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National Health Service

Volume 465: debated on Thursday 26 May 1949

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Parkinson's Disease

10.

asked the Minister of Health whether he will now report on the methods of Dr. Voeller, of Kassel, for the treatment of Parkinson's disease; and on the advisability of his methods being adopted in this country.

This investigation is not yet complete, but I will make the results known as soon as they can be assessed, which will not be for some months yet.

While recognising the possibility of some reports of these cures being exaggerated, may I ask whether the right hon. Gentleman is satisfied that when these cases of cures are reported they are followed up by his Department in great detail?

We arranged for eight patients to go to Germany. Only four have yet returned. I am informed that it is necessary for six months to elapse before a judgment can be made.

Apart from any action which my right hon. Friend has taken in this case, can he say whether there is any department of his Ministry the duty of which is to check up on the claims that are made in America and Switzerland of successful treatment in cases of Parkinson's disease and disseminated sclerosis; and will such a department investigate them, and find out if they are really working?

This is one of the investigations which has been put in hand. Investigations are taking place all the time when there are definite lines of research to be followed.

Can the Minister say whether there are any obstacles against these methods of treatment being carried out on an experimental scale in this country?

No. It was first suggested that there was a person in Germany about whom it was alleged that he had a cure for this disease. We are now testing that claim. I hope that no unnecessary publicity will be given to the claims until we have assessed their worth.

Dentists

13.

asked the Minister of Health how many dentists are now operating the general dental service of the National Health Service; and what is the latest estimate of the annual cost of the general dental service.

There were 9,347 dentists on the dental lists in England and Wales on 1st May. The Ministry of Health Estimates, Class V (2), provide £28,204,000 for the cost of the general dental service in England and Wales.

Then how is it that this estimate is so much higher than the original estimate? Why was the original estimate so far out?

I do not quite know to what the hon. Member is referring. If he is referring to the Supplementary Estimate which was debated, I thought that a full answer was given to the satisfaction of the Opposition at that time.

Dental Estimates Board

14.

asked the Minister of Health how many people are employed by the Dental Estimates Board.

Spectacles

20.

asked the Minister of Health whether he is aware that in the case of an eleven year old boy at Kettering an oculist's prescription under the National Health Service was handed to an optician six months ago and no spectacles have yet been delivered; and what steps he proposes to take to expedite the delivery of spectacles to schoolchildren in the area, whose eyes may be damaged by work at school without proper spectacles.

I would refer my hon. Friend to my reply to the hon. Member for East Islington (Mr. E. Fletcher) on 19th May.

Is not my right hon. Friend aware that that referred to a scheme by which opticians might give priority; and will he consider the advisability of arranging for doctors and ophthalmic surgeons to give priority in the case of these children, particularly where delay may obviously be very bad for their eyes?

It is extremely difficult to work a priority service. If too many people are put into the priority classes, that merely disturbs the distribution of spectacles all round. I am doing my very utmost in this matter. We have increased production by 50 per cent. above what it was before this scheme started, but the demand for spectacles still exceeds production.

Would not one useful step towards avoiding these delays to schoolchildren's spectacles be to put visitors from abroad at the bottom of the waiting list?

I had not time on Tuesday to give the explanation about visitors from abroad. The fact is that hon. Members opposite are riding that horse to death. If we eliminated all the medical attention given to visitors from abroad, it would equal less than 01 per cent. of the total health expenditure.

When this scheme is prepared and in operation, will my right hon. Friend take steps to see that it is sufficiently publicised, particularly in the schools?

Will the right hon. Gentleman bear in mind the very serious effect which this delay is having upon many schoolchildren who are having to sit in the front row in class because they cannot see, and who are also suffering grievously from headaches?

I believe it is desirable that we should try to provide spectacles for these young children as early as possible; but they went without them for many years previously.

35.

asked the Minister of Health what steps he is taking to relieve the shortage of spectacles in Swindon.

