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Lord McIntosh of Haringey: My Lords, my noble friend is right to suggest that poorer countries are the worst affected by lack of primary education. Unfortunately, the problem is not always poverty: it is their governments' attitude to primary education and whether they give it enough priority. Therefore, the commitment that we have made at Dakar, and encouraged others to make, is that no government who are seriously committed to achieving education for all will be held back by lack of resources. That has been our policy for a number of years.
Baroness Rawlings: My Lords, Thomas Bediako, the NGO representative at Dakar, said that the draft framework falls well short of what we hoped for: that it is short in time-bound commitments; weak in financing; lacks mechanisms for transparency and accountability; is vague; and lacks detail. How can Her Majesty's Government support it and do they endorse that criticism?
Lord Dormand of Easington: My Lords, does my noble friend agree that one of the most depressing features of such conferences is that nothing appears to happen as a result? Does he accept that this country can greatly benefit from the commitment outlined in his Answer?
Lord McIntosh of Haringey: My Lords, it is important to recognise that the policies that the Government have put forward since publication of their White Paper in the autumn of 1997 have resulted in a more realistic appraisal of the causes of poverty and the need to deal with it in the world. It is also important to recognise the relationship between poverty and education. If we have achieved something in convincing others of that, my noble friend is right.
Baroness Williams of Crosby: My Lords, I appreciate the Minister's reply, but is he aware that during the east Asian financial crisis there was a sharp drop in the recruitment of children to primary schools; for example, in Indonesia by as much as 20 per cent? Can he assure the House that one of the outcomes of the Dakar forum will be that when such countries in financial difficulties approach the International Monetary Fund or the World Bank it will be ensured that the education of their children will not be one of the areas to be cut under pressure to achieve a budget surplus or balance?
Lord Patel of Blackburn: My Lords, I thank the Minister for his Answer. However, does my noble friend agree that, despite the Government's positive action policy, the number of people from a minority ethnic background in the NHS trusts who win merit awards, become executive directors or even chief executives is disproportionately very low?
Lord Hunt of Kings Heath: My Lords, my noble friend has undoubtedly identified a challenge which the NHS must face. However, there is no doubt that considerable progress has been made. I can assure him that we have a target to increase the number of black and minority ethnic people as executive directors of NHS boards to 7 per cent by the end of March 2004. Furthermore, since May 1997 more than 12 per cent of non-executive board appointees have come from minority ethnic groups.
Lord Tope: My Lords, we want to express our appreciation to all those from whatever race and origin who work in the health service. However, undoubtedly, discrimination takes place within the health service. The Minister will recall that during the passage of the Health Bill through this House we urged the Government to insert a non-discrimination and equal opportunities clause. They said that they agreed in principle and that in due course they would introduce such legislation. Where does that pledge lie now with only a year or so to go before the general election?
Lord Hunt of Kings Heath: My Lords, the Government are committed to doing everything they can to remove discrimination within the health service. I mentioned the targets that have been set for executive board directors by 2004. In addition, we have set targets to reduce harassment to staff in the health service; we have signed up to the CR leadership challenge; by April 2001 all NHS organisations must use the Employment Service's two-tick symbol to guarantee interviews to qualified disabled applicants; and we have established NHS equality awards. Our whole approach in ensuring equal opportunities is cohesive.
Baroness Gardner of Parkes: My Lords, my question relates to the north-west area. I believe that it is particularly appropriate in view of the fact that this Question comes from the noble Lord who is from Blackburn. Is the Minister aware--I am sure that he is--that the worst area in the whole of the United Kingdom as regards dental condition is the North West? Three years after this Government came to power, does he not consider that definite discrimination is continuing against the very poorest people in those communities through the failure of the Government to introduce fluoride to the water
Lord Hunt of Kings Heath: No, my Lords. I am afraid that I cannot agree with the noble Baroness. She well knows that we have established an expert review to examine the issues of efficacy and safety in relation to fluoridation. When that review reports, we shall of course be able to take forward appropriate policies. The situation with regard to access to NHS dental services is one that we inherited from the government which she supported. Many people were finding it difficult to access NHS services. For that reason, we established the investment in dentistry scheme. We have established dental access centres which have enabled many more people to access NHS services. In the future, we shall develop an NHS dental strategy.
Lord Laming: My Lords, will the Minister note that the very helpful Question of the noble Lord, Lord Patel, referred to all forms of discrimination? In addition to the schemes and initiatives that he listed, will the Minister agree to keep an eye on discrimination against the treatment of elderly people in the NHS?
Lord Hunt of Kings Heath: My Lords, we return to a subject which is rather familiar to your Lordships. Perhaps I may repeat that there is no place for discrimination against older people in the National Health Service. We established a National Service Framework for Older People in order to guarantee high quality, consistent services for older people throughout the NHS.
Earl Howe: My Lords, does the Minister agree that, sadly, one of the sources of racial harassment in the NHS is the behaviour of certain patients? Is that not a particularly difficult part of the problem? What can be done to condemn and discourage such behaviour within hospitals and clinics?
Lord Hunt of Kings Heath: My Lords, I believe that the noble Earl has raised an interesting point. There is no doubt that harassment of staff is a worrying problem. The latest published data suggest that 60 per cent of black nursing staff have had difficulties with patients for ethnic reasons and 58 per cent of Asian nursing staff have experienced similar problems. I believe that we can take a number of actions and we have developed a process of setting targets to reduce harassment. It is most important that individual local employers make it abundantly clear to staff that harassment will not be tolerated and that they have appropriate policies in place to deal with it. However, I agree with the noble Earl that it is also important that we give the message to members of the public that that kind of behaviour cannot be tolerated.
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