§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Wells.]9.34 am
§ Mr. Geoffrey Clifton-Brown (Cirencester and Tewkesbury)
I am grateful for the opportunity to raise this morning's debate. I also welcome my hon. Friend the Minister of State, Foreign and Commonwealth Office, the hon. Member for Upminster (Sir N. Bonsor) to the debate. It is an unexpected pleasure to see him on the Front Bench, as my right hon. Friend the Member for Richmond and Barnes (Mr. Hanley) usually deals with overseas aid matters.
It is a great privilege for me, as chairman of the all-party group on population, reproductive health and development, to initiate a debate on such an auspicious day—the eve of World Population Day.
Our group owes a great deal to the late Lord Houghton of Sowerby, who founded it in 1978 and was its president from 1983 until his death this May. I send my sympathies and that of the group to his widow. He was an inspiration to the entire world population movement, and we shall miss his wise counsel greatly.
You will know, Madam Speaker, as you take an interest in the subject, that our group is extremely active on a cross-party basis in both Houses. We have organised European parliamentary conferences, and recently a workshop at which my right hon. and noble Friend Baroness Chalker delivered a keynote speech. I am delighted to say that, as a result of that conference, we are now in contact with several European parliamentary groups. I hope that we will be able to help them form several similar groups.
No issue is more important than population and reproductive health. Approximately 1 billion people in the developing world—one fifth of the world's population—live in abject poverty. Successful reproductive health programmes could eliminate some of that unnecessary and cruel suffering. My noble Friend Baroness Chalker said in her excellent Rafael Salas memorial lecture recently:it would be a scandal if the people of the OECD countries who consume 75 per cent. of the world's resources failed to help the poor.I agree entirely.
It took 123 years, up to 1870, for the world population to reach 1 billion. Today, the figure is 5.83 billion, and unfortunately it will take only another 11 years for a further 1 billion people to be born. The action we take now will determine the severity of the problems that our 316 children will face in the forthcoming millennium. If we do nothing now, the trend will continue inexorably upwards towards 12 billion in the following millennium.
Absolute numbers are not the real problem. Many of the world's worst problems stem from unsustainable population growth, which can lead ultimately to wars such as those in Rwanda and Burundi, as well as drought, famine, hunger, unscientific farming methods and—most importantly in the coming decades—water shortages.
What is to be done? There have been significant changes in population policies over the past few years. The Cairo United Nations conference in September 1994 was a landmark, in that 189 countries agreed a global action plan which in essence provides an unprecedented framework for all people to seek and enhance, freely and responsibly, their own health and well-being.
The conference affirmed the universal right to sexual and reproductive health, and upheld as a core principle freedom from discrimination or coercion in all such matters. Such principles and rights have, of course, been affirmed many times in the past—indeed, there is a United Nations convention on discrimination, which many countries have signed—but they were reaffirmed at that highly successful Cairo conference.
Rather than viewing people as mere numbers and objects of Government policy and politically motivated ideals, which often occurred before the conference, the international community has made a gigantic commitment to individual people and their development. Thus, a programme for action includes ensuring universal access to reproductive health care, the need to reduce poverty, promotion of economic development, provision of education and basic services for everyone, and improvement of women's status.
The fourth United Nations conference on women in Beijing in 1995 further endorsed the commitment to women's right to control their own fertility. My noble Friend Baroness Chalker, who so often leads the world's thought processes on such issues, said at that conference:We will carry forward the principles set up in the Platform, including the aim of ensuring that all women, regardless of age, ethnicity, religion, disability, or other characteristics, have equal opportunities, choices and rights.I wholeheartedly agree.
The same issues were debated at the Habitat conference in Istanbul in May. Women's sexual and reproductive health rights are firmly integrated into the international agenda in order to achieve better quality of life for all.
If anything encapsulates this morning's debate, it is that desire for better quality of life for all. If we are in politics for anything, it is to improve the quality of life of our people, and to give to those who have least in the rest of the world. "Children by choice, not chance" is the accepted aim of almost 200 nations, but it should be enshrined in every nation's constitution. Indeed, the slogan should be enshrined in the heart of every Minister and Government official.
I must sound a word of caution. As a committed Christian, it gives me no pleasure whatever to say that, when so much positive action is being taken throughout the world and so much good has come from the United Nations conference, which was organised with such care, it is disappointing that efforts to address some of the serious issues are being hampered by the Vatican's 317 negative attitude. No one condones any coercive practice, including abortion, but it is wholly questionable for the Vatican, which occupies only official observer status at the United Nations, to pursue its outdated views on voluntary family planning and artificial contraception at every turn.
§ Mr. Hartley Booth (Finchley)
Before my hon. Friend moves on from his erudite litany of what is happening around the world, will he deprecate the appalling practices in China, which are well recorded and have been going on for 60 years? In the 1920s, an aunt of mine adopted two girl babies who had been thrown out to die, and similar practices are still going on.
§ Mr. Clifton-Brown
I am absolutely delighted that my hon. Friend has raised that issue. I join him in wholly deprecating not only the practices in China, which are some of the worst in the world, but any coercive practice anywhere in the world. Some of the scenes in China, especially those filmed in such programmes as "The Dying Rooms" and its sequel, are wholly abhorrent and totally unacceptable. I share his sentiment. None of the non-governmental organisations involved in China would in any way condone what the Chinese Government are doing, and it is appropriate that some of the western NGOs are helping that country to promote better practices. I hope that they will continue to do so.
I should like to describe some of the problems that the world faces. About 585,000 women die each year as a result of unwanted pregnancy and childbirth—99 per cent. of them in developing countries. That is an appalling amount of suffering. Around 120 million women do not wish to become pregnant, but have no access to any family planning advice or services. There are 20 million women who have unsafe or coercive abortions each year, which results in tens of thousands of deaths, millions of disabilities and a quite unacceptable amount of suffering.
The effect of voluntary contraceptive provision on reducing reliance on abortion is dramatic. For example, in Russia, the abortion rate per thousand women aged between 15 and 49 was 108.8 in 1990, 8.88 per cent. of whom used contraception. As the use of voluntary contraception rose steadily to 23.59 per cent. in 1994, the rate of abortion fell to 83 per thousand women in 1994, as would be expected. That is extremely good news, and if it could be replicated elsewhere, as it is in Latin American countries and many parts of Asia, it could dramatically reduce the number of unsafe births.
