Healthcare Development: International Partnerships
Thursday, 17 September 2026
Contributions
Question for Short Debate
Asked by
Lord Crisp
To ask His Majesty’s Government what steps they are taking to ensure that their international partnerships with organisations in African and Asian countries support the development of healthcare in those countries.
Lord Crisp (CB)
My Lords, first, I thank noble Lords for participating in this last sitting before our Recess. I declare an interest as patron of Global Health Partnerships, GHP, formerly known as THET, which is what people probably know it as. GHP has received some funding from the FCDO over several years to support these sorts of partnerships; I will refer to one in Myanmar that it currently contributes towards. I understand that my noble friend Lady Prashar will refer to a recent important report from Global Health Partnerships on the recruitment of health workers from low and middle-income countries. I am delighted to know that the noble Lord, Lord Oates, and others will be referring to some of the many different sorts of partnerships, and I believe that the right reverend Prelate will be talking about his personal experience in this area. My purpose in this debate is to think a bit more strategically about this issue. I want to ask the Minister about strategy and encourage him and the department to think about how health can contribute more extensively to development and foreign policy—this is why I wanted an FCDO Minister to respond, rather than a Health Minister. The context is that the UK is one of the great leaders in health globally, second only to the USA, for example, on medical research. The UK is extremely prominent in professional education, with many innovators in biomedicine and medtech, and great not-for-profits such as Global Health Partnerships and, of course, the much bigger Wellcome Trust. I and others will be publishing a report in the next year about the global footprint of the UK in health. The UK has extraordinary reach in health, and this is the fundamental underpinning point. In our last report, 10 years ago, it was shown that 63% of peer-reviewed medical journals where there was a British author had a foreign second or third author. There is extraordinary partnership. Even as we sit here, there will be emails whizzing back and forth between researchers all over the world. We have extraordinary reach, partly because of the Commonwealth. I am sure this is true of other sciences, but I am talking about health. Let me get to my conclusion at the beginning, just to make sure that I do not get carried away by talking about the examples. The sort of things that I am talking about here cover the ordinary overseas development agenda, if I can put it like that, which relates to the benefits of supporting low and middle-income countries with their health issues. It deals with the ODA goals and the global goals. The UK also has great influence in global health policy. There is a whole set of development agenda. Another set of issues here involves how that development is delivered, and it is something that I will come back to in the case of Myanmar. It is about the ability not to go Government to Government but to use civil institutional links that exist to provide support and ultimately help to rebuild countries and rebuild peace. The third area is about UK values, and our health professionals carry those with us. That is not just about soft power. People talk quite softly about soft power, but this is about some real leverage that comes with this. Of course, we need all the friends we can get at the moment in this dangerous world. The fourth area is the commercial benefits of partnerships. I forget what it is called now, because it keeps changing, but NHS Global, I think it might be called these days, sponsors partnerships between commercial organisations and our brilliant innovators. Finally, there is the whole area of support for the NHS. It can be extraordinarily valuable to work in overseas countries and then to come back to the UK with different ideas, to see one’s own health service in different ways and to develop. I know that is outside the FCDO remit, but it is part of what I am talking about here. I invite the Minister to tell us where he thinks health fits into the wider partnership strategy of the department, and whether he thinks, as I do, that it could play a much more strategic role in foreign policy, whether we could leverage health much more effectively in foreign and development policy, and whether it would be useful for him or colleagues to meet a few people from the sector—I would gladly bring them together to discuss how the health sector could provide more leverage and support. In the last three minutes, I turn to two examples, including one that I know I have circulated to noble Lords about the awful situation in Myanmar, five years on now. Health workers were among the leaders of the original civil disobedience movement. They were targeted and they retreated to the countryside, and they needed new skills—people had to learn how to deal with bombs and bomb fragments, and nurses had to deal with bullet holes and such like, and of course health deteriorated. There has been an extraordinary response, which has come, in part, from Burmese/Myanmar health professionals in this country. It was very good that the Government allowed them to work here professionally—some of them were here already but some subsequently came. I think that is tremendous. It is also good that the Foreign, Commonwealth and Development Office has supported the approach here of dozens of Myanmar and UK health professionals providing training, with something like 290,000 consultations, training, mentorship and education activities. Over 1,600 health workers have had training or support in the past two years. A new nursing school has opened, sort of behind the lines, because we have moved on from purely a coup to a civil war—it is now a really difficult situation. There are monthly medical training webinars, with 16 groups of educators from 12 ethnic health groups and four ethnic medical schools receiving technical support. It is a tremendous voluntary effort, with some support for its underpinning from the FCDO. It is a one-off example—I hope it is a one-off example—but it shows how important this is. It is clearly important to the UK, not least because of the great history and relationship between our two countries but because the UK is the penholder for Myanmar at the UN. My second quick example concerns a group of anaesthetists. In 2012, I got some funding from DfID, as it was in those days, to support a training programme for anaesthetists in Zambia. Zambia had no way of training anaesthetists, who had to go abroad to be trained and did not necessarily come back—they stayed in South Africa or wherever. We set up a programme in 2012 which is still going, under its own steam now and its own funding, where anaesthetists from this country go out to that country for short or longer periods. These are often anaesthetists in training, and they work with the local anaesthetists, train them and, of course, gain so much themselves. In conclusion, I invite the Minister to tell me how he thinks health fits into the wider partnership and whether he believes, as I do, that we could leverage it more effectively in foreign and development policy.
