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Comprehensive Spending Review
4. Andrew Gwynne (Denton and Reddish) (Lab): What impact he expects the comprehensive spending review to have on his Department’s future spending plans. [158520]
The Secretary of State for International Development (Mr. Douglas Alexander): With the increases in aid announced last week, Britain will deliver on the promises that we made at the Gleneagles summit in 2005 and make faster progress toward the millennium development goals. We will double aid to Africa, invest more in education and health, and increase our support for growth and good governance. We will strengthen cross-government work on climate change and conflict.
Andrew Gwynne: I am grateful to my right hon. Friend for that answer. Can he confirm that the settlement in the comprehensive spending review means that the United Kingdom is now on track to meet the commitment to spend 0.7 per cent. of gross national income by 2013 on aid, and that at least half of all new aid will go to Africa, as promised at Gleneagles?
Mr. Alexander: I can give the confirmation that my hon. Friend seeks—we are now on track to meet that 0.7 per cent. GNI commitment. We are the first Government in British history who have given a time scale by which we will meet the UN target, and we took a decisive and significant step toward that goal with the comprehensive spending review announced last week.
John Bercow (Buckingham) (Con): Given the right hon. Gentleman’s success in the spending round, will he confirm that the settlement that he secured will allow for the quadrupling of British aid to Burma, including provision for increased cross-border assistance, backing for the Shan Women’s Action Network and other women’s groups, and funds to assist the worthwhile and valuable efforts of exiled pro-democracy groups—all of which have been recommended by the International Development Committee?
Mr. Alexander:
Let me begin by paying tribute to the work of the International Development Committee on this issue and, of course, to the high-profile role that the hon. Gentleman has taken on it. I gave very serious consideration to the recommendations of the IDC report
in the summer, and I made sure that there was a carefully drafted response that reflected my determination that there should be a significant increase in the work that we are doing in this area. In addition to the terms of the report and the Government response, we have committed £1 million more toward the immediate humanitarian challenges facing Burma, in the light of the terrible events that we have witnessed in recent weeks.
Sustainable Forestry
5. Paddy Tipping (Sherwood) (Lab): What steps he is taking to help develop sustainable forestry in Africa. [158521]
The Parliamentary Under-Secretary of State for International Development (Mr. Gareth Thomas): We are committing over £70 million for sustainable forestry in Africa, including £50 million for the Congo basin forest, to help improve governance, reduce deforestation and safeguard the livelihoods of poor people.
Paddy Tipping: Does the Minister accept that although biofuels can help to combat climate change, unless they are introduced in a planned and sustainable way, natural habitat and forestry will be destroyed? What analysis has he made of the problem, and what steps will he take to resolve them?
Mr. Thomas: I share my hon. Friend’s view that biofuels have an important contribution to make in tackling the impacts of climate change. He is right to say that the increase in interest in biofuels needs to be managed in a sustainable way. We are working with a range of partners, including the World Bank and the African Development Bank, to look at exactly this issue.
Derek Wyatt (Sittingbourne and Sheppey) (Lab): The Chinese are almost raping the forests in Gabon. What representation have this Government and the EU made to the Chinese authorities about the way in which they are abusing their mineral and forestry rights in Gabon?
Mr. Thomas: My hon. Friend may not know, but we have been working closely through the European Union with a number of countries, including China, to address how we can improve governance of forests and conservation and reduce the rate of deforestation. UK representatives attended a conference at Beijing to look at exactly this issue, and to see how we can develop that relationship with the Chinese still further.
Zimbabwe
6. Mr. Shailesh Vara (North-West Cambridgeshire) (Con): If he will make a statement on the humanitarian situation in Zimbabwe. [158522]
7. Mr. David Evennett (Bexleyheath and Crayford) (Con): If he will make a statement on the humanitarian situation in Zimbabwe. [158523]
The Secretary of State for International Development (Mr. Douglas Alexander):
The situation in Zimbabwe continues to deteriorate as a result of the appalling corruption and wilful mismanagement of the Mugabe
regime. We are, however, making a major contribution to humanitarian relief and working to protect the people of Zimbabwe from the worst effects of hunger and HIV.
Mr. Vara: I thank the Secretary of State for those comments. Given that more than 3,000 people die of HIV/AIDS in Zimbabwe every week, does he agree with me that the measure of success is not how much money is spent, but the number of people protected from infection and the number treated? Given those circumstances, what is he doing to ensure that British aid money is used to maximum benefit?
