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National Health Service

Volume 480: debated on Thursday 9 November 1950

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Kingston Victoria Hospital

24.

asked the Minister of Health his decision as to the future of the Kingston Victoria Hospital; and what steps he is taking to ensure that facilities for treatment of their patients in hospital continue to be available to general medical practitioners in this district.

This hospital is to be used as a gynaecological unit. The Surbiton annexe hospital is to be converted to give alternative facilities to general practitioners.

Can the right hon. Gentleman say when the Surbiton annexe is to be converted and what is to happen to the patients concerned during the interval before that conversion is completed?

Arrangements are being made for the other patients, and the Surbiton annexe will be furnished and re-furbished as soon as we are aware that the general practitioners are prepared to make use of it.

Is the right hon. Gentleman aware that there are 37 seriously ill patients in this hospital at the moment, that the regional board is making every effort to close it, and that no alternative exists at present?

The hon. Gentleman must take it for granted that whenever a hospital is changed from one speciality to another, arrangements are invariably made for the care of the patients.

On a point of order. In view of the fact that the right hon. Gentleman has not dealt with the immediate situation and fate of the patients in this hospital at this time, I beg to give notice that I shall raise the matter at the earliest opportunity.

Benefits (Reciprocity)

25.

asked the Minister of Health what reciprocal arrangements have been made during 1950 with other countries whereby British citizens may receive Health Service benefits without payment when abroad.

Arrangements providing for varying degrees of reciprocity have been or are being made with the following places outside the United Kingdom—Isle of Man, States of Jersey and Guernsey, Belgium, France, Luxemburg, the Netherlands.

As there are comparatively few countries on that list, can the right hon. Gentleman say what the reason is for the small number? Is it generally the time taken to work out the arrangements, or is it that the other countries are unable to offer facilities? Will he press this as hard as he can, especially in view of the fact that it affects many merchant seamen who are away from this country for nine months each year and who pay their contributions but cannot get the benefits?

We are trying to do this, but other nations have not got our advanced facilities.

Will the right hon. Gentleman use his bargaining power by threatening not to treat foreigners in this country or, alternatively, asking foreign countries to subscribe a lump sum for the services which their people receive here?

If we are to have reasonable arrangements with other countries it is better to start off in an atmosphere of conciliation rather than of threats.

If the right hon. Gentleman cannot control other countries, as obviously he cannot, will he arrange for a refund to British nationals, to be paid to them from National Health Service funds when they return to this country, for the cost of treatment incurred abroad?

That is an absurd suggestion. It is suggested that a patient shall make arrangements with a doctor, a surgeon, a hospital, a dentist or anybody else in another country and present the bill for us to pay although we have no say as to whether the charges are reasonable or not. I am certain that the hon. and gallant Gentleman did not reflect upon his suggestion.

43.

asked the Minister of Health if he will now make regulations under the National Health Service (Amendment) Act, 1949, whereby foreign residents visiting this country will have to pay a charge for using the Service.

I am keeping this under review, but am not at present satisfied that there is enough evidence of abuses to justify action.

In view of the fact that the Minister said, in answer to an earlier Question, that most other countries do not have the facilities which we have here and that, therefore, reciprocal agreements cannot be made, how long is this one-way traffic in benefits to continue; and why does the right hon. Gentleman not use the powers which he took in the 1949 amending Act?

It was made perfectly clear that the powers were being taken only to deal with abuse if it arose. I can assure the House that if I tried to take or use power to deal with the very small number of cases that might exist, the expense of administration would be far more than the gain to the Health Service.

Can the right hon. Gentleman tell the House what was the expense last year so far as foreign nationals were concerned?

No, because if I was able to say what the cost would be I would have the administrative machinery that I suggested. We can only make a guess, and our guess is that it is a very small proportion indeed. My right hon. Friend the Home Secretary prevents the entry into this country of people who come only to use the Health Service.

Spectacles

28.

asked the Minister of Health why Mrs. Burchall of Crantock, Cornwall, who was tested for new spectacles in May, 1949, received them only on 17th October, 1950, and then only after the hon. Member for North Cornwall had complained to his Department about the delay.

This lady needed bi-focal glasses, which have frequently taken many months to supply; but the arrears of orders are being overtaken and the waiting time which is already less should diminish substantially in the next few months.

35.

asked the Minister of Health why ophthalmic opticians are debarred from prescribing prism-controlled bifocal lenses.