The Lord Bishop of Leicester
I am very grateful to the noble Lord, Lord Crisp, for securing this debate, and it is an honour to follow him. I thank him sincerely for his sustained work over a number of decades to show how medical partnerships with low-income and middle-income countries bring benefits both to those countries and to our own NHS. This is something very dear to my own heart. My wife is a paediatrician and, together, we worked for a number of years in west Africa. My son has just graduated and started his first job as a doctor in Derby. Earlier this year, he did his medical elective in east Africa and, because he studied at the University of Newcastle, he was able to do the whole of his second year at Newcastle’s campus in Malaysia, an advantage he did not know about when he applied to that university. In a number of ways, cross-cultural medical work has been a big part of my family’s experience. More than this, the principles that in giving we also receive and that we have much to learn from those with whom we differ—culturally, socially, economically, religiously, or whatever it may be—have shaped my experience of Church ministry in various parts of the world and in the multicultural context of Leicester, where I now serve. Indeed, I have written about my learning on gift exchange in different contexts. So there is a lot that I could say on the benefits to our own NHS of UK-based healthcare workers spending time working in low-income and middle-income countries. A quick list could include: increased awareness and knowledge about cultural differences and similarities; increased cultural sensitivity, which is so important for the NHS today; the ability to work with limited resources, which, again, is critical for the NHS today; the ability to deal with the unexpected and work towards solutions; improved flexibility and adaptability; and the ability to innovate in overcoming challenges. The list goes on. Importantly, these skills and attitudes are hard to pass on in classroom settings or familiar clinical contexts. Working overseas is a particular learning experience that really does have a lifelong impact. However, I also want to speak of something that is, I believe, a major barrier to healthcare partnerships, particularly where lower-income countries are concerned: the attitude that we know best and have nothing to learn from these countries. As one chief executive is recalled to have said in a report by NHS England, “What on earth are we going to learn from these poor countries?” This air of superiority—assuming that, because of our technological advances in this country, we are also culturally superior—was, of course, core to colonialism and, sadly, is still present today. We have it in the Church, and we see it in academic studies and so many other areas. There is, therefore, a need to develop what I call “cultural humility”—that is, an approach to interacting with people of other cultures that says, “We always have something to learn”. This is linked to the concept of “reverse innovation”, as mentioned by the noble Lord, Lord Crisp, whereby higher-income countries learn from and adopt practices developed in their lower-income counterparts. Kangaroo care in neonatal units is one example; oral rehydration sachets are another. The lack of cultural humility is also, I suggest, a factor that explains why UK healthcare professionals working in other countries do not always have the local impact that they would wish for. People can sense whether we have a genuine desire to serve them or are simply in it for our own gain. Good partnership working requires cultural humility—both the willingness of the individual to learn from the other and the willingness of the other to receive the gift that is being offered them. In other words, it is a form of gift exchange; as I say, there is a whole body of literature on that. I ask the Minister: what are the FCDO and the Department of Health and Social Care doing to encourage genuine partnerships with overseas healthcare bodies and to equip staff to work well within these partnerships? It is not simply a case of having formal partnership agreements, important though they are; there is also a need for the training and development of staff to work well within these partnerships. For instance, I am struck that my wife, who works in the NHS, has protected time for teaching and learning, quality improvement and clinical governance—all of which are recognised as statutory requirements—but it is much rarer for any NHS employee to have protected time to support global health. This means that it has to done in evenings and weekends, or during annual leave, thereby restricting it as an option for many—particularly those with caring responsibilities. Perhaps most surprising of all is the fact that there is little recognition of those who have spent time working in other countries. Indeed, research with some of those who volunteered abroad found that., because it means deviating from the typical training pathway, it is sometimes considered career suicide. Some returning healthcare professionals report difficulties with professional revalidation or securing permanent employment on return because, more generally, they lack experience in this country. This could be addressed, as participants in the NHS England report mentioned, by having national bodies, such as the DHSC or NHS England, recognise the benefits of global health partnerships and encourage executive buy-in. If this were more common across the NHS—indeed, if every trust had an enduring partnership with a hospital overseas—the two-way positive impact would be greatly magnified, and the obstacles that some individual volunteers face would be done away with. Finally, just before the matter of costs is raised as a possible barrier, let us remember that by recruiting healthcare workers from overseas, it is estimated that the NHS has saved £14 billion in training costs. That saving should surely come with a responsibility to offset the loss to these countries’ own healthcare systems.