While delay is unfortunately general I am not aware of any peculiar difficulties in Swindon. All possible steps are being taken to increase the supply of spectacles generally, both by expanding production in this country and by imports from abroad.

If I send my right hon. Friend a report showing that Swindon people have been kept waiting for eight months, and sometimes for a year, will he look into it?

Hearing Aids (Export)

24.

asked the Minister of Health why supplies of the Medresco hearing aid are being exported when there is still so much delay in meeting demands in this country.

I would refer to the reply I gave on 5th May to the hon. Member for Stafford (Mr. Swingler) and the hon. Member for Hemel Hempstead (Viscountess Davidson).

Is the Minister aware that another make of hearing aid is being exported by the Medresco people, and would not it be better if the Minister contracted to take over the whole of the output of this company, so that there would be more hearing aids available for the people in this country?

The output of the Medresco hearing aid will shortly be doubled. In the meantime the aid that is being exported is not the Government hearing aid. Of course, it is essential in all these matters to have a proper balance between home demand and the export market.

Can the Minister say whether any part of that doubled production will be for export, or will the whole be available for home consumption?

I am speaking of the Medresco aid, and the whole production will be for the home market.

Does the Minister think that the 30,000 people waiting for this hearing aid will be satisfied?

I am satisfied that all those people who have had the Medresco aid—almost all of them—are highly satisfied, and before very long the waiting list, I hope, will be met. There are 25 centres open in the country at the present time, and as soon as we get the hearing aids they will be made available.

General Hospital, Epping (Mental Cases)

27.

asked the Minister of Health if he is aware that there are three low grade defective children in St. Margaret's General Hospital, Epping; that they are confined to bed in the wards of the aged and chronic sick patients; that they have been there for many years; and what steps he proposes taking to remove these children to more appropriate surroundings in accordance with the spirit of the Children Act.

I am aware that there are three low grade mentally defective children in this hospital, and the hon. Member may be assured they will be removed as soon as alternative accommodation is available.

May I ask my right hon. Friend whether any steps are being taken to extend and expand the accommodation for children of this type? There are many thousands of them in the country in their own homes, but where they are in hospital they are actually taking up the care of nurses which ought to be devoted in another direction?

I quite agree that this is a serious problem which, of course, accumulated during the war as a consequence of the fact that there was no new building, and I am taking urgent measures to try to deal with it.

Has my right hon. Friend seen the report which the relevant authority has just sent up saying that it may be eight or ten years at the present rate before all these defectives are accommodated, and will he take note of the proposal in that report that temporary accommodation should be built at once?

I do not know what report my hon. Friend is referring to, but it sounds very pessimistic.

May I ask the Minister how many low grade mental defectives there are on the Front Bench?

In view of the fact that these three children have been, respectively, seven, seven and four years in this hospital, could my right hon. Friend make them a very early charge on his attention?

Is the right hon. Gentleman aware that owing to a shortage of accommodation for mentally defective children and mentally defective people, frequently these mentally defectives have to be certified by doctors when they are not really deserving of certification, because they can get into a home or shelter only if they are certified.

I would be loath to believe that children are certified who ought not to be merely in order to get accommodation. That is a very serious statement to make.

Aged Sick (Hospital Accommodation)

28.

asked the Minister of Health if he is aware of the inadequacy of existing facilities for the care of the chronic and aged sick in the city of Birmingham; and what steps he proposes to take to improve such facilities.

The regional board has two groups of experts investigating the problem, and will take further action in the light of their reports. Meanwhile unused beds are being brought into use wherever possible, and arrangements made with the local health authority for home nursing.

Whilst I appreciate that answer, is the Minister aware that within the past year more than 90 aged persons, chronically sick, have been admitted to mental hospitals; would he consider this aspect of the problem, especially in view of the fact that I understand that about 17 died within one month of admission, which really is a very grave matter?

