too complex for innovators to navigate and too slow to adopt promising technologies. That is why last summer, at my noble friend’s instigation, the department undertook an innovation landscape review, which identified the need for a system which was more joined up between healthcare partners, and for improved support for late-stage evidence and a better strategic alignment of priorities, such as how we support emerging technologies, including AI, drug discovery, mentioned by the noble Lord, Lord Kakkar, and precision medicine.

As my noble friend Lord Prior pointed out, it is also important to recognise the role of collaboration between NHS, industry and academia. During the landscape review, we found huge appetite for change and more ambition within the healthcare stakeholders who need to implement it. That is why the sector deals, the NHS long-term plan and the tech vision have all begun the process of transforming a significant part of strategy within government policy. Through the establishment of the accelerated access review and NHSX, as has been mentioned, we have started to build the necessary infrastructure effectively to support health innovation in this country. Under the expert leadership of the noble Lord, Lord Darzi, the AAC brings together senior leaders from the key government, NHS and industry partners with patient and clinician representatives to promote innovation within the NHS. Already, the AAC has made significant progress in supporting uptake.

We must agree that AHSCs and other structures must work hand in hand with AHSMs and wider innovation infrastructure to ensure that this is wired into the ARCs and will be in AHSCs. This is why I have asked the AAC to consider AHSCs, to ensure that the whole system is joined up, because that is what it is leading on. It is important that we give the AAC and the noble Lord the opportunity to build a cohesive health, research and innovation ecosystem that meets the challenges that we have set and the ambitions that we need our life sciences sector to deliver. That is why I have asked the AAC to consider AHSCs’ role within the health system as part of the boost agreement. That will ensure that the future designation of AHSCs complements the innovation support landscape, rather than adding further complexity. The AHSCs will therefore support the AAC in achieving its new objectives, including commitments to establish globally leading testing infrastructure, improving the system’s capacity to adopt innovation.

We plan to extend the existing DHSC AHSC designation until March 2020 to enable that new designation process to be held. We will announce the timescales soon. I appreciate that is not necessarily the answer that noble Lords want, but I hope that the strategic vision, the need for ambition and the purpose, which is to deliver innovation for patients which changes their quality of care and the ambition of our life sciences ecosystem is understood as the reason for that change.

Sitting suspended.

European Union–Western Balkans Summit

Question for Short Debate

Asked by

To ask Her Majesty’s Government whether the recent European Union-Western Balkans summit in Sofia has strengthened their support for European Union enlargement now and after Brexit.

My Lords, I am grateful for this further opportunity. I warmly thank the Minister and all distinguished colleagues for taking part. We are close to the 20th anniversary of our military intervention in the western Balkans, as I shall mention later. A secure and stable western Balkans means a secure and stable Europe. This is an obvious mantra which most of us would sign up to. However, I leave it to others to discuss security or Russia today. I will focus on enlargement.

If you go back to the good old days, when we were active EU members, it was consistently British government policy, under all Administrations, to support a wider Europe. This is not forgotten and I hope that the Minister will confirm it. We did not want a Europe pinned down by the eurozone, closer union or a European Army. We had the pound and NATO to look after our interests. We believed in the nation state and border controls to allow us to draw up our own immigration policy. But at that time, despite all these reservations, we could proudly call ourselves Europeans. It is quite tragic that, owing to a narrow vote in an advisory referendum, we have now had to abandon a position that originally commanded a majority view, namely to belong to a Europe that could look outwards rather than inwards and could adapt to the priorities of its members.

The great test came in the 1990s when, with the collapse of the Soviet Union, the EU had an immediate opportunity to invite new members from eastern Europe who were queueing up to join. Countries such as Bulgaria and Romania, and later Slovenia and Croatia, met the criteria early, but there were others who did not. In that category were the western Balkans, and many of them—even those that are NATO members—remain in limbo for a range of reasons, chiefly the EU’s chapters on the rule of law, governance and corruption. While enthusiasm for enlargement in Europe, especially in Paris, has waned, for those countries it remains very much alive. The UK in particular is seen to be deserting them owing to Brexit, although I recognise the efforts our Government are making to dispel this impression.

The political background is becoming much more unsettled with the rise of anti-immigration parties and the gradual end of the Merkel-Macron entente. A few weeks ago, Le Monde reprinted a photo of the two presidents happily together in the forest of Compiegne back in November. Below it, a headline said that the differences in the bosom of this Franco-German couple are finally revealed. Monsieur Macron opposes enlargement because he wants more reform and a closer union. The Dutch and Austrians support him against Frau Merkel who is in favour but has to go through constitutional procedures. As a result, EU foreign and Europe ministers recently postponed an important decision to open accession talks with North Macedonia and Albania.

I said in an earlier debate, in January, that the idea of enlargement has been discredited quite unfairly, because it remains a sensible policy for Europe. The key figures are now changing but Donald Tusk is one of those who keep reminding Ministers that decisions have to be made. Speaking before the summit in Sofia last year, he said that Europe remained the western Balkans’ strategic choice:

“Investing in ... the Western Balkans is in the EU’s best interest. And it will be the objective of our summit”.

After Sofia he was even more forthright:

“I don’t see any other future for the Western Balkans than the EU”.


“are an integral part of Europe and they belong to our community”.

There is therefore still plenty of good will behind the so-called Berlin process, which is now nearly five years old. It continues later this week in Poznan, when member states will again consider the more practical aspects, such as the economy, connectivity, the civic dimension and security, which underline the whole purpose of enlargement. The Minister will assure us, I hope, that even if and when we are outside the Berlin process, we will support these objectives. This is because we are already deeply engaged. We have supported not only enlargement in general and the candidature of Macedonia and Albania but the specific case of Serbia’s and Kosovo’s membership.

As noble Lords will know, while recognised by the UN as an independent state, Kosovo is not yet recognised by Serbia, Russia or even some EU members, including Spain, which fears the consequences for its own separatist campaign in Catalonia. But we have just passed the 20th anniversary of the end of the Kosovo war, and it is time to recall the full horror of that event.

The war between the Kosovo Liberation Army and Serbia/Montenegro lasted from February 1998 to June 1999. As a result, 13,500 died—more than 10,000 of them ethnic Albanians—and more than 1.2 million fled. There were atrocities on both sides, but NATO finally intervened to save civilian casualties, although some could not be avoided. Even today, 3,500 NATO peacekeeping troops remain in Kosovo because of the continuing tension between the two communities. On an IPU visit, I witnessed this tension from the elegant bridge over the Ibar river at Mitrovica, which separates Serbs in the north from Albanian Kosovars in the south. Only a few weeks ago, the Serbian army went on full alert when Kosovan police arrested Serbs during an anti-corruption drive. Four police were injured while removing a roadblock but the situation calmed down in a couple of days. These things are happening.

Since Sofia, we have continued to encourage dialogue between Kosovo and Serbia; this was once the favourite project of the noble Baroness, Lady Ashton, when she was high representative and is now her successor’s. The latest topic is a proposal to swap land which has a majority of ethnic Albanians on one side for land that is largely occupied by Serbs. The idea is firmly opposed by both the Commission and member states, because such a swap could lead to similar proposals in Bosnia and elsewhere and might become a tinder-box. However, according to one Kosovar MP who was here recently, although it is a bad idea, it is about the only subject that will keep the two presidents talking. I expect the Minister will say that the Kosovo-Serbia dialogue keeps alive the prospect of membership but that there are many other criteria in the rules that still stand in the way.

Similarly, North Macedonia’s name change and Albania’s local elections should assist their EU applications, but these, too, are being held up by ethnic tensions and the chaotic political scene on Sunday in Tirana. So the situation is still uncertain, both because of differences and changes among European leaders and because of the innate problems of the region.

What can be done besides encouraging good governance? I argue that every effort should be made to encourage investment alongside the gradual reform of institutions, to ensure greater stability and security. The region as a whole has seen stronger economic growth, with even Kosovo’s economy—usually one of the slowest—growing at 3.9% last year and continuing upwards.

The Poznan summit will certainly consider energy. The European Bank for Reconstruction and Development supported by the EU, has embarked on an impressive regional energy programme financed through the Western Balkans Investment Framework. This includes green technology investments in Bosnia-Herzegovina and an online catalogue of over 4,000 energy-efficient products called the technology selector. There are specific targets to combat climate change and appalling pollution—mainly caused by 16 coal-fired power stations—which must be met urgently. All this can be achieved if the Balkans are seen as a European priority that now requires our support.

I very much look forward to hearing what others, including the Minister, will say.

My Lords, I have always, as has my party, supported the enlargement of the European Union to bring in the former socialist states of central and eastern Europe. It was right that in 1990, despite the Prime Minister’s mistakes in her approach to German unification, we were among the strongest supporters of setting the countries of central and eastern Europe on the road to enlargement.

I was one of those who had to go over there in 1990 to 1991 to explain to representatives of those countries that this was not as easy as they thought and that it would take a great deal longer than they expected. I recall a conference in Kiev in December 1991 in which the foreign minister of that newly independent state said that Ukraine had two foreign policy objectives for the following two years: first, to join the European Communities and, secondly, to join NATO. The Americans in the delegation looked at me and said, “You are going to answer that one”. It has been and remains difficult but enlargement, at least as far as the Polish-Ukrainian border, is part of how we extend security, prosperity and democracy across Europe.

My interest in this comes from that period and from helping to set up the international relations department in Central European University, finding myself teaching Bosnians, Croats and Serbs together and hearing some of their stories of what they had been through together over the previous two or three years. Teaching international relations to people who have seen their friends killed a year or two previously is not easy. My interest in this also comes from having worked with Paddy Ashdown and learning from him that the British could not stand away from this. I remember well how irritated John Major was as Prime Minister when Paddy began to raise the issue and how, gradually, John Major was brought around. To his intense credit, John Major was the only politician who attended Paddy’s family funeral at his own request. He was a great Conservative who really understood how important all this was.

Now the “bastards” on the right-hand side of John Major’s party—who said to him that south-eastern Europe was no concern of the party’s, that the Germans could sort it out and that we should be a global Britain—have won. We no longer have a coherent foreign policy and, in a sense, this debate is therefore at the margins. However, it was right to commit to eventual enlargement and it is still right that we should support it if we are to continue to have any influence, which, of course, we are just about to give up. These are small, weak and internally divided states, and the combined European contribution to the stability of the western Balkans over the last 20 years has been considerable. This has been achieved through EUFOR; financial assistance—part of our net contribution to the European budget, as the recent Foreign Secretary and former Brussels correspondent of the Daily Telegraph would not wish to admit; and working on good government and the rule of law. We have helped to stabilise those countries while recognising that there is still a long way to go.

We must recognise also that enlargement fatigue, as it is so widely called, is well established in the other member states of the European Union. This is not entirely surprising when we see that Hungary, where I used to teach the students to whom I referred, has now, sadly, gone backwards, that the university in which I taught has now more or less been expelled, and that Bulgaria and Romania are now full members without having completed the full transition to the rule of law, anti-corruption and transparent democracy. Welcoming in new countries that are further down the road on that is not entirely easy. They have polarised politics; to one degree or another, corruption remains a problem; their economic conditions are poor; and, as the noble Earl, Lord Sandwich, has already noted, there are external pressures such as Russian interference and Chinese attempts to engage using cheap loans.

What do the British Government intend to do after we have left? Apparently, as I read in a government statement some months ago, we are promising financial assistance, so some of the money that Boris Johnson promises we will save by not contributing to the European community budget will perhaps go into what that budget was going to in the first place: financial assistance to south-eastern Europe.

Beyond that, it is not clear what influence we will have. I note that the government statement talked about maintaining our commitment to European values in the region, although at present we are not showing very much commitment to that as a “global Britain” which, if either of the two candidates for leadership wins, seems to represent a foreign policy in which, first, we follow President Trump and, secondly, we cosy up to the autocratic regimes in the Middle East and disengage from the European continent.

It may no longer matter whether or not Her Majesty’s Government support further enlargement, which I regret. I regret also that a substantial part of the Conservative parliamentary party may well not care.

My Lords, I congratulate the noble Earl on securing this debate. I realise that he has had to wait some time to reschedule it, but it turns out to be just the right moment. After all, this year we remember that it is 15 years since the big bang expansion of the EU in 2004, and later this week at Poznan we have the next round of the Berlin process, so it is on the money that we have the debate today.

As the noble Earl and the noble Lord, Lord Wallace, have said, the western Balkans have gone through some transformations since the appalling conflicts in the 1990s. Slovenia and Croatia have joined the EU and NATO, Albania and Montenegro are NATO states and Serbia has candidate status. However, the region suffered very badly from the results of those conflicts. The legacy is instability, yet of course stability is the very thing that the UK needs in that region. History has taught us that if you have instability in the western Balkans it becomes a direct danger to us.

