On a point of order, Mr. Hancock. I am sorry to bring this to your attention but there was a minor degree of panic, in that there was no Opposition spokesman for this debate. There is a misprint on the front of the Order Paper today—it says that this debate should take place between 10 o'clock and half-past 11; of course, it should say that it will begin at 11 o'clock. I do not wish to be picky about this, but we need to get these things right.
It is a delight to be able to introduce this debate under your chairmanship, Mr. Hancock.
It is quite unusual for a Member of Parliament to decide to spend three weeks of August in a country that they have never visited before. I had read about Sierra Leone and taken part in debates in the House on it, but I decided to get more involved. I was able to do so via a new scheme run by Voluntary Service Overseas called Volpol, which allows Members of Parliament to immerse themselves as other volunteers would in countries in which VSO is present. It was an amazing experience—one that I shall never forget.
I am delighted that my hon. Friend the Minister is replying to the debate. I had enormous respect for him in his previous role and I know that he will be a great champion for Britain and its development work in the world. I am looking forward to hearing his response to my remarks on some of the things that I found Sierra Leone, and the fact that I would like to see that work continue. I believe that the work is valuable and that it is making progress in that country.
Sometimes, we feel a little bit guilty when we do things outside our constituency, but my largest regular postbag from people in my constituency contains letters from those who care about the poverty of some overseas people and the conditions in which they have to live. It was with that in mind that I felt able to travel and work there for three weeks in August. I should like to pay tribute to Dawn Powell, one of my constituents. She is a tireless campaigner on world poverty, and never stops beating a path to my door to tell me to encourage the Government to do more. Nevertheless, it is widely recognised that the Government have done more than any previous Government to develop the way in which we engage with the rest of the world—we need to have that on the record before we go further.
Most people will have seen the old Bounty bar advert in which a gorgeous girl bites into a Bounty bar on the most fabulous beach in the world. That advert was made in Sierra Leone. It should be paradise, but in fact it is hell. It is hell for women who deliver babies—it is the most dangerous place in the world to have a baby. Mothers are also likely to lose children to a preventable disease such as malaria; one in four children dies that way. Health care is almost non-existent, and what there is has to be paid for. People have to scrimp and scrape to save someone who might be the person who earns a living for the family. The nation was born in what should have been a fantastic spirit of freedom from the slave trade—the capital is called Freetown—but it has become one of the most difficult places on earth to live. That is why I wanted to go. I felt that there was no point in taking part in a programme such as Volpol unless I was going to engage fully in the things that other people immerse themselves in.
Of course, the country has seen the horror of a war that lasted for more than a decade. The effects are apparent everywhere. Roads and buildings have been destroyed, and infrastructure no longer exists for most people. Day-to-day living in Sierra Leone is difficult, which is why I was delighted that VSO went back into the country following the war. The organisation works not in countries where there is strife or difficulty, but in places where it can build capacity and work with people to develop their skills. In just three short years, the organisation has done an amazing job.
I want to focus on the work of VSO and the Department for International Development—many other aid organisations are doing fantastic work in Sierra Leone—because you will be very cross with me, Mr. Hancock, if I do not focus on issues that directly relate to the Government. DFID is the major donor to VSO— £28 million of the £40 million it receives comes directly from the Government. I should like to demonstrate why I believe that that is good value for money. The organisation uses its resources to procure skills, and not only in the UK. Amazingly, although most are from the UK, volunteers come from around the world. Those volunteers could earn thousands of pounds here working as consultants, for example, but they do not. Instead, they get only a stipend, and go to live and work in the community that they are trying to develop. They become immersed in the culture, thereby gaining the strength and the commitment of people who, on the whole, feel utterly hopeless about the conditions in which they have to live. The volunteers learn to lift those people's spirits and skills to a level that allows VSO to walk away and say that those people are able to get on with the job themselves. That is what is spectacular about their work.
I should like to pay tribute to those fantastic volunteers. I was slightly worried that I would be unable to live up to their fantastic reputation, being a lowly Member of Parliament, and I probably did not do so most of the time. The volunteers truly were amazing people, dedicated to their work, and a credit to this country. It was impossible to walk down the high street in Freetown without people asking whether I was from the UK or from VSO, so people have a real sense that we are doing good work in the country.
