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Public Health

Volume 414: debated on Thursday 25 October 1945

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Tuberculosis Patients (Allowances)

6.

asked the Minister of Health if, in view of the alarm which is created when the allowances are stopped, he will arrange for allowances to tuberculous patients to continue, in cases which are considered incurable, on the same terms as for curable cases.

I would refer my hon. Friend to the reply I gave to the hon. and gallant Member for New Forest and Christchurch (Colonel Crosthwaite-Eyre) on 18th October, of which I am sending him a copy.

Would the Minister look again at this situation, because these people, when they are deprived of their allowances, are, in effect, receiving a death sentence?

This is a most grievous and painful affair. I have not, however, any powers to alter the situation. I will look into the administration to see whether I have sufficient powers to alleviate it but, as my hon. Friend well knows, this and other anomalies will, I hope, be ironed out when we have the all-in scheme of National Insurance.

Health Centres

10.

asked the Minister of Health whether he has made himself acquainted with the work carried out in the interest of public health, by the Peckham Health Centre, before the outbreak of war; whether it is his intention to encourage such health centres in other parts of the country; and whether, with this object in view, he will make provisions for including them amongst his proposals to come before the House.

Yes, Sir. I am aware of the excellent work carried out by the voluntary organisation to which my hon. Friend refers. With regard to the second and third parts of the Question, I have the proposals for a National Health Service, including the provision of health centres of various types, at present under active review.

Mental Deficiency Cases (Acccommodation)

11.

asked the Minister of Health whether he is aware of the present shortage of accommodation in the country for cases of mental deficiency; and what degree of priority is being given to the reconstruction of the necessary buildings and to such new construction as is necessary.

Yes, Sir. I hope that, when building operations of this kind can be allowed to proceed it may be possible to accord a high degree of priority to the work to which the hon. Member refers.

River Thames (Sewage Effluents)

15.

asked the Minister of Health what representations have been made to his Department by the Thames Conservancy Board, supported by the Metropolitan Water Board, with regard to the concern that both these authorities feel at the low standard of a number of sewage effluents in that part of the Thames under the control of the Conservancy; and what action he proposes to take.

Representations have been made to my Department by these two boards that facilities should now be given to enable the local authorities concerned to carry out works for improving the sewage effluents. I am pressing the local authorities to complete the preparation of their schemes as quickly as possible, and the labour requirements of the schemes are receiving special attention. I will keep the matter under constant review.

Rural Water Supplies Act (Schemes)

16.

asked the Minister of Health what action he proposes to take with those authorities who up to the present have not submitted schemes under the Rural Water Supplies Act, 1944.

I am keeping in close touch with the progress made by rural authorities and I am encouraging them to complete the preparation of their schemes so that work on them may be carried out as soon as the labour position allows. I have no reason to think that these authorities are not proceeding as rapidly as they can with the present shortage of technical staff available to them.

Doctors (Hayes, Middlesex)

17.

asked the Minister of Health if he is aware that the supply of doctors for the urban district of Hayes, Middlesex, is one for every 4,000 inhabitants and in the near future will be reduced to one for every 5,000 inhabitants; and whether he has any proposals for the supply of doctors in order to remedy this state of affairs which is a menace to the health of the people in this area.

I am aware that the medical position in the area referred to is difficult and I am in communication with the Central Medical War Committee who are going into the matter with the local committee. I will let my hon. Friend know as soon as possible what steps are proposed to improve the situation.

In view of the reference in that Question to the shortage of doctors for the number of patients, will the right hon. Gentleman consider in the interest of patients who do not require the services of orthodox doctors, the recognition of unorthodox practitioners?

Arising out of the answer to the original Question, as this is surely a matter of interest to the nation and not to one part of the country only, would the Minister make a statement in the House upon this subject at the earliest possible moment?

Yes, Sir, I am doing all I can to try to increase the supply of doctors for civilian purposes and I hope shortly there will be a very substantial increase in the number.

Diphtheria Immunisation (Advertising)

18.

asked the Minister of Health the total cost of all advertising matter in connection with the immunisation campaign during each of the last five years.

