The Parliamentary Under-Secretary of State, Foreign, Commonwealth and Development Office (Lord Wood of Anfield) (Lab)

My Lords, I am grateful to the noble Lord, Lord Crisp, for securing this debate. I pay tribute to his work on strengthening global health partnerships and championing collaboration, as well as to his role as a patron of Global Health Partnerships; I will come back to his Myanmar example later. I echo his words on how our health sector is world-leading with extraordinary reach, as I think he said. That is the foundation of the development partnerships, which we and—to go back to the point from the noble Earl, Lord Courtown—the previous Government have pursued with such principle and vigour; I pay tribute to them as well. I thank all noble Lords for their contributions. So many of your Lordships have such valuable experience in the area of health partnerships—experience that I have not had. I wish the son of the right reverend Prelate the Bishop of Leicester good luck, and I thank the right reverend Prelate for his story about his son’s experience. Our approach to development is having to modernise, as noble Lords know, with the aim of having a greater impact abroad and achieving better value for money at home. That is not an easy combination. It is based on four shifts: from donor to investor; from service delivery to system strengthening, on which I very much take the point made by the noble Baroness, Lady Uddin, about the sustainable development of new systems, rather than just transitory ones, being crucial; from grants to expertise; and from international intervention to local leadership. In health, this means an approach that is increasingly rooted in partnership by listening to countries, responding to their priorities, combining UK expertise with local knowledge and building relationships based on mutual benefit—as we have heard about today from various noble Lords’ experiences—in order to strengthen health systems, build sustainable capability and support locally led approaches. I refer again to the point made by the right reverend Prelate the Bishop of Leicester about the gift relationship and cultural humility—I, too, am a Richard Titmuss fan—as well as the idea that knowledge transfer is not just one-way. The noble Lord, Lord Oates, spoke very movingly about how it changed his life; I will come back to the programme that he talked about in a minute. Unless exceptional circumstances or a crisis require a different approach, we see our role as not to deliver services on behalf of others but to work alongside partners in order to strengthen their own institutions, capabilities, and systems. To support this, the Foreign Office has established a community of expertise for health, which brings together expertise from across the UK and around the world and makes it available to our international network. Its purpose is to help partner countries strengthen their health systems, improve health security and deliver better health outcomes, particularly for women and girls—another thing that the noble Baroness, Lady Uddin, rightly highlighted as an oft-neglected dimension of development work. A fundamental principle of this community is that it is demand-led and not donor-driven. This brings me to today’s Question. Let me answer the noble Lord, Lord Crisp, directly on what we are doing. We support healthcare development by working with Governments, health ministries and local organisations. We focus on the priorities that countries have identified for themselves, rather than imposing our own. We focus on areas where the UK has expertise to offer, while drawing on local knowledge. Of course, there are occasions where more direct support is required, and one such example is the current Ebola outbreak, which the noble Lord asked me to comment on. The outbreak on 15 May has been declared an Ebola outbreak—the 17th. We are allocating up to just under £80 million to support an Africa-led response, and we are helping the WHO, the United Nations and NGO partners to strengthen surveillance, support front-line workers, improve infection prevention and control, and support access to life-saving care. I thank all those who are taking part in the collective effort to respond to this crisis as we speak. The UK was among the first international partners to commit funding to the Africa-led response and is providing up to £80 million through the WHO, Africa CDC and the United Nations. Together, we are helping to strengthen surveillance, support front-line workers, improve infection prevention and control, and accelerate access to vaccines, treatments and diagnostics. In all our activities, we are working through a range of partnerships, including partnerships at home with the NHS, universities and professional bodies. We supported health system partnerships in countries including Ghana, Malawi, Nepal, the Philippines, Tanzania and Zimbabwe, which draw on UK expertise, including from NHS England, and create opportunities for health professionals to improve their quality of care and experiences. We have heard today many examples of successful partnerships supported by this and the previous Government. The noble Lord, Lord Oates, discussed the Global Health Volunteer Fellowships programme and gave some quite moving examples. He responded to some of the challenges put forward by the right reverend Prelate the Bishop of Leicester of embedding training in specific contexts rather than expecting skills to be transferred without bespoke training. I want to thank the doctors who take part in that, who provide their valuable time and skills on a volunteer basis. As explained by the noble Lord, Lord Oates, the programme provides clinical support through placements for doctors in partner countries but also encourages mutual learning between practitioners from different countries. I am not aware of DHSC financial plans for this programme but I will make it my business to try to find out for the noble Lord. The experience and evidence that it generates will clearly be valuable, whatever programme develops in the future. I will get back to the noble Lord, Lord Oates, on anything I can discover in advance of the spending review. We also provide flexible technical assistance. We help partner Governments access the expertise they need to address their priorities and strengthen their health systems. Good examples include Bangladesh, also brought up by the noble Baroness, Lady Uddin, where we are supporting efforts to improve services for women and girls, and Somaliland, where we are helping the Ministry of Health strengthen health financing and planning. Alongside this, a recent £19 million DHSC programme has operated in several countries across Africa, linking NHS organisations, universities and royal colleges with counterparts overseas, helping to strengthen the health workforce through learning and collaboration. The noble Lord, Lord Crisp, mentioned Myanmar and the fantastic work done by what I think became known as the UK Health Partnerships for Myanmar after the military coup five years ago. This involved a UK coalition, which the noble Lord mentioned in some detail, of more than 50 institutions, including royal colleges, NHS bodies, universities, parliamentarians and local clinicians, which developed teleconsultations, GP support, quality improvement, a nurses’ college and virtual clinical support—a real flagship example of what health partnerships can do. I also want to draw attention, parochially, to my own department, the FCDO, whose principal health partnership programme since 2023 is the Health Systems Connect programme. The noble Baroness, Lady Prashar, rightly pointed to the importance of having multiyear programmes rather than single off-one grants or more fleeting forms of financial assistance. This is a four-year initiative, delivered through the NHS Consortium for Global Health, which connects partner Governments with expertise from NHS England, UKHSA and other bodies. The partnership work aims to accelerate progress toward improved healthcare systems and universal access. The noble Baroness, Lady Prashar, asked an important question about the impact of recruitment in the UK on the supply of health professionals in low-income and middle-income countries. This is obviously a complicated question. As she pointed out when talking about the GHP report that she discussed, the Government’s health plan aims to reduce reliance on international recruitment by reducing it to under 10% by 2035. That said, a continuing reliance on overseas recruitment will still be there. It is important, therefore, that we approach this in an ethical and sustainable way that supports, rather than undermines, the UK’s wider development objectives. As the noble Baroness knows, our code of practice for the international recruitment of health and social care personnel is the foundation of these ethical standards, which prohibits active recruitment from red-list countries, as she mentioned. We will continue to invest in partnerships that strengthen national health workforces in countries facing the greatest health system challenges. All these efforts sit alongside our major investments through multilateral institutions and global health initiatives. Through partnerships with organisations such as the World Health Organization, the World Bank, Gavi and the Global Fund, we are helping to strengthen health systems more broadly. The Government seek to ensure that their support for healthcare in partner countries starts by listening to partners and supporting their priorities. We work alongside the Governments, civil institutions, organisations and local workforces on which health outcomes truly depend. Lastly, I again congratulate the noble Lord, Lord Crisp, on this debate and the work that he and the GHP have championed. I thank all noble Lords for the experiences that they have shared today.