Mr. Alexander: On the specific issue that the hon. Gentleman raises, we are providing HIV treatment to 50,000 people in Zimbabwe this year and helping to keep AIDS-affected children in school. Clearly, this is a hugely challenging environment in which to be working at the moment—significant migration out of the country is taking place, its Government are in a relative state of collapse and its economy is diminishing almost by the day—but I assure hon. Members that we are determined to continue to provide humanitarian support, today and tomorrow, to the people of Zimbabwe.
Mr. Evennett: Has the Secretary of State seen the recently published report by Save the Children, which highlighted the plight of unaccompanied children, some as young as seven years old, crossing the border from Zimbabwe to South Africa? What is his Department doing about that? Has he had any discussion with the South African Government about that important issue?
Mr. Alexander: I assure the hon. Gentleman that through various different channels we are in regular contact with the South African Government on those issues. It is clear that Zimbabwe no longer represents simply a challenge or the humanitarian crisis of one country; given the outflow of migrants, be they children or older people, it is a crisis for the entire region. I pay tribute to the work of the Independent Television News broadcasting organisation, for bringing the plight of those children to the wider attention of the British public in recent years, and to Save the Children. I assure the hon. Gentleman that we continue to work closely with regional partners, including South Africa, to ensure that our humanitarian effort is targeted towards those most in need. Indeed, we have in recent weeks announced £8 million more for the World Food Programme to try to address the hunger needs of such populations.
Prime Minister
The Prime Minister was asked—
Engagements
Q1. [158502] Mr. Graham Brady (Altrincham and Sale, West) (Con): If he will list his official engagements for Wednesday 17 October.
The Prime Minister (Mr. Gordon Brown): This morning, I had meetings with ministerial colleagues and others, and in addition to my duties in the House, I shall have further such meetings later today.
Mr. Brady: The owner of a local small business wrote to me yesterday, saying:
“I was made redundant...and started my own small business...I am approaching retirement and was hoping the sale would help support my pension which has already reduced by...the raid on pensions made by Gordon Brown.”— [Interruption.]
Mr. Speaker: Order. Let the hon. Gentleman speak.
Mr. Brady: Under the new tax rules, my constituent’s tax bill will rise from £2,520 to £9,504. Can the Prime Minister tell him what he has done wrong and why he is being penalised?
The Prime Minister: We have cut capital gains tax from 40 per cent. since 1997, when the Tories were in power. We have, as the Leader of the Opposition acknowledges, the most successful economy. We have created 2.5 million jobs, unemployment is down today, and businesses are thriving.
Anne Snelgrove (South Swindon) (Lab): My right hon. Friend will be aware that last Saturday marked the anniversary of the collapse of Farepak, in which 122,000 small savers were robbed of their money. I have just met the administrator, who tells me that she is unlikely to pay back any money before Christmas this year. In addition, none of the reports will be made public under law. Would he be prepared to meet me and my hon. Friend the Member for Livingston (Mr. Devine) to discuss how we can speed up the process and get justice for the victims of Farepak?
The Prime Minister: What happened to Farepak was completely unacceptable. We have worked very closely with all those people who have lost money as a result of Farepak and we will continue to do so. I will be very happy to meet my hon. Friend and any other hon. Members who are concerned about Farepak so that justice is done.
Mr. David Cameron (Witney) (Con): In the past four years, the number of people who have died from the hospital-acquired infection clostridium difficile has trebled. Ninety patients died in one hospital trust alone. The Healthcare Commission said last week:
“where trusts...are under severe pressure to meet targets relating to finance and access, concern for infection control may be undermined.”
Will the Prime Minister now accept that the number and extent of his top-down targets are contributing to this problem?
The Prime Minister: It is because we are concerned about MRSA and C. difficile that in the past few weeks we have taken very special measures: isolation wards; we are about to appoint 3,000 more matrons; and we are about to do a deep clean of hospitals. The right hon. Gentleman raises the issue of targets and cites the Healthcare Commission, so let me quote to him what its chairman, Sir Ian Kennedy, has said:
“Targets or their equivalent are an inevitable feature of a modern 21st century healthcare system...The obligation to meet targets cannot be used as an excuse for failing to meet other managerial objectives.”
He also says—and I hope that the Leader of the Opposition will take this into account—
“targets are not to blame for the trust leaders taking their eye off the ball.”
“Managers always have to deal with conflicting priorities and plenty of organisations...do it successfully.”