The expenditure on publicity for the immunisation of children against diphtheria has been as follows:

£
1940–41800
1941–422,276
1942–4319,909
1943–4430,777
1944–4532,467
I may add that since the immunisation campaign began, the number of deaths from diphtheria has fallen to one-third of the pre-war average. Apart from this saving of children's lives, the number of cases has fallen by 28,000—and as each child suffering from diphtheria costs about £30 for hospital care, this means a saving of over £800,000 a year.

Sickness And Disability Certificates

19.

asked the Minister of Health whether it is his intention in the new health service Bill to permit any qualified practitioner, even if he or she is not necessarily recognised by the British Medical Council, to issue certificates of sickness or disability.

I am afraid I cannot add anything to the answer which I gave my hon. Friend on 18th October.

Needy Persons (Choice Of Doctor)

24.

asked the Minister of Health whether pending the establishment of a national health service, he will encourage public assistance authorities to introduce the open choice system of medical assistance for needy persons not covered by the health insurance Acts, so that they may be able to obtain free medical treatment from their own doctor.

I am prepared to consider favourably any application for my consent from a public assistance authority which finds it practicable to introduce the open choice system.

While thanking the Minister for his reply, may I ask him to go further and circularise the appropriate local authorities, inviting them to consider the introduction of the open choice system so as to remove the Poor Law atmosphere from the administration of medical assistance for old people and others in need?

I sympathise very much with the desire behind the supplementary question. I am anxious not to send too many circulars out just now, I am already sending a storm of them, but probably this Question and answer will be given sufficient publicity to stimulate local authorities to apply the system.

Vaccination (Compulsory Powers)

27.

asked the Minister of Health whether in view of the fact that there are a larger number of claims for exemption from vaccination than those submitting to the operation, he will consider abolishing the compulsory powers of the Vaccination Acts.

This is among the matters under examination in connection with the proposals for a comprehensive health service.

Will the Minister consider whether any useful purpose is served by having these exemption forms witnessed by a Justice of the Peace?

I would not like to anticipate the provisions of the new Act at the moment.

Nurses (Training)

34.

asked the Minister of Health if, in view of the shortage of nurses, he will reconsider the regulation by which former V.A.D.s and auxiliary nurses, wishing to qualify as State registered nurses, will only be exempted from six months of their four years' training.

This is primarily a matter for the General Nursing Council, who decided after full consideration and discussion that the remission to be allowed in suitable cases should not exceed six months, thus reducing the minimum period of training from three to two and a half years. I have agreed to approve a rule to that effect.

When the right hon. Gentleman uses the word "primarily," will he be good enough to explain whether he does or does not accept Ministerial responsibility for the conditions under which State registered nurses are serving?

Yes, Sir, I believe the ultimate responsibility rests with me, but I am sure the Noble Lord will realise that if you reduce the period of training, the nurse is not necessarily helped thereby, because she has to acquire qualifications in a shorter time, which means a very great strain on those who are at the moment, unfortunately, having to do a great deal of domestic work in addition to their own work as nurses.

In view of the fact that the Minister admits that he is constitutionally responsible for this matter, and in view of the calamitous shortage of nurses, both in municipal and voluntary hospitals, is there any chance that he will be able to make a statement at an early date as to how he proposes to deal with the shortage?

I believe there is another Question on the Order Paper raising that point. I am extremely anxious about the nursing position, and I am taking most urgent steps to deal with it.

Hospitals (Nursing Staffs)

43.

asked the Minister of Health the number of nurses estimated to be required adequately to staff the hospitals of this country; and what steps he is taking to obtain them.

According to returns submitted to my right hon. Friend the Minister of Labour and National Service, there were on the 30th June, 1945, vacancies for about 30,000 nurses of all grades in hospitals and allied institutions, including nursing homes, in Great Britain. I am consulting my right hon. Friend and the organisations principally concerned on the whole nursing position and hope to make a full statement in two or three weeks' time.

In the meantime, as it is obvious that there must be a very reduced need for nurses now in the Services, since the war is over, would he not consult with the Minister of Labour to see if there could not be some immediate releases?

I have already done so, and releases have started. I think the hon. and gallant Member must realise that a large number of nurses in the Forces when they are released, will go home, and not necessarily into hospitals.

Can the Minister say which authorities he has consulted, and whether these authorities include local authorities, and members of hospital boards throughout the country, who are seriously concerned?