asked the Minister of Health whether he is aware of the delay in the payment of an Exchequer contribution to the Hampton House Home for Old People, Hereford; and whether, in view of the financial difficulty the society now find themselves in, he will expedite the payment of this grant in view of the fact that application was first made to the county council under Section 28 of the National Assistance Act in June, 1951.

Yes, Sir. A provisional payment of grant was made on 22nd February to the county council for the society, pending determination of the basis of payment to be applied in the future. This has now been settled, and a further payment on account of grant will be paid in the course of the next few days.

Will the hon. Lady expedite a further grant, because the Committee of the Hampton House Home is now considering whether, unless it gets the full grant to which it is entitled, it will be possible to maintain the provision made for these old people?

I can assure my hon. Friend that the delay was due to a question of a legal ruling. The matter has been settled, and I think he will find it satisfactorily completed in the manner which he hopes.

asked the Minister of Health (1) what action is taken against doctors who prescribe medical and surgical material under the National Health Service on request without inquiring for what purpose it is required;

(2) what instructions are given to doctors to ensure that they ascertain that medical supplies are necessary before they prescribe them;

(3) if he is aware that a doctor in the East Midlands, of whom he has been in formed, working in the National Health Service, has prescribed cotton wool in large quantities without satisfying herself of the purpose for which it was requested, and that it was afterwards used for stuffing cushions; and if he will instruct the appropriate executive committee to investigate and take action in the matter.

asked the Minister of Health whether he has considered the case of a medical practitioner under the National Health Service in the East Midlands, details of which have been brought to his attention; that this doctor twice prescribed cotton wool for a patient before she learned that it was being required for the stuffing of a sofa and cushions; and what further steps he will take to prevent laxity in the giving of prescriptions.

asked the Minister of Health whether his attention has been called to the fact that a medical practitioner under the National Health Service, whose name has been sent to him, has prescribed cotton wool for a patient which has been used for stuffing sofa cushions; and what steps he will take to prevent doctors from abusing the National Health Service.

A practitioner should prescribe only what is necessary for proper treatment, and if the cost of his prescribing is in excess of the amount necessary on this basis a sum may be withheld from his remuneration. I am sure that practitioners are co-operating in an endeavour to avoid excessive prescribing. I see no necessity for any special action in this case.

Can the Minister say whether he has investigated the case, which was drawn to his attention, of a doctor—Lady Barnett, of television fame —who prescribed cotton wool in excess of the amount required, and whether any action is being taken, in view of the fact that she is a well-known Conservative worker in her constituency and that other doctors who have prescribed cod liver oil and malt have been fined for excessive prescribing?

The hon. Member seeks to show on the basis of one reported case, that there is abuse in this matter and that there is a case for the Minister of Health taking action to avoid financial abuse. There is something to be said for the latter point of view. The only thing I would add to my first answer is that this occurrence took place in the autumn of 1948.

Is the Minister aware that this story about cushions was made public by Lady Isobel Barnett, not in 1948 but a few weeks ago? Has he considered the possibility of the story being used by Lady Barnett in a purely allegorical sense, with a view to discrediting the Health Service in the minds of her ignorant and credulous audience, and will he discourage the telling of flat-footed falsehoods by doctors who are on his pay roll?

Is the Minister aware that the Opposition have always held the view that abuses in the Health Service can take place only with the connivance of doctors, dentists or opticians; and does not he think it wrong that a Tory doctor should use her own professional shortcomings as an instrument of propaganda against the Health Service, when most professional people and thousands of voluntary workers of both political parties are giving admirable service?

All I need to add to my previous answer is that I see nothing whatever in the report which I have read which affords any justification for any of the statements made from the Opposition benches.

Does not the right hon. Gentleman think that it would be in the interests of the Health Service for him to say that this case is unique, and that no similar case has been brought to his attention?

Certainly no similar case has been brought to my attention. I have told the House when this event took place and, quite frankly, I am quite certain that I and the executive council concerned have better things to do than to inquire whether or not, six years ago, a patient did or did not use an appliance correctly.

asked the Minister of Health the gallonage of fresh milk supplied to the Dartford group of hospitals in 1953; and the comparable figure for 1951.

The amounts were 115,218 and 124,113 gallons respectively.

