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11 Nov 2009 : Column 122WH—continued
Jobcentre Plus has also continued to react promptly to events in Plymouth, and has ring-fenced £150,000 in rapid response service money to serve the needs of those made redundant in Plymouth, including the 270 redundancies announced at Toshiba between June and January this year. City College Plymouth has made Picquet barracks available for 20 weeks at a total cost of £30,000. Plymouth city council is contributing £9,900
to that and Jobcentre Plus is contributing £20,100. The barracks have been set up as an outreach centre for large redundancies.
My hon. Friend mentioned that Princess Yachts and Toshiba have both used that facility to ensure that a quick and effective service is provided to those involved in large-scale redundancies. The site will subsequently be used to provide a support service to unemployed customers. As a result of that prompt action, of the 139 ex-employees of Toshiba who made a claim to benefit, 73-more than half-found work within the first 10 weeks of their claim. We are not sticking with the status quo; we are investing in the future and introducing programmes to ensure that individuals and the country come out of the recession stronger, not weaker.
All this is part of the Government's national strategy to introduce measures to minimise the impact of the recession on unemployment as speedily as possible. The Government have increased funding to Jobcentre Plus by £3 billion to ensure it continues to provide personal help and advice to everyone who needs it. That money also ensures that the flexible new deal, which will provide tailored help for the long-term unemployed, can cater effectively for high volumes of jobseekers. On 12 January, a further £500 million investment was announced to provide, from April this year, opportunities for those who are still unemployed after six months to take up support.
We have also introduced the young person's guarantee, so that from early 2010 all young people approaching 12 months on jobseeker's allowance will be required to take up the offer of a job, training or meaningful activity. That offer will be delivered in the form of a new job created through the future jobs fund, or help with getting an existing job in a key employment sector, or work-focused training, or a place on a community task force delivering real help in the local community.
As part of that guarantee we have introduced the future jobs fund, which is worth around £1 billion, and to which local authorities and others may bid. It aims to create about 150,000 job opportunities, a significant proportion of which will be in areas of high unemployment. The fund will form a key component of the guaranteed offer to young people, and Jobcentre Plus will continue to meet the needs of Plymouth and the south-west. Today, my right hon. Friend the Minister for Employment and Welfare Reform, who is also the regional Minister for the South West, announced the 30 successful bids in the fourth wave of future jobs funding, which will create up to 7,200 jobs in England and Wales.
To date, the successful bidders have created about 95,000 jobs. In Plymouth, Wolseley Community Economic Development Trust was a successful bidder. Its work will
create up to 181 jobs in Plymouth with a range of roles, including youth work, administration, customer service, maintenance, horticulture, and learning and support. Those jobs are targeted at deprived neighbourhoods with young people working in those neighbourhoods, and contributing to public services such as health and care provision, and supporting third sector organisations. The trust is also working closely with Connexions staff to launch a new team to support the district young people's strategy. We are using the customer feedback gathered by Connexions as a part of its work with young people to develop a service that meets the needs of local young adults. Jobcentre Plus is fully committed to Backing Young Britain. The process for contacting employers endorsing Backing Young Britain is currently being designed and is due to be launched later this month.
My hon. Friend raised the important issue of green jobs. The Department is helping the growth of green jobs partly through the future jobs fund-the environment is one of the community benefits against which people may bid-and we have a fund to provide 100,000 jobs in key sectors. The green arena is one of those key sectors.
Linda Gilroy: Will my hon. Friend comment, as I asked, on whether employers, including in the green sector, are coming forward to provide opportunities for the future jobs fund and Backing Young Britain jobs?
Helen Goodman: My hon. Friend is right. This is partnership working, and we need employers to continue to make bids via local authorities. I hope they will do that to provide real jobs that have community benefits, are innovative, and provide good, quality experience so that people learn the skills that will be useful not just for the present, but as we come out of recession.
My hon. Friend spoke about pensions. The Government have made a commitment, which is enshrined in law, to restore the link between the basic state pension and earnings in 2012 or by the end of the next Parliament at the latest. State pension forecasts already include information to alert people to that change, and the effect that it may have on the amounts in their pension forecast. All requested pension forecasts include a specific flyer insert, and our web-based service provides specific links to further detailed information.
Both the Department and Plymouth have been extremely successful over the past 12 years. The Department has improved its services, helping millions of people into jobs and millions more to improve their job prospects. At the same time, Plymouth has grown and prospered, with increased employment and improved services.
Mr. Joe Benton (in the Chair): Order.
Female Mortality (Africa)
7.30 pm
Mr. Phil Willis (Harrogate and Knaresborough) (LD): Thank you very much indeed, Mr. Benton. This is the last debate of the day, and I thank you in advance for your chairmanship.
I am delighted to have an opportunity this evening to discuss a problem that I believe the Minister, his Department and the Government have taken seriously and on which we have a lot in common. I want to try to draw attention not only to the problems, but to some of the low-cost solutions that we can perhaps bring to bear.