The UK’s Ambassador to Montenegro, Alison Kemp, speaking in May this year at the workshop on the fight against corruption in the western Balkans, said,

“ensuring compliance with and implementation of key standards and reforms required in the areas of rule of law, good governance, and human rights remains a pressing issue. This was recognised in the EU Enlargement Strategy for the Western Balkans, launched in February 2018, which indicated that a concrete and sustained track record in tackling corruption is a key benchmark for West Balkan countries wishing to join the EU”.

However, as the noble Earl said, the EU 27 themselves have exactly not shown unanimity on the question of further enlargement. So is not the real question today: how serious are the EU 27 about further enlargement, with or without us in the EU? Austria, France and the Netherlands have all expressed caution about extending membership. Chancellor Merkel and President Macron displayed distinct differences of view about enlargement at the mini-summit in Berlin on 29 April this year.

Chancellor Merkel sees the place of states in the western Balkan region as being within the EU. She is pragmatic and understands that it is will take some time for them to adapt to be able to open and close chapters to be able to become members. President Macron, however, appeared to show little interest in further enlargement, believing it would further weaken the cohesion of the EU and fuel populist or far-right movements.

Does the UK intend to try to resolve the apparent blockage on enlargement caused by the reported difference of views held by Macron and Merkel? Against that background, the EU Commission says that Albania and North Macedonia have made good progress towards EU membership and that accession talks should now be opened. Do the Government agree with the Commission on this point, while we may disagree on so many others?

I note that my noble friend Lord Callanan issued a Written Ministerial Statement on 5 June after he attended the General Affairs Council. He said:

“Under discussions on enlargement, some Member States hoped that progress would be made at the June European Council to allow accession talks with North Macedonia and Albania”.

Was the UK among those who spoke in support of making progress at the Council?

The question of enlargement was expected to come up at the June EU Council. Can the Minister say whether it did? I listened carefully to the debate in this House on the summit Statement eight days ago but did not hear any indication that there was such a discussion. The Leader of the House said that the,

“European Council focused on climate change, disinformation and hybrid threats, external relations and what are known as the EU’s ‘top jobs’.—[Official Report, 24/6/19; col. 979.]

and I gather that they still have problems over the last item. So was progress made on enlargement at the June Council, or has that discussion been relegated to September?

The International Relations Select Committee report last year concluded in paragraphs 60 and 62 that EU membership for the countries of the Western Balkans was,

“the most reliable path for Western Balkan countries to achieve security, stability and prosperity”,

and that the UK should remain a,“champion for accession”, outside the EU. Do the Government agree with the committee’s assessment? If so, what are their plans to be that champion now and after Brexit?

My Lords, I congratulate the noble Earl on his initiative. I wish he had been with me some 15 years ago when I was ushered into the office of the then Greek Foreign Minister, Papandreou. On the wall was a large map of Europe. It was of course, as the noble Baroness, Lady Thornton, has said, the time of enlargement. One piece of the jigsaw was missing: the western Balkans. Papandreou said to me, “This issue is manageable and should be managed”, looking at the relatively small number of countries that are there and of course the relevance to us in western Europe. If we do not go there and seek to find means of getting closer to those countries, they will continue to come to us in terms of corruption, drugs and gang warfare. We are aware that some of the worst gangs in London are Albanian and Kosovan.

Papandreou’s aim of a European perspective for the western Balkans has been echoed in a series of warm declarations since, culminating in the Sofia declaration of 17 May 2018, which talked of a shared vision,

“underpinned by our historic, cultural and geographic ties and by our mutual political, security and economic interests”.

It is significant that prior to the Sofia summit it was 16 years or so ago that the Thessaloniki summit took place. Although there have been many warm words since, there has been relatively little and slow progress. On 18 June this year, as has been said, the EU foreign and European Ministers postponed a decision to open accession talks, not even allowing the relevant countries to be on the foothills of accession.

The fact is that there are forces in Europe that are increasingly cautious about enlargement, partly because of disagreements but also because of the problems within those countries. We think of the paralysis in Bosnia-Herzegovina since the time of Dayton. Clearly there are many relevant factors, not least the backsliding, the authoritarian developments, the corruption which leads to hesitation about enlargement and the fact that many see risks to Europe in that enlargement.

Serbia and Montenegro are the frontrunners, but Serbia has not taken the normal first step of getting closer to NATO, in part because of the role of NATO in the Kosovo war. Serbia recently welcomed President Putin with ecstatic crowds in Belgrade, which suggests that it is not wholly committed. Certainly the Prime Minister wishes to ride two horses.

So far as Montenegro is concerned, I have met Dukanovic on many occasions. There are allegations of continuing corruption, particularly in his case. There are allegations of cigarette and tobacco corruption and links over centuries with the Italian Mafia and its predecessors. Nevertheless, Montenegro is forward in terms of adopting first the deutschmark and then the euro.

Some argue that the region should be seen as a whole, but that would penalise the front-runners. The date of 2025 has been mentioned for leading candidates. It is always useful to have a target date, but its realisation needs one to be very sceptical.

How then should we make progress? Obviously, it should be through step-by-step initiatives such as those set out in the annexe to the Sofia declaration. I am particularly concerned about the first priority in that declaration on law and order. If and when we leave the EU we shall still be a member of the Council of Europe, which has expertise in law and order, justice and institutions such as the Venice Commission and the European Court of Human Rights. We might argue that the European Union has the money and the Council of Europe has the expertise. Recently it has made a new priority of working with the countries of the western Balkans. Exactly a week ago, the Council elected a Croat as its secretary-general. There are clearly links between the UK and the area beyond the European Union. I think of the British Council. It would be foolish of us to think that since our weight will be reduced within the European Union we can still argue credibly for enlargement. If we are a member of a club and we leave that club, we can hardly have much credible voice in seeking additional members for it. Indeed, any such initiatives might be considered impertinent by members of the club.

My Lords, the answer to the question we are debating today—whether the recent EU-west Balkans summit in Sofia has strengthened support for EU enlargement—can be provided quickly, clearly and shamefully. It is no. Support for EU enlargement since the Sofia summit has not been strengthened. If anything, it has been weakened. When the Foreign Ministers met in June, they made no progress towards opening accession negotiations with North Macedonia and Albania. The noble Baroness, Lady Anelay, asked questions about the recent EU Council and I shall be interested in the answers, but I have to point out that if you read the communiqué you will see that the Heads of State and Government did not spend a single minute on enlargement; they merely noted the Foreign Ministers’ decision not to open negotiations. That is pretty feeble. We are still a member of the European Union and we were a party to that lamentable performance, so I hope the Minister can explain why and what we did to resist such an undesirable outcome.

Why does this matter? Ever since the 1990s, when Yugoslavia broke up and the west Balkans flirted with the sort of full-scale hostilities which caused the region massive damage and suffering twice before in the 20th century, it has been pretty clear that a large part of the task of stabilising the region and ensuring its future prosperity would be played by embedding its countries in a supportive international environment, to be done by membership of the United Nations, NATO, the Council of Europe and, mostly importantly, the EU. That was the conclusion of the report produced by your Lordships’ International Relations Committee 18 months ago and quoted by the noble Baroness. I suggest that it remains as true today as it was then.

The EU’s failure in June was open to criticism most particularly in respect of North Macedonia. Not only has the reformist Government in Skopje moved the country sharply towards EU standards and away from the previous nationalist agenda but that running sore in the western Balkans, the dispute over the country’s name, has been settled with Greece. I gather that subsequent progress has been made on accession to NATO—perhaps the Minister can tell us about that and when North Macedonia will become a full member of NATO. However, it would not fully compensate for the pusillanimity over EU accession.

Is the damage done by the failure irretrievable? It almost certainly is not. North Macedonia’s and Albania’s EU accession bids will be back on the agenda when the Foreign Ministers meet in October and the Heads of Government do so later that month. What will the Government say then? What will they do in the run-up to those meetings—we will still be a member then—to assure a better outcome and what are the prospects for achieving that?

This whole sorry saga illustrates another prevailing theme: the collateral damage done by Brexit to the UK’s influence. For long one of the champions of EU enlargement and stabilisation of the western Balkans, we are now little more than a faint voice crying from half way out of the door. It is surely no good us trying to deny that loss of influence. If anyone is tempted to do so, I suggest they try talking to anyone from any of the countries of the western Balkans. Is it irretrievable? Perhaps it is not, but that is a story for another time and another place.

My Lords, I am grateful to the noble Earl, Lord Sandwich, for bringing forward this timely debate. I am also relieved that I am only winding up for the Liberal Democrats and do not have to answer the debate, because it is one of the most depressing debates that we could be having at the moment. We face challenges to British influence and severe questions over the European Union’s willingness to enlarge. How different it was a quarter of a century ago, when there were prospects of eastward enlargement and the UK played a key role in leading it.

In 2019, enlargement to the western Balkans remains vital to those countries. As the noble Earl said, it remains vital to our security and, as the noble Baroness, Lady Anelay, suggested, the security of the western Balkans matters to the United Kingdom. However, it is unclear what influence the United Kingdom can have. When the International Relations Committee, whose report has been referred to already, took evidence from Sir Alan Duncan, I asked that question of him. I perhaps did so slightly inappropriately. I queried what influence the Government thought they could have when certain members of the Tory party were spending such a lot of time denigrating Germany’s role in Europe and suggesting that European integration was a bad thing. Surely that made it somewhat difficult—or impertinent, as the noble Lord, Lord Anderson, put it—for the UK to be advocating enlargement to the western Balkans, or at least encouraging the western Balkans to seek to join. If we are too good to be part of the EU, why on earth should we be encouraging other countries to join? That seems a little strange. Anyway, Sir Alan Duncan suggested that my question was “inappropriate” and therefore decided not to answer it, so I wonder if today the Minister could give an answer about whether she feels that British influence on this question is in fact declining. As a country that is, as the noble Lord, Lord Hannay, has just suggested, essentially half way out of the door, with a declining voice, how does the UK envisage having an influence?

It could all have been so different, and arguably should have been. The idea of enlargement and the reasons for countries seeking to join the EU are very similar to the founding reasons for European integration: peace, security and stability. The six founding member states understood the reasons to co-operate. The countries of central and eastern Europe that joined in 2004 understood the reasons for being part of the European project, and so have the countries of the western Balkans—up to a point. As we have heard, there are questions about how far countries have actually changed. The EU has seen enlargement as a way of exercising soft power and exporting the values of democracy, human rights and the rule of law, all values to which the UK aspires and which we think of as British values as much as European. However, we have already seen that the countries of central and eastern Europe that got their act together, met the Copenhagen criteria and were allowed to join in 2004 or 2007 have begun to turn their backs on those European values. Viktor Orban talks about illiberal democracy. Other countries are facing questions of corruption or questions about their judiciary.

The EU’s ability to exercise its soft power may have come under question, but at least it was a positive aspiration. It was an aspiration best understood by Germany, which always felt that you could expand geographically but also deepen the integration process. We have heard that France under Macron is reluctant to enlarge to the western Balkans, but in many ways he is simply reiterating the concerns of France over decades, feeling that enlargement will weaken the integration process.

Do the current UK Government believe that in the final days of our membership of the EU—unless of course by some deus ex machina we do not leave—they can exercise any influence over President Macron and the other laggards on enlargement to persuade them that it is in the interests of the EU to enlarge? What influence do the Government think they can have on the countries of the western Balkans? We in this Room may feel that it is in the interests of the UK and the western Balkans to see enlargement, but so far the countries seem to be facing the dictum that I first heard in Budapest in 1996: “They pretend they want us and we pretend we’re ready”. The idea still seems to prevail that the EU does not look terribly open to enlargement, and perhaps the western Balkan countries are not as ready as they would like us to think they are.

My Lords, I thank the noble Earl for initiating this timely debate. He opened with the mantra: “A secure and stable western Balkans means a secure and stable Europe”. It is worth repeating because it is the crux of this debate. We have a shared interest in working together to increase stability and help the region on its Euro-Atlantic path.

As the noble Baroness, Lady Anelay, said, the excellent report of your Lordships’ International Relations Committee identified a number of challenges, and those challenges are still there: US disengagement and increasing Russian influence. Regardless of whether we are in or out of the EU, we cannot afford for the Balkans to be unstable. We have seen six western Balkan nations seeking eventual membership of the EU: Albania, Bosnia and Herzegovina, Kosovo, North Macedonia, Montenegro, and Serbia. While the EU opened accession talks with Montenegro and Serbia last month, the noble Lord, Lord Hannay, highlighted that member states chose not to agree to the opening of accession negotiations with Albania and North Macedonia. As the FT put it in its editorial:

“Setting these countries on the path to membership is vital not just to maintain reform momentum but to send a message to the wider region—the most volatile in Europe—that the EU’s doors remain open”.

In particular, I strongly believe that the Greece-North Macedonia agreement deserves to be acknowledged by opening talks. I hope the Minister will agree with that this afternoon and will ensure that we use our influence. As we have heard, the failure to open negotiations was largely due to the concerns of France and the Netherlands. Commentators have suggested that they were fuelled by enlargement fatigue and anti-migrant sentiment, although 14 members states released a joint statement urging that talks begin. It is about expectations and hope. The noble Lord, Lord Hannay, made this point very strongly. At the summit in Sofia we had a very strong commitment about the EU’s intentions to strengthen its support for the region’s political, economic and social transformation. Social transformation is vital in embedding the values we have heard about into those countries. EU enlargement and the accession process are vital components of delivering change and the economic development required for longer-term peace and security.