Conversely, it is estimated that a 35 per cent. cut in United States funding for family planning, leaving some 7 million couples without access to any contraceptive methods, could lead to an additional 1.6 million abortions—often in very unsafe and unsavoury conditions—as well as millions more unwanted pregnancies.
I know that some subjects are difficult to discuss in the House, but it must be recognised that more than 100 million women, mainly in Africa, have been subjected to genital mutilation. Such treatment is abhorrent. Will the Minister explain what conclusions have been reached in Government-funded research on the best way in which to change people's attitude to such an 318 abhorrent practice where it occurs? If he cannot give me the answer this morning, I should be grateful if he would ask his officials to write to me in due course.
§ Dame Elaine Kellett-Bowman (Lancaster)
Has my hon. Friend any evidence of the prevalence of the practice in this country? I understand that it takes place here.
§ Mr. Clifton-Brown
The short answer is no, although I would not be surprised if it occurred in some corners of our inner cities. Female genital mutilation is a tribal practice, and I am sure that some extremely small ethnic minorities have brought it into this country. If it does occur here, I hope that the authorities will root it out everywhere, and try to educate people who are practising it about its unsavoury, unsatisfactory and abhorrent nature.
Approximately 15 million girls aged between 15 and 19 give birth yearly. Pregnancy and childbirth are the main causes of death in that age group, and 20 per cent. of infant deaths—this is a staggering statistic—could be averted if all births were at least two years apart. By 2000, about 40 million people will be HIV-positive—mostly in Africa and Asia. Education and proper information on health and contraception could considerably reduce that figure.
The total cost of attaining universal integrated reproductive health care for all in the developing countries and the economies in transition is estimated to be $17 billion by 2000, rising to $21.7 billion by 2015. Those are large figures, but it is estimated that up to two thirds of that amount should and could be provided by the countries themselves. I wish to focus on the other third.
The United Nations for Population ActivitiesUNFPA—target of Governments' allocation of only 4 per cent. of overseas aid, which would meet the cost of that universal access to reproductive health services, has so far been committed only by Norway and the Netherlands. The UK's allocation stands at a credible 2.3 per cent. As a result of lobbying by our group and others who deal with the matter, that figure has almost doubled over the past two years.
Will the Minister tell our right hon. and noble Friend Baroness Chalker that we are extremely pleased that our arguments have been recognised by the Government? We are not asking for any more money. Many people with different causes ask for more money, whereas we merely ask for a reallocation of the aid we already give. As I shall show later in my speech, that can be an extremely effective way of giving aid to the third world.
In sharp contrast to the Overseas Development Administration, which committed £184 million in 1994 to the end of 1995, thereby doubling its funding over the past five years, the United States Congress cut 35 per cent. from the population and family budget of the US Agency for International Development, the largest supporter of such programmes in the world. The measure was part of a foreign appropriations Bill attached to the legislation to prevent another Government shutdown, and was signed by President Clinton.
It is now clear that the £17 billion needed by the year 2000 will not be met. That is a tragedy, because the universal demand for family planning and reproductive health will suffer enormously as a result. The UK 319 Government, as well as many other Governments and donor agencies, need to review their contribution in that vital area.
I hope that my hon. Friend will also press for an improvement in funding in Europe, the United States and many other industrial nations. We need urgently to increase the proportion of overseas aid budgets devoted to that issue.
The group has been dismayed to learn that the cut in USAID's funding budget has led to United States NGOs taking 50 per cent. of the ODA's United Kingdom seedcorn funding in 1994–95. The US NGOs establish branches in London and then compete for our additional seedcorn funding. It is unfair that foreign NGOs are allowed to compete for that seedcorn and core funding, whereas ours are not allowed to do so because they are deemed to be already in existence.
But the newly established NGOs are simply affiliates of already existing NGOs in the United States. I urge my hon. Friend to look at that matter, because, although our aid agencies may be able to tolerate it in the short term, in the longer term the effectiveness of British NGOs will suffer. That would be a tragedy, because the British NGOs that deal with population problems are some of the most respected in the world.
The group has consulted its sister group in the European Parliament, in both London and Brussels. The EU has set a post-Cairo spending target of some 300 million ecu on population and reproductive health programmes by the year 2000. However, the EU does not have a single coherent instrument for funding population-related programmes. Its highly cumbersome system for gaining access to funding, with several aid provisions relating to different geographical and sectoral agreements, is often exceedingly complicated for NGOs to pursue. The UNFPA-sponsored Marie Stopes International recently produced a useful handbook on European support mechanisms for population and reproductive health programmes, which sheds some light on the Byzantine complexities within the Commission.
Do the Government intend to press, at the next Overseas Council, for simplification of that system? If funding cannot be accessed because of the system's complexities, it seems wrong that it then disappears in the next financial year. There should be a process for bidding for it, even if it is not used in the current financial year, so that it can be used the following year, especially as the whole programme is committed up to the year 2000.
Of particular concern is the dearth of qualified reproductive health staff in Europe in relation to the budget and the number of applications for funding. It was exceedingly welcome news when the ODA was able to attach one of its experts to the Commission, but family planning and reproductive health services still need to be greatly strengthened with committed experts within Europe.
Earlier this year, I visited the Planned Parenthood Association of Thailand, and witnessed an example of one of the most effective NGOs in the world, which receives some funding from the International Planned Parenthood Federation in co-operation with the Thai Government. It performs an outstanding service to people in that developing country.
As an example of that NGO's efficiency, it employs a full-time staff of only 123 people, but has organised an effective volunteer force of 30,000 people. Staff members 320 go to remote villages and find the most responsible and respected person in the community. They recruit him or her as a volunteer to organise their family planning programmes and education in his or her village. That person not only speaks the language, but is part of the local culture.
I was lucky enough to go to one of those family planning clinics on the Thai-Burma border. I met tribeswomen who had walked 70 km that morning, many of them barefoot with a young child at their heels, to get to the family planning clinic. They had come to the clinic without their husbands' knowledge. I was able to talk to them through an interpreter. When I asked why they had come, they said that it was because they wanted only one child. When I asked why, they said, "Because we are so poor. You can see from the clothes that we and our children are in—no shoes on our children's feet—that we cannot afford to feed more than one child."
