Panel (Maximum Of Patients)
asked the Minister of Health the maximum of patients a doctor may have on his panel; and to what extent he may increase this number by having an assistant?
The maximum number of patients for whom an insurance practitioner working single handed tray accept responsibility is 3,000. The Insurance and Panel Committees have power to fix a lower number as the limit for their particular area or for any portion of it. The extent to which the number may be increased in the case of a practitioner who employs a permanent assistant is a matter within the discretion of the local committees. The information available indicates that in general the employment of an assistant is held to justify the increase of the number by approximately 50 per cent.
Does the right hon. Gentleman consider that a doctor can deal with 3,000 patients?
What are the restrictions on a veterinary surgeon when he is dealing with cattle?
I do not think cattle have health insurance yet!
Is it not the fact that the numbers given are not patients, but only potential patients—that there is only a small number of actual patients?
That is so.
asked the Minister of Health if he is aware that the Medical Sub-Committee of the Durham County National Health Insurance Committee have recently fined medical practitioners on the panel for alleged excess in the cost of drugs given to panel patients, asserting that drugs of a less expensive character should have been given and that medicine should have been ordered to have been given at greater intervals: and will he have inquiries made into this with a view to the proper treatment of those suffering from ill health?
In answer to the first part of the question. I would observe that the withholding of remuneration on the ground of excessive prescribing is settled not by a Sub-Committee, but the Insurance Committee itself, who receive independent medical advice from the Panel Committee. I have not yet received the reports of the particular cases to which the hon. Member refers, but I have no jurisdiction to review the Insurance Committee's decisions unless the doctors concerned exercise their right of appeal to me. There must be some safeguard against extravagance in prescribing, but the present arrangements are not working well and are under revision.
Widow S' Pensions
asked the Minister of Health if he will place before the House the Report prepared for the Ministry of Health on the cost of widows' pensions, showing the basis upon which the estimate of over 400,000 widows with dependent children was arrived at?
The estimate mentioned is the result of an actuarial calculation based on the Census of 1911 and other relevant data. Direct information on the subject will be obtainable in due course from the Census of 1921.
Will the right hon. Gentleman answer the question on the Paper? Will he place before the House the Report asked for in order to clear away the grave suspicion in regard to the matter?
I will consider that point.
asked the Minister of Health whether, during the recent small-pox scare in London, any intimation was sent out from his Department to medical officers of health or other persons on the subject of the closing of business premises in the event of smallpox occurring thereon; and, if so, what was the exact tenour of such intimation?
The only, communication which can be traced on this subject is a statement in reply to an inquiry by a certain firm of solicitors, that the Department were not aware of any statute or regulation empowering the Minister of Health to order the closing of a factory in which cases of small-pox had occurred. The question whether it is desirable or otherwise to advise the closing of a factory on account of the occurrence of cases of small-pox rests with the medical officer of health of the district.
asked the Minister of Health whether he can state the methods adopted by the medical inspectors of his Department in order to decide whether cases of illness examined by them are smallpox or not; and whether the vaccinal condition of the patients is taken into account as one of the factors to decide the diagnosis?
The medical officers of the Ministry who advise in regard to the diagnosis of suspected cases of small-pox are those who have had considerable experience of that disease, and in forming an opinion as to the nature of the illness they take into account all known factors, including the vaccinal condition of the patients.
asked the Minister of Health whether the official from his Department who went into Derbyshire to investigate the outbreak of small-pox has made his report; whether such report is available to Members; and whether the suggestion of the district council that there, should be an isolation of contacts is being accepted?
The answer to the first part of the question is in the affirmative. These reports ale intended to be confidential and, as at present advised, I do not propose to publish the reports made by medical officers of the Department in regard to this outbreak. As regards the last part of the question, I am advised that isolation of the contacts of a case a small-pox is not generally necessary either in the interests of the contacts or for t he protection of the public, unless and until the contacts themselves develop the disease.
Are we to understand that the report is not available for the council or councils interested in the cases?
Yes, Sir; it is a confidential report to the Department.
Is it not essential to isolate if it is a case of infectious disease?
The reference is to "contacts," not to people actually suffering from the disease.
It is infectious!
The "contacts" are not suffering from the disease.
Animals (Humane Slaughter)
asked the Minister of Health whether the Ministry of Health has issued to the local authorities concerned the circular upon the more humane slaughtering of animals which was promised on 24th July, 1922, by the then head of the Department; if so, will he let Members have a copy of it; and if not, when will it be issued?
As my hon. Friend was informed on the 12th December, the issue of the promised circular was deferred in view of the decision to have the matter considered by a Committee of the Cabinet. The deliberations of the Committee have been unavoidably delayed, but the matter is receiving attention.
Reigate And Redhillhospital
asked the Minister of health if he is aware that it is proposed to spend £30,000 in alterations to the Reigate and Redhill Hospital, which is built on a cramped and unsuitable site; whether the Surrey Voluntary Hospitals Committee, of which the Lord Chancellor is chairman, has given careful consideration to the proposal and has advised the hospital authorities not to proceed on the present site; and whether, in view of the urgent need for a modern, well-equipped hospital to serve the south-eastern area of Surrey, and especially having regard to the fact that a suitable and commodious site has been presented to the hospital committee, he will endeavour, by conference with all the parties concerned or otherwise, to persuade the hospital committee to reconsider its decision?
I understand that the Voluntary Hospitals Commission have not received any communication on this matter from the Surrey Committee, of which the hon. Member is a member, but I have asked that the question should be brought to the notice of his colleagues on that committee.
asked the Minister of Health if his attention has been called to the increase in the number of cases of intoxication due to the consumption of methylated spirits; and if he will consider what steps can be taken to render this class of spirits non-potable?
I have been asked to take this question. The matter is one which has received the attention of my Department for some years in connection with convictions for drunkenness, of which the cases believed to be due to the drinking of methylated spirits have shown a tendency to increase. It is not a matter as to which I have any powers, but I shall continue to study it in consultation with the proper authorities, in the hope of finding preventive measures. I understand, however, that it has not been found practicable to make the spirits more unpalatable than they are at present.
If the Government have no power to deal with this matter, can the right hon. Gentleman say who has power? Is he aware that only last week one constable at a London police court brought forward four of these charges of drunkenness in four days, and as there has been an enormous increase in the number of these cases, if he has not the power. can he say if there is any Government Department that has power to deal with them?
Does the right hon. Gentleman think that a reduction in the taxation on spirits is likely to reduce the consumption of this spirit?
Is it not true that the papers generally put it that methylated spirits are only consumed in countries where there is prohibition?