asked the Minister of Health if he will inform all local authorities of the facilities available in the country for the rehabilitation of men and women suffering from tuberculosis, and the desirability of using these facilities to their full capacity.

The attention of local health authorities has been drawn, most recently in July last, to the means available for this purpose, and I am sure they will share my view that they should assist in using these means to the full.

Is the Minister aware that the British Legion village of Preston Hall in Kent today has 50 vacancies for ambulant ex-Service men, and will he again impress upon the local authorities their moral obligations in this matter?

I am sure that this exchange of question and answer will draw attention to the existence of these facilities.

asked the Minister of Health how many beds were available in England and Wales for tuberculosis patients on 1st January, 1949, 1950 and 1951, respectively; and how many patients were awaiting admission to the beds on those dates.

Comparable figures are not available for these three years, but hospital board returns at 31st December, 1949, for the first whole year of the Health Service, showed 28,450 beds in commission (including about 1,250 beds used in hospitals outside the Health Service) and a waiting list of 10,980. Figures at 1st January, 1951, are not yet ready.

While appreciating the progress that has been made, may I ask my right hon. Friend if he will give his closest attention to this problem, and do his utmost to reduce the size of the waiting list of these patients, some of whom are infectious to other people?

Yes, Sir, certainly. I was glad that I was able to give rather encouraging figures to the House last week, and I certainly intend to keep very close personal contact with this particular problem.

Will the Minister say when he proposes to take advantage of the beds available in Switzerland?

There is another Question on that matter on the Order Paper today.

asked the Minister of Health the number of tuberculosis patients in England and Wales awaiting admission to hospitals and sanatoria at the latest convenient date.

The number at present on the waiting list, as provisionally ascertained, is approximately 10,400.

Are the numbers waiting and the period of waiting tending to increase or to decrease?

The figure is about 600 fewer than a year ago. This is the first decrease recorded since the war.

In view of those figures, does the Minister not think that an addition of 1,000 beds to the available beds to deal with tuberculosis would be a very desirable thing, and that it should not be allowed to drag on in the way in which it is now being allowed to drag on?

I have already told the right hon. and gallant Gentleman that I have not yet had a complete report, but such information as I have does not indicate that anything like 1,000 beds would be available.

How does the right hon. Gentleman square that with the relevant figure for Scotland given by his colleague the Joint Under-Secretary of State for Scotland?

I am sure that the right hon. and gallant Gentleman does not want me to try to take the beds away from Scottish patients.

Is my right hon. Friend aware that there are already a number of sanatoria in Switzerland ready to talk on this matter and to take patients at a reasonable cost?

Yes, Sir. I have had two officials in Switzerland recently looking into the matter, and for certain technical reasons it has been decided to send out, tomorrow I think, a senior medical officer to amplify the report they have already rendered.

How can the Minister say that the size of the waiting list is being reduced when he has already this afternoon, in reply to Question No. 1, given a figure of 10,000 for those waiting a year ago, whereas it is now 10,400?

I should like notice of that question. I think my figures do, in fact, show a reduction from 10,980 to 10,400. It may not be precisely 600, but it is very near to it.

asked the Minister of Health whether he will make a statement as to the future of the tuberculosis clinic at 2, Effra Road, Brixton.

It is proposed to close these unsatisfactory premises as soon as possible and to transfer the work to St. Francis' Hospital, Dulwich.

As some of the patients of the now inadequately housed clinic in Brixton may have to pay up to 1s. 6d. for a rather complicated journey to Dulwich, will my right hon. Friend arrange to investigate the possibility of a new clinic in Brixton?

Very up-to-date and modern facilities are now being supplied in Dulwich, which are an enormous improvement on what was available before. I am assured that the distance is only about one mile, but I will certainly gladly look into the accuracy of that information.

asked the Minister of Health whether, in view of the continuance of the dispute as to the future of the Kingston Victoria Hospital, he will now arrange for an independent investigation into this matter.

I would refer the hon. Member to my statement on the Adjournment debate on 30th January.

Does the right hon. Gentleman recall that he did not deal specifically with this issue during that debate, and in view of the fact that this suggestion was put forward by the British Medical Association is it not entitled to serious consideration?

I hope that the hon. Gentleman accepts the suggestion I made at the conclusion of that debate so that we can go into this matter very thoroughly.