In the UK, no woman in the advanced stages of labour would be expected to walk 30 km to receive medical treatment; that would be unacceptable. No woman in the UK would be allowed to die for the want of such basic medical treatment as a blood transfusion or a simple antibiotic to ward off infection. In the UK, fewer than 13 women die in childbirth for every 100,000 live births, but in Mozambique one woman dies in childbirth for every 100 live births. That is unacceptable, and to stand by and allow it to happen is simply not acceptable.
Every year around the world, 80 million women face an unwanted or unplanned pregnancy; 20 million women risk an unsafe abortion rather than carry their pregnancy to full term, and 68,000 women die as a result of botched abortions. Every year around the world, 50 million women suffer from a serious pregnancy-related illness and 4 million women are disabled as a result of pregnancy or childbirth. One woman dies every minute from problems related to pregnancy or childbirth. That is not to mention the many millions of women every year who are permanently disabled, left unable to walk or ostracised by their communities because of severe incontinence. The tragedy has reached such a scale that, in their recent report, Baroness Tonge and the all-party group on population, development and reproductive health questioned whether a significant number of the women affected by those problems would be better off dead. That is an incredibly sad thing to say.
However, the real tragedy is that 80 per cent. of these deaths result from one of the five well understood and relatively common obstetric complications that can be readily treated with existing and inexpensive medical or surgical interventions. They are: bleeding; infection; complications of abortion; high blood pressure associated with pregnancy, and prolonged or obstructed labour. All of those problems would be treated with standard simple medical solutions here in the UK.
What is the Department for International Development doing to help to resolve those problems? I put on record the fact that DFID should be congratulated on, and we should be proud of, the work that it has done so far. Its 2004 document, "Reducing maternal deaths: Evidence and action", is an excellent piece of work. It set international standards, establishing a clear strategy for tackling the tragedy and for meeting millennium development goal 5, which is:
"reducing mortality by three quarters between 1990 and 2015".
I understand that that strategy is being updated to take into account the fact that millennium development goal 5 has been amended to include an additional target to be achieved by 2015: universal access to reproductive
health care. I know also that DFID has been working closely with the Norwegian Government to produce an evidence paper that will set out the strategies that have been proven to work in improving maternal mortality rates on the ground. All of that work should be applauded.
A great deal more could still be done, however. At the current rate of progress, we will never meet millennium development goal 5-it will be beyond us. Maternal mortality in developing countries has barely decreased in the past decade, despite the efforts that our Government and others have made. In parts of Africa, maternal mortality and morbidity rates have increased. Some have argued that the targets are too ambitious, but they are not. We must question whether our response could be more effective; we need to heighten our work on the solutions rather than on the problems. There is evidence that it is possible dramatically to reduce maternal mortality rates relatively quickly. In three countries-in Egypt, Honduras and Yunnan in China-the maternal mortality rate has already been successfully reduced to about 100 deaths per 100,000. Honduras has reduced its rate by nearly 50 per cent. in the past seven years. Such changes are achievable.
The failure to mobilise world efforts to reduce maternal deaths stands in sharp contrast to the successful efforts of past decades to reduce child mortality and recent global efforts to tackle HIV and AIDS, tuberculosis and, of course, malaria. The relative lack of investment in reducing maternal mortality is deeply worrying when compared with the investment in tackling health problems such as major communicable diseases.
Maternal health has not had a high profile internationally, and the international conferences of 1987 and 1997 have not led to sustained action on the scale that is needed. The reduction of maternal mortality should be defined as both a human rights issue and a health issue. Almost all such deaths are avoidable and are rooted in inequality of access to care, which is a sign of a denial of women's rights. Maternal mortality rates reflect the greatest disparities between rich and poor and they are a good indicator of the extent to which a health system is rights-based. Indeed, DFID has gone so far as to say, in paragraph 63 of its 2004 report, "Reducing maternal deaths: Evidence and action", that
"maternal mortality can be considered as the best single indicator of the effectiveness of a country's health system."
Hallelujah! That is absolutely right.
Sadly, in many countries women's rights are consistently overlooked and ignored. In the UK, we do not consider women's health care to be a secondary priority; for that reason alone, we should take the lead on this issue internationally and redouble our efforts. In addition to the moral and ethical arguments, there is an economic argument. The USA has said that maternal and newborn mortality accounts for costs in lost productivity of $15 billion a year across the world. The death of a mother is a sharp and unpredictable shock to the livelihood of any household and is likely to deepen poverty. Few poor households are secure enough to absorb the loss of their most economically and socially active member, and every year as many as 2 million children are orphaned by the death of their mother. If we want the millennium development goals to mean something, we need to stop that travesty and see what concrete steps we can take to bring change.
In 1994, Thaddeus and Maine described the three delays that contribute to maternal mortality: delay associated with the decision to seek care, delay in arriving at the point of care and delay in the provision of adequate care. In my constituency, one small social enterprise company, eRanger, is attempting to tackle each of those delays with practical and low-cost solutions. Looking at the problem differently will give us the greatest breakthroughs. The eRanger company produces low-cost motorcycle-side trailer combinations that offer three customised options: an ambulance, a mobile clinic for outreach work and a mobile education unit. It utilises a robust 200-cc motorcycle with a custom-built, padded sidecar in which a patient can lie down and be safely strapped in. In an emergency, a nurse or midwife can travel behind the driver-
Mr. Joe Benton (in the Chair): Order. I am sorry to interrupt the hon. Gentleman, but there is a Division in the House.