Baroness Prashar (CB)
My Lords, I too thank the noble Lord, Lord Crisp, for securing this debate. He has made a unique contribution in this area, and characteristically he has situated this today very strategically in terms of what we can do about developing partnerships. He has given a powerful account of the benefits of partnership working in health and how these support the development of healthcare in those countries. These partnerships embody the Government’s new approach to development, as stated by the new Secretary of State for Health: from paternalism to partnership. As we heard from the noble Lord, Lord Crisp, these arrangements are highly cost effective and give NHS staff insights that improve clinical practice, leadership and efficiency. They are equitable and country-led, and UK and overseas health services can invest in, learn from and mutually benefit from them. The noble Lord also mentioned the values of the National Health Service, which I think are extremely important. Partnership working was introduced in 2008. Now, nearly two decades on, there is an opportunity to breathe new life into this approach. This means moving away from voluntary arrangements to some formal partnerships supported by predictable and multi-year funding, and obviously by looking at them much more strategically as well. Renewed investment in global health partnerships following the recent cuts would not only enable the Government to reinforce their commitment to partnerships but would be mutually beneficial for the UK and other countries. Such partnerships can be further enhanced if we take a different approach to the international recruitment of the health workforce. In this context, I draw the attention of the Committee to the report published in March that the noble Lord, Lord Crisp, referenced, which was published by the All-Party Parliamentary Group on Global Health and Security, entitled An Honest Account of the Benefits and Costs of International Health Worker Recruitment . The report was prepared by Global Health Partnerships, an organisation which has not been mentioned but which acts as a secretariat for this APPG and has done some excellent work to promote health partnerships. The noble Lord, Lord Crisp, and I were members of this inquiry, so we both declare an interest. The report argued that international recruitment will remain a necessary component of the National Health Service workforce for the foreseeable future and it would neither be responsible nor fair to continue with ad hoc recruitment, which in the long run I think is detrimental to the sending countries and often not fair to those individuals who are recruited. Source countries often lose health workers faster than they can replace them. These include countries such as Nigeria, Zambia and Zimbabwe which are currently on the red list, which means that no recruitment from these countries should take place. Evidence from Kenya and Uganda captured in this report describes the loss of doctors, nurses and clinical educators, with serious consequences for patients and overstressed health services. This has become such an important issue that the WHO’s guidelines were updated this year for the first time in 16 years, adding an expectation that countries recruiting from abroad also invest back into the health systems that they recruit from. The report proposed recruitment through deliberate partnerships that deliver mutual benefit and strengthen systems globally, an approach which is responsible, ethical and in our self-interest. International recruitment is a structural feature of the National Health Service, and the report estimated, as has already been said, that over the years the UK has saved approximately £14 billion in training costs. The inquiry concluded that the UK must move from a reliance on massive overseas recruitment to a more structured and responsible approach. As I said before, international recruitment will continue in the short to medium term. Reducing dependence on overseas recruitment as proposed in the 10-year plan will take time, and recruitment from overseas in the short and medium term will remain a necessity. This report recommended replacing the ad hoc recruitment drives with transparent government-to-government partnerships, aligned with national health workforce plans and priorities. This approach would align self-interest and practical gain for both parties. A connected, responsible global health force will strengthen us, support partner countries and enhance global health security, an issue that is high on the Government’s agenda. Minister McNeill, in a speech on 14 September, named health as one of the five securities that will define the UK’s approach through its G20 and G7 presidencies. The logic of the argument that this report advances is compelling and deserves serious consideration. Today, the Government have