It is a real pleasure to follow the right hon. Member for Kingston and Surbiton (Sir Edward Davey) and all the other speakers. I fully support the motion and all the actions that it calls for. Much has been said about the urgency of ending the scourge of tuberculosis abroad, but I want to focus on what we can do here in the UK to help to stamp out TB among our citizens. If we are going to champion the fight against TB in countries where the prevalence is far greater, but where the general economic situation is far poorer, how can we hold our heads up when England still has one of the highest rates of TB in western Europe? That is from the Public Health England report of this March, so I apologise to colleagues from other nations of the UK—no doubt the figures are similar there.
Of course I support research into the causes and prevention of TB. Of course I support our programmes abroad to help to reduce the millions of deaths in less developed countries. Of course I support the search for new, more effective drugs, but we already know some of the causes, and the lack of effective policies on poverty and homelessness in our country make our commitments to eradicating TB abroad look—how shall I say this?—inconsistent. Public Health England is doing many of the right things, such as improving access to testing and diagnosis, but if we look for the reasons for the 20-year rise in TB rates in the UK from the mid-1980s to the early years of this century, the causal factors are not hard to find.
Some of the policies of the present Government, and, indeed, all Governments since the 1980s, have not helped. First, there is homelessness. Whether the homeless person was born in the Marshall Islands or in Margate, we know that if they are sleeping rough they are far more susceptible to infection and far less likely to seek treatment. Thirty per cent. of people in this country with TB do not seek treatment for more than four months, even after the symptoms have started, and during that time they are infecting the people around them. A very high proportion of those people are marginalised, without easy access to healthcare and
without the motivation to seek it. We can try to work with homeless people, and I was delighted to hear about the London find and treat team, but how much better and more effective it would be to eradicate homelessness, and especially rough sleeping.
Secondly, there is our attitude to immigrants. It is yet another outcome of the hostile environment that so many immigrants suffer from diseases and do not have the information or the confidence that would enable them to seek help. Three quarters of TB sufferers in this country last year had not been born in the United Kingdom. That does not mean that they brought the disease with them, but it does mean that we do not do enough to inform immigrants to this country of the healthcare that is available, and do not give them the confidence to seek help from official organisations, including the national health service.