Yesterday I met the Serbian ambassador. Obviously there are tensions and difficulties in Serbia. It is in a process of change, but if the people of Serbia see that we are turning our backs on them and that the pathway we are advocating will not be delivered, we will end up with greater problems.

We have the Berlin process, as the noble Baroness, Lady Anelay, said, with the sixth annual summit between EU and western Balkan officials in Poznan. The focus is on youth, culture and security. Foreign Affairs, Interior and Economy Ministers will be working together and meeting the following day. At last year’s London summit, there were 140 civil society and youth attendees. What has happened since the London Berlin process? What will be reported to the delegates at Poznan about progress? Whatever path we follow, we want to be able to identify progress, because if we do not we will fuel disillusionment. We need to maintain confidence in the process. We need more than simple talking shops. We need political engagement. It is not for me to answer for the Government about how we maintain positive momentum, but it is important not to see this progress as simply engagement with Governments. It is about politicians and parliamentarians. It is about broad engagement with civil society. I know the Minister, the noble Lord, Lord Ahmad of Wimbledon, will meet WFD officials shortly, and I would like to know more about the programmes we are undertaking to use soft power to influence the agenda so that, whether we are outside or inside the EU, we continue our engagement.

My Lords, I am sorry for coughing, but the air conditioning is not doing my throat any good. I thank the noble Earl, Lord Sandwich, for tabling this debate and all noble Lords for their interesting contributions. I reassure the noble Baroness, Lady Smith, that it is actually a pleasure to respond to this debate which has been constructive and illuminating. It is certainly timely, coming in the same week as the western Balkans summit in Poznan under the Berlin process and two weeks after the General Affairs Council discussion on enlargement.

I recognise that there is concern in the region and, indeed, among some in this House that the UK’s departure from the EU might lessen our commitment to the western Balkans. I reassure noble Lords that this is absolutely not the case; quite the opposite. In response to the noble Lord, Lord Wallace of Saltaire, the western Balkans matter—as he rightly identified—for the security of the UK and of Europe, and that is why we are increasing our engagement in the region. I shall say more about this shortly. I reassure the noble Earl, my noble friend Lady Anelay of St Johns and the noble Baroness, Lady Smith of Newnham, on the issue of EU enlargement. Irrespective of our departure from the EU, we remain of the view that the EU accession process is important in helping the countries of the western Balkans to become more secure, more stable, more rules-based and, ultimately, more prosperous. I thank the noble Lord, Lord Collins, for underpinning and underlining that point. We will continue to support those countries committed to the accession process to meet the necessary requirements. That was the message that the Prime Minister took to the EU-western Balkans summit in Sofia last year, when she reassured EU and western Balkans leaders of the UK’s continuing commitment to promote prosperity, security and stability in the region in the years ahead.

The General Affairs Council two weeks ago, to which I referred, endorsed conclusions on EU enlargement which reaffirmed the EU’s commitment to enlargement as a strategic investment in peace, democracy, prosperity, security and stability in Europe and recognised what has been achieved in the region so far. We welcome these conclusions and played an active role in their drafting. The conclusions, and the Commission’s country progress reports, which were published as part of the annual enlargement package on 29 May, also rightly highlight the significant challenges that remain in the western Balkans and the progress that must be made ahead of accession. My noble friend Lady Anelay of St Johns raised the particular issue of France and Germany. President Macron is very sceptical about enlargement. He said again this week that that was his view. On the other hand, Chancellor Merkel remains very attached to enlargement. The important point is that the EU has agreed to return to this question in October at the latest. We do not play a leading role in the debate on EU enlargement, but we think that the EU should recognise progress when it is made. For example, progress has been made in North Macedonia.

My noble friend and the noble Lords, Lord Hannay and Lord Collins, asked what was discussed at the European Council. I think that the question was discussed at the General Affairs Council rather than the European Council. As I said, the Commission has recommended that accession negotiations should begin with North Macedonia and Albania. I am not aware of whether my noble friend Lord Callanan spoke during the General Affairs Council debate, but the overwhelming majority of EU member states—and the UK, of course, is one of those countries—were ready to accept the Commission’s recommendation. It was France and one or two other countries that wanted to postpone the discussion until October.

On that tack, I think it was the noble Lord, Lord Hannay, who asked specifically about North Macedonia and its NATO application. I understand that membership was agreed in principle in July 2018. Ratification by each of the member state parliaments is pending, and that will have to be obtained, but I believe that accession is expected by the end of 2019 or in early 2020. The UK will ratify the relevant accession protocol in early autumn this year.

Obviously, the countries of the region must adhere to the core values of the rule of law, fundamental rights and good governance. It is right that rigorous conditionality is maintained, requiring countries to demonstrate a commitment to European values and to meet the necessary conditions before accession. It is clear that the countries of the region all face significant challenges in meeting these conditions, albeit to differing degrees. These challenges are set out in the country progress reports, and I group them into two key areas.

The first is security, from terrorism and violent extremism to serious and organised crime, including trafficking of people, drugs and firearms. I think it was the noble Lord, Lord Anderson of Swansea, who raised these important matters, and he is right to do so because, as he observed, they can directly affect the United Kingdom. We should not lose sight of the threat of malign Russian interference. That also has implications for the security of the region, as we saw in the Russian-backed attempted coup plot in Montenegro in October 2016, which was, quite frankly, an outrageous example of Russia’s attempts to undermine European democracy.

The second key area of concern relates to weak governance, corruption and the erosion of the rule of law. Sustained progress is needed to address these issues. Disturbingly, we have seen movement in the opposite direction, particularly on freedom of expression. According to the Reporters Without Borders world press media freedom index, western Balkan countries are ranked among the lowest in Europe. We are deeply concerned about the politicisation of the media, violence against journalists and unbalanced media coverage in election periods.

The noble Lord, Lord Hannay, was pessimistic in his contribution, as to some extent was the noble Baroness, Lady Smith of Newnham, but let me seek to reassure them. The UK remains at the forefront of work with European and other international partners to address these challenges. The noble Earl also raised this in his contribution. As the Prime Minister announced at the London western Balkans summit last year, we are increasing our spending on the region to £80 million a year by 2021 and doubling the number of UK staff working at our embassies on security-related challenges. The UK’s growing portfolio of assistance is focused on supporting stability, increasing security co-operation and implementing much-needed administrative reforms, as well as enhancing the region’s long-term prosperity. Importantly, the UK is also investing in the region’s law enforcement, rule of law and civil institutions. I need not tell your Lordships how important that is.

My noble friend Lord Ahmad had the opportunity to emphasise the UK’s commitment to the region during his visit to Serbia and Bosnia and Herzegovina two weeks ago. Two particular priorities for the visit were conflict-related sexual violence and media freedom, both of which will be the subject of major international conferences here in London this year, with the involvement of the western Balkan nations. Your Lordships may be aware that there is to be a media freedom summit this month and a prevention of sexual violence in conflict conference in November. The precise date and the personnel for that are to be confirmed.

This brings me to the Poznan summit, to which a number of your Lordships referred, in particular the noble Earl and the noble Lord, Lord Collins, who specifically asked what we have done and what we hope to achieve. The challenges I have talked about will be among those addressed at the next summit of the Berlin process in Poznan later this week. It is to be attended by the Prime Minister, the Minister for Europe and the Americas, Sir Alan Duncan, and, I understand, the Security Minister, Mr Ben Wallace. My noble friend Lady Anelay of St Johns rightly identified that the Poznan meeting is an important moment to emphasise our enduring commitment to the region and to acknowledge the progress the UK and our partners have made through the Berlin process since our UK summit last year.

That includes progress in three key areas. First, in education and skills, the UK’s £10 million 21st century schools programme is equipping students throughout the region with IT coding skills. Secondly, in security and organised crime, Interior and Security Ministers will take forward the security agenda launched in London and discuss important issues, including improving real-time information exchange between law enforcement agencies, combating modern slavery and human trafficking, controlling the spread of small arms and light weapons and the need to combat corruption and illicit finance. Thirdly, in regional co-operation and reconciliation we are working with the region to take forward the landmark joint declarations on missing persons, war crimes and good neighbourly relations which were signed by the 14 Berlin process leaders in London last year.

The noble Lord, Lord Collins, spoke tellingly when he used the phrase “social transformation”. He speaks for us all. That is what we want to see, and we hope that that might be the consequence of the aggregate approach which has been taken in endeavouring to support these western Balkan countries in their endeavours.

In conclusion, the UK remains committed to working with European partners to drive forward reform, embed stability and address shared challenges in the western Balkans. We remain of the view that the EU accession process is important for delivering security, stability and prosperity, and we will continue to support countries committed to the accession process to meet the necessary conditions.

Sitting suspended.

Publicly Funded Infrastructure Projects

Question for Short Debate

Asked by

To ask Her Majesty’s Government what steps they take to provide Parliament with up to date cost and cost/benefit information for major infrastructure projects to which public money has been committed.

My Lords, it gives me great pleasure to introduce this debate concerning the information that Parliament and the public need about major projects. There is a lot of information around. According to the Treasury-owned Infrastructure and Projects Authority, more than £300 billion-worth of projects are on the go in the MoD and the Department for Transport alone. They are projects with government funding, but there are quite a lot of other projects which some argue should be included in this category, such as Hinkley Point. We should then ask: are they good value for money? Do they fulfil the function for which they were planned? Would there be a cheaper and better way of doing it? Are Ministers keeping an eye on their projects to make sure that they do not go badly wrong?

The IPA is supposed to give Ministers this information, but do they take any notice? The IPA has a successful role in project delivery. It does a great deal of work in collecting and analysing data, looking at the structures of management and risks. As many noble Lords know, it publishes a score-card in its annual report—many noble Lords probably have a copy. It uses a traffic-light system: green means that a project is going well; amber denotes some concern; amber/red signifies:

“Successful delivery of the project is in doubt … Urgent action is needed to address these problems”.

Red is:

“Successful delivery of the project appears to be unachievable”.

There are hundreds of examples. I shall select two successful projects. DCMS’s broadband delivery programme has been green for four years, and the Department for Transport’s management of a search and rescue helicopter contract has been green for five years. Who are the culprits? The MoD earned five reds last year and many amber/reds—I shall not list them. The Department for Transport’s Crossrail programme had five years of green and then it went amber/red. Where is it going to go next? We do not have the latest information, but I expect that it will get rather worse.

What happens to the information that the IPA provides? My worry is that the answer is nothing much. Who challenges Ministers on whether what they want to build is the most suitable solution to a problem? It should be Parliament. One has a fear that many projects become vanity projects. Should the new Astute-class submarines be called the Penny Mordaunt class, or should HS2 be called the Grayling line? We could give all of them names, but it is not a good idea.

I fear that the policy of successive Governments on big projects is to set up a structure which defies scrutiny until so much money has been spent that they argue that it is too expensive to cancel or alter. Then the blame game starts, with those who fear for their future careers trying to jump ship before they are found out. I am afraid that this applies equally to Ministers and officials—who knows what and when?

I shall give two examples. Crossrail 1, a joint TfL/Department for Transport project, was going swimmingly until last summer. It was going to open in the autumn and now it will probably be two years late. We can debate why this has happened. Let us not go into blame game now, but how did the news of the delay and cost overrun not get to the promoters much sooner? We will know eventually, but it is pretty embarrassing for everybody concerned.

HS2 is 10 times worse, not only because its costs are very much higher than that of Crossrail but because the evidence of cost overruns, cover-ups and, I must say, fraud and worse are rampant even before the permanent construction work has started. I will not discuss the House of Lords Economic Affairs Committee report, which is excellent, because Ministers have promised us a debate on it before the Summer Recess. Many people on HS2 believe that the specification was ridiculously high. It started as a vanity project to get to the northern cities faster. It eventually became a project to create extra capacity on the network, but they did not change the spec.

On costs, the House of Commons Library briefing on 20 June noted:

“A comprehensive breakdown of costs for the full Y”—

of the scheme—

“has not been published since 2013”.

That is six years ago. This was confirmed by the IPA giving HS2 an amber/red category for six years running on a project estimated to cost more than £50 billion on the Department for Transport’s figures. The department argues with me and the cost engineer Michael Byng, who has suggested that it is more like £156 billion, but no one has ever challenged his estimate. The Government just say that they do not recognise it. They have not come up with any alternative, even in front of the Select Committee a few years ago.