not responded to the report, but it merits serious considerations here and in international fora such as the Commonwealth and the upcoming G20 presidency next year. I urge the Government to discuss the report’s recommendations with the members of the inquiry and its authors. Further, the Government should demonstrate global leadership by putting this issue on the agenda of the forthcoming G20 meeting in 2027. Health worker mobility is exactly the kind of cross-border risk-sharing issue that the G20 under the UK’s leadership should be addressing. The Global Health Partnerships, the organisation that supported this publication, organises the health summit each year. The summit in 2027 would be a suitable vehicle for promoting these partnerships. I attended the summit this year and can speak from experience about its value and impact. I remain hopeful that the Government will give serious consideration to health partnerships highlighted in this debate. I look forward to a positive response from the Minister.
Baroness Uddin (Non-Afl)
My Lords, it is a great honour and privilege to follow my friend the noble Baroness, Lady Prashar, and the right reverend Prelate the Bishop of Leicester. I thank the noble Lord, Lord Crisp, for securing this debate and for the briefing he so generously shared with all of us taking part. His long-standing record on global health and international partnerships reminds us that our commitment to international development is beyond the significance of finance. It is about co-operation between people, institutions and nations—a partnership capable of building sustainable capacity and strengthening development systems at country level. Yesterday, a number of noble Lords listened to the right honourable Speaker of the Parliament of Uganda. It was clear from that conversation that many African nations continue to value Britain’s partnership in economic development, education, health research, technology and defence. But we must acknowledge honestly that our bilateral relationship across Africa and the global South have historically included an approach too often defined externally. Development assistance has rightly supported vaccination, literacy, maternal health and other services, but these relationships have existed alongside different co-operation cloaked historically as international development assistance and the extraction of valuable natural resources, sometimes without sufficient attention to the priorities and aspirations of local people. Today, we face an increasingly complex environment, with wars and conflicts and infectious diseases, including Ebola, in our daily view. Dengue and malaria continue to threaten communities, while famine and hunger remain realities for many millions. At the same time, international development funding is under extraordinary pressure with the reduction by the US and the changes in the UK’s defence priorities. The consequences, with receding resources, are fewer health services and less support for women and children, which communities have come to rely upon for decades. In these circumstances, we need a collaborative response. I would welcome the development of a stronger coalition between international funding agencies, national Governments, respected local organisations and experts. Such co-operation would pool scarce resources and help donor organisations design services more effectively, reduce duplication and improve service delivery. It would put the people who understand local circumstances at the heart of determining priorities. That includes women. The UK has an honourable tradition of supporting women’s organisations across the world, yet in societies afflicted with conflict, displacement or economic instability, women’s voices and influence often diminish precisely when they are needed most. In the face of these existing and emerging crises, how do the Government intend to ensure that the basic needs of vulnerable women and children in Africa and Asia are reflected in the way that development programmes are planned, designed and delivered? I seriously question whether women themselves would prioritise defensive military training within the framework of international development over feeding and educating their children, securing clean water, accessing healthcare and ensuring the safety of themselves and their families. The UK’s modern approach to development is very welcome. It recognises the importance of local leadership in defining country priorities, but the principle must be lived in practice. We need to ask what happens to well-established programmes when international NGOs withdraw offices because of funding cuts. Have we done enough over the years and decades to ensure that locally created organisations and solutions have the capacity, resources and confidence to respond when international support diminishes? I sincerely hope that we will not sacrifice the good work that is already under way. Nevertheless, Britain retains significant strength and influence. As has been mentioned, our universities, financial institutions, the NHS—as was mentioned—research and technological capabilities and strong civil society have all contributed to the relationships and co-operation built over generations. They are assets which readily enable Britain to remain a trusted international partner with humility as well as expertise. I recognise that practice can sometimes fall short of the principles we espouse, and we must remain