I appreciate the need for economy in any Government service, but will the Minister bear in mind that there is cause for some concern at the fact that in two years the use of skimmed milk powder has increased by 50 per cent, and the gallonage of fresh milk, of which there is plenty, has gone down? Will he see that this process is not overdone in the interests of economy?

Of course I shall bear that in mind, but the figures I have for this particular group show that there has been an increase from 7,000 lb. to 9,300 lb. in the supply of powdered milk, which is clearly not of the order of 50 per cent. Powdered milk is used in these instances only in bulk cooking.

In view of what the Minister has just said, will he refer to the answer he gave to a Question on 11th February, when he said that in 1951 the use of milk powder was 5.3 per cent, and in 1953 it was 7½per cent.? Is not that an increase of 50 per cent.? Will not he look at these figures again before he answers the next Question on this subject?

I have given accurate figures. There is all the difference in the world between an increase in percentage and an increase in the amount used.

asked the Minister of Health the correct procedure for appealing against decisions by his Department in respect of the award of invalid tricycles.

There is no formal procedure, but representations made to my local appliance centre or to the appliances division at Norcross are always fully and carefully considered.

Can my right hon. Friend say whether there has been any change in this system since his Department took over the administration of these cases? Does not he think it would be advisable to have some sort of system of appeals against decisions of his Department?

There has been no change. The difficulty about having any formal system of appeals is that there is not statutory entitlement upon which we can base it. I should have thought that the present system was working pretty well. Representations can be made to the local appliance centres, and when Members of Parliament bring cases to the attention of the Parliamentary Secretary or myself, we look into them.

asked the Minister of Health how many of the regional boards allow transfer from whole-time to part-time consultant medical service.

All do in suitable cases, subject to the needs of the service.

Can the Minister say what is his view about the matter? Has he noted that the service is not normally well served, or best served, by men in full-time service transferring to part-time service? Would not the right hon. Gentleman consider giving some further thought to, or direction in, this matter?

I do not think that any such generalisation can be drawn. The policy which I have indicated in my original answer, that all boards allow transfers, subject to the needs of the service, is based on the 1948 circular, and there has been no change in that. I believe that a part-time consultant service is a very good thing, and I have certainly no evidence to show that there is any deterioration in the service provided to the people.

Is the Minister aware that he is giving some encouragement to the transfer from full-time to part-time service? Is it not the case that some regional boards are offering the maximum number of part-time sessions, as an alternative to full-time sessions, to the great detriment of the service, and to its added cost?

Boards may well interpret circulars—in particular the 1948 circular—in different ways. As the hon. Member knows very well, there are different trends in different regional boards. I have no reason to think, however, that the boards are not applying their general policy to individual cases—which is what matters—in a reasonable manner.

Will the right hon. Gentleman consider asking regional boards to inform him of the number of these transfers which have been made during the last year or two, in view of the fact that he could not give this information to the House when I asked a Question some months ago?

Speaking offhand, the reason I cannot give that information is the form in which the information is at present collected. It may show the number of posts, but it does not necessarily follow that that is the number of persons in those posts, because people may hold more than one. If it is worth while, I shall see if I can get that information, but I am not anxious to put additional paper work on to the boards.

asked the Minister of Health whether he will give an estimate of the financial saving that would follow the abolition of the part-time consultant service and its replacement by a service employing only full-time specialists.

No, Sir. I do not think the financial effect of such a hypothetical circumstance can possibly be assessed.

None the less, is the Minister aware that some of us think that the saving would be very considerable? Is he further aware that men working full-time as consultants are not allowed any of the perquisites, such as expense allowances and so on, that follow service of a part-tune nature? If there could be a switch over to full-time service, would it not be possible to make that full-time service much more attractive, even financially?

I am aware of the way in which remuneration of all forms is treated rather differently as between whole-time and part-time specialists. As the hon. Member knows perfectly well, that goes back to the Spens Report. The first half of his supplementary question —I do not know whether I am to take it as an expression of opinion from the Opposition benches—is in direct conflict with the 1949 amending Act. Any suggestion of part-time service being abolished would certainly be a breach of faith with the profession.