Those women sat in rows watching in a disciplined fashion a video on the need for further education and health planning services. They then lined up in an orderly way to have their cards examined to see when they last attended the clinic. They were referred to the doctor if they or their child had a problem. If they had no problem, they were referred to the nurse for a three-monthly contraceptive injection or whatever other family planning services they wanted. If the volunteer in their village said that they were too poor, they did not have to pay the 25p that everyone else had to pay. That is an example of what the best family planning and education in the world can do.
§ Mr. Clifton-Brown
My hon. Friend says that it is socialism. It is not. Those people walked to the clinics of their own free will. They would not have walked 70 km if they did not want to improve their lot. I spoke to those women, and did not see the fear in their eyes which I have seen in the eyes of people in other parts of the world. I have seen people in refugee camps in Pakistan with no arms and legs who are in real fear of their lives, and one can see it in their eyes.
Those women had smiles on their faces, and welcomed the contact with the more stable lowland population, which was also there in a different group. They were enjoying their morning out, and there was a little market next door for those who could afford to buy things.
The result of that excellent programme is that Thailand has a population increase of about 1 per cent. per year and a stable population of about 50 million, whereas the Philippines, which started similar programmes in the beginning of the 1970s, now has a population of about 80 million and double the rate of population increase—2 per cent. That is an example of what can be done, and it shows us why this debate is so important.
I should like to be able to conclude on a positive note. Since 1950, life expectancy in the developing countries has increased. Family planning has increased from 10 to 50 per cent. Since the 1960s, and, above all, more couples are choosing when to have their children. They have control over their lives; they can have a family when they want it. On average throughout the world, quality of life is improving, even in some of the poorest parts of the third world, although there are pockets where life is still getting worse.
321 The slogan "Children by choice, not chance" should be emblazoned on every Government and every official throughout the world, especially in the third world.
It would set a wonderful example to the rest of the world if Britain became the first large western nation after Norway and the Netherlands to meet the target of 4 per cent. of overseas aid devoted to population and reproductive health issues. It would require no extra money, merely a reallocation of the existing budget. All other types of overseas aid are merely fire brigade actions—they are merely remedial for the problems that have already been encountered by unsustainable development. Aid devoted to population programmes is preventative, and if we met the 4 per cent. target, it would be the best possible bequest to future generations in the next millennium.
I urge the Minister to consider seriously the reallocation of this aid budget, which would set a dramatic example to the rest of the world. If Britain, which is acknowledged as one of the leaders in this field, were to meet the 4 per cent. target, I have no doubt that many other countries, especially some of the richer and emerging countries, such as Japan and some of the south-east Asian nations, which contribute very little to population reproductive health programmes, might thereby be encouraged to come in and contribute.
That would help to meet the £17 billion of unmet need—not a huge amount of money worldwide—give universal access to family planning and education programmes to all in the world, and reduce the unnecessary suffering, some of which I have described.
Madam Deputy Speaker, I am grateful to you and Madam Speaker for giving me the opportunity to raise this subject.
§ 10.1 am
§ Rev. Martin Smyth (Belfast, South)
I welcome the opportunity to take part in an important debate, and I understand the depth of sincerity with which the hon. Member for Cirencester and Tewkesbury (Mr. Clifton-Brown) presented his case. I am not altogether sure that the simple slogan "Choice, not chance" is fairly representative of a Christian conviction, because I still believe that there is a sense in which children are a gift; that emerges from the Old Testament and the experience of many of us, and one is concerned at times to think that modern science believes that scientists can dictate the terms of how children might be born.
I am also aware that we live in a world where we use language to soften what we mean. Some folk might think that I am intellectually challenged or physically disadvantaged, but we must examine some of the definitions that are given, and today I want to consider, in the context of the debate, the definition of "reproductive health" given by the World Health Organisation in its "Technical Definitions and Commentary" prepared for the international conference on population and development in Cairo in 1994:Reproductive health implies that people are able to have responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed of and to have access to safe, effective, 322 affordable and acceptable methods of fertility regulation of their choice, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.There is much in this definition that everyone would applaud, but I want to consider briefly the meaning of the term "fertility regulation". The World Health Organisation has provided an official definition:Fertility regulation is the process by which individuals and couples regulate their fertility. Methods that can be used for this purpose include, amongst others: delaying childbearing, using contraception, seeking treatment for infertility, interrupting unwanted pregnancies and breast-feeding."Interrupting unwanted pregnancies" is simply, in my understanding, a euphemism for abortion on demand. It is clear that "reproductive health", according to the official WHO definition, includes abortion on demand.
In that context, we must place on record the fact that our Government's Overseas Development Administration, under the noble Baroness Chalker, has an obsession with "reproductive health" in its international aid programme, which I believe is positively unhealthy.
The ODA, in a briefing paper entitled "British Aid for Health and Population" published in May 1995, states:Throughitsaid programme Britain is working to promote human development through better education and health, particularly reproductive health".The next paragraph states:Central to the ODA's health and population strategy is a commitment to ensure access for people most in need to essential health care, particularly reproductive health care".However, a powerful leading article published in The Lancet in July 1995 last year, although plainly in favour of abortion and other forms of birth control, made a strong attack on the notion that "reproductive health" should be at the top of the international health agenda. The article states:Yet health is defined in a surprisingly one-dimensional manner; it seems to exist in a reproductive context only. When seen through the lens of fertility control, the notion of 'health' is distorted beyond all recognition".The article argues that women's reproductive health needs are in fact the social tool through which the aims of population control are being met. It continues:One does not have to be either 'conservative' or 'extremist' … to question the assumptions on which the reproductive health and family planning 'movement' is based".The article concludes:The new colonialism of the international women's health agenda is a dangerous strategy. It places western utopianism before local pragmatism … Equality means far more than achieving the right to reproductive health".That obsession with reproductive health is nowhere more evident than in the massive multi-million pound annual grants to the International Planned Parenthood Federation, with which our Government "work closely" in this matter.
§ Dame Elaine Kellett-Bowman
Does the hon. Gentleman agree that the House, by voting for what is virtually abortion on demand, has set an exceptionally bad example, and does he regret, as I do, the fact that we have made life very cheap in this country?