I fear that there is a concerted effort by officials and successive Ministers to prevent scrutiny of the costs and programme, to refuse to discuss ways to reduce costs and generally to batten down the hatches over a six-year period for what I think is the single most expensive project on the IPA list. My worry, therefore, concerns, first, the project’s scope. There were many estimates. There are rumours that the estimate put before the Select Committee was inaccurate. The property requirements for both permanent and temporary works have not been properly estimated. On parts of the engineering, the approaches to Euston, alternative proposals for Wendover, track design and, of course, the engineering and cost implications of very high speeds, came up against officials who would not consider any option offering to reduce the cost. There seems to me to be a strong element of putting your head in the sand, hoping it will all go away. Contractors have signed up to design-and-construct contracts but they cannot make the figures work. That is why we are getting delayed at the moment.

In addition, there have been many staff changes. There is a churn of staff which is disastrous in such a project: get rid of people who know too much or who disagree with the policy and we will keep to the original budget over six years. The Permanent Secretary, Philip Rutnam, was promoted to the Home Office when the original cost estimates were challenged, and David Prout, who was responsible within the Department for Transport for HS2, retired to run an Oxford college. HS2 has had at least four chairmen in that period. The chief executive, Alison Munro, felt able to sign the estimates, knowing, I think, full well that the budget was shot to pieces. She left soon after, as did Beth West and Jim Crawford, who resigned last week. Two whistleblowers, Andrew Bruce and Doug Thornton, who are both highly skilled professionals on property issues, were sacked half an hour before they were due to present their findings on property costs to the Department for Transport’s client board. They were sacked because they refused to lie about property cost estimates.

The last matter here is that Simon Kirby, a former chief executive, was found a job at Rolls-Royce—very conveniently—because he was blamed for awarding £2.7 million of unauthorised redundancy policies to HS2 staff, which I have on good authority was actually used to pay off the whistleblowers. This is a very sad situation, coupled with a culture of secrecy. New Civil Engineer wrote a piece last week saying that HS2 has signed a total of 280 non-disclosure agreements,

“with ‘external parties’ between 2012 and March this year, with 40% of those signed in 2018 alone”.

The department found it more difficult to avoid internal scrutiny by the IPA. One of the senior advisers, Paul Mansell, was embedded in HS2 for a year and reported in a confidential report, which I think everyone now has, that,

“the status of the programme is between Amber-Red and Red”.

I will not go through all his conclusions but they basically say that the project will remain fundamentally flawed unless greater transparency and frankness are provided. Mansell’s report was leaked and the IPA confirmed his findings later.

There is a big problem here. I hope that the new “lessons learned” report from the Department for Transport will put some of these things right, but I believe that other government departments need to take note of what has gone really wrong with Crossrail and HS2 and come up with some solutions to make the new projects a better place.

My Lords, I congratulate the noble Lord, Lord Berkeley, on obtaining this debate today. I am grateful for his forensic dissection of the problems of HS2.

How many of us, when we are having work done on our own property or making a major purchase, fail to take steps to ensure that we are getting value for money and that our money is being sensibly spent? If we are doing that with our own money, how much more important is it when we are spending someone else’s—in this case, taxpayers’ money, with all the present demands on it for important and deserving causes?

HS2 is a totally misconceived project. It was supposed to cost £50 billion but will probably cost in excess of £100 billion and maybe more. Just imagine what could be done with that money if sensibly spent. Recently the TaxPayers’ Alliance did a splendid operation, working out just what it could do with it. That amount of money would seriously transform the rest of our communications network.

When I first came to take an interest in HS2, I could not believe what I discovered. The biggest infrastructure project in Europe had been put together in a totally shambolic way that was guaranteed to produce chaos and failure at the cost of misery to thousands of families and businesses whose lives would be disrupted, and of billions of wasted taxpayers’ money. On 31 January 2017 I asked the House of Lords to put a stop to HS2. It could have done so but sadly I did not receive sufficient support. On my side were two former Permanent Secretaries to the Treasury, the noble Lords, Lord Burns and Lord Macpherson, who surely know the true position better than anyone else.

Today I want to highlight and question the unbelievable bunker mentality of those responsible for HS2, both Ministers—I absolve our present Minister, who is absolutely blameless—and civil servants, who display intransigence, blocked ears and total unwillingness to listen to reason and common sense. Ever since April 2015 experienced transport planners and engineers have been seeking meetings with Ministers to explain their grave reservations about HS2. Inexplicably, all such meetings have been rebuffed. On 14 April 2017 Mr Jonathan Tyler, principal of Passenger Transport Networks in York, wrote to Andrea Leadsom, then Secretary of State for the Environment, Food and Rural Affairs, setting out all the attempts that had been made to meet Ministers to discuss HS2. I do not have time to give all the details but they include letters to everyone from the Prime Minister downwards.

I quote from is letter:

“On 31 October 2016 a group of 54 people with extensive experience in transport planning, regional economics and railway management wrote to Mr Grayling requesting a meeting to express their concerns … On 2 December 2016 a civil servant in the High Speed Rail Group of the DfT replied saying, ‘I am sorry to have to tell you that the Secretary of State is not available to meet with you to discuss these issues’ … On 8 February 2017 the group wrote to the Cabinet Secretary, the Permanent Secretary of HM Treasury, the head of the Government Economic Service, the Comptroller of the NAO, the Chair of the Public Accounts Committee of the House of Commons and the Chair of the Treasury Select Committee, expressing our concern that the process of the Bill authorising the construction of HS2 had not allowed a number of significant issues that we and others had raised to be properly addressed. We summarised these issues, asked for them to be investigated and offered a meeting … In early February 2017 the diary manager of Andrew Jones, Parliamentary Under Secretary of State at the DfT, wrote to Jonathan Tyler saying that his letter to the Secretary of State had been passed to Mr Jones, who, because of the pressures on his time, would be unable to manage a meeting”.

This attitude is both rude and, more importantly, totally unbusinesslike. Not to avail yourself of second opinions from such eminently qualified people on such a massive project is unforgiveable. Meanwhile, HS2 heads for the buffers, with costs and building timescale totally out of control and the Department for Transport sending out what can only be called fairytale press releases and Answers to Written Questions.

The good news is that there is light at the end of the tunnel. Amid mounting demands from the Green Party, and the Brexit Party, to cancel HS2, at least one of the candidates for the Conservative Party leadership has promised a review, which will reveal the true position. Although some expenditure has already been incurred and preparatory work undertaken, a notice to proceed has not yet been signed, and will not be for some time. A timely and speedy review will result in a halt to the project, which will give time for the true position to be established; a thorough investigation to take place; sensible, non-governmental advice to be taken at long last; and, hopefully, lessons learnt about how to properly plan and cost major infrastructure projects.

My Lords, I thank the noble Lord, Lord Berkeley, for initiating this important debate. It pinpoints our national inability to build big projects successfully. They are almost always dogged by controversy, delay and cost overruns. Why has the “can-do” country of the 19th and early 20th centuries become the “Can we? Can’t we?” country of the 21st? We have a system which takes so long that the approach to the project—if not the project itself—is outdated before we start. The Heathrow third runway is an example of this. It has been kicking around for decades and, in that time, approaches to aviation have changed and we would not invent the project now. There is a very lengthy, cumbersome planning process, with delays to big projects. I am not arguing for public opinion to be ignored, but it should not be beyond us to streamline the system without sacrificing democracy. Above all, there is a system of tendering which incentivises both project sponsors to encourage funders with an artificially optimistic idea of the project and tenderers to minimise costs. This means minimising problems and failing to allow for a realistic level of difficulties encountered during construction.

We deal with these projects piecemeal and efforts to have a joined-up approach to skills have so far failed because we agonise and dither for so long and because government is structured to take the short-term approach. We do not have an integrated approach nor a long-term programme for government, so we cannot get skills co-ordination on a grand scale. I give the example of Great Western electrification. It has cost double what was anticipated, and some major errors have been made along the way. Yet another emerged this weekend: equipment installed in the Severn tunnel is rusting before it has even been used. We have known for more than a century that the Severn tunnel is very damp.

For the rest of my speech I shall concentrate on HS2. I take a rather different view from that of the noble Lord. I call myself a critical friend. I am 100% behind the purpose of the project. I support linking the Midlands and the north and eventually Scotland using a new line created according to the highest standards. The problem is that HS2 has not been good at PR, to say the least. There has been a lot of opposition to the project, some of it local, for obvious reasons, and some of it for entirely misguided reasons. HS2 has entirely failed to inspire us and to answer those criticisms. A country that still reveres Brunel does not feel the same about HS2. Important decisions on the progress of HS2 have coincided with the macho posturings of the two men vying to be leader of the Conservative Party. It has become a kind of virility test to denounce the project.

Conveniently, that fits with the financial hole they are rapidly digging for themselves. All those tax cuts have to be paid for, and HS2 has a very big price tag. It would normally be unthinkable to cancel a project so late in the day, a project that is so well advanced with so much money already spent, but there is nothing normal about the times we live in. There is a very urgent need for HS2 to get its act together and bring its costs under control. The north is already suffering from a lack of trust in politicians. If the Government cancel HS2, they risk a massive backlash, and if they take fright at the cost of phase 1 and cancel the rest of it, all they will have done is to change Birmingham into a outer suburb of London, and the north will not forgive them for that.

If the Government cancel HS2, we will be an international laughing stock, but there are serious criticisms that must be addressed. The Economic Affairs Committee report published in May lists those serious concerns and the solutions to some of them. Speed costs money. The report questions the value for money of building to the highest speeds in the world, especially when a large part of the route will be in tunnels where it is not possible to do very high speeds. It points to the flaws in the cost-benefit analysis, which artificially relies on aggregating up very small time savings per journey. One must question the value of saving five minutes on a journey of several hours. The committee also pointed to the elderly surveys on which the cost-benefit analysis relies. They must be updated. Finally, it also questioned the obsession with Euston. Old Oak Common would be an excellent terminus. It is a real regeneration project and is very well placed in a network of rail lines. That is where the terminus should be.

My Lords, I have not made any secret of my support for this great project. For me as a former railwayman and as a resident of the city of Birmingham, it is not just an ethereal paper concept; it is a great contribution to the regional and, eventually, the national economy. In and around Birmingham cranes can be seen all over the place. Values are rising and hundreds if not thousands of jobs have been created. It is not just in the city of Birmingham, of course; between Birmingham and London there are 250 sites where work has already commenced. Almost 10,000 jobs have been created and 2,000 businesses are already benefiting from this project before it has even properly commenced. Incidentally, 98% of those businesses are British.

I respectfully remind those who oppose this project, particularly the noble Lord, Lord Framlingham, that it is not just ex-railwaymen like me who are in favour; virtually the whole of British industry happens to be in favour of HS2 in its entirety. In June 2019 business leaders including the CBI, the Institute of Directors, the Federation of Small Businesses, the British Chambers of Commerce and London First published a joint open letter calling on the next Prime Minister to commit to delivering HS2 in full.

My noble friend Lord Berkeley and I have been friends for approaching 40 years now, and I hope we remain so after this debate. We first met when I was an officer —I think I was the chairman—of the All-Party Parliamentary Group on the Channel Tunnel. In a different capacity, he was an accurate and hard-working paid advocate of that concept. I remind him respectfully that, when completed, the Channel Tunnel cost £4.65 billion, around £12 billion in today’s funds, and was 80% over budget at the time. Although I have listened to him on many occasions, I do not think he pointed out at the time that that great project could and should have been cancelled because it was likely to be over budget.

No, I just said that my noble friend did not say it should be cancelled, despite the massive cost overrun—about which I do not remember him complaining at the time, although I might be wrong. Because of the nature of the way that we do business in this country, most of these projects overrun.

The noble Baroness, Lady Randerson, touched on that point during her refreshing and accurate contribution. The fact is that these projects overrun, not just in this country. We have a habit of flogging ourselves and thinking that only we can get things wrong but these great infrastructure projects overrun all over the world. Fly to Berlin and try to land at Brandenburg Airport; building commenced in 2006 and the latest opening date is 2020, although even that is not particularly certain, and it is eight times over budget, yet we are born and brought up on the myth of German efficiency. I do not know whether the German equivalent of the noble Lord, Lord Framlingham, is wandering around Berlin shaking his head sadly at the overrun of that project, although I am sure that there are similar gloomy outlooks.

I am not surprised at the noble Lord being a member of a committee set up by the TaxPayers’ Alliance to look into this project, but I am a bit surprised at my noble friend. I have to say to him that I have never been a fan of the TaxPayers’ Alliance. Right-wing, self-appointed guardians of the public purse do not normally attract members of the Labour Party so I am a bit concerned and surprised that my noble friend should have agreed, particularly as the organisation produced a brochure about a better way to spend the billions. The picture on the front is of a motorway junction, so there is a bit of a clue to where the TaxPayers’ Alliance would like money to be spent.

I do not think that the doom and gloom that we are seeing about this project is sustainable long-term. In my view it is a great project that should continue and be implemented and opened as quickly as possible. One thing that I never hear from its critics is any alternative, although I hear ethereal stuff about spending the money on “something else”. Let us look at the west coast main line, the area of railway that will get most relief from the completion of HS2. I picked a random hour of arrivals and departures at Euston station. Excluding the Underground, there were 42 trains in and out of Euston station between 10 and 11 am this morning. Three of them went to Birmingham, one through to Scotland, one direct to Glasgow and three to Manchester.