Does the right hon. Gentleman realise that great cost is in-flicted upon the service by the payment of travelling time and expenses? Would not the withdrawal of those facilities—which apply only to part-time officers—save him a lot of money and give him an opportunity to improve the service in other directions?

I understand the point but I do not agree with it. I think the question is perhaps more appropriate to Question No. 44.

asked the Minister of Health whether he is aware of the financial advantages enjoyed by part-time specialists employed by hospital authorities in comparison with those employed full time; and whether he will refer the matter to the Guillebaud Committee for their consideration in view of the heavy cost of payments for travelling time and domiciliary visits charged by part-time specialists.

I am aware of the arrangements which were agreed in 1949. In reply to the second part of the Question, it is open to the committee to consider the point made by the hon. Member, but I do not think that it would be appropriate for me to ask the Committee to inquire into particular topics.

Would the right hon. Gentleman not agree that very heavy expenses are being involved in travelling time from a specialist's home to the hospital, and from hospital to hospital, and in the charges for domiciliary visits; and would it not be right that the Guillebaud Committee should consider this matter as one which concerns the economy of the service?

These matters, as I indicated earlier, stem from the Spens Report on consultant specialists and its implementation by the late Government in the terms and conditions of service. I think that if there is to be any adjustment, whatever form that may take, in these terms and conditions of service, it is far better left in the ordinary way to the Whitley Council, where it can be fully discussed, and in part is being discussed in connection with the claim to which I referred earlier, before the medical Whitley Council. I think that is a better forum than the Guillebaud Committee.

Does the right hon. Gentleman not agree that he cannot divest himself of some responsibility in this matter in view of the fact that it is bound up with the treatment of patients and the waiting time in hospitals?

I am not suggesting that I should divest myself of responsibility. I merely say that I think the Whitley Council is the best forum to discuss it. There is no reason at all, as this clearly falls within the terms of reference of the Guillebaud Committee, why that committee should not discuss it as well.

asked the Minister of Health if anti-haemogloben serum is available for emergency treatment to patients in hospitals who are haemophilics.

A limited supply is available on application by doctors, but its efficacy is still the subject of research and is not yet established.

Is it not the case that in an emergency operation where a blood coagulant has been required, it has been necessary to send to the United States? While we much appreciate their help, is it not very important in the case of bleeders that doctors should know where to get an immediate supply of coagulant?

If there is any doubt about it. I will see whether we can circulate the information more widely. Perhaps I can give the information now. Application should be made to the Lister Institute, Chelsea, or to the appropriate regional blood transfusion centre. I should be very happy to look at individual cases if any hon. Member likes to bring them to my attention. No doubt the reason that this serum is in limited supply is the reason which I gave—that it has not yet been accepted as fully efficacious in all circumstances.

asked the Minister of Health what negotiations are in progress regarding salary scales to consultants, senior hospital medical officers and registrars; and if he will make a statement.

A claim for higher salaries is before the Medical Whitley Council, and the hon. Member will not expect me to make a statement while it is under consideration.

It has been under consideration since the Spens Report a number of years ago. General practitioners had their pay settled under the Danck-werts award more than a year ago. Cannot the Minister do something to speed this matter up, or does he enjoy the delay?

It has not been under consideration for quite as long as that, although it has been under consideration for a very long time—some 16 or 17 months, which is a very long time indeed. I had a meeting on this subject this morning. There will be no unnecessary delay, and I think we are now nearing conclusion on the matter. I am sure that the hon. Lady recognises that this is a matter of the most profound importance which will have repercussions in many other fields.

asked the Minister of Health whether he will request the regional hospital boards to make an inquiry into the facilities offered in outpatients' departments and the efficiency of the methods adopted for cutting out waiting time.

This is a matter which hospital boards and committees have constantly before them, and I myself make inquiries if information about unreasonable waiting comes to my notice. If my hon. Friend has particular instances in mind, I shall be happy to look into them.

Is my hon. Friend aware that the problem is not necessarily just the waiting time but also concerns the variety of methods of handling outpatients, which are just as important, such as ensuring that there are plenty of seats and that tea or some other refreshment is available? Would not my right hon. Friend agree that to circulate the various arrangements, as between one hospital and another, might enable hospitals which are in a difficulty to tighten their procedure for the out-patients and improve it?