§ Rev. Martin Smyth
I share the hon. Lady's views. One evening, as a result of confusion in the House, we 323 actually increased the age for abortion to an unacceptably high level, especially in the light of medical opinion, when it could have been reduced with greater effect.
I feel strongly about this issue. In Northern Ireland, the major political parties and religious faiths are opposed to abortion on demand. We are well aware of the abortion-promoting policies of the International Planned Parenthood Federation, which held a symposium in Northern Ireland in November 1994. The British Medical Journal reported:Delegates called for a number of options to be pursued, including extending the 1967 Act to the Province, opening an abortion clinic as a challenge to existing legislation, attempting to introduce a private member's bill, and taking a test case to the European Court.In Northern Ireland, an abortion can be performed if a doctor believes that it is in the interests of the woman's health and is a necessity—we do not have the open-door policy that was introduced by the Abortion Act 1967, and which has been broadened in the recent past.
The IPPF report, under the heading "Rights of Young People", said that abortion, sterilisation and contraception should be made available to children aged 10 and upwards without parental knowledge or consent. We should be strengthening the family, but if we put blocks between parents and children, that will not happen. When a child faces a particular problem, however difficult, the parents should be made aware of it so that they can give guidance—they should not be ignored.
§ Mr. Clifton-Brown
I have listened to the hon. Gentleman's speech with care. Parents should give guidance, but it is often lacking. If parental guidance is lacking, someone has to provide sexual education. If it were not for the work of the International Planned Parenthood Federation, the United Nations Fund for Population Activities and others in the third world, there would be no education on which people could make sophisticated and proper choices. I hope that the hon. Gentleman focuses on some of the positive work that is going on in the United Kingdom and in the rest of the world, and does not focus his entire speech on one negative aspect—abortion.
§ Rev. Martin Smyth
I am redressing an aspect of the hon. Gentleman's speech. I am amazed that, in a western democracy, we talk about people in developing countries being able to make sophisticated choices. With all the sophistication of our western democracy, we have not dealt with this problem. It has been said that the only place that children can get sex education is in school—and, to some degree, I accept that that is accurate. However, because of the emphasis on sex education—it is also on our televisions—children are experimenting at an earlier age than ever before. The emphasis should be on restraint, not on encouraging children to experiment at an early age.
Why is an organisation that is openly committed to obtaining abortion on demand—whatever the views of national legislatures and parents—receiving millions of pounds from the British taxpayer in the name of reproductive health? It received £11 million in 1993–94 and £6.5 million in 1994–95.
§ Mr. David Alton (Liverpool, Mossley Hill)
Is the hon. Gentleman aware that, in the past two weeks, the 324 European Parliament has unanimously passed a resolution, proposed by the Labour party, opposing coercive population measures? In particular, it criticises the British Government's China policy. In China, it is illegal for a person to have a brother or a sister. That law is aided and abetted, and collaborated with, by money provided by British taxpayers.
In the course of his speech, will the hon. Gentleman seek clarification in this regard from Members on the Labour Front Bench, who have made it clear that they will continue to fund the programmes?
§ Madam Deputy Speaker (Dame Janet Fookes)
Order. The hon. Gentleman's intervention was extremely long.
§ Rev. Martin Smyth
Members on the Labour Front Bench heard the question asked by the hon. Gentleman, and I hope that they will clarify the situation. No doubt some people want to restrict their family to one and are delighted to do so.
A letter from Baroness Chalker to The Times of 12 May 1995 claimed:Neither the British aid programme, nor IPPF"—which receives grants through the aid programme—backs coercive family planning or abortion programmes.However, the IPPF's publication shows that Baroness Chalker's statement is incorrect. According to its People magazine—Volume 1, No. 1, 1989, page 20—volunteers working for the China Family Planning Association, an affiliate of the IPPF,sometimes collect the occasional fine when a couple breaks the birthplan rules".According to Baroness Chalker's Department:IPPF does provide some financial support to the China Family Planning Association. IPPF expects CFPA to exercise a beneficial influence on the implementation on China's population policies in a number of ways.Does this "beneficial influence" to which the ODA refers extend to collecting occasional fines from couples who dare to have a child unauthorised by the Chinese authorities?
I return to where I began: in an age when we use nice definitions to cover up what we are talking about, when we speak of reproductive health, we should emphasise the need for health care and guidance for families and parents. Money should not be given to terminate the lives of those who have great potential.
§ Mrs. Ann Winterton (Congleton)
It is a pleasure to follow the hon. Member for Belfast, South (Rev. Martin Smyth) in the debate.
I congratulate my hon. Friend the Member for Cirencester and Tewkesbury (Mr. Clifton-Brown) on taking over from his predecessor, our hon. Friend the Member for Croydon, South (Mr. Ottaway). If my memory serves me correctly, we had a similar debate in the House this time last year.
I shall examine further the points that were raised by the hon. Member for Belfast, South. I refer to a letter from Baroness Chalker's office at the Overseas Development Administration to Mrs. Phyllis Bowman of the Society for 325 the Protection of Unborn Children, which was written just before the Cairo conference on population and development in 1994. It stated:The ODA position on population and reproductive health is not to support population control.The word "not" is underlined. However, this emphatic statement, expressing Government policy, needs to be examined very closely. In addition, I propose to examine the ambiguity in words and phrases that are used in debates on this matter—they can be extremely misleading.
The hon. Member for Belfast, South referred to the World Health Organisation's official definition of the term "reproductive health" in its "Technical Definitions and Commentary", which was prepared for the international conference on population and development in Cairo in 1994. The definition states:Reproductive health implies that people are able to have responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation of their choice, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.There is much in the definition to applaud. However, we should examine the language it uses.
What is meant by the term "fertility regulation"? In the same paper, the WHO provides its official explanation. It states:Fertility regulation is the process by which individuals and couples regulate their fertility. Methods that can be used for this purpose include, amongst others: delaying childbearing, using contraception, seeking treatment for infertility, interrupting unwanted pregnancies and breast-feeding."Interrupting unwanted pregnancies" is a euphemism for abortion on demand, which we have in this country at present. Therefore, according to the official WHO definition, it is clear that reproductive health includes access to abortion on demand. It is there in black and white.