With all respect, it is not enough to give the proportion of old people who died within a month of being admitted to hospital. People do die, and the assumption that they died because they went to hospital is one we ought not to make. When it is said that people are in mental hospitals, I would remind the House that during the war a great deal of the E.M.S. was in fact housed in separate parts of mental hospitals. They are not in the mental hospital as such but occupy the same physical accommodation as other people.

The right hon. Gentleman cannot get away with that. Is he aware—he should be aware—that of the first 31 of these aged people of over 65, to whom the hon. Member has referred as being admitted to hospital, 25 died of heart diseases, which was nothing to do with mental affliction. Is it not absolutely wrong that these old people should be certified as mental cases for the first time in their lives?

I cannot accept the statement that old people are being certified as mental cases in order to be taken into hospital. That is a gross and offensive charge against the doctors concerned. When the statement is made that a certain percentage of old people died from heart failure, well, old people have been dying from heart failure for millions of years.

Is my right hon. Friend aware that I have been the chairman of a big mental hospital in Birmingham and that the statement made by the hon. Member for Solihull (Mr. M. Lindsay) is quite untrue?

Before 5th July last the care of old people was the obligation of the local authorities and since 5th July it is the regional hospital Board who are not prepared——

On a point of Order, Mr. Speaker. As regards the certification of people, it is the responsibility not only of a doctor, but of a magistrate. Is it in order to suggest in this House that magistrates have not properly discharged their duty and that a wrong certification has resulted?

As the right hon. Gentleman must be aware, in the terminal stage of life there is very often muddleness and it is quite easy to certify people in order to find accommodation for them when previously they would never have been certified because there was accommodation available provided by the local authority.

The assumption which is being made, and the charge which is being made, is that the doctors concerned and the magistrates concerned are certifying old people as mental who might not be mental. The politics of the Opposition are now leading them into making the most grave charges.

In view of the serious statements made which suggest wrongful certification, will not my right hon. Friend cause an inquiry to be made?

Certainly I will cause an inquiry to be made, but I do think that before allegations are made in this House which might cause grave pain and anxiety the facts should first be ascertained. The hon. Members should be ashamed of themselves for saying such things.

On a point of Order, Mr. Speaker. It is one of the rules of this House that an insinuation should not be made. I, for one, ask whether you think it is right that the right hon. Gentleman should accuse Members of the Opposition of exploiting cases of great tragedy purely for political ends?

One can always accuse a party of doing all sorts of things. To accuse individual Members is another matter, but parties can always be charged. We always charge each other's parties with all sorts of offences.

Might I say that there was no such implication in my Question? I was only concerned at the large number of sick people who had been admitted to mental hospitals.

Mental Hospitals (Nurses)

29.

asked the Minister of Health to what extent the Birmingham mental hospitals are understaffed; and what steps are being taken to step up the recruitment of nurses in such hospitals.

I assume that my hon. Friend has in mind nursing staff. At Winson Green Hospital the deficiency of female nursing staff is 28 per cent. and of male 27 per cent. At Rubery Hill the deficiency is female staff 50 per cent., male staff nil. Persistent efforts are being made to recruit staff through the Ministry of Labour and by local recruiting campaigns and advertisement. Nurses' salaries have recently been increased.

Is my right hon. Friend aware that a number of those who are caring for the mentally sick are very much concerned that one of the things retarding recruitment of nurses to mental hospitals is likely to be the American film, "The Snake Pit," and could he make any statement or take any action?

Is the right hon. Gentleman aware that the reason why these mental hospitals are comparatively understaffed is because of the transfer of the aged people referred to in the previous Question who are now being treated as mental cases for the first time?

I should like to give notice that in view of the fact that my information has come from a Socialist who is chairman of the mental hospital concerned, and as the right hon. Gentleman classes it as quite untrue, I will endeavour to raise the matter on the Adjournment.