vigilant and willing to improve at all times. I say this having visited UK-supported programmes and spoken to Rohingya women in Bangladesh who had experienced rape, torture and ethnic cleansing, and to women from Syria, Lebanon, Sudan and elsewhere facing equally devastating circumstances. It is impossible to overstate the hopelessness of such experience and of how far removed women are from the decisions made about development assistance that directly affects their lives. We should therefore be cautious about imposing burdensome conditions that, however well intentioned, can unintentionally undermine the well-being and dignity of the very people the programmes are intended to support. Of course, at the same time, we must keep in mind the legitimate expectation of British taxpayers that public money is properly governed and accountable. Transparency, therefore, should not become disconnected from upholding humanity. We need a balanced approach that recognises the realities of people who have endured extreme hardship, lost homes and livelihoods, been deprived of basic choices and, in many cases, fled unimaginable violence. In the current financial environment, this is undoubtedly a difficult balance for all countries and Governments, who are managing competing demands while families in their own nations experience pressures and bear the cost of living crisis. This is precisely why locally led solutions can be more sustainable, responsive and cost-neutral, particularly when we place women as partners at the heart of development decisions. Women’s organisations across Africa and the global south possess practical experience in all the areas that development assistance intends to address. A similar principle applies to young people. As usual, I have written far too much to read out, but I want to say that I am encouraged to see the shift in the Government’s approach towards Africa, which places greater emphasis on mutual respect and the long-term relationship, encompassing trade, investment and education. I believe that that approach can inspire a new generation of young women and men to see Britain not as a donor but as a partner and help build towards a better international development space and a more balanced and equitable world.
Lord Oates (LD)
My Lords, I join other noble Lords in thanking the noble Lord, Lord Crisp, for securing this debate and for his long-standing leadership on global health. I also pay tribute to the work of the global health partners with which I have had the opportunity to work in the past. This is the first time I have taken part in a debate with the noble Lord, Lord Wood, since he has become a Minister, so I welcome him to his ministerial position and congratulate the Prime Minister on making such an excellent appointment. I have spoken in previous debates about my experiences earlier in my career: teaching in a rural school in Zimbabwe and, later, working in South Africa for a few years. Although I hope that the contribution I made in those roles was valuable to the communities in which I worked, I know that it was absolutely priceless to me. I learned about living in a resource-constrained environment, about the ingenuity and commitment of the community and about the perspectives of people with very different life experiences and cultural backgrounds from mine. Those experiences shaped my life. They taught me how much we have to gain when we are prepared to listen and learn. That is why, this afternoon, I want to speak in particular about the contribution of NHS England’s Global Health Volunteer Fellowships programme, which puts that principle into practice. I want to make what seems to me to be the overwhelming case for continuing the modest financial support that enables the scheme to operate, allowing doctors from the UK to contribute overseas and bring valuable skills home. The programme deploys doctors for four to six months in health facilities in a number of low and middle-income countries, including Kenya, Malawi, Namibia, Sierra Leone, South Africa, Uganda and Zimbabwe. These doctors are paid a small stipend to cover travel and living expenses. More than 450 have been deployed to date, making a significant contribution to the communities they have served but also gaining new skills and experiences, to the benefit of our National Health Service. An independent evaluation of the programme by Hughes Hall, Cambridge, found that 94% of fellows responding reported improved clinical skills, while 92% reported better problem solving and decision-making. One doctor described returning to British general practice calmer, more confident and more aware of how poverty shapes patients’ health; working with limited diagnostics had sharpened his skills of observation, examination and clinical judgment. Another explained how they managed presentations of which they had little or no prior experience, including trauma, burns and snake bites, building confidence and a practical skill set that they would not have developed in the UK. Another described learning from highly skilled South African doctors and incorporating those skills directly into NHS practice. These are benefits that they can provide to the NHS and their patients throughout their careers. Secondly, the programme encourages a more thoughtful use of resources. Doctors described learning to weigh decisions carefully, adapt to constraints and avoid waste. An Oxford radiology registrar who worked at George