The WHO's official definition of reproductive health is enormously significant, and the implications must be clearly understood. It explains why developing nations attending the Cairo conference on population and development fought so hard for language in the final Cairo document which seeks to restrict the international promotion of abortion. Section 8.25 of the Cairo programme of action begins:In no case should abortion be promoted as a method of family planning".The Cairo document also upholds the sovereign right of nations to determine their own abortion legislation according to their national culture, beliefs and traditions.
Last month in Istanbul, at the United Nations conference on human settlement, despite the intense pressure brought to bear by the United States and the European Union, the G7 nations stood firmly against including several reproductive health references in the final document. They allowed only one such reference, on the basis that it must be understood according to the restrictive language agreed in Cairo.
326 I know from my contacts with non-governmental organisations that attended the United Nations conference in Istanbul how the speech of my right hon. Friend the Secretary of State for the Environment at that gathering was deeply appreciated by the representatives of developing and Islamic nations. Referring to the "culture of death", my right hon. Friend spoke aboutthe street children who disappear, the old and the young who die when they could have lived, the babies whom we kill before they have a chance to live".Developing nations were greatly encouraged to hear a strong Christian voice speaking unexpectedly from the heart of Europe.
It is extremely disturbing that, again and again, the Minister for Overseas Development and her Department promote reproductive health, without any qualifications or restrictions as regards abortion, as the top priority in Britain's overseas aid spending. However, they declare at the same time that the ODA is not directing its efforts towards population control.
I noted earlier that some concern was expressed about parts of the speech by my hon. Friend the Member for Cirencester and Tewkesbury, who suggested that population control is the most important policy for the third world, whereas it was felt that further expenditure in the third world should be devoted to policies other than those that my hon. Friend outlined.
We learn from an ODA briefing paper that the organisation has committed £100 million over two years to improving access to family planning and to extending reproductive health. It works closely with international bodies such as the United Nations Fund for Population Activities. In an answer given to the noble Lord Braine of Wheatley in another place, the Minister said that the United Kingdom grant to the UNFPA increased from £10.5 million in 1993–94 to £11.25 million in 1994–95.
Proponents of funding the UNFPA often quote its assurances that the agency does not support abortion programmes anywhere in the world. The UNFPA does make that claim, but it has also proclaimed repeatedly that China's population programme is purely voluntary. In spite of years of documented evidence of forced abortions and forced sterilisations in China—not least, evidence provided by the US Department of State—in an interview on CBS "Nightwatch" in November 1989, the UNFPA executive director, Mrs. Nafis Sadik, said:The implementation of the policy (in China) and the acceptance of the policy is purely voluntary.In an exclusive interview with China's official news agency on 11 April 1991, Mrs. Sadik said:China has every reason to feel proud of and pleased with its remarkable achievements made in its family planning policy and control of its population growth over the past 10 years. Now the country could offer its experiences and special experts to help other countries.Bearing in mind an earlier intervention about the policies in China and the response from my hon. Friend the Member for Cirencester and Tewkesbury, I invite him to join me in condemning that statement, which is contrary to the views that he expressed. According to the UNFPA's annual report for 1988, its on-going activities in China include participation in the State Family Planning Commission.
§ Mrs. Elizabeth Peacock (Batley and Spen)
Will my hon. Friend tell the House whether that organisation has produced any figures for the number of partial birth abortions occurring in China at present?
§ Mrs. Winterton
That is an interesting point, but I cannot reply to my hon. Friend. I shall make some inquiries in that regard. That practice is completely repugnant to most informed people, and it would be disastrous if it were carried out in China—although I would not be surprised, in view of the forced abortions and sterilisations that occur in that country, which everyone must abhor.
As I said, the UNFPA's activities include participation in the State Family Planning Commission. Its headquarters oversees enforcement of the nationwide one-child programme and the funding ofnational training facilities for family planning professionals and family planning administrative personnel".They are the commissioned officers who enforce the coercive abortion and sterilisation population policies. I should not be surprised to learn that partial birth abortions are part of China's population control programme—its policies are certainly horrific enough to include that.
§ Mr. Alton
The hon. Lady has made a good point about partial birth abortions, but is she also aware that, last year in China, laws were passed that allow handicapped babies, who have been born, to be killed merely because they are handicapped? That is not just forced abortion or partial birth abortion, but infanticide.
§ Mrs. Winterton
I am grateful for that intervention. Indeed, my right hon. Friend the Secretary of State for the Environment included that practice in the culture of death that he mentioned in his speech in Istanbul. That may be emotive language, but it is highly descriptive, and it reflects the true position. I cannot believe that anybody who considers himself or herself to be civilised can support that policy of killing handicapped children. It is indeed infanticide.
§ Mr. Clifton-Brown
My hon. Friend will have heard that, earlier in the debate, I condemned the practices in China in the strongest possible terms, but I hope that she is not suggesting that no western NGOs should be involved in reproductive and family planning activities in China. Surely that would be naive, because we are trying to influence the Chinese Government to introduce better practices. The experts in the field, such as the UNFPA, are trying to promote proper practices in China.
§ Mrs. Winterton
I am grateful to my hon. Friend, but he has been sucked in by those organisations, just like everybody else. Nobody objects to the aims and objectives of voluntary family planning, as long as people work with the culture of a country and what the people want, but everyone—including my hon. Friend, who made a forceful speech—must realise that those organisations, as I have spelt out in my speech, are working hand in hand with the organisations in China that implement other, abhorrent, policies.
My hon. Friend must get his friends to clean up their act, wash the blood off their hands and be honest for a change, instead of being disingenuous with the facts. When he does that, I will respect his view and the views of others who agree with him. Until then, I shall believe that my hon. Friend, like his predecessor, is exceptionally naive.
328 It should be recognised that the UNFPA is a major funder of another abortion programme—the human reproduction programme of the World Health Organisation. That project is heavily involved in funding clinical studies on RU486, which is a pill used—especially in France—to abort women who are between five and seven weeks into pregnancy. Both the WHO and UNFPA officials say that they intend to perfect the abortion pill as a back-up method of birth control for women in less-developed countries, who will be used as guinea pigs.
The 1993 UNFPA report, on page 17, states:UNFPA continues to support projects that link family planning with income generating activities for women".That report makes it clear that, if women want to get help with setting up micro-enterprise projects, they must accept family planning services, and that the UNFPA must ensure that family planning services are available to meet the demand generated by the projects. The funding for the way out of poverty, through economic activity, for those women will be provided only with the quid pro quo that they restrict the number of children they have. They may even be required to have no children.