In other words, it is not targets that are to blame. We have got to invest in the health service. Will he invest in the health service as we will?
Mr. Cameron: It is clear that the Prime Minister has not read the Healthcare Commission report. The report could not be clearer. On the Maidstone hospital, it says:
“senior managers were...reluctant to implement major infection control measures”
because of the need to meet targets. It was not just that one hospital. The report on Stoke Mandeville said:
“The achievement of the Government’s targets was seen as more important than the management of the clinical risk inherent in C. difficile. This was a significant failing.”
Almost one in two hospitals agrees that targets are getting in the way of infection control. The National Audit Office and the Public Accounts Committee both agree. What makes the Prime Minister think that he is right and they are wrong?
The Prime Minister: The right hon. Gentleman has not done his research. Targets are responsible for waiting lists, which were at a quarter of a million, being almost zero for those people at six months. Targets are responsible for a 17 per cent. fall in heart disease. Targets are responsible for a 40 per cent. fall in coronary disease.
The right hon. Gentleman quotes the Healthcare Commission. I have quoted Sir Ian Kennedy, who is its chairman, saying that targets are not to blame. Let me also quote the new chief executive of Maidstone and Tunbridge Wells NHS trust. He said:
“targets are there for a reason but that should not stop us from focusing majorly on patient safety, that is the number one priority”.
The Leader of the Opposition should recognise that the reason we can invest more in tackling MRSA and C. difficile is that we are spending more money on the health service. He voted against that spending.
Mr. Cameron: The Prime Minister— [ Interruption. ]
Mr. Cameron: The Prime Minister came to office saying— [ Interruption. ]
Mr. Speaker: Order. I hope that the hon. Member for Dudley, North (Mr. Austin) will not keep shouting. You have a difficulty in Prime Minister’s questions because you keep shouting. You should not do it.
Mr. Cameron: It comes to something when you have to tick off the Prime Minister’s Parliamentary Private Secretary, Mr. Speaker.
The Prime Minister said that he would listen to people, but he is not listening to those working in the NHS. The Healthcare Commission quotes one senior manager saying that
“if anyone says the top priorities aren’t money and targets, they are lying”.
The nurse of the year, who resigned today, says that she is leaving because of bureaucracy, reorganisation and paperwork.
MRSA deaths have quadrupled. C. difficile deaths have trebled. If we are going to deal with hospital-acquired infections, does not the Prime Minister understand that he has got to listen to the people who work in the NHS?
The Prime Minister: It is precisely because I have been listening to the British people that we have put an extra £100 million into tackling MRSA and C. difficile. It is precisely because we are listening that since I took over this job we are now insisting that every patient who comes to hospital will be screened against the possibility of MRSA. It is precisely because we are listening that we are going to do a deep clean of hospital wards. It is precisely because I am listening that we are going to double the number of matrons.
None of that extra expenditure would be possible if we accepted the Conservative party’s plans on spending. It has a £6 billion black hole in its spending plans, which would mean deep cuts in the national health service. The Leader of the Opposition should listen to the experts on this matter, who are saying that targets are not to blame. We need investment and reform in the health service, and only we on this side of the House can do it.
Mr. Cameron: If the Prime Minister wants to ask me questions, he should call an election. In the meantime, he says that this is all about how much he listens, so let us ask about the other important issue of this week and whether he is listening. His manifesto promised a referendum on the European constitution. The overwhelming majority of people in this country want a referendum on the European constitution. European leaders, the European Scrutiny Committee and his own representative on the European Convention all say that the new treaty is the same as the constitution. Will he tell us why will he not grant a referendum on that constitution?
The Prime Minister: I see that the right hon. Gentleman has given up on the health service now. Let us come to the European issue.
In 1992, every member of that shadow Cabinet refused a referendum on a far more significant treaty. The Foreign Secretary voted against a referendum on Maastricht. Why is this treaty different? It is different because it is not a constitutional treaty; it is an amending treaty. Why is it different? It is different because we won a protocol in the charter of rights, we got an opt-in on justice and home affairs, we got an emergency brake on social security, and we have exempted the security issues. All those changes have been brought about in the past few months, and that is why not one Government in Europe—apart from the one in Ireland, who are bound constitutionally to have a referendum on anything—are proposing a referendum on this treaty. Just as those on the Conservative Front Bench voted against a referendum in 1992, they should have the honesty to vote against it now. [Interruption.]
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