I wanted to focus on nursing and nurse education, because that was my profession. The needs of Sierra Leone are overwhelming, so it was vital that I stuck to that one aspect. What patients have to endure, day in, day out, in the Connaught hospital in Freetown—it is the major hospital—is appalling, but what nurses and nurses in training have to endure made me break down in tears in the first week. Those dedicated people have little or no equipment to work with, or leadership, and although they tried their best, and were paying to become nurses, they were faced a most difficult task. We often complain in the UK. I talk to student nurses here all the time about what is happening in their lives but frankly, having seen those students in Sierra Leone, I can say that we have absolutely no idea of how difficult things can be.
I also felt it necessary to talk to all the other aid agencies in the country. The United Nations is pulling out bit by bit because the emergency situation is relaxing, and World Health Organisation officials are there in numbers, but the most impressive organisation that I found in the country was DFID. I was utterly impressed with Joanna Reid, who does an amazing job developing a child and maternal health strategy to ensure that the system has capacity, so that not as many children are lost and not as many women die in childbirth. Listening to the day-to-day stories of the struggle to build capacity in the health and sanitation department was amazing. I am utterly in awe of the quiet and steady work that Joanna Reid did. The work was not easy and not many people hear about it, but I want to ensure that the work being done out there is properly recognised in the House.
I am sure that the Minister will be kind enough to tell us about the sums that are involved. Although I was given an indication of the spend in Sierra Leone, that is not the only issue; it is about helping those who are working in the Department to lift their game, so that they use the money effectively and ensure that it does not get lost in the system or go missing through corruption.
It was such a struggle to see the work going on in Sierra Leone, but it was excellent work and I have a huge admiration for it. It is okay for someone such as me to skip in for three weeks and then walk away—although I have no intention of walking away from those fantastic nurses in Sierra Leone—and quite another to work day in, day out with the huge structural problems of Sierra Leone.
With its little office in the heart of Freetown, VSO looks after its volunteers very well. During our stay in the country, we lived with the volunteers. There were no grand hotels in which to stay. The visit was about immersing Members of Parliament in the work. Eleven of us were working in nine different countries over the summer. I felt that the best thing that I could do was to support those who were trying to provide a decent education for the nurses in Freetown.
I was working on the day that the student nurses' exam results came out. I was amazed because, overwhelmingly, they had passed. Those students had no equipment. They did not even have the equipment to take someone's temperature or blood pressure, or to raise a bed properly. They did not even have proper pillows to make patients comfortable, and yet, through their dedication in reading their textbooks, they learned how to nurse. I, like others in Sierra Leone, want to assist those nurses to ensure that they have the equipment to do their work.
I was so impressed with Matron Thomas, who was looking after me in the Connaught hospital. She was a truly formidable matron. She reminded me of the matrons who were about when I was doing my training decades ago. All the nurses respected her tremendously because she was doing such a fantastic job.
I thank the hon. Gentleman for that because I might have given the impression that it is all absolute disaster, but it is not. Those elections last year were a tremendous success. They were peaceful and everyone was greatly relieved by that. A huge amount of development work is happening. The newly elected Members of Parliament and the President are working to ensure that those who are in positions of power can govern in a fair and honest way. Although the little contretemps that we have in the UK are replicated in Sierra Leone, the system, on the whole, is well supported. The potential to improve is massive. Real opportunities exist, which is why I initiated the debate today. I want to ensure that the UK remains engaged with Sierra Leone. I believe that we have a responsibility to the country, and I want to ensure that we stay there and continue with the fantastic work.
Let me return to the work that I did in the country. I was most impressed with Dr. Etam-Hoteh, who lives in London but who was asked to take on the job of dean in the faculty of nursing. He took a sabbatical from his own top-level NHS job in the UK to go to Sierra Leone to do the work—for no pay whatever. He is doing an immensely worthwhile job as he licks that school of nursing into shape. We would love to see our nurse education being delivered in the same way. I ask DFID to consider supporting that post. I believe that if we support those who have the ability to give lots of information and skills to many people, that is an effective use of UK money. Supporting that one man as dean of the faculty would mean that he could oversee the education of 200 nurses in training. He could increase nurses' abilities and clinical skills, and improve the health in Sierra Leone. That is the crux of my debate. I have written to my right hon. Friend the Secretary of State to see whether it is possible to support the post, because I believe that enormous strides could be taken in the teaching hospital in Freetown.
