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Primary Care Trusts
14. Miss Anne McIntosh (Vale of York): What recent representations he has received on the setting up of primary care trusts; and if he will make a statement. [122875]
The Minister of State, Department of Health (Mr. John Denham): I and my officials have regular meetings with a range of relevant national and local organisations to discuss the establishment of primary care trusts.
Miss McIntosh: What action are the Government planning to take, through primary care trusts, to improve treatment for osteoporosis?
Mr. Denham: Primary care trusts, with other players in the local health economy, have a key role to play in drawing up local health improvement plans and in ensuring that those plans reflect national and local priorities. Therefore, issues such as osteoporosis can certainly be dealt with by primary care trusts in conjunction with other local organisations. Additionally, as primary care trusts will be able to bring together existing general practitioners and practice nurses with staff from community health trusts in many areas, some of the care that is provided particularly for patients living in the community may be better provided in future. For a range of chronic conditions, but particularly those affecting the elderly, primary care trusts offer new opportunities to provide better services in the new NHS.
Sierra Leone
3.31 pm
The Secretary of State for Foreign and Commonwealth Affairs (Mr. Robin Cook): With permission, Madame Speaker, I shall make a statement on Sierra Leone.
When I made my first statement to the House, I announced that the British military presence would be of value in securing two objectives: to get British nationals out and to get more United Nations forces in. I am pleased to report that we have made good progress on both objectives.
The United Nations force has expanded rapidly over the past month and, by next week, we expect it to be at its original authorised strength of 11,000. That successful build-up has been possible only because of the increased efficiency that the British presence has brought to logistic movements. We have provided security for the airport and provided a lead that has encouraged UNAMSIL contributors to deploy quickly.
The security situation has much improved, in part because of the United Kingdom presence. The rebel advance on Freetown has been reversed and their leader is under arrest. All the 500 UN personnel who had been seized by the rebels have been released, although we continue to watch with care the situation of Major Harrison and Mr. Smith.
We remain on course for our target of withdrawal by mid-June. The 1st Battalion of the Parachute Regiment has already withdrawn, and we expect 42 Commando to be withdrawn next week. At that point, the security of Lungi airport will be transferred to the United Nations. At the weekend, I spoke to Kofi Annan, Secretary-General of the United Nations, who expressed his appreciation for what he described as the magnificent effort by the British troops in helping to stabilise the situation in Sierra Leone.
Much more remains to be done to ensure that the UN mission is not only at full strength, but an effective force. We will continue to provide valuable back-up to that UN operation, such as better communications to its units and military advice to its headquarters. The achievement of the past month, however, has been to avert an immediate threat to Freetown. As a result, Sierra Leone may have dropped out of the front pages--but we shall secure lasting stability there only if we, the international community, and the Government of Sierra Leone follow through the gains of the past month with a sustained effort. We must also expect to see some local reversals before we succeed in bringing the conflict to an end.
On Thursday, I shall be visiting Sierra Leone to explore with President Kabbah how we can take forward our work in partnership. Today, I wish to outline to the House our strategy for building on the progress of the past month. The strategy has three priorities: to repel the rebels; to restore the peace process; and to rebuild Sierra Leone.
The first priority is to equip the Government of Sierra Leone with an effective and accountable army of its own. Since the Lome agreement of last year, Britain has been the lead nation in training a new Sierra Leone army. We propose to accelerate our training to achieve a rapid boost in troop capacity. We shall therefore be providing a short-term training team to provide an intensive infantry course for 1,000 new recruits--all of them screened
recruits over 18-years-old. The training will be conducted by about 180 personnel drawn from 2 Royal Anglian. They will be supported by HMS Argyll and RFA Sir Percivale, both of which will provide communications and back-up offshore. Additionally, 40 junior officers of the Sierra Leone army have this week commenced training in Ghana with the British military and advisory team there.We anticipate that the intensive phase of initial training will be completed over the next two months. In the longer term, we will retain the lead in military training of the Sierra Leone army and in advising the Government of Sierra Leone on structures for the democratic accountability of that army. We will be deploying shortly the lead elements of a long-term training team of about 90 personnel, but their full deployment will depend on establishing a secure environment.
The second priority is to restore momentum to the peace process. Before the recent return to conflict, more than a third of the armed groups had entered into the disarmament process started by the Lome agreement. It is vital that the option of demilitarisation remains open to all those willing to lay down their arms. The United Kingdom is by far the largest donor to the peace process in Sierra Leone, and we have committed about £70 million from the development budget. We will be seeking further support from other donors, including the World Bank, to help match the resources required by the shattered economy and society of Sierra Leone.