7.39 pm
Sitting suspended for a Division in the House.
7.52 pm
Mr. Willis: As I was saying, the eRanger motorcycle, with its custom-built sidecar, can also take a doctor or nurse as a pillion passenger, if that level of support is needed.
The average cost of an eRanger ambulance is £4,000, which includes spares to allow smooth running for 12 to 18 months or 10,000 km. The vehicles are put together in South Africa; a local co-operative is used to build the cycles and sidecars. The price equates to about one sixth of the cost of a 4x4, and there is less opportunity for abuse by local workers. In other words, for every 4x4 operating as an emergency medical care vehicle in Africa, there could be six eRanger vehicles, reaching six times more women and potentially saving six times more lives.
The eRanger education unit is vital in teaching women about birth control, but the ambulance model has proved to be the most successful in combating female mortality. In August this year, UNICEF, recognising the very significant contribution that the eRanger ambulances made, signed a long-term agreement, for two years, to supply eRanger ambulances, mobile clinics and education units. So far, 22 ambulances have been delivered to Sierra Leone, and eRanger has an expected order for between 20 and 50 ambulances for Liberia. Since 2005, more than 400 eRangers have been deployed in Africa and Afghanistan. In 2004-05, DFID sponsored a pilot scheme in the Dowa district of Malawi using 21 bikes, and about 250 eRangers are now in operation in Malawi. The Minister of Health for Malawi plans to place a combination of eRangers in every single health centre in the country under community control. Largely as a result of eRanger presence and, indeed, the support of DFID, maternal mortality rates in Malawi have dropped by an incredible 60 per cent. since 2005.
Access to an eRanger motorcycle can ensure that a woman in labour gets to her "local" health centre. The drivers are on call using satellite mobile phones and can
get to most women extremely quickly, which can almost entirely remove delay 2 in Thaddeus and Maine's analysis. The motorbikes can also significantly contribute to the reduction of delay 1, associated with the decision to seek medical help. The education bikes can inform women of the medical treatment available to them, reassure them of its safety and remove the common perception that medical centres and hospitals are just places where people go to die. The fact that the journey is free, easy and safe also encourages many women to seek help rather than suffer in silence. Once at the medical centre, eRanger bikes can be a further help with delay 3. There are many reported cases in which blood transfusions or other supplies were needed at a medical centre, but there were simply not the resources to deliver them to the patient. The eRanger is an affordable way of solving the problem.
As demonstrated in Malawi and across Africa, the bikes can make a world of difference, so why are they not more widely used? What I seek today is a more active response from DFID. Despite DFID's encouragement of eRanger's work to date-I acknowledge that it has been supported-the organisation currently has no point of contact within DFID. It is difficult to understand where DFID is placing its effort in Africa, particularly in sub-Saharan Africa, without having a point of contact, yet that is something that could easily be achieved. The organisation has no interaction with DFID in the UK regarding planned or implemented projects that could benefit from using eRangers as part of a maternal mortality road map. The very thing that DFID says that it wants to do-I believe that it does want to do it-could be helped if there was some interface with what is a very small non-governmental organisation.
Unlike the agreement with UNICEF, there is no agreement with the Department to supply eRangers to DFID projects. It is extremely difficult to interface with organisations in Africa and Afghanistan unless one has a contact in DFID in those countries that will open doors. Although the Minister has given a pledge to supply those contacts, that arrangement does not appear to be in place at the moment. It seems that DFID will only interface with large, established NGOs, yet often it is organisations such as eRanger that can provide huge advances at a fraction of the cost.
In DFID's strategy document, the Department states:
"Effective communications and transport are critical to success...New solutions to reduce barriers are needed."
The eRanger organisation does exactly that. It has produced a low-cost solution to deliver the sorts of health care provision that we need. Clearly, eRanger is a solution that has been proven to reduce barriers, and I hope that the upcoming evidence paper will reflect that. It would be of great assistance if the Minister assured eRanger that it will have sight of the new updated paper as soon as it is published, and if he agreed to himself or his policy officials meeting myself and representatives of eRanger to discuss further engagement with DFID and how to combat the problem of maternal mortality internationally. In addition, will he commit to agreeing to supply eRangers on DFID projects, should the evidence paper find that that is a successful and economically viable intervention? If it does not, fair enough.
Finally, I place on record my thanks to the Minister and his officials for the impressive work that the Department
has carried out in this area. My plea is for him to go further, to think outside the box, not to reject small NGOs and to make a real difference to women who currently suffer needless pain and death. As Dr. Kiptu, the medical officer in charge of Magunga health centre in Kenya, states:
"It is not just making things better in the hospital-it is saving lives every day. God bless you for that."
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