How can we justify the fact that the ODA made a grant to the UNFPA of more than £11 million in 1994–95, when we know that women in developing countries, including China, are being put under tremendous pressure to accept birth control? Would the ODA find similar practices acceptable in Britain, or are we supposed to be different from the women in developing countries?
§ Mr. Martyn Jones (Clwyd, South-West)
In the couple of minutes left to me by the hon. Member for Congleton (Mrs. Winterton), I shall try to make one or two points. I had hoped to make more, but unfortunately time is against us. It is entirely appropriate that our debate is taking place on the eve of World Population Day, and I congratulate the hon. Member for Cirencester and Tewkesbury (Mr. Clifton-Brown) on initiating the debate.
I pay tribute to Lord Houghton, the founding chairman of the all-party group on population, reproductive health and development, who died in May this year at the age of 97. At his ripe age, he was well aware of the concept of sustainability, and his distinguished career bears testimony to his commitment to others. He will be much missed.
Some hon. Members will know that my personal expertise is as a biologist, and that led me to become involved in the all-party group. Since my involvement, I have become much more aware of the interconnectedness between the environment and every aspect of Government policy—not only the UK environment, but the international environment—and I am pleased that that fact was recognised in Labour's recent manifesto publication.
Wanted children are a gift, but unwanted children can be a curse. On a global scale, as a biologist, I know that the population of any organism that does not have predators or any in-built mechanism to control its growth will ultimately destroy itself by disease, starvation or both.
World population and reproductive health issues are at a critical stage. According to Population Concern, the global urban population is growing at a rate roughly 329 equivalent to eight cities the size of London each year. Migration from the countryside accounts for 40 per cent. of the annual increase in urban populations, and, within a few years of the new millennium, more than half of the people of the world will live in cities, but one third of today's citizens, some 600 million people, do not have the means to meet their basic needs.
As one might expect, women and children make up the largest sector of those who suffer such colossal deprivation. Therefore, services such as health and education help in the fight to escape poverty.
According to the International Planned Parenthood Federation, some 585,000 women die every year as a result of pregnancy and childbirth, many in the third world. Some 120 million women do not want to be pregnant, but have no access to contraception. As we heard, by 2000, 40 million people will be HIV-positive, and more than 300 million new cases of sexually transmitted diseases occur annually.
As we have also heard, in sharp contrast to the United Kingdom—which committed £184 million to its budget in 1994, thereby doubling its funding over the past five years—the US Congress cut 35 per cent. from the population and family planning budget of the US Agency for International Development, which had been the largest supporter of such programmes in the world. The measure was part of a foreign appropriations Bill, and was attached to legislation to prevent another Government shutdown, signed by President Clinton.
The hon. Member for Cirencester and Tewkesbury rightly said that £17 billion will be needed by 2000 to meet the universal demand for family planning and reproductive health, but it is clear that that need will not be met. The United Kingdom Government, and many other donor Governments, need urgently to review their contributions to that vital area.
Population stability is the single most important issue facing the human race. If we, as intelligent beings, do not attain it ourselves, war, famine and disease will, and they will touch all countries, including those of the west. I urge the Government to commit more funds to that vital issue, and to press the United States to restore its funding as a matter of urgency.
§ Mr. George Foulkes (Carrick, Cumnock and Doon Valley)
I also wish to congratulate the hon. Member for Cirencester and Tewkesbury (Mr. Clifton-Brown), not just on obtaining the debate, but on his election to the chairmanship of the all-party group on population, reproductive health and development, of which I am also a member. Last year, as the hon. Member for Congleton (Mrs. Winterton) said, we had a debate initiated by the previous chairman of the all-party group, the hon. Member for Croydon, South (Mr. Ottaway). Unlike other hon. Members, I shall not repeat what I said on that occasion.
I also wish to join my hon. Friend the Member for Clwyd, South-West (Mr. Jones) and others in paying tribute to our late friend Lord Houghton, who founded the all-party group, and who died recently at the age of 97. Some months ago, I heard him speaking in the House of Lords on the Dangerous Dogs Act 1989, and he was full of vigour and eloquence. He is a loss for us all.
330 As the hon. Member for Cirencester and Tewkesbury said, we now face the fastest growth in human numbers in history which, it is widely recognised, will result in serious economic, environmental and political problems in the developing world. As the hon. Gentleman said, the issue was discussed in Cairo, Beijing and Istanbul at successive UN conferences. However, with growth at an all-time high of 90 million people annually, the increase must be tackled by a sustained programme of education and family planning. It is encouraging that the international community is responding and that the ODA is playing a pivotal and positive role. I find myself adopting an unusual posture in congratulating the ODA and the Government on their initiative and work.
In September 1994, at Cairo, there was an unprecedented agreement among 189 countries in producing a global action plan. The following year, at Beijing, the United Nations conference on women endorsed the Cairo commitment to women's rights to control their fertility and their families. At the Habitat conference at Istanbul, the issue was discussed again in the context of growing populations within cities. That conference endorsed previous statements.
Family planning, reproductive health and female education are some of the best available aid investments. I disagree with the hon. Member for Cirencester and Tewkesbury only to the extent that they are not the only preventative areas of aid. Other areas of investment—for example, irrigation—can prevent hunger or starvation, and I would like to see more moneys directed to them. I accept, of course, that family planning, reproductive health and female education are some of the best aid investments available. That has been recognised throughout the international community. The Labour party has supported the ODA in its efforts and negotiations.
Perhaps it would not be me—it might surprise Conservative Members too much—if I did not have one little criticism of the Government. The Labour party recognises the lead that the ODA has taken, but that must be seen in the context of a declining overall aid budget. I am pleased that the Minister of State will speak on behalf of the Government, and I remind him that Baroness Chalker, who speaks in the other place on overseas development, has fought a doughty fight on behalf of the overseas aid budget.
Unfortunately, the Treasury has won the battle, and we have a declining overall budget. The target of 4 per cent. of the ODA's budget which, as the hon. Member for Cirencester and Tewkesbury said, has been worked towards by the United Kingdom, has not been reached. Instead, we are contributing 2.3 per cent. of a declining budget. That is not as spectacular as the hon. Gentleman suggested.
