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National Health Service

Volume 462: debated on Thursday 3 March 1949

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asked the Minister of Health whether patients attending eye hospitals are restricted in their choice of optician to the contractor for the hospital from which their prescription was issued.


asked the Minister of Health whether any emergency system exists for supplying spectacles immediately to users where the loss or breakage of these renders them unable to carry on their normal occupation.

I would refer the hon. Member to my reply to my hon. Friend the Member for Blackburn (Mrs. Castle) on 24th February.

Is the Minister aware that there are people who are anxious to have their spectacles repaired immediately and there seems to be a great deal of delay?

I am trying to arrange for ophthalmic opticians to give priority to cases of special urgency. I do not want to have a rigid scheme, because that would only give rise to a lot of form filling and unnecessary delays. I am hoping to work out a voluntary arrangement.

Heanor Hospital (Amenities Fund)


asked the Minister of Health on what authority the auditors of the Heanor Hospital accounts demand to audit the accounts of a local amenities fund which is promoted by an outside body and maintained wholly by voluntary contributions, the hospital being only one of the beneficiaries; and if he will make it clear to all would be contributors that these voluntary funds form no part of the financial structure for the maintenance of the hospital service.

The funds of the local amenities committee included sums received by the hospital management committee. As these sums are held on trust by the hospital management committee it was the duty of my auditor to see that they were properly brought to account. When gifts are made direct to the amenities fund, the auditor is not concerned.

Could my right hon. Friend say whether there is an obligation on the part of his auditors to audit accounts which are no concern of the Ministry? I appreciate what my right hon. Friend says in his answer, that the allocations which go to the Ministry ought to be audited, but not the other funds.

These funds are entrusted to the local hospital management committees and, therefore, ought to be audited. Surely there can be no objection to an audit?

No, but these are independent funds created by bodies altogether outside the hospital.

But the only interest is where the funds that are collected by an amenities committee are handed over to a hospital management committee. In such a case the funds, should be audited, and I can see no objection whatever to a proper audit of accounts.

But the Minister must be under a misapprehension. This is a separate fund, of which the hospital is only one of the beneficiaries.

I think my hon. Friend had better read my reply, and then he will see that the point is covered. It is only in respect of the fact that amenities funds are entrusted to a hospital management committee that the question of audit arises.

Aliens (Leaflet)


asked the Minister of Health by what authority he issued N.H.S. leaflet, No. 2.

By the authority of the National Health Service Act, 1946, and in performance of the duty imposed upon me by that Act.

May I ask the Minister whether he really has authority from this House to issue this leaflet to all aliens who arrive in this country and to offer them free health services, including dentures and spectacles; and is he aware that many aliens are taking advantage of these facilities at the expense of the British taxpayer—

Wait a moment—and is he aware that French doctors, to quote one case of which I have knowledge, are losers by this practice?

The answer to the hon. Member is what I have already given him in my reply: I am discharging the duties imposed upon me by the Act of Parliament. The aliens who receive these leaflets are not those who are on short holiday visits but those who acquire registration cards. The leaflets are being held for distribution amongst seamen who may not have seen the original leaflets describing the facilities under the Act. They are obtainable from information bureaux. The new leaflet is more up-to-date than was the original leaflet and I do not want to waste public money by reproducing unnecessary leaflets.

Owing to the unsatisfactory nature of the Minister's reply, I beg to give notice that I shall raise this matter on the Adjournment.

Registered Doctors


asked the Minister of Health the total number of doctors registered with the National Health Service in the first six months from 5th July last, or nearest date; and what are the average salaries earned by doctors concerned in that period.

The total number of general practitioners on the medical list at 5th July was 18,165. Six hundred and sixty-one other practitioners have been admitted since then and approximately the same number have left for a variety of reasons. I have no information as to the average salaries earned by doctors in that period.

Am I justified in concluding that these doctors are now receiving much greater remuneration than before the Act came into force?

I must see how the average turns out before I am able to reply to that question. Certain payments are, of course, made to doctors outside the National Health Service Act.

Can the Minister say whether payments have been made to doctors for all midwifery and temporary residence cases which they have treated?

If the hon. and gallant Gentleman will put that question down I will try to obtain the information.

Can the Minister give to the House the percentage figures of doctors already in the scheme compared with the number who are entitled to join it, and is he satisfied that the number of medical practitioners in Britain is sufficient to meet the needs of the extra demands made upon them by the National Health scheme?

The two supplementary questions, of course, go substantially outside the original Question. There are more general practitioners taking part in the administration than we estimated for at the beginning. There is, of course, a general overall shortage. Perhaps there is a shortage of doctors in some places and a surplus in other places. [HON. MEMBERS: "No!"] There is a surplus of doctors in some places and, as they redistribute themselves, there ought to be adequate doctors for all.

Hearing Aids


asked the Minister of Health if within the Health Service, there is provision made for any form of appeal from the decision of a doctor not to recommend a hearing aid.

Do I understand the Minister to say that there is no appeal and that a doctor's opinion virtually will condemn a man to deafness for life in the event of that opinion being against the man?