Does the Minister mean that his case is so bad that he is not prepared to submit it to independent investigation?

asked the Minister of Health if he is aware that there is a shortage of bone conductor hearing aids in the North-West Region; and if he will take steps to improve the supply of these aids.

Bone-conduction aids are not yet supplied by the National Health Service in any part of the country, but will be as soon as possible.

Is the right hon. Gentleman aware that the fact that these hearing aids are not supplied causes great hardship, particularly to a lot of old people, and will he give what I am sure will be his sympathetic consideration to the need for going into the whole of this question again and trying to provide them as soon as possible?

Yes, Sir. I understand that very considerable research is being done by the Post Office, that it is still going on, and that there are prospects of some success.

Is my right hon. Friend aware that the batteries for these aids are very expensive, costing something between £8 and £10 a year, and will he, through the Health Service, assist people to buy them?

asked the Minister of Health how many applications for hearing aids are outstanding in the boroughs of Wimbledon and Malden, respectively; and how long is the average period of waiting.

Information relating to these areas is not separately available.

asked the Minister of Health whether his Department has yet received a reply from the Durham County Council to their letter of 17th November, 1950, on the subject of that county council's intention to make trade union membership a condition of employment in the health services controlled by that council; and whether he will publish in the OFFICIAL REPORT the terms of any reply received by him.

I have received a reply a copy of which I am placing in the Library.

asked the Minister of Health how many merit awards have been made under the National Health Act; and what is the total sum involved.

One thousand seven hundred and forty merit awards have been approved in England and Wales, representing an annual cost of approximately £1¼ million.

asked the Minister of Health whether it is proposed to hold a public inquiry into the origins of the recent smallpox outbreak; whether the original contact entered the United Kingdom from an area where smallpox was prevalent; and whether he was in possession of a vaccination certificate.

As the origin of the outbreak was immediately established, the need for such an inquiry does not arise. The answer to the second and third parts of the Question is "Yes, Sir."

Would the right hon. Gentleman like to pay a tribute to the medical officer of health and all the nurses and doctors who have worked unceasingly to contain this outbreak, to very great effect? Will he also take the earliest opportunity of making it clear that an outbreak affecting some 30 or 40 people among a population of a quarter of a million is one which should not cause this town or district to be isolated from the outside world because, at the moment, it has brought considerable disaster to local trade? Will the right hon. Gentleman do everything to combat that?

I certainly join the hon. and learned Gentleman in saying how greatly we appreciate the work which the doctors and all concerned in the matter have done in the course of this admittedly small outbreak.

asked the Minister of Health what number of beds are now available in Switzerland for English patients suffering from tuberculosis.

asked the Minister of Health if he can yet make a statement in respect to the proposal for sending tuberculosis sufferers to Switzerland for treatment under the National Health Service.

asked the Minister of Health if he will make it possible for patients from England and Wales to have similar facilities to those to be provided by Scottish hospital authorities for sending their tubercular patients to Switzerland.

asked the Minister of Health whether he has yet found a way in which beds available in tuberculosis sanatoria in Switzerland can be utilised for patients waiting for accommodation in hospitals in this country.

asked the Minister of Health if he can now announce what arrangements have been made for the use of sanatoria in Switzerland for people from England and Wales suffering from tuberculosis.

The possibility of using the available Swiss beds is being considered, but I cannot yet add to previous answers on this matter.

Will the right hon. Gentleman please explain why it is possible for Scotland to have these facilities when the English have not got these facilities? Is it because the former Minister of Health decided that there would be no beds, and is the right hon. Gentleman proposing to carry on that policy to the detriment of the English?

I have said nothing at all in any way in contradiction of what my hon. Friend the Joint Under-Secretary of State for Scotland said recently. She said that explorations were being made on behalf of the Secretary of State for Scotland. They are being made on my behalf, also, in Switzerland at the present time.

Will my right hon. Friend explain the mystery of why it was possible, last week, to give Scotland this facility, when this week it is not possible to make a declaration with regard to England?

I wish my hon. Friend would read HANSARD. There was no declaration that facilities had been afforded or provided for Scotland. There was a declaration that it was under consideration, and that, in particular, discussions were going on with my right hon. Friend the Chancellor of the Exchequer.

In his consideration, will the right hon. Gentleman bear in mind that there is a great deal of urgency, because one of the larger establishments, Montana Hall, is about to close?