Pressure must be put on our partners to ensure that they do not give up in the developing world. We must not give in to the lobby that has sought to cut development funding. It is unfortunate that media attention and the overall agenda are persistently diverted from the real issue at hand.
As the hon. Member for Cirencester and Tewkesbury rightly said—the hon. Member for Congleton did not take up the matter—5 billion people are in abject poverty throughout the developing world. It is clear that the cost of attaining universal integrated reproductive health care 331 for all in developing countries, including those with economies that are in transition, will not be met. As the House knows, the overall cost amounts to £17 billion.
Aid budgets are declining. For example, the United States is reducing its funding of family planning projects. An end to the upsurge of the world's population is not nearly in sight. Populations will not level out for many years to come. Over the next decade, 94 per cent. of the increase in the world's population will be in the developing world. The prospects for some countries are extremely daunting. For example, the World bank's demographers tell us that Nigeria's population will rise from 100 million now to an eventual 382 million before stabilising in the year 2100. Tanzania's population is predicted to increase fivefold, from about 25 million to 116 million.
The work of all NGOs is supported by the Labour party, and I make no apology for that. We support the Government's contribution to the UN Fund for Population Activities, to the International Planned Parenthood Federation and to the World Health Organisation. These organisations and the British NGOs have shown over many years the benefits that their work has brought to the developing world.
I say to the hon. Member for Liverpool, Mossley Hill (Mr. Alton), who told me that he had to leave the Chamber, to the hon. Member for Congleton and to others, including the hon. Member for Belfast, South (Rev. Martin Smyth), that the Opposition do not support coercive policies in China or elsewhere, and neither does the IPPF. However, the IPPF, by working in China, can bring pressure to bear from within to try to improve the situation. There are, of course, many other human rights problems in China. We must work to ensure that China introduces improvements in a wide range of areas.
It is no use criticising the IPPF because of what is happening in one of the countries in which it operates. Multilateral organisations such as the IPPF have played a crucial role. I am especially pleased that the European Union has set a post-Cairo target of 300 million ecu to be spent on population and reproductive health programmes.
It is well documented—I understand that the ODA recognises the position—that access to funding is convoluted and difficult. It is a process that puts a severe strain on small budgets and the administrative capacity of NGOs. I hope that the Government will make representations to the EU to try to simplify the procedure of obtaining access to funds.
Reducing population growth in the developing world is but one important factor in the battle against poverty. There may be no intrinsic benefit in a reduction of the world's population, but our primary concern must be the alleviation of grinding abject poverty. To that end, the consumption of scarce resources must be considered against the background of a growing population.
That should not detract, however, from the duty of the industrialised world towards developing countries. It is incumbent on any population programme to aim, in the context of a wider strategy, to tackle poverty generally. Family planning and health education are basic human rights. The ODA has taken a proactive stance, and one which the Opposition wholeheartedly support. We shall do so when we form the next Government after the next general election.
§ The Minister of State, Foreign and Commonwealth Office (Sir Nicholas Bonsor)
It is a great pleasure for me to be able to take up the remarks of the hon. Member for Carrick, Cumnock and Doon Valley (Mr. Foulkes). I agreed with an enormous amount of his contribution to the debate. It is a pity that he spoilt his speech with his last sentence. We cannot, of course, expect a perfect speech from the Opposition Benches.
I do not have long in which to respond to the debate, but I must add my tribute to the admirable work of the late Lord Houghton of Sowerby, and extend my sympathy and that of the Government to his widow. His work is well known, and it contributed enormously to the advances that have been referred to this morning. I congratulate my hon. Friend the Member for Cirencester and Tewkesbury (Mr. Clifton-Brown) on his chairmanship of the all-party population, development and reproductive health group, and on the excellent and lucid way in which he presented his comments on a complex range of issues.
We cannot over-emphasise the importance of responding to the world population and reproductive health issues. In the hour and a half that we have spent in discussion this morning, the world's population has grown by a further 16,000. We know that 95 per cent. of the growth of the world's population is in the developing world, which is the least well equipped to cope with the consequences. The United Nations has recently estimated that, in the 50 years between 1970 and 2020, 93 per cent. of the world's urban growth will take place in the developing world.
More and more people want to plan their families, have fewer children and give them a better start in life. At least 200 million couples are not able to have access to the contraceptives they want when they want them. The services for millions more leave much to be desired. If these demands cannot be met, the world's population will grow to 17 billion—three times its present level—in the next century. If they are met, we can hope to stabilise the world population at about 12 billion, which may well be manageable.
Stabilisation of the world's population will improve prospects for sustainable development. Well-designed human development initiatives contribute to children by choice, not chance, and smaller families. Human development means education, health and opportunities for women. It means also placing individuals at the centre of development.
Governments should enable men and women to be able to choose when and in what circumstances to have children; they should not control, compel, deny or disempower them. That is an important part of the equation, which has been stressed this morning. Such an approach means providing women and men with education, skills and resources to enable them to make informed decisions and choices, and then designing and providing services in ways that best fit the needs of the clients, not merely the administrative convenience of the suppliers.
In many countries of the developing world, childbirth remains an acutely hazardous experience—and unnecessarily so. As my hon. Friend said, new estimates from the UN suggest that almost 600,000 women die each year in pregnancy and childbirth for lack of ready access to basic care. For every woman who dies, possibly 30 more incur injuries and disabilities that can be lifelong.
333 The focus of our policy for reproductive health is therefore on meeting unmet demand for accessible and reliable family planning services, to improve access to, and the quality of, all aspects of reproductive health services, and to make giving birth safer.
Since the ODA launched its "Children by choice, not chance" initiative in 1991, that phrase has become commonly used by others around the world. It means a number of clear goals, which we all share: giving people the ability to exercise choice about the size of their family, and the spacing and timing of the birth of their children; striving to ensure that family planning services are affordable, acceptable and accessible to all who need and want them; improving the quality of family planning advice, information and education; enabling women to go through pregnancy and childbirth more safely; and enabling people to protect themselves against sexually transmitted diseases and one of their major consequences, infertility.
