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Healthcare Development: International Partnerships

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.

3.36pm