My plea is that we stay in Sierra Leone and continue with the tremendous development work that is going on. We should support VSO, which is doing an amazing job of transferring skills from the UK to Sierra Leone. Even if such transfers are for a short time only, it will help. Short placements are a great idea. Clinical tutors who go to the country for a month to give specialist education to nurses would be incredibly valuable. Recent changes from the Department of Health mean that people's pensions and contributions can continue to be paid while they volunteer. That is such a good move, allowing skills to be shared around the world. It ensures that other countries can benefit from fantastic technological advances and a world-class health service.
I am delighted to appear under your chairmanship, Mr. Hancock—I think that it is the first time. As this is my parliamentary debut in this brief, I can think of no better person to debate with than my hon. Friend Laura Moffatt. I reciprocate her very kind remarks; it was a great privilege to work with her at the Department of Health. We both feel that we contributed towards the significant progress in reforming and improving the NHS.
I pay tribute to my hon. Friend for making the decision to spend some of her summer finding out the challenges that ordinary people—people on the front line and our employees—face on a day-to-day basis in a country such as Sierra Leone. When we have debates in the House, it is important that, wherever possible, they are informed and that hon. Members have experienced the realities on the ground. Such experience gives us a unique insight and capacity to shape and influence the development of parliamentary debate and, more importantly in this context, Government policy.
I thank my hon. Friend making the decision to go to Sierra Leone. The feedback that we have from VSO and from the project at which she worked suggests that she would be more than welcome to return. She made a tremendous commitment while she was there. Her nursing expertise and professionalism were very relevant and useful. The fact that she has committed herself to continuing that involvement with those projects will be a source of great comfort to the people involved.
It is also important to pay tribute to VSO. The organisation provides opportunities for a whole range of people, including many of our constituents, to go out there and contribute. We know that we live in a shrinking world and an increasingly interdependent world. As my hon. Friend said, people such as Dawn Powell who visit her in her surgery, and others in my constituency, care and are passionate about the importance of this country's leadership role in addressing poverty and inequality in the developing world.
In any debate about the kind of society that we live in—we are often told that we live in a broken society—we may forget that there are hundreds of thousands of people who in one way or another care enough about another individual or another part of the world to want to make a difference and a contribution. I echo what my hon. Friend said about that. That army of people such as Dawn Powell—the fact that we have such domestic support—is incredibly important to the Government's ability to take a leadership role in the world on such issues. I discovered only recently that 10 million people bought one of the wristbands that were part of the Make Poverty History campaign—a massive number of people who made a positive choice and said "This really matters to me, my family, and my country."
We can be very proud of the fact that, as my hon. Friend was good enough to say, addressing poverty is a moral mission on which the Government have chosen to provide leadership around the world. The Prime Minister has also shown personal moral leadership; he has made poverty one of his top policy priorities at home and abroad. In my short time in my job, I have found that that is reflected in the reputation of the Government and the Department for International Development in the developing world, which should be a source of great pride to this country. We can have debates about foreign policy and this country's reputation and how it is perceived in different parts of the world, but if one goes to the developing world, one will find time and again in countries where we are active and involved that when it comes to agencies making a difference, the DFID brand is the most positive.
Non-governmental organisations also play a crucial role; it is a question of partnership involving the Government and other Governments around the world. Of course, it is not only the fact that we provide aid and run programmes, but the fact that we have banged the table in international institutions and demanded that the world step up to the mark and take responsibility, that has an effect; and it is a matter not just of individual nation states or consortiums of nation states or multilateral institutions, but of the voluntary sector and the contribution of NGOs in this country. My hon. Friend referred to that fact.
