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Baroness Amos: My Lords, I do not agree with the noble Earl that the targets are unrealistic. Although the targets are difficult, they are achievable if there is strong political will and commitment behind them. The international development targets are important because they are a commitment by all the members of the UN. The noble Earl asked specifically about the setting of intermediate targets. Individual countries, through their poverty reduction strategies, set intermediate targets. If countries write poverty reduction strategies, the inclusion of long-term, medium-term and intermediate-term targets which they intend to reach at specific points is compulsory. Both of those matters are important. Individual countries have the opportunity to set intermediate targets, but international development targets are an international effort.
Lord Redesdale: My Lords, does the Minister agree that some of the countries in sub-Saharan Africa are
going backwards at the moment? Considering that the targets for Africa are not being met, will there be a reassessment of viable targets in Geneva in June? In asking that question, I recognise the good work that DfID has done over the past five years.
Baroness Amos: My Lords, we are experiencing difficulty in meeting the targets in sub-Saharan Africa for a number of reasons, including the scale and spread of HIV/AIDS and the degree of conflict in many of those countries. But it is important to recognise that there are differences between countries in sub-Saharan Africa. For example, Nigeria and South Africa have a very good record in economic growth. Therefore, we should not be pessimistic about the region as a whole. As for a reassessment of our ability to meet the targets in sub-Saharan Africa, I repeat my response to the noble Earl, Lord Sandwich. As a global community it is important to have a commitment to a set of international targets. How we apply those targets in individual countries will depend partly on the degree of commitment by those countries to putting in place pro-poor development policies. We do not want to roll back from the commitment to those targets, but clearly when countries put in place their poverty reduction strategies we shall look at what they can realistically achieve.
Baroness Rawlings: My Lords, we all agree that one of the main routes towards the successful eradication of world poverty is through the education of adolescents, especially young girls. Can the Minister tell the House what additional plans Her Majesty's Government have prepared to target female education and healthcare? Does DfID have any links with important charities in this field, such as the International Women's Health Coalition and AMREF?
Baroness Amos: My Lords, I am in total agreement with the noble Baroness that it is important to invest in education. It has been shown that such investment is one of the most important determinants in meeting all the other targets, including health and poverty targets, because of what happens to families where, for example, mothers and daughters have been educated. In the past three years we have committed £400 million to support primary education programmes, all with a strong focus on gender equality. The noble Baroness will be aware that of the nearly 900 million people across the world who are illiterate 600 million are women. So the education targets are very important indeed.
The noble Baroness asked about health. Infant and under-five mortality rates fell by more than half between 1960 and 1990. But progress has slowed during the 1990s. In most regions, particularly sub-Saharan Africa, which we have already mentioned, a big effort will be needed to meet the targets.
The noble Baroness asked also about AMREF and one other organisation. We are in touch with AMREF. I had a meeting with AMREF relatively recently. We are in touch with a number of NGOs which are working in this area.
Lord Tomlinson: My Lords, in pursuit of the objective of poverty reduction, will the Minister ensure that European Commissioner Lamy's proposals in the "Everything but Arms" initiative do not prejudice either Article 12 of the Cotonou agreement, which provides for prior consultation with the African, Caribbean and Pacific countries if their interests are detrimentally affected, or the legal status of the sugar protocol or the sugar regime proposals which, inter alia, provide for the renegotiation of the special preferential sugar agreement? Either of those will have a serious effect on Caribbean producers. It would be wrong to pursue poverty reduction in some parts of the world at the expense of creating poverty in others.
Baroness Amos: My Lords, my noble friend will be aware that we worked extremely hard in the successor to the Lome Convention to protect the interests of Caribbean producers. We shall continue so to do. In principle, we support "Everything but Arms" and we are willing to work with the European Commission to help Caribbean industries adjust. We want to look at the impact of "Everything but Arms" on Caribbean countries. However, I reiterate to my noble friend that we want to protect the interests of Caribbean producers.
Lord Bridges: My Lords, perhaps I may ask the noble Baroness a question which has puzzled me for some time. For so long as we define poverty as a percentage of GNP, how can we hope to arrive at its abolition?
Baroness Amos: My Lords, it is important that we recognise that poverty reduction is not just about aid to developing countries; it is about development and in particular looking at the capacity of developing countries to improve economically. Therefore, part of our strategy relies on seeking to work with business and with other partners to achieve economic prosperity and growth in developing countries.
Speech and Language Therapists
2.53 p.m.
Lord Faulkner of Worcester asked Her Majesty's Government:
- Whether the levels of recruitment and retention of speech and language therapists are satisfactory.
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, the number of qualified speech and language therapists increased by 310 between September 1997 and September 1999. The NHS plan will see a further 6,500 therapists and other health professionals by
2004. The department's recruitment and retention strategy embraces this important and valued group of staff.
Lord Faulkner of Worcester: My Lords, I thank my noble friend for that reply. Is he aware that there is still a serious shortage of therapists? As a result, waiting lists are long and vulnerable children are not getting the assessments and treatment that they need. Is he satisfied that the problems which were identified in the study carried out by the Royal College of Speech and Language Therapists last year of poor morale, low pay and poor recognition have been addressed and that, therefore, speech and language therapists can expect the increase in recruitment to which my noble friend referred and can continue to perform their absolutely invaluable role in helping children overcome their communication difficulties?
Lord Hunt of Kings Heath: My Lords, I certainly share my noble friend's view of the importance of speech therapists. I also acknowledge, as I did in my main Answer, that we need to see further increases in the number of speech and language therapists employed within the National Health Service. We have made good progress in the past two years; and we shall be looking at the number of training places that are available as one way in which to increase the numbers of therapists in the long term.
My noble friend referred to morale. In common with other groups of non-pay review body staff, speech and language therapists have benefited from an above inflation pay increase this year. Additionally, a new pay and grading structure was introduced on 1st April 2000. This importantly extended the existing pay spine for speech therapists in line with that of clinical psychologists. That will increase the pay availability for senior speech and language therapists by around £20,000.
Lord Clement-Jones: My Lords, I welcome what the Minister said on cases of equal value and the settlement of those cases earlier in the year. One of the reasons for problems with the morale of speech and language therapists referred to in the survey mentioned by the noble Lord, Lord Faulkner, is the constant change in reorganisation of the National Health Service. How will the Government's new proposals on regulation of the professions allied to medicine improve that? Surely, they will only compound that problem.
Lord Hunt of Kings Heath: My Lords, I do not agree with that but over the past 20 years the various managerial changes have adversely impacted on many of the professions allied and supplementary to medicine. Part of our strategy in relation to those professions is to ensure that at local level their views, concerns and management are given sufficient attention by the boards of NHS trusts.
But so far as concerns regulation, what is proposed in the consultation paper that we are considering will enhance the whole regulatory process for this and
other similar professions. It will speed up disciplinary processes and enhance public confidence. Through that I believe new confidence will be established among the professions.
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