HC Deb 04 July 1979 vol 969 cc1520-30

Motion made, and Question proposed, That this House do now adjourn.—[Lord James Douglas-Hamilton.]

10.50 p.m.

Miss Betty Boothroyd (West Bromwich, West)

If he looks at the declaration of the rights of the child, will the Minister find, as I do, that it is hard to see which, if any, of its principles will be implemented? I can think of few greater impediments to their fulfilment than the growth in population. It is probably the greatest impediment of all.

Demographers throughout the world have produced terrifying figures indicating that the world's population will grow at the rate of nearly 2 million children each week over the next 20 years. That means an additional 100 million children each year, all with the basic needs for food, clothing, shelter, pure water and health care. It is a daunting prospect. Equally daunting is the fact that the majority of that growth takes place in the less developed countries, where already about 80 per cent. of the world's children live, and where poverty exists in its various forms.

Incredible as it may seem, about 1,200 million children cannot read or write, and for millions there are no schools. Such children grow up knowing no freedom from want. Words such as "progress", "democracy" and "achievement" are meaningless to them. Unless we can improve their status we shall deny them the fundamental right to become useful members of society, and they will be unable to develop their individual abilities.

Ignorance brings poverty, too. Although malnutrition and disease are child killers, according to social indicators 300 million children today are kept alive by the barest minimum of food, and their bodies and minds become stunted, as they exist in a state of hunger from birth until they die. Their rights are nullified, because children starving to death have no rights under any international code of conduct.

A most revealing statement was made two weeks ago in a broadcast from Calcutta, when a nun in the Mother Teresa clinic there said: Many women in Calcutta throw away their children or kill them at birth because they are not wanted. The interviewer could not believe it. He asked her three times, and three times the nun repeated the same statement. No one who has seen Calcutta can fail to acknowledge that the sight of poverty there not only shocks the mind but invades the heart.

In many countries the infant mortality rate is far too high. The reality behind the cold figures is that in a family of five one child dies before it can reach its first birthday. High mortality encourages larger families, because parents who expect children to die have more children as an insurance policy against their own old age.

If we want the programme for the International Year of the Child to succeed. spasmodic relief, valuable as it is in some instances, is not the answer. It is like taking a sleeping pill. We have to find long-term remedies that take the population factor into account as well as the need that exists for family planning activities. It has to mean more than contraception. Fertility regulation programmes become effective only when life expectation and living standards have also risen. The first need is to relieve poverty and to create a social framework conducive to fertility regulation.

One of the long-term remedies lies in assistance for the provision of primary health services to aid the reduction in infant mortality rates, to go further in assisting preventive health care, family planning work and the reduction in the loss of young lives from diseases that are curable if only they are tackled.

About a year ago, I had the opportunity to see at first hand work going on in a health centre in a rural area of India. A good deal of the money had been made available from United Kingdom sources. I visited a sub-centre, where the health worker had prepared a short report on the use of vaccine in preventive medicine. His report said: The vaccine is kept at the health centre in a refrigerator and is carried to the sub-centre in a thermos flask by a man 20 kilometres along a pucca road, Neither you nor I, Mr. Deputy Speaker, would acknowledge that it is a pukka road. The report added: A refrigerator is not available at the sub-centre and afterwards he carries the quantity back in a thermos flask and returns the unused vials. In case there is immediate need, it is brought quickly by a horse conveyance. At times, the subcentre cannot return unused vaccine in vials. Then a pitcher is kept in a wooden case surrounded by sand. The pitcher's mouth is covered by a gauze piece. The sand is soaked with water and all is kept in a dark place. I quote this report to show that with little opportunity, there is initiative and a real desire to do a job in preventive medicine. The sub-centre is responsible for the health of 94,000 people. There are two health workers, who have had three months' training. To have a doctor is beyond their wildest dreams. Their attainable aim is one trained worker per thousand of the population. The eradication of diseases that are curable, the spreading of knowledge and the avoidance of disease make it possible for those children who are born to be planned for, to be wanted and to be cared for. That is surely the object of the United Nations declaration.