Where will these trains go? These days, it is impossible to modernise a railway system and run trains at the same time. It did not used to be. In my younger days—I confess that I remember the first electrification of the west coast main line—much of the work was done between trains, although there were lots of alternative routes. The Manchester trains went over to Great Central. The brains that run this country decided to close that line, so the trains went on the Midland main line, now closed between Matlock and further north. There are no alternative routes. The Liverpool trains went on the Great Western from Paddington to Birkenhead. That does not exist any more; indeed, part of it is a tramway through my former constituency.

There is no alternative to HS2, and I hope that the gloom mongers, sincere though some of them may be, will have their arguments refuted and that this great project gets the go-ahead.

My Lords, I congratulate the noble Lord, Lord Berkeley, on securing this debate. I must say that I have learned more from him in debates on transport in the House of Lords than I could possibly have imagined before joining. I agree with his analysis to a certain extent. I very much agree with the general approach to HS2 of the noble Lord, Lord Snape. Within the limited time I have available, I hope to return to what he said.

As a Rail Minister, I looked at HS1 in great detail, and I tell the noble Lord, Lord Berkeley, that it was very difficult constantly to keep up with fresh problems discovered by the contractors. We had to change the route in some cases, particularly near the Channel Tunnel, to accommodate construction and, as far as possible, avoid excessive noise to some of the houses on the route. Changes are almost inevitable, and he is absolutely right to suggest that there should be regular updates by the Department for Transport as projects proceed.

I was deputy chairman of the HS2 Select Committee considering the route as far as Birmingham. We regularly asked for and received information about the cost of changing the route, both to avoid noise and inconvenience and to make the train route as fast and comfortable as possible. I think HS2 will be a tremendous advantage to those travelling north. Birmingham is already assigned as the first major stop, but if there is to be further development of routes across the Pennines, the extension of HS2 will only help that. Given the advance in identifying problems of pollution coming from certain motor vehicles, high-speed trains will do a great deal to provide clean and fast services.

I am bound to point out to your Lordships that, according to the newspapers, Boris is against HS2 and Jeremy Hunt is in favour. My colleagues will correct me afterwards on whether that is true, but it shows that there is still a great deal of debate.

Returning to the purpose of the debate, we owe the noble Lord, Lord Berkeley, thanks. It is very important that the department regularly monitors the costs of any major transport project so that Ministers can decide where to make adjustments or amendments to the project—or indeed extend it. That has been a gap in the past, certainly in my experience. A regular flow of information about the actual problems that inevitably occur when you are building a railway line enables Ministers to make decisions to save money or change the route.

I therefore very much welcome the prospect of a high-speed rail link to the north, I am absolutely certain that it will come, and the fact that Jeremy Hunt came out this morning publicly to support it, which I am delighted about, gives me a great deal of confidence. I congratulate the noble Lord, Lord Berkeley, on securing the debate, which I have enjoyed and learned a great deal from.

My Lords, I too thank my noble friend Lord Berkeley for creating this debate. This is a subject on which I have some form. Between 1988 and 2000—some 12 years—I was managing director and chairman of London Underground, and over that time I sponsored many projects, which probably all added up to about £6 billion-worth of expenditure. In London Underground, all decisions were subject to cost-benefit analysis. This took account of time for the customers, the environmental impact, the ambience of the railway, the money—both revenue and cost—and safety. The whole process worked well for us, and we refined it over time. In projects up to, say, £200 million, we tended to be able to deliver on time and within, say, 10% of the cost. It works well with incremental improvements—improving a station, buying a new fleet, and so on. However, big projects are different, and my big project was the Jubilee line extension. The noble Lord, Lord Freeman, approved it at £2.1 billion but it turned out to be £3.5 billion: some 70% over budget and 21 months late—thank God the benefits were massively greater in reality than in the original projection.

Why are big projects a problem? First, they have not been done before; when we built the Jubilee line extension it was 20 years since we had last done an underground railway line. The projects are so big that you have to have multiple contractors. That in itself is a tremendous overhead, because whatever you say in your contract, you have to integrate them and make sure that they work together. Big projects happen over a long time, and things change over time. One of the things that changes is that you discover problems in the environment you are working in, or perhaps the techniques are not there. The other thing about big projects is that their real value tends to be beyond the normal parameters, particularly as regards regeneration. Therefore anybody who tells you that they delivered a major project on time and on budget has cheated.

How can we do better and should Parliament have a role? Two things have happened since I was in that role. First, the Infrastructure and Projects Authority has been formed and produces its annual report; I believe the latest one was on 4 July last year. The second is that the DfT has produced an excellent report, developed with the Infrastructure and Projects Authority, called Lessons from Transport for the Sponsorship of Major Projects. This was developed by Bernadette Kelly, Permanent Secretary at the DfT, and Matthew Vickerstaff at the IPA.

Here I will pause to ask: what you are looking to do with the project? You are trying to get value for money, which means that you are trying to create a total contribution to the general good across the board that is better when compared with total cost. I propose a solution, which seems to have emerged in a couple of speeches, which is that departments, in this case particularly the DfT, should produce an annual response to the annual report of the Infrastructure and Projects Authority. This should cover: the total projected costs that have changed since its last report; the expected date of delivery; a review of the benefits, which will change over time as the world changes; and any changes in scope and any new initiatives—and this should be laid before Parliament.

Having worked in this environment, that will change how people manage and will create a situation where there could be an opportunity for structured scrutiny by, say, an appropriate Select Committee or debates in the House. It would create an internal discipline which would force rigour and better communications within the project. I put my solution to the Minister. I hope she will take it back to the department and perhaps tell us whether there is any warmth for it.

My Lords, I am delighted to respond to this important debate, and I echo other noble Lords in congratulating the noble Lord, Lord Berkeley, on having secured it. At the risk of stating the obvious, there are extreme views on HS2, and we have heard them today without falling out, which is a major concession.

With noble Lords’ permission, I shall set out the Government’s position on major infrastructure projects and the vital matter of transparency, which all noble Lords raised today, before turning to some of the specific points raised. This Government have demonstrated their clear commitment to transforming the nation’s infrastructure. More than 4,900 public and private infrastructure projects have been completed since 2010. We are increasing public investment to levels not consistently sustained in 40 years, including through our £37 billion national productivity investment fund. We established the National Infrastructure Commission in 2015 to provide impartial, expert advice to government. Alongside the spending review, we will publish a major national infrastructure strategy, responding in full to the commission’s landmark assessment of the UK’s infrastructure needs.

It is essential that this significant investment is properly monitored, and the Government take this extremely seriously. Transparency is crucial for accountability, but it is also essential so that the Government can learn lessons when things go wrong and seek to improve in the future. This is a key reason why the Infrastructure and Projects Authority was established in 2016. The IPA oversees the Government Major Projects Portfolio. This includes the Government’s most complex and strategically significant projects and programmes including, but not limited to, infra- structure. As of the 2018 annual report, the GMPP included 31 infrastructure projects with a total whole-life cost of £196 billion.

Large projects in government must undergo independent assurance and pass through a staged process of assurance and approval points before they are given the green light. Those projects on the GMPP also have to provide quarterly data returns, which include up-to-date information on project costs, benefits and timescales and assessments of delivery confidence. This intelligence informs the IPA’s work with government departments to support improvements in the delivery of major projects.

The Government have published clear transparency guidance which sets out how major project data is used and published. The National Audit Office has access to the full body of data, and its analysis supports the work of parliamentary committees in holding government to account. Additionally, committees often seek input from the IPA directly. The National Audit Office also holds the IPA itself to account and has consistently been positive about its efforts while acknowledging the need for continuous improvement and identifying areas for further action. A snapshot of GMPP data is published each year in an annual report. Of course, this is the tip of the iceberg, and the IPA supports departments in properly undertaking projects of all shapes and sizes. As noble Lords will know, Parliament is also able to probe spending through its routine scrutiny of departmental annual report and accounts documents and supply and supplementary estimates. Also, the IPA publishes an annual National Infrastructure and Construction Pipeline, which looks ahead to future public and private investment, and a summary of data on all PFI and PF2 projects. Over and above this, departments also publish relevant information directly, including progress updates, business cases and cost-benefit analysis information.

It is worth noting that the UK Government’s approach to managing, monitoring and providing transparency on major projects, and tracking costs and benefits, is regarded as world-leading. Aspects of the Treasury’s Green Book have been used as best practice and adapted by the G20 and the New Zealand Treasury. We have been invited to share our experience with countries across the globe, from Indonesia and Hong Kong to Australia and Brazil. However, we are not complacent. The recent experience of a number of high-profile projects demonstrates clearly that we still have a great deal of work to do. As in the rest of the world, major infrastructure projects in the UK are prone to escalating costs and increasing timescales. Commercial, technical, political and behavioural factors all play a part in these challenges. The Government are committed to identifying and addressing the causes of these issues. For example, in recent years we have strengthened the way in which the benefits of projects are captured and tracked, to help avoid unrealistic claims—that might get a smile—or skewed decision-making. Having previously called for action in this area, the National Audit Office commended the IPA in a 2018 report for driving improvement in the reporting of monetised benefits for major projects, and for ensuring a clear,

“distinction between cash savings … and wider economic benefits”.

More recently, in response to challenges in the rail sector, the IPA and the Department for Transport have carried out and published an in-depth study to identify key lessons from transport for the sponsorship of major projects. These lessons are now being implemented in the DfT and elsewhere, with oversight from some of the most senior officials in government. The noble Baroness, Lady Randerson, questioned the time taken to get infrastructure projects through. There is clearly some optimism and short-termism, as she raised. Improving infrastructure delivery will be the focus of our forthcoming national infrastructure strategy, and the IPA is focused on optimism bias as a key risk to project deliverability, cost and timescales. This was a key theme in the recent IPA-DfT lessons-learnt exercise.

The spending review will see a renewed focus on delivery because too often in the past Governments have signed off too optimistic or unrealistic plans for complex major projects. The Chief Secretary to the Treasury is carrying out a zero-based review of major projects. As in the past three spending reviews, we will be running a zero-based review of capital spending to maximise the value of our investments. The Treasury will appraise the bids, with the guidance of a panel of independent economists and delivery experts, according to several criteria including strategic case and economic value. We are finalising membership of the expert panel and will communicate this in due course. I am able to tell noble Lords that HS2 is within the scope of the zero-based review.

The noble Lord, Lord Berkeley, asked why HS2 has been amber-red for the past six years. I apologise if I am stating the obvious: HS2 is one of the Government’s largest and most complex projects. The delivery confidence reflects the overall scale and complexity of the programme. A red or amber-red does not necessarily mean that the project will not be successfully delivered but that sufficient risks need to be investigated. By taking the right steps following the IPA reviews and managing challenge effectively, DCAs are often improved; they do change.

My noble friend Lord Framlingham is consistent and persistent in his position on HS2, and all credit to him for those characteristics. Parliament has approved phase 1 of HS2 following scrutiny by both Houses. HS2 still has strong support in this House and, as I understand it, in the Midlands and the north. I believe the noble Lord, Lord Snape, expressed his support for the project.

The noble Lord, Lord Berkeley, said that HS2 costs are out of control. I am advised that HS2 remains within the limits of the 2015 spending review.

I come to the point made by my noble friend Lord Framlingham about HS2 being scrapped. This debate is not about whether HS2 should be cancelled but about how all major infrastructure projects are monitored. HS2 will become the backbone of our national rail network. It will improve capacity, connectivity and growth, carrying over 300,000 people a day. It remains government policy, was a manifesto commitment and retains cross-party support.

I thank the noble Baroness, Lady Randerson, for her support for the project. It is good to know that local authorities, elected mayors and regional businesses in the Midlands and the north support HS2 and recognise that Northern Powerhouse Rail is dependent on HS2 infrastructure being delivered.

I am going to run out of time, which is common these days in such important debates. If I have not answered anyone’s question, we will review Hansard and I will write to them. I finish my contribution by recalling the words, “a country with a can-do culture rather than a can’t-do”. I hope that, with all the good will and all the commitment there is to make our country a great country to live in wherever you are, these projects will be successful. We will work very hard to make sure that they are.

Sitting suspended.

Pakistan: Aid Programmes and Human Rights

Question for Short Debate

Asked by

To ask Her Majesty’s Government what assessment they have made of the relationship between their aid programmes and human rights and the treatment of minorities in Pakistan, and in particular the case of Asia Bibi.

My Lords, Pakistan’s illustrious and enlightened founder, Muhammad Ali Jinnah, crafted a constitution which promised to uphold plurality, famously saying:

“You may belong to any religion, caste or creed—that has nothing to do with the business of the State”,

and that:

“Minorities, to whichever community they may belong, will be safeguarded. Their religion, faith or belief will be secure. There will be no interference of any kind with their freedom of worship. They will have their protection with regard to their religion, faith, their life and their culture. They will be, in all respects, the citizens of Pakistan without any distinction of caste and creed”.