Hospital Legacies

33.

asked the Minister of Health if his attention has been called to the remarks of Mr. Justice Harman, in the Chancery Division, on 11th May, as to the destination of legacies to hospitals; and if he will introduce amending legislation to clear this matter up.

31.

asked the Minister of Health if his attention has been called to Mr. Justice Harman's judgment in re Kellner's Will Trusts, in which reference is made to the faulty drafting of Part 2 of the National Health Service Act, 1946; and whether he proposes to introduce legislation to amend that Part of the Act.

I would refer the hon. Members to the reply given to my hon. Friend the Member for Stafford (Mr. Swingler) on 19th May.

Why did the right hon. Gentleman try to kill all the finer instincts of charitable people by his materialistic policy? Why does not the Minister answer?

Doctors And Pharmacists (Registration)

34.

asked the Minister of Health how many applications for confirmation of provisional registration under Sections 1 and 4 of the Medical Practitioners and Pharmacists Act, 1947, have been made; how many of these applications have been granted; and what is the reason for the delay or delaying with the remaining applications.

Twenty-nine, of which nine have been granted. As regards the others, the General Medical Council have not yet been able to complete the inquiries necessary to satisfy them that the statutory conditions are fulfilled.

Hospitals (Accountancy)

41.

asked the Minister of Health if he will take immediate steps to settle outstanding accounts rendered by chartered accountants for service to hospitals.

Yes, Sir. I regret that there has been some delay in dealing with these claims.

The Minister may regret it, but I ask him what he proposes to do about it, because apparently the forms on which application should be made have been out of print since 10th February, and it is impossible to get hold of them. Will he see that at least forms are printed so that payment can be made forthwith?

Infectious Diseases (Control)

43.

asked the Minister of Health if he is satisfied that, in view of the increased and increasing speed of modern transport, he has adequate powers to control the introduction into this country of infectious diseases from overseas.

I am considering whether any further powers are needed. The general question of quarantine control will next month come before the Second World Health Assembly. The problem is not simply to control infectious disease, but to control it with the minimum hindrance to traffic.

Can the right hon. Gentleman say whether his existing powers include the absolute right to refuse to allow people to land from ships that are in quarantine?

I believe that there are powers which can be exercised in certain cases to that effect, but I am not quite satisfied that they are adequate and I am making inquiries.

44.

asked the Minister of Health to what extent his regulations authorise port medical officers at ports in the United Kingdom to prevent persons who have been in contact with infectious diseases from landing; and what conditions they are permitted to impose before allowing such persons to land.

As the answer to the hon. Member's Question is long, I will, with permission, circulate a statement in the OFFICIAL REPORT.

Following is the statement:

I have no power to prevent persons from landing on account of infectious disease.

The Port Health Regulations, 1933 and 1945, prescribe separately the conditions that, in general conformity with the relevant International Sanitary Convention, may be imposed against plague, cholera, yellow fever, typhus fever and smallpox. A full answer to the hon. Member's Question would therefore be very long.

Normally the greatest risk to this country is presented by smallpox. If a ship arrives that has, or has recently had, a case of smallpox on board, any person suffering from the disease is disembarked and isolated.

Any person exposed to infection on board, unless in the opinion of the port medical officer that person is sufficiently protected by recent vaccination or by a previous attack of smallpox may be—

  • (a) offered vaccination and placed under surveillance for 14 days, or
  • (b) placed under surveillance for 14 days without vaccination, or
  • (c) offered vaccination and isolated until the result of the vaccination is known, and thereafter kept under surveillance for 14 days from the arrival of the ship, or
  • (d) isolated for 14 days after the arrival of the ship.
  • The requirements ( c) and ( d) may not be imposed unless the port medical officer considers that there is an exceptionally serious risk of the introduction of smallpox into the country.

    "Surveillance" is defined in the relevant International Sanitary Convention to mean that the persons are not isolated, but that the health authorities of the places to which they are going are notified of their coming. The port health regulations impose on such persons obligations designed to secure that they can be effectively supervised.