Programmes need to be encouraged to assist the urban and the rural poor to increase their productivity and their income. Over the past few years the World Bank has initiated programmes which confirm that development projects have doubled the income, particularly of rural families. The experience shows that appropriate technology, which makes plentiful use of the surplus labour available, and economic use of scarce capital provide increased family income. This leads to an improved standard of living for families and for children. By reducing poverty, the attendant fertility is also reduced, which is another objective.

The key factor in providing the child's basic needs lies in improving the status of women, particularly in the less developed parts of the world.

Two-thirds of the world's 800 million illiterates are women. Where they are isolated in their families, where they lack opportunities, where they are blocked by illiteracy from involvement in and contact with a larger society, their means of fulfilling their own lives are so narrow that childbearing stands out as the only alternative they have.

But there is evidence that where women participate in programmes aimed at expanding their basic education, increasing their knowledge and instruction about child care and nutrition, and where they have access to knowledge and family planning techniques, they have fewer children and the children that they have are healthier and live longer, and receive improved care throughout their childhood.

It is obvious that malnourished and illiterate mothers give birth to weak and unhealthy infants. Greater resources are needed to enhance the status of women in a variety of ways. Other Governments should be encouraged to introduce legislation about marriage and women's rights to ensure that better prospects exist for today's children in this International Year of the Child—for they are tomorrow's parents.

The United Nations estimates that about $500 million a year, from all sources, private and governmental, is spent on population activities throughout the world. Would the Minister make many people happy by agreeing that it would be a good idea for the Government to take a lead in urging the international community to aim at a target of, let us say. $1 billion over the next five years so that the United Nations can have a cohesive programme of population activities, thereby implementing the point in the declaration of the rights of the child-It would be splendid if, in the International Year of the Child, the Government could give that lead.

Can the Minister confirm my information that in 1977 £5- ½ million of aid by this country was spent on population activities, which is the equivalent of only 1 per cent. of our total aid budget? I believe that the survey for 1978 is not yet completed, but it seems that about £8 million or £9 million was devoted last year to this programme. If so, that is a grati- fying and sizeable increase and I hope it will continue.

I seek an assurance that aid for population activities will not be reduced. I go further, and ask for a firm indication that the finance to be made available over the next few years will be increased. It would be tragic at this time if we did not acknowledge that the condition and future of the world's children is inseparably linked with the peace and prosperity of tomorrow's world, and if, particularly now that we are halfway through the International Year of the Child, we did not show by our deeds, rather than by words alone, our intention of reaching the objectives in that declaration.

11.5 p.m.

The Minister of State, Foreign and Commonwealth Office (Mr. Neil Marten)

I congratulate the hon. Member for West Bromwich, West (Miss Boothroyd) on having secured the Adjournment debate and on having chosen this subject, which I know, from past experience, is very dear to her heart. She, like me, has travelled, thanks sometimes to the Commonwealth Parliamentary Association, on our delegations to overseas countries. We have seen what she so graphically described tonight.

The hon. Lady asked about our financial support. Our contribution to be made for 1979 –80 to the International Planned Parenthood Federation is £2 million. For the United Nations fund for population activities we shall give another £2 million. Our direct expenditure for 1979 –80 under the aid programme on population activities will be about £10 million. I cannot be more precise, because that subject covers a wide area.

The hon. Lady referred quite rightly to the fact that health is one of the most important factors in the future of a child. Perhaps I may outline the sort of work that we in the Department are supporting. We support several World Health Organisation special programmes, including the expanded programme of immunisation and the diarrhoeal diseases programme. We contributed £1 million to that in 1978, and I am glad to say that the United Kingdom was the largest contributor to the programme.

We also supported the International Centre for Diarrhoeal Diseases Research in Bangladesh and its outstations in that country. Its programme now includes all acute diarrhoeal diseases and research into the relationships between them, malnutrition and overpopulation, which was the point made by the hon. Lady. We hope to increase our contribution in the future.