These and certain other special types of lens are supplied through the hospital service only.

The reason is because we consider that people with this very high degree of loss of sight ought immediately to be under the influence of hospital authorities, where the specialists are.

36.

asked the Minister of Health how many prism-controlled bifocals have been prescribed by the hospital eye service since the commencement of the Health Service.

37.

asked the Minister of Health if he is aware that glasses delayed in delivery for several months are often found to be useless owing to eye deterioration; and if he will renew his efforts to speed the delivery of glasses.

There is now very little delay except for certain complicated lenses such as bifocals and steps have been taken to increase production of these types.

This is very important. Can I give the right hon. Gentleman a typical case? Is he aware that a matron of a home waited eight months for glasses and when they came they were so unsuitable that her eyes became bloodshot? The glasses were no use at all.

If, as a consequence of not being able to get bifocal glasses there is a deterioration, then obviously bifocals ought not to have been recommended, but two pairs of glasses.

Regional Hospitals

32.

asked the Minister of Health what advice he has given to regional hospital boards to preserve the individuality of hospitals and to refrain from obliterating or submerging their identity by over-emphasis on their control by hospital management committees.

I am sending to the hon. Member copies of circulars dealing with this point.

Is the right hon. Gentleman aware that in certain areas, and particularly recently, there is a desire, by over emphasis on notice boards, notepaper and the like, to stress the name of the management committee and so to submerge the local name, which has meant much to the hospital and to the area?

I agree that probably one jealousy is driving out another, but I am anxious, as I said when the Bill was before the House, for the local hospital to preserve its identity and its tradition consistent with integration in the National Health Service.

Is the Minister aware that some hospital management committees are very anxious to get rid of the names by which the hospitals are called, because under Public Assistance the hospitals had a very bad reputation for the treatment of patients?

There is that point, also; I have known people who have been anxious not to be sent into a particular hospital because it was called "the old infirmary."

Doctors (Compensation)

34.

asked the Minister of Health at what date he is proposing to put into operation the scheme whereby it is proposed to apportion the global sum of £66 million which is to be distributed amongst doctors on their retirement in compensation for the goodwill of their practices.

The apportionment will not be possible until the claims of all the doctors have been received and assessed. The final date for the submission of claims has been extended to 31st December, 1950, or, in special circumstances, 28th February, 1951.

Is the right hon. Gentleman aware that many of these people have been waiting for over two years, perhaps suffering hardship, for this sum to be distributed, so that they can buy a farm or cottage to which to retire? They want the money as quickly as possible?

Those cases are always met by making a grant of a substantial portion of the sum needed.

Could my right hon. Friend say whether any doctor who leaves the Health Service has any claim on this £66 million?

He has, certainly. There is set aside for him a proper proportion of the £66 million.

Prescriptions

38.

asked the Minister of Health, in view of the difficulties of National Health Service doctors in resisting the demands of patients for prescriptions for medicinal preparations advertised direct to the public, what steps he proposes to take to deal with this matter.

Yes, Sir. Responsibility for prescribing should rest solely on the judgment of the doctor. Sir Henry Cohen's Committee on Prescribing therefore recommended that publicly advertised preparations should not be prescribed under the National Health Service. This recommendation has been sent to all doctors, who have been asked to observe it, and any doctor who refuses importunate demands has my full support.

Is my right hon. Friend aware that there is a section of the medical profession that has been organised to collect funds to resist the Health Service; and would he appeal to them to divert these funds towards the education of the medical profession in the direction which he has just outlined?

From the preliminary information at our disposal, I believe that the recommendation of the Sir Henry Cohen's Committee is being carried out generally. I would not like to believe that the doctors require any further education, but if they do require it, we shall, of course, consider what we have to do.

Is it a fact that, so far, less than 1 per cent. of prescriptions have been for nationally advertised medicines?

No, and if the hon. and learned Gentleman has got that information, and if he would give me its source, I shall be delighted, because I have not got such precise information myself.

Is my right hon. Friend aware that many doctors are greatly perturbed at the wide latitude allowed to them for over-prescribing, and that many are protesting and asking that the old procedure, whereby prescriptions were properly scrutinised, should be reintroduced?

Could the right hon. Gentleman say what, in his opinion, is the figure, if he questions mine?

If the hon. and learned Gentleman puts a question on the Order Paper, I will try to give him the information.