The amnesty within the Lome agreement applied only to crimes committed before the date of its signature; it does not provide immunity for crimes committed in the recent conflict. The rebel leader, Foday Sankoh, is now under detention, and it is our view that he must remain so until he is brought to justice.
The third priority is to reduce the incentive which the illicit trade in diamonds has provided for armed conflict in Sierra Leone. Diamonds have fuelled the war. The people of Sierra Leone remain among the world's poorest while the wealth of its diamonds goes to rebels. In the medium term, the objective must be to bring the diamond area under the control of the Government and of the UN. In the meantime, we must take action outside Sierra Leone to regulate the trade in its diamonds. We are exploring with our partners in the Security Council our proposal for a UN resolution banning trade in diamonds from Sierra Leone except where that is certified as legitimate by the Government of Sierra Leone.
Any action to halt the flow of diamonds out of Sierra Leone and the flow of illicit weapons into Sierra Leone would have a much better prospect of success with the co-operation of neighbouring countries, especially Liberia. I regret to inform the House that there is continuing evidence establishing close links between the rebels in Sierra Leone and supporters in Liberia, and that Liberians are profiting from illegal diamond smuggling. We are consulting the United States and the European Commission on how we can jointly step up international pressure on Liberia to close down its links with the rebels.
The position in Sierra Leone has greatly improved in the month since my first statement to the House. British troops have made a big contribution to this turn-round. The House will want to record its appreciation of the professionalism with which they have carried out their duties and the commitment with which they have served in challenging circumstances.
However, there remains a long way yet to go before Sierra Leone is free from conflict. The best way that we can express our appreciation for the efforts of our troops is to make sure that we build on the gains that their presence has secured. We are determined to do so, and we will continue to make every realistic contribution that is open to Britain. Our objective is to ensure that the people of Sierra Leone are offered a realistic prospect of stability and peace and are freed from the violence of a brutal rebel minority.
Mr. Francis Maude (Horsham): I thank the Foreign Secretary for his statement. The House will want to join in congratulating our soldiers on their role. They have, as we have come to expect, discharged their duties with calm and distinction. As the right hon. Gentleman knows, we have been ready to support whatever tasks they might be asked to undertake.
Clearly, and as we would expect, the Government and the people of Sierra Leone have been extremely enthusiastic about the British presence. Will the right hon. Gentleman say what President Kabbah's view is about its effective military withdrawal, save for the continuing welcome training presence? In the light of his repeated statements that Britain will not let down Sierra Leone, is there not a danger that expectations about the duration and scope of the British military commitment were raised too high, and that as a consequence people in Sierra Leone will now feel let down?
Given that the United Nations mandate is not to defeat the Revolutionary United Front or take control of the diamond mining area, does the Foreign Secretary believe that the Sierra Leone army is now in a position to do either of those extremely important things? What is he doing to secure a change of mandate to one of peace enforcement?
In reality, the situation outside Freetown has barely improved, with Government forces suffering, we understand, setbacks in Lunsar and the area surrounding Kenema and Makeni. Was it really necessary for the rebuilding of the army that British weapons should have been supplied to so many child soldiers?
We would support any effective ban on diamond trading that cut off the RUF's life support. How does the Foreign Secretary square his proposal to the House today with the suggestion by the UN Secretary-General two weeks ago that he would effectively trade such an embargo for the detained UN peacekeepers? Given the news that a further group of UN peacekeepers may have been surrounded, does not the Foreign Secretary's initiative today cut across what Kofi Annan has already held out? Can he say a little more about how it would operate, given the fact, as he has mentioned, that most Sierra Leonean diamonds go out through Liberia or Burkina Faso, with the Liberian Government apparently taking some 80 per cent. of the proceeds of diamond trading from Sierra Leone?
Obviously, it is desirable that the legitimate Government of Sierra Leone are permitted to sell diamonds. That will be their lifeblood for creating a new durable civil order there. However, how will that be monitored in the light of evidence that the RUF is openly co-operating with pro-Government militias in towns such
as Kenema? How confident is the Foreign Secretary that the Belgian authorities, who are crucial in the matter, will co-operate with such an embargo? With Antwerp dominating that market, have they not been the major obstacle to any solution?The Foreign Secretary is suggesting that the active phase of British military involvement in Sierra Leone is drawing to an end, giving place to a longer-term and lower-key commitment. Will he agree to a full inquiry into the events that made that commitment necessary in the first place?
People especially need to know why Brigadier Richards was withdrawn in early April, apparently against the advice of both the Sierra Leonean Government and the British high commissioner. People want to know what the involvement was of the Foreign Office last summer in pressuring President Kabbah into pardoning Foday Sankoh from his death sentence and installing him as vice-president of the country, with full control of the diamond mines. Was that not a fatal error that set him free to return to the path of murderous exploitation, and which made it necessary to send in British troops?
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