Those goals and that philosophy were encapsulated in the programme of action agreed at the international conference on population and development in Cairo, in 1994, which defined the international agenda for future work. The Cairo programme calls for reproductive health care for all and sets new standards for care and services that individual women and men should be able to access. It challenges everyone—Governments, non-governmental organisations, the private sector and donors—to meet these standards.
How are we as a donor responding to the challenge? Since we launched "Children by choice, not chance", ODA expenditure on population and reproductive health initiatives has more than doubled, from £26.5 million in 1991 to £62.3 million in 1995. I think that that defuses the comments and criticism made by the hon. Member for Carrick, Cumnock and Doon Valley.
We are indeed increasing the amount of assets that we are putting into this very important task. After Cairo, we pledged ourselves to make commitments of £100 million in the two years following. In fact, we more than fulfilled that pledge, committing ourselves to more than £184 million. One hundred and twelve new projects were approved in 1994 and 1995. The United Kingdom will remain one of the largest bilateral donors in this field.
§ Mr. Clifton-Brown
Does my hon. Friend agree that, although our multilateral aid to these programmes is important, our bilateral aid to Europe is also very important? Will he respond to the point that I made earlier and implore the Council of Overseas Ministers to simplify access to the funding systems?
§ Sir Nicholas Bonsor
Yes, I can give my hon. Friend that undertaking. That point was also made by the hon. Member for Carrick, Cumnock and Doon Valley. We feel it very important to simplify the EU mechanisms, and we are, of course, a major contributor to the EU funds, as well as to the bilateral funding.
There are, of course, a variety of channels—bilateral, multilateral, NGO—and each has its part to play. We have remained a strong contributor to the United Nations population fund—UNFPA—the main UN agency for helping to implement national programmes of 334 reproductive health. Our annual contributions have risen from £7 million in 1993 to £10 million in 1995. We remain a major supporter of the International Planned Parenthood Federation and its network of family planning associations, contributing £7.5 million in the past financial year. We are also a major contributor to the programme of reproductive health research undertaken by the World Health Organisation.
In answer to my hon. Friend the Member for Congleton (Mrs. Winterton), neither the UNFPA nor the IPPF in any way recommends or accepts abortion as a method of birth control.
§ Mrs. Ann Winterton
Both those organisations may say that they do not accept it, but the practice continues. I suggest that practice should match the words.
§ Sir Nicholas Bonsor
My hon. Friend has been here long enough to know that no Government can work miracles. It is our intention to move steadily towards that objective. For example, we will not be able to change the habits and practices of the Chinese overnight, but the invaluable work that the UNFPA and the IPPF do in China is helping to move it away from the horrific practices of the past.
§ Sir Nicholas Bonsor
My hon. Friend shakes her head, but it is a fact that the situation in China is improving, albeit at nothing like the speed that we would like. We must target our aid and try to persuade people to drop practices with which we thoroughly disagree.
We are also working hard within the EU. The European Community has pledged to spend 300 million ecu—about £250 million—by the end of the century. We shall develop close relationships with the Commission and press it hard and urgently to ensure that it simplifies its systems so that the work can be done even more efficiently.
My hon. Friend the Member for Cirencester and Tewkesbury said that seedcorn funding was US-biased. It is not. There is no bias of any kind towards any source of application for funding. Judgments are made solely on the basis of the quality of the proposal.
Of the commitments made to date, United Kingdom groups have obtained by far the largest share in terms of the number of projects and financial support. Two thirds of the projects are from UK organisations, and a similar proportion of committed funding goes to UK groups. All the applications currently under consideration are from UK-based applicants; none is from US groups or their UK affiliates, so I hope that my hon. Friend will feel that we are addressing that problem adequately.
My hon. Friend also spoke about female genitalia mutilation. That is, of course, an appalling practice, and we shall do our best to stop it, but the problem is that it is an extremely difficult area for us to approach, because it is rooted in deeply held religious principles. Many people who practise it do not fully understand the damage that it causes. We feel that the most important action we can take is through health training, explaining the enormous health risk involved, and weaning them off that practice. Again, that cannot be done overnight, and it must be approached sensitively.
335 A question was asked about the Vatican. We work closely with the Vatican, and share many of its objectives. We both agree that it is important to be able to have children by choice. As the Vatican puts it, to have or not to have children is something that anybody should have the right to decide for themselves. There are areas of disagreement with the Vatican's policy, but we hope that we can reach agreement with it and, over the years, work towards our common objectives, without allowing those differences to intervene too badly in the way in which we undertake our tasks.
My hon. Friend also mentioned United States foreign assistance budgetary aid. We are, of course, deeply concerned about the large cut to the project that the US appears to be making. I am afraid that the amount of help that we shall be able to give will be severely affected by such a cut. We can only hope that the United States will, like us, get over any Treasury limitations that may get in the way, and give the amount of aid that it would wish to give. We think that it will still be giving some $300 million a year, so there will be a substantial pot, but nothing like as large as we have enjoyed recently.
We shall continue to promote new ways to ensure that people have better access to information about reproductive health issues, and to ensure that they are aware of the types and standards of services they are entitled to expect from service providers, whether through Government or non-governmental sources.
Above all, we need to turn around the traditional balance of power. For too long, questions about the quality, quantity and mode of service provision have been cast in terms of what the suppliers of services can or cannot, will or will not, do. There is a need more explicitly in future to base judgments and decisions about services on what best meets the needs of the consumer of those services. We need approaches that allow the exercising of choice by consumers to determine the style and shape of service delivery. It is beginning to happen slowly. We shall look to support further development and testing of such approaches.
I have a slight disagreement with my hon. Friend the Member for Cirencester and Tewkesbury on two points. I do not agree that the percentage of aid budget should be the criterion that we should watch most closely.
We have just said that the United States budget is likely to be slashed. It would be a pity if we cheered because the percentage of the budget spent on this aspect may have improved. It is the total amount we need to spend that matters, not the percentage that it may represent. However, our spending is an improvement on the figure mentioned by the hon. Member for Carrick, Cumnock and Doon Valley: it has risen from 2.3 per cent. to 3 per cent., and we did not do that by cutting the budget.
My hon. Friend the Member for Cirencester and Tewkesbury was rather dismissive about other overseas aid projects. I do not agree with him. We do an enormous amount of good through the ODA and our other aid budgets, and we must not concentrate on one issue, however important it may be.