Tragically, 70 years later, Pakistan’s Ahmadis, Christians, Hindus and minorities, such as the last 4,000 remaining Kalash clinging to a precarious existence in three remote valleys, all face shocking persecution and discrimination.

Last week in Brussels, Shah Mehmood Qureshi, Pakistan’s Foreign Minister, claimed that “individual incidents” of persecution were being whipped up by what he called “western interests”. He said they were comparable to knife crime in London. Try telling that to the two children forced to watch a lynch mob of 1,200 burn their parents alive. Pakistan fails the Jinnah test, not western interests, when no one is brought to justice for the murder of the Christian Minister for Minorities, Shahbaz Bhatti. It fails the Jinnah test when 1,000 Hindu and Christian girls are forcibly married and converted. It fails when, in Punjab, Sadaf Masih, a 13 year-old girl, is kidnapped, forcibly converted and married and when, in Sindh, the same thing happened to two Hindu girls. It fails when it ignores the National Action Plan’s requirement to stop anti-Ahmadi sectarian hate propaganda. It fails the Jinnah test when children from minorities are forced to work in brick kilns, workshops, and factories. It fails when Iqbal Masih, an incredibly brave 12 year-old Christian boy, is shot dead for rebelling against enslavement. It fails those minorities who are ghettoised into squalid colonies and forced to clean latrines and sweep streets and, notwithstanding Mr Qureshi’s assertion that “there is no truth” in stories of girls from minorities being sold in faith-led trafficking to Chinese gangs, saying that Pakistan “would never tolerate that”, we have evidence to the contrary.

I co-chair the All-Party Parliamentary Group on Pakistan Minorities and last autumn, with the co-chair, Jim Shannon MP, and Marie Rimmer MP, we heard horrific accounts of abductions, child marriages, rape and forced conversions and saw first-hand the appalling conditions in the apartheid-style “colonies” where many from the minorities are forced to live. We saw families living in hovels with dirt floors, in shacks without running water or electricity, with little education or health provision and in squalid and primitive conditions, all completely off the DfID radar. Thousands upon thousands of people are condemned to lives of destitution and misery. This left-over from the caste system is graphically illustrated by the case of a boy beaten and excluded from school for touching a water tap. Untouchability remains a curse.

As I asked on Saturday in a letter to the Foreign Secretary, if Prince William and the Duchess of Cambridge are to visit Pakistan, will they be visiting one of these colonies and meeting the minorities? Perhaps the Minister can tell us.

There is an old Punjabi saying that he who has not visited Lahore has not lived but, despite its Mogul glories, this is where, in 2016, 75 people, mainly women and children, were killed and more than 340 were injured while celebrating Easter in Lahore’s Gulshan-e-Iqbal Park.

Beyond the killings, everything is stacked against the minorities. Take the case of Asia Bibi, an illiterate Christian woman who was incarcerated for nine years, sentenced to death for so-called blasphemy. In Islamabad, members of the Supreme Court promised our group that Asia Bibi’s case would finally go to appeal, and to their great credit they bravely defied rioters and lynch mobs. She was finally allowed to travel to Canada, although sadly the UK failed to take her. Do not underestimate the bravery of those judges. When Shahbaz Bhatti and his friend Salman Taseer, the Muslim governor of the Punjab, spoke up for Asia Bibi and called for reforms to the blasphemy laws, both men were murdered. Conversely, Mumtaz Qadri, who murdered Taseer, has been lionised and idolised as a hero.

Asia’s case is only one of many. Asia’s cell in the prison at Multan is already occupied by Shagufta Kauser, another illiterate Christian woman. She and her disabled husband, both unable to read or write, face execution for allegedly sending blasphemous texts in English. By some estimates, more than 70 people are currently on death row for alleged blasphemy crimes. What recent representations have we made about Shagufta Kauser and the need to reform laws that frequently target minorities?

In 2016, after seeing fleeing Christians and Ahmadis caged like animals in detention centres, which my noble friend Lady Cox has also visited, I chaired an inquiry on behalf of the All-Party Parliamentary Group for International Freedom of Religion or Belief, chaired by the noble Baroness, Lady Berridge, who is here today. Our report catalogued systematic persecution and the failure of Home Office country guidance to recognise the nature of this persecution. We concluded that,

“we need to dispense with the fiction that the … minorities are treated fairly and justly. There is outright persecution and we should not hesitate in saying so”.

Following the Sri Lanka Easter bombings, some of those escapees now face even greater danger. In 2016 we recommended that Home Office interviewers, caseworkers and presenting officers needed better training in understanding that persecution. The report also urged DfID to ensure that overseas aid is provided in Pakistan only to recipients able to demonstrate their commitment to upholding Pakistan’s international human rights obligations, not least Article 18 of the 1948 Universal Declaration of Human Rights, which guarantees the right to believe, not to believe, or to change your belief.

Over the past decade, £2.6 billion of British aid has poured into Pakistan—on average, that is £383,000 every single day—but failure to differentiate how and where we spend that money leads DfID to say that it has no idea how much of the aid reaches these destitute, desperate minorities. Disturbingly, last week the National Audit Office, after highlighting an example from Pakistan, said that,

“overall government is not in a position to be confident that the portfolio in its totality is securing value for money”.

I welcome the decision last week of the International Development Committee of the House of Commons to conduct an inquiry into British aid to Pakistan. It should also look at the work of Professor Brian Grim on 173 countries, which found that where minorities are respected and religious freedom upheld, that,

“contributes to better economic and business outcomes”,

and to,

“successful and sustainable enterprises that benefit societies and individuals”.

I hope that new Ministers in the department will reassess how DfID spends UK money, why it does not target beleaguered minorities and why it is not made conditional on the removal of hate material from school textbooks and discriminatory adverts reserving menial jobs for minorities. I hope they will insist that the provision of an affirmative action programme, endorsed by the constitution, is implemented.

Pakistan must challenge forced conversions, forced marriage and the prevailing culture of impunity. I took evidence from a man who had escaped from Pakistan who had seen another man and his family burned alive. That man went to the police, who in turn informed the assailants, having told him that he would be next. He and his young family fled the country.

Our all-party group has also been told of widespread and systematic police brutality and torture. We were told about the beatings of victims who were hung by their arms or feet for hours on end, forced to witness the torture of others and, in some cases, stripped naked and paraded in public. Such brutal treatment needs to be investigated by an independent, autonomous national commission for minorities such as that proposed by Pakistan’s Supreme Court in 2014 and established in accordance with the Paris principles.

When the Minister replies to our welcome debate, I hope that we will hear how our Government will work to make these things happen and to create the kind of society envisaged by Muhammad Ali Jinnah, where Pakistan’s beleaguered minorities are at last treated with respect as equals and fellow citizens. I thank all noble Lords who are participating in today’s short but welcome debate.

My Lords, I thank the noble Lord, Lord Alton, for bringing this important debate before us today and for his dedication to bringing injustices across the world before your Lordships’ House.

At the heart of all we do as part of our important role as an international aid superpower must be constant self-evaluation to ensure that our aid programmes are achieving results in the context of each state that we help. At the same time, we must be aware of the important soft power that international aid allows us in improving lives for everyone in any state we help, including minorities. How to ensure that aid is concentrated on those who really need it in any state is a significant debate within the international aid community. This applies especially to minorities, who are often among the most marginalised in any society.

I do not want to repeat in this short contribution the powerful evidence that we have already heard from the noble Lord, Lord Alton, and, as has been identified by the Foreign Office, that Pakistan is currently woeful in its treatment of minorities. From state-sponsored blasphemy laws to the death penalty, we see how a state creates an easy mechanism for the persecution of religious minorities, especially Christians and Hindus.

In Pakistan, most of these minorities are among the third of the population who live in poverty and who should be the very people benefiting from our aid programmes. At the same time, Pakistan is of course an important strategic partner for the UK and a state that receives significant support in aid—more than £300 million in 2019-20. The reassurances that I seek from the Minister are around the direction of that aid.

I applaud the focusing of UK international development on education, especially for girls in Pakistan, to ensure they have as many opportunities as possible. I would hope that an educated population would by its nature become more pluralistic and less susceptible to the persecution of minorities in these difficult times. I want to ask the Minister about three specific issues.

First, is my noble friend confident that aid in Pakistan is reaching those minorities within the bottom third who live in poverty? It is essential that any aid be focused on need and not on ethnicity or religion. Secondly, can she reassure me that educational programmes that the UK supports in Pakistan are assessed to ensure that they do not allow bigotry or sectarianism to be taught in any UK-funded educational programme? Thirdly, will she impress on her colleagues in the Foreign Office the need to ensure that we make all possible representations against the misuse of blasphemy laws and the retention of the death penalty?

My Lords, like the noble Lord, Lord Alton, to whom I pay great tribute for securing this debate, I believe that there was a strong case for Asia Bibi and her household to have been offered asylum by Her Majesty's Government. In my contact with the family spokesperson, he was clear that the UK was their preferred destination.

I am troubled by how parliamentarians can hold the Government to account in cases such as this when we are told that live cases are not open to discussion. That sense of dis-ease is reinforced by the absence of evidence of diplomatic activity in the Asia Bibi case before it became an international news story.

Last week, I was speaking to a bishop from south Punjab, who said, “There are many Asia Bibis here”. There are many, too, in interior Sindh who suffer similar plights but do so hidden from the world’s media and Governments, their cases not reported. He described the spectre of blasphemy charges hanging over Hindu and Christian families who speak out against injustice or crime. He spoke of Christian girls being abducted into sexual slavery—in a way which we have already heard about—and then forced to convert, their families powerless to defend them because of the threat of the abuse of blasphemy laws.

The bishop’s deepest concerns—and it is an honour to follow the noble Lord, Lord McInnes—were about the effective denial of education for many children from religious minorities, causing them to descend deeper into permanent spirals of poverty and depression. His account was a graphic illustration of the findings of the 2018 CSW report, which tells of bias, discrimination and abuse undermining the constitutional commitments of the Pakistani Government regardless of religion or caste.

DfID is doing much good work in supporting the general aspirations of the Pakistani Government, but I am not yet persuaded that mechanisms are in place to ensure that our aid is addressing the concerns of the bishop and his people and the noble Lord, Lord McInnes, and the needs of other minority people in south Punjab. The ePact evaluation of phase 2 of the Punjab education sector programme deems:

“Inequities in educational access and attainment are persisting”.

It recommends both that equity of access, including socioeconomic status, disability and gender, are mainstreamed and that systems are devised for assessing the success in doing so. Will this advice be applied to future DfID programmes? Does the Minister agree that that task cannot be done without building in some element of minority community criteria? Is the current programme hitting the spot?

My Lords, I join other noble Lords in thanking the noble Lord, Lord Alton, for securing this debate. Pakistan is a big country with a population of 200 million people. Minorities, including Christians, Hindus, Buddhists, Sikhs and others constitute about 3.5% of the total population of the country. There are several hundred places of worship across Pakistan that belong to various religious minorities. Various articles in the constitution of Pakistan, such as Articles 20, 21, 22, 26, 27 and 28, accord rights to minorities as equal citizens of the country, free to profess their religions and visit their places of worship.

Minorities have visible representation in the parliamentary set-up of Pakistan. There are special reserved seats for minorities in all houses of representatives: four seats in the Pakistan Senate, 10 in the National Assembly, and eight in the Punjab, nine in the Sindh and three each in the Baluchistan and Khyber Pakhtunkhwa assemblies. On top of that, minorities are free to stand in any elections as citizens of Pakistan, and they do get elected.

It is important to mention here that there is a 5% jobs quota in the public sector in Pakistan allocated to the minority communities, which constitute only 3.5% of the total population of the country. Furthermore, 11 August is observed as Minorities Day. There is a special ministry at the federal level, called the Ministry of Religious Affairs and Inter-faith Harmony, which looks after minorities’ rights in the country.

Blasphemy is a sensitive issue in Pakistan. It arouses sentiments among the general populace that have led to death and destruction in Pakistan, sadly. Many in Pakistan believe that their country’s blasphemy law is misunderstood, as if it protects only Muslims. In reality, however, it protects all Pakistanis equally. According to the official figures, the majority, 95%, of those accused under the blasphemy law are Muslims. The maximum penalty under the blasphemy law is death but, as I understand, no one has ever been executed by a court of law under this section. I stand to be corrected.

I very much appreciate DfID’s support in education, reducing poverty, building resilience and many other important sectors in the poorest areas of Pakistan, but will the Minister say what Her Majesty’s Government can do to help the democratic Government in Pakistan and support their endeavours to make the country more peaceful, tolerant and prosperous?

My Lords, I thank my noble friend for securing this important debate. As he emphasised, the brutal application of sharia law, in conjunction with the failure of the authorities to ensure due legal process, has resulted in horrendous violence. Blasphemy laws have been used by extremists as a pretext for murder. Young girls have been abducted and forced to change their religion or have been forced into marriage. Others are in prison or have been sentenced to death for apostasy.