We have given substantial aid to malaria control programmes—for example, in the Solomon Islands. Malaria is a notorious killer of young children. We propose to participate in the Sudan primary health care programme in South Darfur province, which will concentrate on mother and child health care. We are co-operating with the World Bank in a £4.32 million mother and child, health and family planning project in Egypt. We support a number of joint research links between the United Kingdom institutions and their counterparts in developing countries. There are one or two more, but I shall not weary the hon. Lady by going through the whole list. I think that I have shown that we are doing quite a lot on the health side.

The Adjournment debate is specifically about the Year of the Child. Perhaps before coming on to that I can answer the hon. Lady's points about population matters in a broader context. We share her concern about population growth and the strain that a rapidly growing population imposes upon the development of nations. That is one of the reasons behind the existence of the population bureau in this Administration, which is directly concerned with these matters and which had provided the advisory service that led to the spending of about £9 million on population activities in 1978.

I am happy to inform the House that I am considering, with my advisers, the family welfare project in India, and this is in addition to our other activities on the subject of population overseas. We are keeping a very close eye on the pattern of demographic trends. While these are still disquieting, we note that the dramatic acceleration in population growth which started around the middle of this century has been slowing down in some parts of the developing world.

There is some hope that the population explosion can be contained, but it is a hope only. I see that the hon. Member for West Bromwich, West shakes her head at that.

The slow improvement in the overall figures cannot blind us to the terrible discrepancies in life expectancy, birth rate and infant mortality in the world. In 1975 the birth rate in the poorest countries was almost three times as high as that in the industrialised world. That illustrates what the hon. Lady said. The death rate at birth was even more shocking. In the poorest of the developing countries it was over eight times the rate for the richer parts of the world. That surely is a challenge for population and aid policy.

The population problem is an integral part of development. That is why it is given high priority in the aid programme. It is a complex problem, which must be approached in many different ways. For the Overseas Development Administration the chief lines of approach are measures to reduce infant and child mortality, with attention to nutrition, the provision of family planning information and services as an integral part of the maternal and child health care services. Sometimes there are clashes with religions. The obstacles do not always involve finance.

In addition we are involved in the provision of improved welfare services and increased research into the cultural background of communities to identify the most effective means of offering family planning services and improving the status of women. That has a great part to play.

I remind the House that the emphasis on activities under the International Year of the Child is with the national programmes for the children of one's own country. This is why, in a similar debate on 7 February this year in the House of Lords, Lord Wells-Pestell laid particular stress on the activities of the Government Departments in the United Kingdom concerned with the IYC which are fundamentally directed towards the needs of children within the United Kingdom.

In line with traditional United Kingdom practice it is also correct that much of the responsibility for activities within the United Kingdom should rest with the voluntary agencies, which, under the general guidance of the United Kingdom Association for IYC are mounting an effective programme.

As was made clear in the earlier debate to which I referred, this is by no means the whole story. We are of course concerned with the needs of children overseas, both as part of our general aid policy and as part of our more specific concentration on those people in greatest need in the poorest of the developing countries.

Children are frequently amongst the most disadvantaged members of the community in the developing world and are consequently themselves much in the forefront of our current aid policy.

We obviously support the aims and intentions of the IYC. However, we do not necessarily see the problems of children overseas as specifically and distinctively separate from the problems of the developing world as a whole. For this reason we particularly welcome the third of the aims of the IYC as defined by UNICEF—to promote recognition of the vital links between programmes for children on the one hand and economic and social progress on the other.

The essence is that this is one development process in which all disadvantaged people share—perhaps children more than most. But the aid policy must comprise all those at greatest risk.

Within this general concentration on aid to the poorest I should also point to specific areas of direct relevance to children which are of great importance to our aid programme. They are, first, the medical services, including primary health care, mother and child care and family planning; secondly, nutrition and food production; thirdly, education; fourthly, aid to multilateral agencies such as UNICEF, UNESCO, the World Health Organisation and so on, all of them concerned with the needs of children and, fifthly, aid to non-Government organisations active in assisting children.

