HC Deb 06 December 1988 vol 143 cc89-90W
Mr. Alfred Morris

To ask the Secretary of State for Foreign and Commonwealth Affairs what are the terms of reference of the desk review of health services in the dependent territories; when he expects it to be completed; and if the House will be informed of the action to be taken in consequence of the review.

Mr. Chris Patten

The terms of reference of the desk review of health services in the Caribbean dependent territories are:

  1. 1. Assemble existing information including the current health plans and any readily available related statistical information from each of the four territories, WHO/PAHO reports, and reports by ODA medical advisers during 1983 to 1988, and other relevant information from ODA files. ODA medical advisers will provide guidance on the material to be examined and will provide oral briefing on the situation in the territories;
  2. 2. Write a preliminary report covering
    1. a. the evidence on the state of health of the population establishing and ranking the main health problems which need to be addressed and their main causes (nutrition, sanitation, health care services, etc);
    2. b. the extent to which these health problems are being addressed by current policies and programmes of health services, public and environmental health, and nutrition;
    3. c. the costs of providing the health and environmental services identified under b. and assessing their cost effectiveness and value for money; examining how the provision of these services is financed and identifying implications for quantity and quality of services supplied and demanded and for other factors relevant to the study;
    4. d. recommendations for future health and environmental services, and measures to improve nutrition, which optimally address the main health problems identified under a. These recommendations should cover:
      1. (i) appropriate levels of health care and other services;
      2. (ii) division of services between those provided on island and those provided off island;
      3. (iii) sources of finance for services;
      4. (iv) the means of delivering health and other services;
      5. (v) levels of staffing and equipment for on island services taking account of financial, medical, physical, institutional and manpower constraints in a manner which makes optimum use of the available resources; and where relevant to identify options where choices can be made.
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    5. e. recommendations for future ODA-funded assistance, with particular attention to manpower, training and advisory services; an analysis of alternatives and recommendations for the administration of ODA programmes with particular attention to professional monitoring and supervision to the extent that existing information so permits.
  3. 3. Identify the main gaps in information;
  4. 4. Prepare a work plan and timetable for gathering the missing information and completing the work required by i. to v., with attention to the order of priority between countries, specify the inputs required for this work from the main professional disciplines;
  5. 5. Prepare an outline for the final report, covering the main chapter and section headings with notes on what is to he covered by each.

This desk study was completed last August. It was the first step, preliminary to a field study, in each of the Caribbean dependencies, for which consultants are at present being engaged. Their report should be available by about next spring; I shall keep the right hon. Member informed.

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