Countless families have been forced to leave their homeland. For example, as my noble friend said, thousands of Christians have sought asylum in Thailand. They arrive in Bangkok on cheap tourist visas, but as soon as their visa expires they are technically classified as illegal aliens and are subject to arrest and detention in horrendous conditions. Given the plight of Pakistani refugees in Thailand, have Her Majesty’s Government raised concerns with UNHCR about the failure to resettle them in safe countries?

I had the painful privilege of meeting some of the families who had escaped to Bangkok. I sat and wept with those who have endured horrendous suffering. One man, called Cale, was accused of blasphemy in Pakistan. He described how he was arrested by the police and taken to a remote location where he was tortured, hanged upside down, shackled and beaten for seven days. After a month in prison he was cleared of the charges, yet the local mob wanted to kill him. He told me, “They want to punish me with a very painful death such as no one has ever seen before. They want to kill me in a way that the Christian community will always remember”.

I also met a courageous man called Hosea. He was kidnapped by a mob in Pakistan for being an apostate. The mob shackled him with metal chains and attempted to amputate his leg. He eventually escaped with his wife to Thailand, but his relatives in Pakistan are still in danger. He told me, weeping: “Even last week my brother and my 16 month-old nephew were taken captive. They grabbed the baby, repeatedly smashed him into a wall and demanded to know my whereabouts”.

These testimonies are indicative of the wider context of Pakistan’s serious violations of human rights, yet our abject refusal to insist that minorities are prioritised only reinforces Pakistan’s culture of impunity because it gives the impression that the UK does not care when victims are subjected to unspeakable violence. Where is British aid money being spent? Will Her Majesty’s Government specifically tackle the plight of minorities? That includes support for adherents of different religious faiths who suffer at the hands of extremists, including Shia and Ahmadi Muslims, Sikhs, Hindus and Buddhists as well as Christians.

On a related point, which was also raised by the noble Lord, Lord Alton, did Her Majesty’s Government refuse asylum to Asia Bibi because of fear that that would prompt unrest in the UK and attacks on embassies? If that is so, does the Minister agree that such an appeasement of militant extremism indicates a serious threat to our democracy and a betrayal of the fundamental principle of providing asylum for refugees under threat of death?

My Lords, I, too, congratulate the noble Lord, Lord Alton, on securing this important debate, and pay tribute to the wonderful work that he does in the field of human rights.

When India was partitioned in 1947, as we have heard, the founding father of the new state of Pakistan, Muhammad Ali Jinnah, then terminally ill, said that it would be a country that respected all its minorities. He did not live to see his hope tragically ignored. A rigid and intolerant form of Islam, Wahhabism, funded by Saudi dollars, now pervades the country.

Strict blasphemy laws are used to prevent open discussion of religion, and the death penalty can apply to Muslims who try to convert to a different faith. As we have heard, a convert to Christianity, Asia Bibi, sentenced to death for alleged blasphemy, spent nine years on death row before eventually being allowed to flee to Canada. Others have not been so fortunate. In one case, children were made to watch as their parents were burnt alive in a brick kiln. Minorities are frequently allocated menial tasks such as the cleaning of public latrines. Homes of minorities are frequently attacked and women and girls kidnapped and converted or sold into slavery.

I have at times questioned the appropriateness of Pakistan, with its ill treatment of minorities, still being a member of the Commonwealth, a club of countries with historic ties to Britain. Members are required to abide by the Commonwealth charter, with core values of opposition to,

“all forms of discrimination, whether rooted in gender, race, colour, creed, political belief or other grounds”.

By any measure, there is a clear case for expelling Pakistan from the Commonwealth, but this will not help its suffering minorities and could make their plight worse. The way forward is to look beyond charters and lofty declarations to clear targets and measures of performance for all erring members—Pakistan is by no means the only one—to nudge them to respect human rights. We must also target aid to specific projects geared to fight religious bigotry and prejudice.

Pakistan is a country revered by every Sikh as the birthplace of Guru Nanak, the founder of the Sikh faith. He taught reconciliation and respect between different faiths. In this, the 550th year of the Guru’s birth, the Prime Minister Imran Khan, in welcoming Sikhs to visit the birthplace of their founder, stated his desire to move in this direction, and we owe it to Pakistan’s minorities to redouble our efforts to help him and nudge him to do so.

My Lords, I was talking recently to a distinguished Pakistan citizen, with businesses around the world. I asked him what life was like in Pakistan at the moment. “Just like here”, he said. “Really” I said, “what about the blasphemy law, and the people suffering under it”? “Oh”, he said, with a rather dismissive wave of the hand, “It’s the uneducated people in the villages”. I am afraid it is all too easy for the elites, whether in Pakistan or this country, to live in an environment divorced from the reality of life for so many. The fact is that the blasphemy law in Pakistan is blighting the lives of countless people, causing apprehension, anxiety and in some cases imprisonment and death. Too many, like the government Minister mentioned by the noble Lord, Lord Alton, live in a cocooned world of their own and have shut their eyes to what is happening in the countryside.

As we know, Pakistan is a country with a number of minority groups. Between 0.22% and 2.2% of the population are Ahmadiyya Muslims, although they are actually forbidden by law from even describing themselves as Muslims. Some 2.6% of the population are Christian, about 2.5 million in all.

Between 1987 and 2017, 1,500 people or more were charged with blasphemy: 730 were Muslims, 501 were Ahmadis, 205 were Christians and 26 were Hindus. Although, as the noble Lord, Lord Hussain, said, no judicial executions have yet taken place, at least 75 people involved in accusations of blasphemy were murdered before their trials were over, and as we have heard, prominent figures who opposed the blasphemy law have been assassinated. It is this mob violence, so vividly brought home by the noble Lord, Lord Alton, and the noble Baroness, Lady Cox, which is so frightening. It affects not just the accused and their family but anyone who stands up for them, especially any lawyer or judge.

We rejoice that Asia Bidi is now safe and in Canada with her family, but we cannot forget the suffering that she had in the years before. We cannot forget that the Minister for Minorities, Shahbaz Bhatti, who spoke against the blasphemy law, was assassinated as a result. We know that the blasphemy law is being used to settle grievances and vendettas in villages. We look to the elite in Pakistan to open their eyes to what is happening. It is quite wrong for successive Governments to refuse to stand up to religious extremism and intimidation. In negotiations about aid, we look to the British Government to make it quite clear that this law causes untold suffering and is totally unacceptable. I hope that the Minister will take from this debate a clear message that aid needs to be directed towards minorities.

My Lords, I accept and respect everyone, irrespective of race, colour, creed or caste; I have been brought up in a multiracial community. I have been concerned about the persecution of Christians and other minority groups in different parts of the world, including Pakistan. I have met Muslim and non-Muslim leaders and spoken on this issue at several meetings. I am looking forward to the Bishop of Truro’s final report. I am in touch with the Pakistani high commissioner, who has taken numerous initiatives towards promoting interfaith harmony.

The rights of minorities are protected under the constitution of Pakistan. Articles 33, 36 and 37 provide legal protection to minorities. The Pakistani Government have established legislative measures that promote and protect minorities’ rights. There is political will on the part of Pakistan’s Government to improve the position regarding the rights of minorities. As far as Christians are concerned, Islam considers them as people of the Book, and the Books of Allah include the Holy Koran, the Torah, the Gospel of Jesus and the Psalms of David. It would therefore be wrong to subject Christians to any discrimination.

The problem unfortunately is with certain religious and community leaders who are insular and have their own agenda. It is necessary therefore to change the culture and attitude of these people, and we need to support Pakistan in this regard. I met Dr Shoaib Suddle in the House of Lords following his appointment as the chair of a commission for minority religious equalities. He personally reached out and briefed me and other partners in the UK, earning our support for his proposed activities. He has a long-term programme of work, which will include implementing reforms for the freedom and protection of minorities in Pakistan. This will be consistent with words spoken by Quaid-e-Azam Muhammad Ali Jinnah in his speech on 11 August 1947:

“You are free. You are free to go to your temples, you are free to go to your mosques or to any other place of worship in this state of Pakistan ... We are all … equal citizens”,

as a nation in the state of Pakistan. I very much hope that this vision is now achieved.

My Lords, I thank the noble Lord, Lord Alton, for initiating this debate. Pakistan has the opportunity to be a great country, but presently its development is limited by an overpowerful military interfering in democracy and a lack of respect for the rule of law and human rights. This is most obvious in its treatment of minorities. As we have heard, 95% of the people are Muslim, and Pakistan has recently created a sense of exclusionary nationalism focused on a definition of Muslimness which has had a dire effect on the status of minority groups, as declared by Minority Rights Group International in 2018.

We have heard that Pakistan was founded on religious tolerance, but recent years have seen the problems of extremism and of minorities being persecuted increase significantly. On human trafficking, the Government said recently:

“The UK Government’s approach to tackling modern slavery … in Pakistan is to reduce the permissive environment through community-based activities and to strengthen legislative and policy frameworks for more effective”,

protection of those affected.

A reasonable question for the Minister is: against a background of worsening religious persecution, what confidence do the Government have that their anti-trafficking programmes can deliver value for money when the structures of the state seem to be undermining them? The Government insist that their aid programmes are blind to religion and are determined by need and need alone. This is for entirely understandable reasons, not least wishing to avoid giving preferential treatment to people of a particular religion, which could easily be viewed as discrimination, but the “need not creed” approach is failing Pakistani minorities. The most marginalised and persecuted groups are most commonly defined by their religion. In Pakistan, blindness to religion is hindering our ability to help. Consider the case of the more than 1,000 Pakistani Christian girls trafficked to China since 2018. The traffickers are specifically targeting Christians, even waiting outside churches with signs promising Chinese Christian husbands. This is an example of faith-targeted human trafficking. The UK’s anti-trafficking programme is well established in Pakistan, but if it remains blind to religion it will be less effective as a result. I serve as a trustee of an anti-human trafficking charity, the Arise Foundation. It summarised the problem, that,

“prevention work is most effective when it addresses why people are at-risk. If our aid programmes remain blind to the fact that the faith of these girls is putting them at risk, how can they possibly be effective?”

So I put that question to the Minister today: what steps are being taken to incorporate religion as an indicator of vulnerability in Pakistan? No one wants our aid programme to discriminate unjustly, but if a misplaced sense of political correctness is preventing us from reaching these girls and others like them, I would argue that we need to change our mentality, fast.

I wonder about the apparent blind eye that is being turned. The Pakistan Foreign Minister said last week that there was no truth to the reports that I have just outlined, but I have had a report from a senior official in Pakistan who told me directly that the reports were credible and that 65 Chinese and 16 Pakistani nationals have been arrested already within the ongoing investigations. Can the UK confirm whether it believes the reports or finds that there is evidence for them? I think there is good evidence, as has been said, that we need to target our aid wisely and reset the dial for the strategy of suspending it.

My Lords, I thank the noble Lord, Lord Alton, for securing this debate. According to DfID’s development tracker, almost one-third of Pakistan’s population, about 60 million people, live in poverty, 22.6 million children do not go to school and half the population cannot read or write. Moreover, Pakistan carries a high risk of natural disasters—2010 saw the worst floods in its history, killing thousands and affecting 23 million people—and it is a little-known fact that the country copes with the second highest number of refugees in the world.

Given its obvious need and our joint history, there can be little argument about the legitimacy of the aid that Pakistan receives, so long as it is properly audited and adheres to the overarching principle of the UN sustainable development goals that no one is left behind, and that includes vulnerable minorities. I hope the Minister will address the issues raised today.

There is one point about the treatment of minorities that I do not think has been mentioned yet: the prevalence of the problem on a regional level. India’s record is worsening year on year, such that in the world watch list by Open Doors it now ranks in 10th place and the BJP-led Government promote the message that to be Indian one must be Hindu. Myanmar is another case in point, where national Buddhists see any non-Buddhists as unwelcome outsiders, and that includes Muslims, Christians and Hindus. Add to that list Nepal, Bhutan and Turkey, all of whose leaders have found that appealing to national religious identity is a way to boost their power, especially in rural regions. What work are our Government doing on a regional level to promote interfaith understanding and tolerance, particularly in rural areas?

I want to be absolutely clear: I abhor the use of the death penalty wherever it is employed, and utterly condemn the misuse of the blasphemy laws in Pakistan. But is there hope that change is coming? As ever, to enact change, leadership is essential, and the courage of the judges in upholding the acquittal of Asia Bibi is commendable. That took real courage, as the noble Lord, Lord Alton, has pointed out, given the fate of Salman Taseer and Shahbaz Bhatti, two brave politicians who spoke up on Asia Bibi’s behalf and were consequently murdered. Does the Minister believe that the new Government in Pakistan are indicating that they want to change the direction of travel and move away from extremism? If so, that is the vision of Pakistan that we must help to promulgate. It is a geopolitical necessity for us.

My Lords, I thank the noble Lord, Lord Alton, for initiating this debate. He set out clear evidence of discrimination and human rights abuses in Pakistan.

