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National Health Service

Volume 463: debated on Thursday 7 April 1949

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Doctors (Payment)


asked the Minister of Health if he will take the necessary steps to pay for a locum tenens when a doctor in the National Health Service is ill or incapacitated.

No, Sir. In fixing the remuneration of general medical practitioners, full account was taken of practice expenses. The cost of employing a locum tenens where necessary forms part of these expenses.

In the event of a doctor being sick and an urgent case coming along, what is to happen to the patient who wants immediate attention? Cannot the Minister arrange for the locum tenens to be paid for the service?

Maternity Cases (Dressings)


asked the Minister of Health where expectant mothers attending ante-natal clinics should obtain maternity packs and dressings for the lying-in period; if he is aware that the West Ham local authority is refusing to issue such free packs and dressings, and that expectant mothers are referred to their general practitioners for the sterile dressings, etc.; and whether it is in order for practitioners to issue such prescriptions.

Local health authorities should arrange for maternity outfits for domiciliary confinements to be supplied at clinics, through midwives, or in some other convenient way, and for other dressings required during the lying-in period to be provided by the midwife in attendance. I understand that the West Ham Council are at once reconsidering their practice. Maternity outfits and sterilised dressings are not included in the schedule of appliances which a general practitioner may prescribe for his National Health Service patients.

Medicines (Tests)


asked the Minister of Health whether he is satisfied that the operation of the dispensing, testing, or analysis scheme will safeguard adequately the standards of medicines supplied on Form E.C.10, since previous testing applied only to medicines compounded and dispensed by pharmacists, compounded medicaments supplied by manufacturing and wholesale firms having been exempt from this inspection.

Does that mean that these compounded medicines will be examined during the visits of the inspectors to the pharmacists?

There is now a double test there is a test upon the manufacturing side, and upon the chemist.

Eyesight Testing


asked the Minister of Health the number of persons who have had their eyesight tested under the National Health Act by ophthalmic surgeons and by opticians, respectively, since 5th July last; and how many have been diagnosed as not requiring glasses, in each category.

Would the right hon. Gentleman consult with the organisations involved with a view of using a discretionary dissuading influence on the demand for spectacles? We do not want to become a bespectacled nation.

I must, of course, rely upon the technical advice that is given by skilled persons. I am, however, about to consider an experiment by which I hope to be able to make a check on whether, in fact, it is necessary for so high a proportion of the population to have spectacles.

Could my right hon. Friend tell the House by what date he expects this information will be available?

Would it be possible to introduce a system of priority for people requiring spectacles, because there are some people who are operated on for cataract who have to wait a very long time for spectacles?

Well, I have asked the opticians to try to deal with cases of urgency before other cases. That applies particularly to children, for example, who often ought to have spectacles at once when they are prescribed. A priority system is very difficult in itself to arrange, and the best thing I can do is to rely upon the co-operation of the opticians themselves. I understand that that is now forthcoming to a much larger degree.

Hospital Beds


asked the Minister of Health what increase there has been in the number of staffed beds for the acute sick in general hospitals in England and Wales since the date of the coming into operation of the National Health Service Act.

Figures for beds for the acute sick as such are not readily available, but between 30th June and 31st December, 1948, the increase in the number of staffed beds in general hospitals in England and Wales was 15,510.

Does the Minister agree with the Chancellor of the Exchequer who yesterday stated that there were 60,000 beds unstaffed in the Kingdom, when the last figure given to this House by the right hon. Gentleman was 53,000?

It may be, of course, that we are not speaking of exactly the same institutions. In some instances, as the hon. and gallant Member knows, some institutions are left outside the statistics. However, I think the House will agree that an increase of 15,500 staffed beds in six months is a very remarkable rate of increase.



asked the Minister of Health when he expects to receive the final recommendations of the Medical Research Council as to the latest types of analgesic drugs and apparatus suitable to be administered by midwives alone.

No forecast can yet be given. Although existing methods will no doubt be reviewed by the committee which has been set up, the question remitted to the Medical Research Council by the Working Party on Midwives was on the possibility of devising improved methods. This is a relatively long-term project involving the initiation and conduct of actual research work, and quick results are not to be expected.

Will the right hon. Gentleman make a statement on the subject at the earliest opportunity, and ask the Medical Research Council if they are actively considering the matter?

The Research Council are actively considering the matter, but one thing we cannot do with a research body is to bring pressure to bear to make them hurry. They must carry out proper tests. The consequences of recommending apparatus not up to standard would be very serious.

Would not my right hon. Friend agree that no final recommendations on this subject are possible? Instead, would he not consider the possibility of establishing a trial area, in which there could be scientific investigation of the appliances which are currently used by the medical profession?

The Research Council will take all those matters into account, and will have a controlled experiment of their own devising before making general recommendations.

How many research workers are engaged on this line of research, and how much will it cost?

I cannot say, but if the hon. and gallant Member will put down a Question I will try to give him the information.

Merchant Seamen


asked the Minister of Health whether he is aware that members of the Merchant Navy, although contributors to the National Health Service, are unable to make full use of the benefits of that service; and what action he proposes to take.

Merchant seamen, like anyone else who goes abroad, are not able to obtain treatment under the National Health Service while out of this country. It is the Government's intention to negotiate reciprocal arrangements with other countries wherever the opportunity arises.

When is that opportunity likely to arise? How many such arrangements are being negotiated at the moment?

Would the right hon. Gentleman consider the fact that these men have not been able to obtain dental service owing to queuing and shortages? Would he consider establishing an emergency organisation in certain ports, to meet this problem.

That is an entirely different question, but I will make inquiries to find out whether sufficient facilities are available in ports.

Has my right hon. Friend observed that this Question seems to arise out of a very common and widespread misunderstanding about the way in which the National Health Service is financed? As he has repeatedly told the House, it is not, in the main, financed out of the weekly contributions. Will he take steps to make that more widely known?

I have tried, over and over again, to educate public opinion on this matter, and my hon. Friend's supplementary question will add to that education.

District Nurses (Superannuation)


asked the Minister of Health whether he is aware that great hardship is being caused to nurses who are ex-members of district nursing associations by the refusal of certain county councils, including the Stafford County Council, to continue superannuation and benevolent schemes such as those undertaken by the Queen's Institute of District Nursing; and what steps he is taking in this matter.

No, Sir. But if the hon. Member will let we have particulars of the cases of hardship to which he refers I will look into the matter.

Is it not important that when the district nursing associations are taken over by the National Health Service their obligations should be taken over as well? Otherwise, recruiting will be restricted?

I should like to have particulars of the obligations which have been incurred before making a general statement.

Coast Erosion, Robin Hood's Bay


asked the Minister of Health what steps he is considering taking to deal with coast erosion at Robin Hood's bay, in view of the fact that there is imminent danger to a considerable number of houses.

I am not aware that anyone, except the owners, has power at present to protect these private houses from coast erosion, but when the Coast Protection Bill now before Parliament has become law I shall be prepared to consider any proposals put to me by the responsible authority.

When that time comes will the Minister, in fixing the amount of the grant to local authorities, bear in mind that many of them were unable to carry out normal work during the war because, for military reasons, access was denied to them?

I should have to take the facts of each particular case into account, of course, and that would be one of the factors.