HC Deb 01 July 1954 vol 529 cc1652-62

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Redmayne.]

10.32 p.m.

Mr. A. Blenkinsop (Newcastle-upon-Tyne, East)

I am raising the question of the contributions we are making from this country to the World Health Organisation, because of what I felt to be unsatisfactory replies which were given in the debate we had in March on the whole problem of world mutual aid, when I took the opportunity of raising the more limited problem of the work which is being done by the Organisation and some of the particular financial difficulties it was facing.

In view of the rather unsatisfactory reply I got then, I put Questions to the Minister of Health to which, again, I felt I received unsatisfactory replies. I then raised the question of why it was that the delegates from this country to the last Congress of the World Health Organisation, held a short time ago in Geneva, should have voted against the full increase in the budget of the Organisation put forward by the Director General.

I do not think that tonight I need argue at all about the value of the Organisation. In this House its work is well known even though, alas, it is not sufficiently well known outside. I think I can perfectly well assume that there is no difference of opinion between the two sides of the House about the enormous contribution this body is making from extraordinarily limited funds. Perhaps it is worth emphasising how very much of the work being done by the World Health Organisation is in our own overseas areas with the full co-operation, I willingly admit, of many other organisations: with the full co-operation, in many cases, of the Colombo Plan organisation, and, in some cases, of the Colonial Office.

It is worth while emphasising that the work being done by the World Health Organisation is making a valuable contribution to our home problems, and reminding as many people as possible that this is a mutual aid scheme. It is not a question of a number of rich countries making contributions to those that are poorly off, although it is true that the main contribution comes from those who are best able to make it, and recipient countries are making out of their meagre resources a much larger contribution than we are. We would accept that as being right. It is part of the aim of the World Health Organisation to ensure the co-operation of the local population in the particular countries in which the particular schemes are being carried out.

Much work is being done in many parts of the world in which large contributions are being made—such as Haiti and elsewhere, where, in addition to making a contribution in their own countries, they are sending people out to help in other countries in spite of the needs of their own areas. Anyone who wants further proof of that has only to read the recent book, "Man Against the Jungle" by Ritchie Calder, which gives a graphic account of the way in which the World Health Organisation and other Specialised Agencies of United Nations are carrying out their work.

I want to emphasise that there is a real danger that the full continuation and development of this vital work of the organisation may be affected by a shortage of funds because of the extreme irregularity of their payment. As may be known, the Organisation secures its finances from three sources. It has its regular budget, finally approved by, the United Nations Assembly: that is produced by the Director-General of the Organisation, and to that approved budget this country makes its contribution—roughly, about 10 per cent. That contribution falls on the Vote of the Ministry of Health, and at present it is the miserly sum of £350,000. That is all we contribute to the regular budget of the World Health Organisation.

It is true that the organisation also secures funds from the Technical Assistance Board, which was designed at one time to try to co-ordinate the work of the many United Nations Agencies which were to work together—the Food and Agricultural Organisation, U.N.I.C.E:F. for dealing with children, and U.N.E.S.C.O. for work in education. They are tackling a combined job, and there ought to be a co-ordinating body. A further technical assistance programme, out of which it was hoped a good deal of extra money could become available, was developed. Some did become available in the first year of the scheme, but, unhappily, it has been unreliable and last year the World Health Organisation had, on two occasions, to cut down very wisely indeed on the programmes planned for several years in advance.

I ought to impress on the House that this not only causes a great deal of disturbance in the plans of the Organisation, but it breaks down the balance of the work in the countries concerned which involves the whole health operations of those countries or could do. It is a very serious matter indeed when schemes that have been understood to be fully approved have to be postponed for some period of time. This is precisely what happened last year, and I fear that it may be happening again this year, largely due to the complete unreliability of contributions coming through from the Technical Assistance Board.

There is a third small source which has been available in the past, from U.N.T.C.E.F.—the children's fund—which, indeed, last year had to step in and help the World Health Organisation out of its debts, which is something which really should not have happened. Because of the irregularity of the pay ments and these other difficulties, it was proposed at the annual assembly of the Organisation that its regular budget should be increased, and that it should be increased fairly substantially—by about 20 per cent. Even that is a small sum of money in total when we consider the work that is being done and if we relate it to the expenditure which we are quite willing to approve in this House for much less laudable purposes.

In any case, it was proposed that the budget of the World Health Organisation should be increased to about 10¼ million dollars. As I understand, our own delegates from this country opposed that proposal which was turned down by 28 votes to 22 votes—a small margin—and a compromise figure was agreed on the proposal of this country and a budget of 9¼ million dollars was approved, which was some increase on last year, but still is a miserably small contribution for work of the quality that is being done by the World Health Organisation.

I understand from answers to Questions which I have put down that the reason put forward by the Minister of Health is that the extra funds should be made available from the Technical Assistance Board. That is all very well if, indeed, those funds are going to come forward, but if we are to judge from past experience, we have no reason to expect them to come forward. I think it is intolerable that for a miserably small extra contribution that has been asked, this country should have taken a prominent part in forcing down the figure of the regular budget instead of giving a more secure financial basis than seems likely today.