I must say also that we were pleased to see that emphasis has been laid on national and local action programmes which are likely to be of particular value in developing countries and which will, we hope, lead to a concentration of expenditure on activities on the ground. This practical approach is very much in line with our own assessment of the needs of the poorest people in the poorest countries.

This concentration on the practical aspects of the International Year of The Child is at the back of our continuing support for UNICEF, which is most concerned with the provision of basic services to the poorer sectors of the communities of developing countries, including assistance to maternal and child health.

This concern must be seen in the light of the very high infant mortality rate, the low life expectancy, the lack of health facilities and the absence of safer water supplies, which are characteristic of the poorest countries of the world.

There is perhaps some indication of our support for this very practical policy in the fact that in recent years our support to UNICEF has been increasing steadily, almost doubling in the past two years, with the hon. Lady's party in Government, and now standing at £5.8 million. In addition to this, we are contributing about £1.6 million to UNICEF "noted" projects, which are projects identified by UNICEF but for which regular programme funds are not available.

Mr. Frank McElhone (Glasgow, Queen's Park)

Having heard the Minister's comments about child welfare and particularly about infant mortality, may I ask him whether this programme, carried on from the previous Administration, will be affected by the £50 million cuts announced by the Chancellor in his Budget Statement.

Mr. Marten

At the moment the £50 million cuts are being examined. I cannot give a specific answer to the question, but I would feel that the programme probably will not be affected. I would not like to be committed to that, because the examination of the cuts is not yet finalised, but I will let the hon. Gentleman know, of course, if it is affected. I hope that it will not be.

The "noted" projects cover such very basic requirements as vitamin A capsules, drugs and diet supplementation kits, drugs for mother and child care clinics, assistance with school roofing and water supplies—all very practical features.

I think that our support for the International Year of the Child is demonstrated more by our general support for UNICEF and its activities and by the general orientation of our aid programme than by any very specific measures directed towards the Year as a whole.

I would like to make clear that we do not envisage the Year as an end in itself, in any way, but rather as an essential boost towards an ongoing programme of support for disadvantaged members of the community in the poorest parts of the world, among whom children are very prominent indeed. This is not to say, however, that there are no initiatives at all directed towards the Year.

I can point in particular to three significant developments directly related to the International Year of the Child overseas. We have contributed £150,000 over a three-year period towards the cost of the international secretariat set up by UNICEF in New York to handle the arrangements for the Year. Secondly, we have contributed £40,000 towards the cost of a conference in London organised by the Institute of Child Health. An additional £115,000 is now to be made available to implement further ideas which came forward at the conference.

Thirdly, we have offered to consider—I underline those words—meeting half the cost of suitable projects in developing countries put forward by the United Kingdom Association for the International Year of the Child. In 1978–79 my Department contributed £319,000 towards community health projects, including £211,000 specifically for mother and child health. Examples of projects include three mother and child health programmes in rural Nepal, mobile medical units in Orissa, India, Kenya and Tanzania, public health education in North-East Brazil, Zaire, and for nomads in Kordofan, Sudan, and sanitation programmes in Bangladesh and Sudan.

Support has been provided chiefly through OXFAM, the Save The Children Fund and Christian Aid, to all of which I pay tribute for the work they do.

To sum up, therefore, our response to the IYC has been threefold. Our support under our normal aid programme for the poorest people in the poorest countries will continue. We are already within the aid programme dealing specifically with areas of direct relevance to the needs of mother and child.

We have already taken a number of specific initiatives directed towards the needs of the IYC for administrative and practical purposes, but we regard these initiatives as a part of our general commitment to poor people within the aid programme rather than as an end in themselves. They are part of a commitment which will not end with the completion of this particular year, important though that year is.

Question put and agreed to.

Adjourned accordingly at twenty minutes past Eleven o'clock.