In the end, we need to be about the business of empowering and enabling the people in the relevant countries—their Governments, professionals, project leaders and ordinary people—to help those countries to develop through aid, economic growth, tackling the scourge of HIV/AIDS and making sure that people have access to universal primary education and health services. Our job, essentially, if it is to be sustainable, is to support those countries with confidence, knowledge, skills, systems and structures, so that we can feel that our aid is about enabling and supporting them to rebuild, often in incredibly difficult circumstances, such as those in Sierra Leone.
The Minister may be interested to know that the Conservative party this summer took 100 people to Rwanda, entirely in their own time and at their own expense, and will be taking 200 people next year to take part in such programmes.
My question is about the fact that the UK has a 10-year memorandum of understanding, and a considerable amount of money is going to Sierra Leone, which has one of the poorest poverty indices of any country on the planet. The International Monetary Fund also gives a considerable amount of money for poverty reduction, and has been critical about the rate of progress in reducing poverty in Sierra Leone. How is DFID getting on in that respect?
I welcome the fact that the Conservative party is sending people to experience and contribute in the developing world. That is a good thing and Members on both sides of the House would applaud it.
To deal specifically with the hon. Gentleman's question about poverty reduction, we have been providing poverty reduction budget support to Sierra Leone since 2002. Our annual contribution is between £10 million and £13 million. That support is given alongside that of other donors in Sierra Leone: the World Bank, the European Community and the African Development Bank. The provision of budget support since the end of the war was not without risks, but it secured macro-economic stability, without which peace would have been much more difficult to achieve. Alongside that poverty reduction spending by the Government has been protected, and the Government have made significant progress in improving their financial management systems, albeit from a low base. We are reviewing how to maximise the impact of providing budget support as we look across the programme of support for the next five years.
When we analyse progress, we must consider the baseline. Sierra Leone started in a dreadful place. As a result of the aid that we have provided and the commitment from some sections of the leadership in that country, which has a new Administration, we must acknowledge the progress that has been made, compared with the situation only a relatively short time ago. The country has only recently emerged from 10 years of brutal conflict, as Mr. Clifton-Brown is fully aware. My hon. Friend the Member for Crawley referred to the recent elections; they were an example to the rest of Africa—and we in this House all know of recent concerns about electoral situations in Africa. However, we are not complacent, and our message to Sierra Leone, in discussions with its Government, is that progress must be sustained.
The challenge now is to fulfil the country's rich economic potential, and to achieve the millennium development goals, particularly in relation to its appalling health indicators, which, as the hon. Member for Cotswold said, are among the worst in the world. My hon. Friend the Member for Crawley will be interested in that point. In a sense we need, in our approach to Sierra Leone, to go from the point of view that the country has done well in an impossible situation to expecting more. We need high aspirations for the aid that we and others give, and for the democratic institutions that now exist. Those are not without problems; we still have concerns about corruption in the country, and we are dealing with them. We must do more than say simply that in difficult circumstances there has been stability. We must move from stability to real progress.
Peace, security and stability: that is a great success story. There will be a long-term commitment from this country, but it is related to an expectation that there should be strong, accountable institutions, and that tackling corruption is non-negotiable. We shall be keeping our eye on the ball with respect to the importance of the country's getting back on track to achieve the millennium development goals by 2015. At the moment Sierra Leone is, on any projection, going to miss all those targets and goals. We shall expect urgent action to get back on track. We are particularly concerned, as we should be in any society, about the fact that child and maternal health indicators are among the worst in the world. I hope that my hon. Friend, with her experience, will be able to help me to think about some of the practical, tangible measures that we can take that could make a difference. She referred to the tremendous work of Joanna Reid, which we want to support, and the role played by Dr. Hoteh. I cannot, much as I should like to, give a cast-iron commitment today on providing practical assistance to him, but I shall certainly look into the issue.
We also need the Sierra Leone Government to raise more revenues of their own, and rapidly to implement a comprehensive public sector reform programme. We need to ensure that the anti-corruption commission, which we now believe is, after a period of great concern, well led, will genuinely become an effective institution.
I again congratulate my hon. Friend on going out to see Sierra Leone for herself. Our commitment to Sierra Leone is cast iron and authentic, but we want to move on from being satisfied that it is a stable country that has done well in difficult circumstances; we want it to raise its aspirations and ambitions, so that its people can have the quality of life that so many people in this country take for granted.