I should certainly not like to give any impression that I did not regard the subject as important. Nevertheless, we must keep a sense of proportion about it. I told the House last week that since the start of the Health Service no fewer than 3,550 additional beds for the care of tuberculosis had been provided in England and Wales, and that a very considerable proportion of those had been provided in the last six months. What is available in Switzerland, though I have not so far had a full report, is only a very small fraction of what has been provided, even in recent months, in this country.

Does my right hon. Friend acknowledge that the position in Scotland is, and always has been, very much worse than that in England: and will he inform English Members that they cannot always get the best of both worlds?

Will the Minister make it quite clear that there are the same dilatory results in both countries, that no beds have been made available to patients from either country, and that the complacency shown in his last answer in face of a waiting list of many thousands is quite unjustified?

In this matter the right hon. and gallant Gentleman must be a good judge of complacency.

I provided more beds than the right hon. Gentleman.

Owing to the unsatisfactory nature of the reply, I beg to give notice that I shall raise this matter on the Adjournment at the earliest opportunity.

Question No. 23, Sir.

Question No. 23 has already been answered with Question No. 8. Does the hon. Lady wish to put Question No. 24?

I could not hear the answer, Sir. There was a lot of hubbub going on and I wished to ask a supplementary.

The hon. Lady can ask a supplementary on Question No. 24.

Is the Minister aware that as far back as 16th November his predecessor said that a question of currency was involved in this matter?

We cannot go back to Question No. 8. The Minister is about to answer Question No. 24.

asked the Minister of Health if he will reconsider the position of tuberculosis patients who have tried to help themselves by finding accommodation in Switzerland at their own expense and make some grant towards the cost of their treatment.

I have no power to make such grants.

How many of these tuberculosis patients would have been sent to Switzerland at the State's expense if the Opposition had been successful in their votes against the Health Service Bill?

Will the right hon. Gentleman represent to the Treasury that they should give favourable consideration to this suggestion?

It is no good giving favourable consideration if there is no statutory power.

Is the Minister aware that before the National Health Service local authorities were able to give some aid to people who sought their help when suffering from this complaint? Would he further consider the matter?

Will the Minister give an answer to that question? Will he also accept the assurance that if it is necessary to afford precedence for legislation of this kind, we on this side of the House will be very glad to do it in preference to some of the legislation which the Government are now bringing forward?

Both those questions seem to me to be hypothetical.

rose—

We have had long enough on this Question.

asked the Minister of Health if he is aware of the shortage of hospital accommodation for chronic cases in Durham and Chester-le-Street areas; and what action he proposes to take to provide sufficient hospital accommodation for such cases.

Yes, Sir; but it is hoped to provide an additional 49 beds within a few months at two hospitals in these areas. Improved out-patient treatment will also help to promote recovery.

asked the Minister of Health whether he is aware of the urgent need in Cardiff for hospital accommodation for old people who have no relatives to care for them; and whether be will make a statement.

I am not aware of special difficulties in Cardiff. If my hon. Friend has any particular case in mind, I shall be glad to make inquiries.

asked the Minister of Health if he is aware of the acute shortage of hospital beds in the Grantham, Sleaford and Lincoln areas; and what steps he proposes taking in the matter.

Yes, Sir. The position will be relieved as St. George's Hospital, Lincoln, is brought into fuller use. Part of that hospital was reopened last year and the board propose to bring further sections of the hospital into operation as soon as circumstances permit.

Will the right hon. Gentleman get on with this matter fairly quickly, as it was brought to the attention of his predecessor some time ago? Is the right hon. Gentleman aware that people who were injured nearly a year ago are still waiting to get into hospital?

Yes, Sir, but good progress has been made, and this hospital will provide 356 additional beds very shortly.

Will my right hon. Friend state the extent to which the hospital service generally has expanded compared with the years before the war, and in making that statement demonstrate to the Opposition that considerable progress has been made?

All the Questions which have been asked relating to long waiting lists reveal the inadequacy of the system which we took over.

Will the Minister agree that we are 50,000 beds short of the figure which was provided during the war by myself and my colleagues?