As we have heard, humanitarian and development support for its people is evident. One-third of them live in poverty, half the population cannot read or write and one in 11 children dies before their fifth birthday. As the noble Lord, Lord Alton, reminded us, Pakistan is the largest recipient of direct UK aid. Part of that ODA is channelled through the Conflict, Stability and Security Fund CAPRI project, the stated aim of which is to increase Pakistan’s capacity to “investigate, detain and prosecute” suspected terrorists. In her letter to me of 13 June regarding my questions on this subject, the Minister wrote that all such projects have robust measures in place to protect human rights and that she was confident that the CAPRI programme has been delivered in a way that is consistent with the UK’s opposition to the death penalty. What are those robust measures? Will the noble Baroness explain exactly what they are tonight?

Last month, the annual review summary for the UK-funded rule of law programme in Pakistan revealed that the full report, which remains undisclosed, accepts that “human rights risks” are,

“a concern which we continue to stress”.

The Government have consistently said that they want UK aid to be more transparent. Will they demonstrate their commitment to this by publishing the full report for scrutiny by Parliament?

I conclude by repeating some of the remarks made by other noble Lords, particularly about the Asia Bibi case. We are all pleased that she has now safely relocated with her family to Canada but, as we have been reminded, there are 17 other cases that do not get the same publicity. What representations have we made to the Government of Pakistan in respect of each of those cases?

My Lords, I thank the noble Lord, Lord Alton, for tabling this debate, and join the tributes made to him for his work on Pakistan and human rights more widely. I also thank all noble Lords for contributing to this short debate. There has been lots to say and not very long to say it in. I share the concerns that all have expressed about minorities in Pakistan. Nobody should face discrimination because of their religion, let alone the examples we have heard tonight of trafficking, forced marriage, forced conversion or threatened or actual violence. Freedom of religious belief is a high priority for the Government’s work in Pakistan. We raise it regularly at the highest levels of government and support grassroots campaigning with our programmes. We continue to urge the Government of Pakistan to guarantee the rights of all people in Pakistan, particularly the most vulnerable, as laid down in the constitution, highlighted by the noble Lord, Lord Alton, in his opening speech.

We have heard much distressing testimony and evidence tonight, but there is some hope. The noble Baroness, Lady Sheehan, asked about the new Government and whether they wanted to change direction. Prime Minister Khan has stated his desire for a more tolerant and pluralistic Pakistan. We welcome his commitments to improve transparency and inclusion. Some progress has been made to date on the passing of a new Child Marriage Restraint Act and the issuing of 3,000 visas to allow Indian Sikhs to make pilgrimage to Pakistan, but there is clearly more to be done, and we continue to support the Government to implement other commitments, including the creation of a commission on minorities, raised by the noble Lord, Lord Alton, and the Christian divorce bill.

The noble Lord, Lord Alton, my noble Friend Lord McInnes, the noble and right reverend Lord, Lord Harries, and many other noble Lords raised the blasphemy laws. We remain deeply concerned by the misuse of those laws, and that religious minorities, including Christians, are disproportionately affected. The harsh penalties for blasphemy, including the death sentence, add to these concerns. The long-term objective is to overturn these draconian laws, which are used not just against minority communities but against Muslims, as the noble Lord, Lord Hussain, highlighted. My noble friend Lord Ahmad raised our concerns about freedom of religion or belief, the blasphemy laws and the protection of minority religious communities with Pakistan’s Human Rights Minister in February 2019. The Foreign Secretary raised those concerns with Foreign Minister Qureshi during his recent visit. We will continue to urge Pakistan to strengthen the protection of minorities, to explain the steps being taken to tackle the abuse of the blasphemy laws and to honour in practice its human rights obligations.

The noble Baroness, Lady Cox, and others asked where in Pakistan aid, DfID money, is being spent and whether we are specifically targeting minorities of all faiths. We have a number of programmes which directly target and benefit minorities. Our new AAWAZ II programme will address a range of modern slavery issues, including child labour and forced or early marriage. Our first AAWAZ programme saw great success, holding community forums and peace festivals and supporting a national anti-hate speech campaign. That programme developed early response mechanisms to try to pre-empt some of the violent conflict we have seen and really work on interfaith and intrafaith conflicts and community dialogue.

In the first AAWAZ programme, we specifically developed and disseminated key messages on non-violence and tolerance in communities. We have also funded a survey on women’s well-being in Punjab, including Christians, Hindus and Sikhs, and trained nearly 6,000 people from minority groups through the Punjab Skills Development Fund. As I said, the new AAWAZ II programme is currently under development, and we will ensure that it definitely reaches the people who need it.

Several noble Lords raised the issue of data collection. It is the case that for our bilateral programmes we do not currently have a breakdown by religion. That is not because we do not see the issue of treatment of minorities as important; it is due to the sensitive nature of collecting data. The noble Lord, Lord Hogan-Howe, highlighted this. There are a number of reasons for this lack of reliable data—sadly, people are reluctant to declare—but we are working proactively to improve this. We recently had some success in collecting more and better-quality data on people with disabilities in Pakistan. We learned from that and will build on it to focus our energy on collecting data from other vulnerable and minority groups. It will be challenging, but we have learned lessons which can be applied to other groups.

We are working very closely with a number of NGOs to help to target minorities, and I agree with the right reverend Prelate that we must do more to focus our programming on minorities. I talked about our AAWAZ programme. That funded four NGOs that work specifically with religious minorities: the South Asia Partnership, Aurat Foundation, the Sarhad Rural Support Programme, and Strengthening Participatory Organization. This made a vital contribution to the programme’s work to raise the voice of poor and excluded people in Pakistan, increase their choices and give them control. As I said, as we develop our successive programme, AAWAZ II, we are looking to identify NGO delivery partners to continue this vital work on inclusion.

I reassure my noble friend Lord McInnes that our development assistance really targets the poor, regardless of race, religion, social background or nationality. We know that those affected by discrimination are likely to be among the poorest. We know, and our NGO partners have confirmed, that our focus on the poorest and most marginalised ensures that we benefit minority groups.

We should not forget, as many noble Lords have said, that being in the religious majority does not prevent many millions of Pakistanis from suffering poverty and its consequences. As has been highlighted, almost a third of Pakistan’s population live in poverty. It is therefore right, and indeed in keeping with Christian values, that we should provide support to people in need, whatever their religious background.

The noble Lord, Lord Hussain, asked about the result of our aid. Since 2011, we have seen real success. UK aid has supported primary education for 10 million children, skills training for almost 250,000 people and microfinance loans for 6.6 million people. We cast a wide net, and justifiably so, but within that net we ensure that minorities receive our help.

My noble friend Lord McInnes asked about education. We have a strong programme of work on education within Pakistan. We have helped provincial governments to review primary curricula and textbooks in English, Urdu, mathematics and science. This has included a reduction in religious content, removal of discriminatory content and the inclusion of new content to promote knowledge, understanding and respect. We have also helped governments to set and implement systems and standards to help remove that discriminatory content. We have trained nearly 100,000 teachers in equity and inclusion and worked with civil society organisations to champion issues of inclusion, but that is a work in progress, and we will continue on that project.

The right reverend Prelate and the noble Baroness, Lady Cox, asked about the asylum offer for Asia Bibi. The UK Government’s primary concern has always been the safety and well-being of Asia Bibi. We were in close and extensive contact with a range of international partners to ensure a positive outcome, and of course her acquittal and release were good news for all those who campaigned on her behalf.

The noble Lords, Lord Hussain and Lord Sheikh, asked what we are doing specifically to support the Government of Pakistan in this area. We are working with that Government to support projects to tackle child abuse and modern slavery by empowering communities to realise their rights, helping to increase citizens’ awareness of their fundamental rights as enshrined in the constitution and lobbying to reduce the scope and scale of the death penalty. We also supported a national human rights conference in October 2018 to commemorate the late human rights activist Asma Jahangir. That is on top of the wider profile of HMG programmes that seek to counter violent extremism, strengthen the rule of law, improve government services, reduce poverty and deliver education.

The noble Baroness, Lady Cox, raised the issue of refugees in Thailand. We have raised our concerns with the Government of Thailand about the detention of foreign nationals seeking refugee status, including of course the nationals of Pakistan. We have repeatedly urged Thailand to sign the 1951 UN Convention on Refugees and have closely followed the detention of around 100 people, mainly from Pakistan, in October last year. We do not believe that those actions were aimed at a specific group or groups but apply to anyone deemed an illegal visa overstayer. The UN High Commissioner for Refugees is working very closely with the Royal Thai Government on asylum and resettlement issues.

The noble Lord, Lord Singh, raised the issue of the importance of the Commonwealth. That is an organisation where we have a strong voice, and we should continue to take action on freedom of religion and belief. DfID works closely with the FCO to raise concerns on freedom of religion or belief with partner Commonwealth Governments. Heads of the Commonwealth have recognised that freedom of opinion and expression, freedom of peaceful assembly and association and freedom of religion or belief are cornerstones of democratic societies and are fundamental to achieving the sustainable development goals. The UK funds the Commonwealth Partnership for Democracy, which is promoting freedom of religion and belief in the Commonwealth during our Chair-in-Office period.

The noble Lord, Lord Hogan-Howe, asked about trafficking and modern slavery. We are deeply concerned about the reports of trafficking, and we continue to urge Pakistani authorities to investigate and take action as needed. As the noble Lord highlighted, our approach is to reduce the permissive environment through community-based activities, but we are also providing support to the Government of Pakistan to tackle modern slavery, including trafficking, more effectively. We recently provided support and advice to enable the recent passage of the Prevention of Trafficking in Persons Act 2018 and the Prevention of Smuggling of Migrants Act 2018, which provide a stronger legislative framework for the effective prevention of trafficking. The AAWAZ II programme that I mentioned earlier will address a range of modern slavery issues, including child labour and forced and early marriage. As the noble Lord highlights, there is some deeply concerning evidence that we have seen on that. We will continue to work with the Government of Pakistan on that.

The noble Lord, Lord Sheikh, highlighted the report by the Bishop of Truro that was commissioned by the Foreign Secretary, and we look forward to its publication. We have seen the interim report, and I think it is going to be a really important piece of work that looks at how we as a Government target our activity on freedom of religion or belief. We very much look forward to that report, which will be released shortly.

There is also the International Development Committee’s inquiry on aid to Pakistan. We look forward to the hard questions that it is going to ask. That will be welcome scrutiny. We work hard to ensure that our aid is targeted properly, but the more conversations such as this and the more scrutiny that we can have, the better, because that will help us to improve.

We actively make the case whenever we can that the most stable societies are those that uphold the right of freedom of religious belief. Our substantial aid programme has helped us to position ourselves as a partner of choice for the Government of Pakistan. That allows us the access to raise these issues at the highest level and to provide advice and assistance to support the implementation of reforms. We have promoted, and will continue to promote, the rights of all Pakistanis as part of our effort to make the best use of every penny of aid to work towards a prosperous, stable and inclusive Pakistan. We should also welcome the royal visit to Pakistan, which will highlight the relationship between our two countries. I am afraid that I do not yet have details of the programme but I know the Foreign Secretary will respond to the noble Lord’s letter in due course.

I understand the frustration that we are not doing more and that we are not moving more quickly; the message tonight has been clear. However, through our programmes, our partnerships and our diplomatic relationships, we target minorities where we can and continue to build the data picture so that we can do so more effectively. I agree with my noble friend Lord McInnes that we must keep our programmes under constant review, and we do so.

I think we are making progress with DfID in Pakistan. We are seeing some positive outcomes. I speak to the team there on a regular basis, and their commitment and diligence on this is clear. We are working hard to identify and reach those most in need in what is a very complex and challenging environment, from both a data and an operating perspective. I know there is more to do on that, but I hope the Committee will recognise the work of the DfID team in Pakistan as we continue to make progress. As I say, it is slow going, but the commitment will continue from both DfID staff and myself to ensure that our aid programmes in Pakistan and indeed elsewhere really reach the people who are in desperate need of our help.

I think I am out of time. I hope I have answered the majority of the questions.

Not yours; I apologise. The noble Baroness, Lady Sheehan, raised the issue of the regional picture and what we are doing in rural areas. I will probably follow that up in writing, if that is okay. On the noble Lord’s question, we work to assess and analyse before we start programmes. I will see if I have anything further to add to the letter that I wrote to provide him with more reassurance, but I will have to do that in writing as well, I am afraid.

Again, I thank noble Lords. There has been a lot of interest in this debate as it is an incredibly important issue. I particularly thank the noble Lord, Lord Alton, who provides the very helpful service of keeping me updated on the deeply concerning evidence and testimonies on this issue. I hope I have provided some assurance of the work that we are doing and will continue to do. I will continue to work very closely with my noble friend Lord Ahmad, who is the PM’s special envoy on this issue, the Foreign Office and the DfID teams in Pakistan to ensure that with all our programming we help the one-third of Pakistanis who need our help, but also ensure that it gets to the minorities who need it.

Committee adjourned at 7.27 pm.