Hospital in South Africa’s Western Cape explained how the experience better equipped him to allocate limited resources, avoid waste and appreciate the resources that are available in the National Health Service. Thirdly, there is the benefit to morale and retention. One participant described rediscovering the joy of practicing medicine. The evaluation records testimony that the programme can help retain GP trainees and renew their commitment. We invest heavily in training doctors; helping them remain motivated and committed to NHS practice should be part of protecting that investment. The benefits to the partner hospitals were also clear. In Mitchells Plain, a highly deprived community outside Cape Town, fellows are described as integral members of the emergency team. Both fellows and local medical staff reported learning from each other. At George Hospital, the partnership has helped sustain patient care while developing future healthcare leaders, and the Tshemba Foundation, which supports volunteers at Tintswalo Hospital and surrounding rural clinics in north-eastern South Africa, describes the Global Health Volunteer Fellowships programme as invaluable and explains why continuity matters so much—a regular flow of fellows allows it to plan. Finally, there is the benefit of the personal relationships that are built, which contribute to the kind of personal diplomacy that is important for the UK’s relationships abroad. I know that myself from the time I spent working in South Africa and Zimbabwe; I built enduring relationships which remain to this day. Lots of those personal relationships contribute to how the UK is seen. Despite all these benefits, there is deep concern that the programme may be discontinued. I very much hope that this will be reconsidered. Ministers should consider what will be lost: training opportunities, clinical contributions and relationships built through years of co-operation. Can the Minister tell us what the Government’s position is in this regard and explain how the benefits to NHS training and partner hospitals are being assessed? I understand the pressures on resources, but we are talking here about very modest funding. A small stipend can make possible months of service and learning, with benefits that last well beyond a placement. We should have the judgment to recognise that value and the commitment to sustain it.
The Earl of Courtown (Con)
My Lords, I join other noble Lords in thanking the noble Lord, Lord Crisp, for securing this important debate on what the NHS can learn from partnerships with hospitals in Africa and Asia. It was particularly interesting to hear his description of the situation in Myanmar, and I learnt much from the noble Lord’s speech. I should also declare an interest, like the right reverend Prelate. My daughter did her elective in Kerala, India, and she spent a year after the pandemic teaching at Warwick Medical School. She was only too aware of the importance of British doctors—people living in England—actually going to help and teach people coming from overseas, and of course there is much evidence of that at Warwick Medical School. As the noble Lord, Lord Crisp, said, we are a leader in this field. Partnerships between the NHS and healthcare providers abroad have been recognised as mutually beneficial by successive Governments. Under the coalition Government, Healthcare UK was launched as a joint initiative between the Department of Health, the NHS Commissioning Board and UK Trade & Investment to increase the profile of UK expertise in healthcare and the trade in healthcare goods and products overseas. Indeed, successive Conservative-led Governments provided funding for Gavi, the Vaccine Alliance. Governments have also signed agreements on healthcare with India and Kenya, and the previous Government published the two-year global health framework in 2023. All this work has helped to strengthen the UK’s reputation internationally as a global leader in healthcare. That is a reputation that has been hard won, and we will support the Government where they seek to improve healthcare provided through the NHS. We will work with Ministers to deliver these improved outcomes. This is slightly outside the Minister’s brief, but for these arrangements and partnerships to work, we need a functioning NHS. Unfortunately, as all noble Lords will be aware, the NHS has too often been brought to a standstill by industrial action, with patients bearing the costs. Can the Minister briefly say what Ministers are doing to protect patients from the damaging effects of strike action in future? Turning back to international partnerships between the NHS and healthcare services, can the Minister say what particular efforts are being made to engage with healthcare providers in Africa in the light of the ongoing Ebola outbreak? It would be useful for the Committee to hear what the Minister can say on this issue. I was also particularly interested to hear the report from the noble Lord, Lord Oates, of his time in South Africa and Zimbabwe. The fact is that partnerships help places experiencing so much undue suffering very much; it was interesting to hear about the noble Lord’s connections there. Once again, I thank the noble Lord, Lord Crisp, for bringing this debate forward. I look forward to hearing the Minister’s reply.
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.
Committee adjourned at 4.06 pm.
Source: UK Parliament Hansard API. Debate ID: 5409272.