It is not the specialist who condemns the patient to deafness; it is nature. What we have provided for is that a person who has something wrong with his hearing goes first of all to a G.P. He then has what he never had before: the opportunity of seeing a specialist at a hospital and a proper otologist. He then is examined. If a specialist says that a hearing aid is of no use to him it is hardly conceivable that there ought to be an appeal against that decision. It is not a judicial matter.

Does the Minister really mean to say that before the National Health Service Act came into force people could not go to a hospital and get free treatment?

The answer is to be found in the distribution of the Medresco Aids. A very large number of people are now having for the first time the opportunity of an aural aid and, therefore, of getting their hearing tested.



asked the Minister of Health if he will name the persons who are inquiring into the delay in the supply of false teeth; whether they will consult organisations representing independent technicians; and whether they will reconsider the proposals in the minority report of the Teviot Committee.

I am not aware of any special inquiry into delay in the supply of false teeth and the second and third parts of the Question do not, therefore, arise.

Will the Minister say what he meant only last week by referring to those who are inquiring into this matter? May I also ask him this as the Teviot Committee reported that we should not have enough dentists for 20 years, and as there was a minority report that dental mechanics ought to be used independently by the Health Service, how does he propose to overcome, except by consultation, what appears to be a deadlock?

The inquiry into the matter referred to is an inquiry into the time which it takes dentists to perform certain operations in order to bring about a revision, if necessary, of the scales of remuneration. As to the supply of dentists, the dental schools are full and we are doing our very best to give them additional facilities.

Hospital Schemes, Birmingham


asked the Minister of Health if, in view of his request for reductions in the estimates for Regional Hospital Boards, 1949–50, he will keep in view the high standard of hospital administration in Birmingham and the various schemes in process for expansion and development, and will consider representations from the Regional Hospital Board on the limits within which economies can be effected.

While I thank the Minister for his reply may I ask are we to assume that in the administration of this country's hospitals our medical service will always take precedence?

I do not know whether the hon. Member has the permission of his Party to make that request.

Is not this a direct attempt to slash our hospital services?

Does my right hon. Friend agree, while, if need be, acknowledging the high standard of administration in Birmingham, that there are some areas with a legacy from the past of a low standard of administration, whose estimates should be reduced least, and will there be some elasticity in this matter and not a flat-rate reduction over the whole country?

It is not a flat-rate reduction, but a reduction which takes into account the hospital needs of each particular area.

Medicine Bottles


asked the Minister of Health whether, in view of the high cost involved in the issuing of new bottles with every prescription dispensed by chemists, he will devise a scheme which will encourage the public to return used bottles.

Yes, Sir, and discussions are taking place with representatives of the pharmaceutical organisations.

Physiotherapy, Spilsby


asked the Minister of Health why it is not considered feasible to establish facilities for physiotherapy at Spilsby, Lincolnshire.

Shortage of trained staff makes it impossible at present to provide physiotherapy for out-patients at every hospital.

Will the right hon. Gentleman bear in mind the very high cost of sending quite a large number of patients who need this treatment to Boston to get it there? Will he take the very earliest opportunity of providing facilities at Spilsby?

There is a shortage of physiotherapists at the moment and that is a limiting factor.

Will the right hon. Gentleman consider using private practitioners, especially ex-Service men in their own homes, instead of clinics?

I think the hon. Member is to see me towards the end of the month on a deputation on this matter and perhaps he will await that interview.

Community Centres Aged People)


asked the Minister of Health if he is aware of the rapidly growing demand among aged people for recreation and social facilities such as community centres; and whether he will introduce legislation to grant powers to local authorities to provide such amenities.

In view of the existing powers of local authorities, including those recently conferred by the National Assistance Act, I do not think further legislation on the lines suggested by my hon. Friend is necessary.

Is the Minister aware that local authorities have power to farm out this work of establishing social centers, but that they have not the power to establish and control the centers themselves? Will he, in the new Bill, confer powers upon local authorities to do this work rather than to farm it out?

I think my hon. Friend will find that the powers conferred upon local authorities are fairly wide, but if the local authorities find any difficulty. I wish he would let me know.

Are they wide enough to establish these centers for the old age pensioners who are now demanding them in all the cities?

I would like to see what is the precise proposal before I can say whether it comes within the Statute.

Voluntary Welfare Services


asked the Minister of Health if he is aware that public support of voluntary organisations for the welfare of the blind and other handicapped persons is being adversely affected by his recent pronouncement regarding hospital collections; and if he will make it clear that the State does not defray the cost of this welfare work.

My pronouncement referred solely to hospitals in the National Health Service. The National Assistance Act fully recognises the valuable work of the voluntary bodies referred to and I am glad to take this opportunity of correcting any impression that they are no longer playing an effective part in the provision of welfare services.

Will my right hon. Friend also make it clear that the social security services cannot possibly function without the voluntary welfare services, which depend very largely on the goodwill of the public for voluntary funds? Will he also make it perfectly clear that blind and deaf persons are not necessarily sick persons?

I have always, elsewhere—and I do. so with great pleasure here—expressed the view that in my opinion the voluntary organisations are the only means by which effective assistance can be given to handicapped classes of all kinds and I therefore very much endorse what my hon. Friend has said.