The Question relates to Lincoln and not to the country as a whole.

asked the Minister of Health (1) what immediate steps he proposes to take to increase the number of hospital beds available at the Cardiff Royal Infirmary and the Llandough Hospital;

Work is in progress on a new maternity unit of 87 beds at the Royal Infirmary but no extension is at present contemplated at Llandough. This will not prejudice the proposals for a new teaching hospital.

Since the extension of Llandough is possibly less expensive than other proposals, would it interfere with the proposed new teaching hospital?

No, Sir.

asked the Minister of Health the average length of time taken for the supply of spectacles under the National Health Service Act from date of application to date of delivery.

An average figure is not available. With the exception of certain complicated lenses most glasses can now be supplied with very little delay.

Is the right hon. Gentleman aware that, while the production of spectacles has been speeded up in recent months, the bottleneck now appears to be in the arrival of the form authorising the manufacturer to deliver to the applicant; and will he try to shake up his Department after the recent lax administration?

I am assured that the period between the date of the order for spectacles placed by the optician with the manufacturer and the date of delivery is now only about one week.

Is the right hon. Gentleman aware that I have been waiting for two months?

asked the Minister of Health if he is aware that Mr. Horace Graydon, Morecambe, has been waiting 21 months for his spectacles, that now he has got them they are no good because he has meantime become partially blind through cataract; and if he will make sure that Mr. Graydon now gets the appropriate spectacles quickly.

Mr. Graydon was supplied on 18th January with spectacles which, he states, are quite satisfactory.

I am very glad of that, but will the Minister arrange some method for dealing with complaints of this kind so that people can get satisfaction quickly without the necessity for intervention by a Member of Parliament?

Yes, Sir. The spectacles, as I am sure the hon. Gentleman knows, were of a very special kind—bifocal glasses with Crooks A.I. tints—but now that the back of the other problem—the supply of the general type of glasses—is obviously broken, there should be less delay in the supply of these special glasses.

Would the Minister give particular attention to this question of the long delay in delivery of spectacles, especially in view of the recent activities of his colleague the Minister of Food?

asked the Minister of Health in what year the practice of immunisation against diphtheria became general; and how the notifications and deaths in the previous year compare with the latest year for which the statistics are available.

The diphtheria immunisation scheme sponsored by my Department began in 1941. Notifications and deaths in 1940 numbered respectively 46,281 and 2,480. In 1949 they were 1,881 and 84.

Would the right hon. Gentleman be good enough to send a copy of his answer to the various anti-vaccination and anti-vivisection societies?

asked the Minister of Health what allocations of money have been made for capital developments to the various hospital management committees in the Birmingham Regional Hospital Board; and what is the average population served by each of these hospital management committees.

Capital works are the responsibility of the regional board and no allocations have been made to individual committees.

asked the Minister of Health if he has now received the report of the regional hospital board upon the circumstances preceding the death of Charles Walker who was found dying outside a lonely hut in Urmston meadows to which he had been returned after being refused admission to Park Hospital, Davyhulme, because he was not sufficiently ill, and to a welfare hostel at An-coats because he was too ill; and the steps taken by his Department to secure a more realistic liaison between the National Health Service and those responsible for the administration of National Assistance and the Vagrancy Acts.

Inquiries are not yet complete, but a preliminary report suggests that the failure was not one of liaison between services but of judgment on the part of certain officers. I will make a statement when I have a full report.

Why has it taken so long to get the report? The West Manchester Hospital Committee held an inquiry on 30th December and issued a report to the public. Why does the right hon. Gentleman's Department take so long to get down to this very serious matter?

Because the question of possible failure of diagnosis obviously needs to be considered very carefully.

asked the Minister of Health whether he is aware of the waste of paper and labour entailed in the dispatch of corrigenda to regulations issued by his Department relating to unimportant details; and if he will cause this practice to stop.

I am not aware that there is any such waste.

Is the right hon. Gentleman aware that the following corrigendum was issued quite recently under the heading "Capital and Maintenance Works and Expenditure":

"Page 2, paragraph 3 (iii), line 4, delete semi-colon after 'sterilising'"?

I hope not. I expect that it is one of those matters where the lawyers insist on accuracy of punctuation.

Will the right hon. Gentleman agree that these corrigenda have no statutory authority whatsoever?

I should require notice of that question.

Is my right hon. Friend aware of the very great appreciation of the population of the country of the National Health Service, and their impatience with this niggling kind of Question?

asked the Minister of Health whether he will made a statement on the report which he has received from the Committee on the Supply and Demand, Training and Qualifications of Physiotherapists in the National Health Service.

