§ Mr. William Hamiltonasked the Minister for Overseas Development if he will publish in the Official Report a list showing the paid public appointments within his gift, the highest and lowest emoluments payable and the total sum paid in 1975 and 1970, respectively.
§ Mr. Prentice,pursuant to his reply[Official Report, 1st April 1976; Vol. 908, c. 581],gave the following information:
The appointments are:
the field of health and medicine, his policy that aid should be concentrated on the poorest people in the poorest countries.
§ Mr. PrenticeBritish aid in these fields has in the past been largely based on the concept of a network of doctors and hospitals on the lines adopted in the developed countries. Latterly, however, opinion has been moving away from the idea that the developed country model provides the best means of improving health in the developing countries. The World Health Organisation and other international bodies and assemblies with health interests, in which these countries form the majority, now recognise that the mass extension of Western-type medical services is an unrealistic and inappropriate aim. Much of the disease in the Third World is due to poverty and ignorance, and its prevention is likely to be more effective and less costly if based on public health preventive measures 253W rather than on curative measures, however desirable these still are.
This "community health" approach implies greater emphasis on the social, economic and environmental determinants of health; on improving nutrition, child health and family planning and providing safe water and proper satitation; and giving priority to simple systems of primary health care, manned by locally trained and suitably supervised staff, to provide a service accessible to the whole population rather than more sophisticated services which benefit only a minority. My future policy will be increasingly to concentrate on the furtherance of these objectives in my programmes of capital aid and technical assistance to Governments which share them. The Governments themselves must, of course, bear the primary responsibility.
On the other hand research into tropical disease must remain an area where much of the initiative rests with the developed countries. Because of the finances and skilled manpower required, such research can be given a new impetus only by a co-ordinated effort led by international institutions and the appropriate expertise of the developing countries in which the diseases occur. I shall give the full support of my Ministry to this effort.