The Government expects to spend nearly 50 per cent more than the £230m previously allocated, which will go towards treatment centres and safe burials and “urgent needs”. More expenditure is expected to follow, officials admit, as more NHS staff are deployed to the country.
Critics partly blame the growing bill on the coalition slashing the amount of aid allocated to Sierra Leonean health projects in recent years, leaving the country ill-prepared, with an acute shortage of doctors. Without an effective health system, Sierra Leone was easily overwhelmed by the outbreak.
The UK is Sierra Leone’s biggest donor, but, while increasing the overall aid budget to the West African country, the Department for International Development (DfID) reduced dedicated health aid from £22m in 2010-11 to £12m, £16m and £14m over the following three years.
MPs from both the Labour and Conservative benches argue that the cuts were financially counterproductive. The UK will spend hundreds of millions of pounds on expensive emergency measures to subdue an outbreak which has already killed more than 3,000 people in Sierra Leone and thousands more in Guinea and Liberia.
The increased cost was revealed in evidence to the parliamentary Public Accounts Committee. Conservative MP Stephen Phillips, a member of the committee, accused DfID of having “rather dropped the ball” over health spending, with only 120 doctors in the entire country by the time of the Ebola outbreak. Even before the cuts, Mr Phillips argued, too little attention had been placed on improving Sierra Leone’s health infrastructure over the past 15 years.
“You should have been spending much more on a robust healthcare system inside Sierra Leone and these other countries well before this outbreak occurred,” said the MP, who visited Sierra Leone six times in 2014.
DfID Permanent Secretary Mark Lowcock said he agreed with the “fundamental point; we need to put more emphasis on this”. However, he pointed out “lots of health workers trained in lots of extremely poor countries end up leaving”.
Mr Lowcock also admitted “had the world, the government of Sierra Leone, WHO [World Health Organisation], we and others acted earlier, it would have been cheaper and easier to solve the problem”.
DfID’s chief scientific adviser, Professor Chris Whitty, acknowledged that Nigeria had been effective in controlling Ebola because it had “got on top of the first two or three cases very early”. He added: “The real failure of the international community was that between December  and March  we knew that there was an Ebola outbreak in Sierra Leone, but the expectation was that it could be brought under control, as all previous ones had been. Then there was really a delay between March and the end of July… when the whole international community did not move fast enough. That was the point at which it was allowed to take off.”
Mary Creagh, Labour’s International Development spokeswoman, said last night: “DfID’s top civil servant has admitted the Government made mistakes in responding to Ebola. Ministers were wrong to cut investment in health systems in Sierra Leone and should have focused on getting proper healthcare in place. Now over £300m of taxpayers’ money is being spent on emergency measures, the most expensive form of aid.”
A DfID spokeswoman said: “This is an unprecedented crisis in one of the world’s poorest countries and few health systems could withstand an outbreak on this scale without further help. Britain was the largest bilateral donor to Sierra Leone before the outbreak and more than a quarter of our direct aid has been used to strengthen its health systems in recent years.”
The news comes as DfID finds itself under fire for spending more than £1bn in only eight weeks at the end of 2013, so it could hit its target of spending 0.7 per cent of GDP on overseas aid and development. Sir Malcolm Bruce, the LibDem chair of the International Development Select Committee, has announced that DfID officials will face a hearing to explain what happened. His committee has also been previously critical of cuts in UK health aid to Sierra Leone.
If Labour wins the election, Ms Creagh intends to review the Government’s decision in 2013 to reduce the level at which aid projects need ministerial sign-off. Previously, ministers only had to approve projects costing more than £40m; this is now £5m.
Ms Creagh is concerned that this makes aid spending overly bureaucratic and leads to delays. But a DfID source said: “This level of scrutiny ensures UK funds are directed where they can have the greatest impact and in a way that will ensure maximum value for taxpayers’ money.”