No, Sir; I am not yet ready to do so. I wish to study the Report more fully.

Can my right hon. Friend say when he expects his study to be completed?

It must at any rate take some weeks.

asked the Minister of Health what quantity of heroin was used in the United Kingdom in 1950, compared with 1938; and to what causes he ascribes the difference.

The quantity in 1938 was 46 kilos, and in 1949 it was 136 kilos. Figures are not yet available for 1950. Diamorphine is widely used in this country as an ingredient for cough-linctus. A rise in consumption can, therefore, be attributed in part to medicinal use under the National Health Service.

Is the Minister satisfied that that increase is due to an increase in medicinal use?

I am only able to reply to that part of the Question which concerns me. Other questions would more properly be referred to my right hon. Friend the Home Secretary.

asked the Minister of Health on what grounds he has decided to extend the franchise to certified lunatics.

The franchise has not been extended. The law is, and has been for many years, that, apart from idiots, a person suffering from any form of mental disability, if on the electoral register, is entitled to vote if he presents himself at the appropriate polling station and satisfies the presiding officer as to his capacity to do so.

asked the Minister of Health if he will identify the powers by which he has instructed benefactors under covenant of voluntary hospitals to pay instalments to him; if he will publish in the OFFICIAL REPORT a copy of his demand for such payment; and if he will refrain from enforcing such claims in the courts.

The powers are contained in Section 7 of the National Health Service Act, 1946. I will circulate a copy of the letter in the OFFICIAL REPORT. I am advised that a person who executed a deed of covenant has himself no power to cancel it; and I hope, therefore, that action in the courts to enforce compliance will not become necessary.

As this is grossly unfair, will the Minister introduce amending legislation to relieve benefactors of voluntary hospitals from any liability?

I should have thought that this gives the opportunity that hon. Members opposite and many on this side of the House think is desirable of associating voluntary effort with the work of the hospital service.

Does not the Minister recognise that these gifts were made to an individual hospital and were not made to any group that the Minister may select? Does he not realise that it is grossly unfair to have done what his Department have done?

The House of Commons discussed the National Health Service Bill very thoroughly and passed the Act in the form in which it now stands. It is my duty to administer it.

asked the Minister of Health if he will reconsider the case of Mr. F. W. Harris, 40, Uffington Road, West Norwood, who is now being taken to court by the hospital authorities for payment of fees amounting to £85 1s. in view of the fact that when advised by his doctor that his wife must have an immediate emergency operation, he took a semi-private bed for her in King's College Hospital as no public bed was available.

No, Sir. My information is that Mr. Harris asked his doctors to obtain a bed at King's College Hospital and accepted a bed in a semiprivate ward on being told that no bed in a general ward at that hospital was available. I have no power under the National Health Service Act to reimburse the cost of arrangements entered into privately.

Should there not be some room for humanity and elasticity in the operation of the Health Service? Would the Minister realise the state of mind of my constituent who was told that his wife would die within an hour if she could not have an emergency operation? Would not any one of us have signed any form for any bed rather than let his wife die?

I must tell the hon. and gallant Gentleman that my information does not appear to coincide precisely with his. If he would like to come to see me about it, I will explain the position.

If the inference in the Question was correct, that it was an immediate emergency, would the Minister say why a public free bed was not available in private accommodation, as the Act provides?

The situation was that a private bed was asked for, and because it was asked for specially at that particular hospital no application was made to the free bed roll. I am satisfied that the officer concerned had every reason to believe that it was a private bed at King's College Hospital which the gentleman concerned required for his wife.

Would it not be far better to abolish private beds in hospitals altogether?

Would the Minister realise that I have been most carefully into this case with the doctor and my constituent? The doctor assures me that he wanted to perform an emergency operation at the hospital. He rang up the hospital for any bed. They replied that there was no public bed, but that they could make available a semi-private bed. I am satisfied that those were the facts of the case.

I do not for a moment doubt that the hon. and gallant Gentleman made the best inquiries he could. He must accept that I did the same.

asked the Minister of Health what is the total number of general practitioners in practice at the latest convenient date.

The number of general practitioners on the medical list in the National Health Service in England and Wales on 1st July, 1950, was 18,710. I have no information about those in private practice.