I should like the Parliamentary Secretary to say what sort of guarantee she thinks there is, not only this year but for the future, of the Technical Assistance Board carrying out what we all originally hoped it would be able to do, and make the larger contributions which we all hoped would be possible.

I should like to make this further point. It seems to me that until we in this country and other countries are able to give some greater certainty as to the level of payments over a period of years, it is going to be very difficult, if not impossible, for bodies like the World Health Organisation—and this applies equally to the other United Nations Agencies—to secure the type of technical skill that they want.

If one thinks in terms of the World Health Organisation, with which I am chiefly concerned, their job is to secure assistance for training people, in countries such as Indonesia and other places in the Far East, and elsewhere, in public hygiene, which is very important indeed, and in the best manner of controlling particular diseases such as malaria, and so forth. A high quality of technical assistance is needed to carry out that work. It may be said that we can get some extremely skilled and very able people, from our universities, teaching hospitals, and elsewhere, to go out for short periods. No doubt that is excellent, in its way, but we find it difficult to get people to take up appointments for any considerable length of time indeed. I do not know whether such appointments can be offered, because there is no guarantee that sufficient funds will be available to enable their work to be carried out.

This is forcing the World Health Organisation to concentrate upon short-term schemes when it would be far more economical to do more work of a long-term character, and to concentrate much more on long-term training of local personnel, which is the main job that has to be carried out. I suggest the hon. Lady should try to persuade her right hon. Friend the Minister to seek Treasury support for the setting up of some form of international Civil Service, which would be able to offer some guarantee of appointments for technical work of this kind. It might be linked with the Over-sea Civil Service which has only recently been inaugurated, since much of this work is in Colonial Territories.

It is desperately important that we should get the full value of this constructive work, and get the right type of person to take on the jobs which are so badly needed in these countries. The temper of the debate we had a little time ago has shown that it is agreed throughout the House that all this good and constructive work is worthy of the best we can do, and it is a shocking thing the relatively small sum of £100,000 is preventing us from giving the guarantees which would enable these world health schemes to be carried out.

10.47 p.m.

Mr. Nigel Nicolson (Bournemouth, East and Christchurch)

I rise to give my warm support to everything that has been said by the hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop). I know that in this case I am not fighting a battle with the Parliamentary Secretary; the person who should be in her place tonight is the Chancellor of the Exchequer or the Financial Secretary to the Treasury. I am sure she feels—although she may not be able to express it so openly as we do—the same wish to foster this growing Organisation. If the Chancellor were here I am sure that he would not resent the mild pressure which the hon. Member and myself are now putting upon the Government to liberate more funds for this purpose.

I merely wish to draw attention Lo three points. First, health is the whole basis of the aid which we are bringing to these backward countries. If the people of those countries are not well they can derive no advantage from the other more material and tangible benefits which are being brought to them under the technical aid programme. Secondly, this is a growing Organisation. It is young, but already, during the live or six years of its existence, it has gained momentum and has expanded, as it was intended to do. If, at this moment, contributions are curtailed or even kept only at their original level, that momentum cannot be maintained. It is up to us—a country with tremendous experience in the organisation of international methods of health control—to give the lead which the rest of the world is awaiting, by making a contribution which is in proportion to the growing needs and achievements of this Organisation. Not to do so will merely mean wasting the past efforts we have made.

Finally, I would support what the hon. Gentleman said about making our contribution a firm annual contribution, a sum of money to which the organisers can look forward with certainty, because without that certainty all our efforts will be frustrated. They must have the knowledge that such and such a sum will be forthcoming from the various countries, particularly ours, if there is to be certainty that their work will bear the fruit that it should. So I add my appeal to that of the hon. Gentleman opposite that my hon. Friend, even at third remove, will do her best to bring about this increase in the contribution we make to the World Health Organisation.

10.51 p.m.

The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)

The hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) has raised a matter that commands general support in the House, and I agree with him in what he said about the very great work that the World Health Organisation does not only directly by itself but also through the Technical Assistance Programme in which it participates. I am doubly grateful to him for initiating the debate because it provides an opportunity to clarify the functions and scope of the two very distinct parts of the Organisation's work, and to sort out some of the misapprehensions that have arisen.

The position is complicated by the fact that since 1950 the Organisation has taken on certain additional duties in relation to the expanded Technical Assistance Programme which, hon. Members will remember, was a plan for the economic development of under-developed countries. I would make clear the differentiation between the funds. First, the regular budget of the Organisation is financed by contributions from member States which contribute annually on an internationally agreed scale based on each member country's assessed ability to pay. The Government have regularly paid their assessed contribution of about 11 per cent. The Technical Assistance Programme funds, on the other hand, are contributed on a purely voluntary basis by a number of countries including the United Kingdom. Of the Technical Assistance funds the World Health Organisation draws about 20 per cent.

Difficulties have arisen in that the Organisation and all the Specialised Agencies concerned with the Technical Assistance Programme funds have found that the T.A.P. has fallen very far short of the somewhat over ambitious expectations—and, I should say, unjustifiable expectations in some cases—of the Agencies themselves. They budgeted for money they hoped to receive voluntarily and which they did not get.

Mr. Blenkinsop

The hon. Lady will agree, will she not, that they had every undertaking that the Technical Assistance Programme funds would be forthcoming?

Miss Hornsby-Smith

I would not accept that from the hon. Gentleman.

I want to make clear that the responsibility of my right hon. Friend is limited to the World Health Organisation. The United Kingdom contribution to the Technical Assistance Programme is the responsibility of the Foreign Office. This is a matter that has been very carefully discussed in the Assembly this year. It gave rise to considerable thought and decision. While the functions of the Organisation are described in its constitution in very wide terms it is quite clear that there must be a practical limit. One must accept a dividing line between what are the regular and proper activities of the W.H.O. and what are the activities of the Technical Assistance projects that may overlap into the field of health.

Where technical assistance is given to increase the productivity and the economic well-being of the receiving nation it is not unreasonable that a receiver nation should contribute to the project. It was agreed at the recent Assembly meeting that from the practical point of view the regular activities must be controlled, and that there must be a dividing line between the regular and proper activities of the Organisation and the activities that properly are financed by Technical Assistance funds.

This was endorsed at the recent World Health Assembly, and a resolution adopted recommending that, in future, the Director-General should keep the two programmes separate. In fact, some World Health Organisation money has been spent in financing technical assistance projects. But the establishment of machinery for the prevention of the spread of epidemics and for the organisation of work in its real "health" sense, in this sphere our contribution has not been limited.

Our contribution has been fully met, and when the appropriate increase for World Health Organisation work, amounting to 1 million dollars was put to the Assembly, the United Kingdom delegation supported that increase. That was put forward by the Director-General, and was supported by Her Majesty's Government's representatives, although the increase was voted against by several member States. In our view, in general, the operational work carried out by the World Health Organisation at the request of member States under the Technical Assistance Programme is to assist in the matter of health problems peculiar to certain countries. It is our view that these matters are more properly dealt with under technical assistance; for example, we have had the successful anti-yaws campaign in Siam, which has gone no small way towards helping the economic well being of that country. Our representatives rightly claim that the budget for that type of work ought properly to be considered as technical assistance, and not as a World Health Organisation programme.

But, since that programme started, there has been a considerable increase in expenditure; in 1948, the programme was for 4¾ milion dollars, and in this last year it had grown to 8½ million dollars, of which we have made our contribution of about 11 per cent. For the 1955 budget, our representative supported the 1 million dollars increase which was put forward as necessary for what I might term purely World Health Organisation activities. Of the remainder of the increase, about 700,000 or 800,000 dollars were due entirely to projects dealing specifically with individual Governments, and the operation of which it was calculated were to be wholly beneficial to those particular areas.

It is our view that those come properly under the heading of technical assistance, and we did not agree that they should be included in the World Health Organisation budget proper. If we accept that any programme of this kind hitherto financed from voluntary funds should be put under funds raised by a fixed levy from member States we believe that the number of claims which would be put forward would be unlimited and that the number of claims put forward by countries wishing to avail themselves of the opportunity for such claims would also be unlimited.

We believe that such schemes of technical assistance must be divided from the work of the World Health Organisation. We feel that technical assistance should be bound up with the capacity and willingness of member States to make the necessary contributions as they think fit. If those much wider schemes were included in the work of the World Health Organisation, we feel that they would bedevil its work and extend it beyond its proper sphere and probably beyond its capacity.

The World Health Organisation budget has a fixed contribution, constant in proportion to a proper and regular programme. I am happy to give an assurance that, subject to Parliamentary approval and to the exigencies of our financial situation, Her Majesty's Government will continue to support most whole-heartedly the central programme of the World Health Organisation, provided always that the Government of the day continue to be satisfied with the way in which such things are administered.

The last Report of the Technical Assistance Board states frankly that it would like to know what it will receive in a long-term programme, but it recognises that for constitutional reasons—which concern not only this Government but all Governments—it is extremely difficult for Government to make commitments of their nations' finances for many years ahead. With the best will in the world, they cannot commit themselves beyond a year ahead. The Report states, however, that if the board could at least have a good will statement, some general statement of policy, pledging support, without the Government necessarily committing themselves, it would be helpful. Her Majesty's Government have so far made their contribution to the general programme of all these agencies and will continue to do so.

Perhaps in the last minute of the debate I can deal with the recruitment of experts. My information is different from that of the hon. Member for Newcastle-upon-Tyne, East in that, as far as I am informed, the experience of the World Health Organisation has not shown that it has encountered insuperable difficulties in recruiting staff. It is true that specialists required, particularly for the technical assistance programmes, have had to be seconded from employment in their nations and—

The Question having been proposed after Ten o'Clock, and the debate having continued for half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at Two Minutes past Eleven o'Clock.