It is my impression that information on these matters has been circulated to boards and committees, but if anything further can be done I am entirely in sympathy with my hon. Friend's suggestion, and I shall be glad to consider it.

Is the right hon. Gentleman aware that the principal concern in this matter is that a great deal of time is wasted in waiting in the out-patients' departments of many hospitals in the country? Has he any knowledge of the period waited on average, compared with that waited by private out-patients using the same hospitals? My experience is that they can walk through the department and receive almost immediate treatment, whereas in some cases other patients have to wait for many hours, with inadequate seating accommodation, in crowded ante-rooms.

I think that all hospitals should have a block system, or something like it, of waiting appointments in the out-patients' departments. It is important to realise, however, that it is very difficult to be more precise than that. The examination of a patient which, it is thought, may take only a minute or two, may in fact uncover some disease which was unknown before, and the examination may take half an hour or more, upsetting the waiting times of all the other patients. It is very difficult to card-index patients and their diseases in this way, but I am most anxious to see that all hospitals have such facilities as are necessary. Perhaps the best way of doing it, apart from the general assurance which I have given to my hon. Friend, would be for any hon. Members to let me know when they think that the circumstances in their own area are unsatisfactory in this respect. I will look into hon. Members' comments.

Does not the Minister agree that some reduction in the number of part-time specialists and an increase in the number of full-time specialists might improve this position?

When my right hon. Friend is giving consideration to these matters, will he bear in mind the very bad conditions prevailing at the hospitals in both Horsham and Crawley, the details of which I have given him?

I will take note of that.

Will not the Minister reply to my question?

asked the Minister of Health what guidance he has given to local authorities concerning the policy of bulk buying for the requirements of old people's hostels, day nurseries and other similar institutions.

None, Sir. This is a matter for the local authority.

asked the Minister of Health what steps are being taken by his Department to ensure that in East Sussex the long-standing custom in private practice whereby the closest liaison possible is maintained between hospitals and general practitioners regarding patients sent to hospital by the latter is continued in the present set-up of the National Health Service.

Every opportunity is taken by circular and otherwise to impress on hospital boards and committees the desirability of close liaison with general practitioners about their patients, whether by personal discussion during treatment or by supplying information in writing both then and on discharge. If my hon. and gallant Friend has a particular case in mind, I shall be glad to make inquiries.

asked the Minister of Health if his attention has been drawn to the danger that four men in Norfolk may have contracted fowl pest after helping with the slaughter of chickens among which the disease had broken out; and if he will make a statement.

My right hon. Friend is advised that this disease, although in a limited sense transmissible to man, is not readily passed on among human beings. The only known clinical form of the disease in man is a mild inflammation of the eyes without constitutional disturbance. In the instance referred to the men are now back at work.

Does the Parliamentary Secretary appreciate that the policy of the Minister of Agriculture towards this disease is very drastic, being one of slaughter and compensation? I do not want her to pursue such a drastic policy towards human beings, but would she take an opportunity to make it quite clear to farmers and farmworkers how great or how small the risk may be?

I think it might reassure my hon. Friend if I told him that, while it is not unreasonable to attribute the eye condition in the two men concerned to contact at work with the diseased fowls, the laboratory tests which were made did not confirm this association.

asked the Minister of Health if he is aware of the increasing costs of administration and maintenance of old hospital buildings in the southwest region; and why, in view of this, he reduced the grants by nearly £1,000,000 below the estimated hospital board's requirements.

Old hospital buildings are not peculiar to this region, which has been allocated what is in my view a fair share of the total sum available for hospital running costs in 1954–55.

Is the right hon. Gentleman aware that if he puts into effect the contemplated reduction, it will mean the closing of hospitals in the south-west region? Is he aware that a large number of these hospitals are very old and in a dilapidated condition and that they need more money, not less? Further, is he asking local authorities and local committees to estimate 7 per cent, to 10 per cent, above their requirements so that, when the estimate reaches him, his Department will have an opportunity of reducing the sum by that amount?

I am sure that the hon. Member knows the way these things are done. I should not think any region in any year has ever got what it asked for. Indeed, as a matter of interest, I looked up what happened to the regions in the last year of the Socialist Government, and I found that the estimates for every region were reduced, some of them by a larger sum than is indicated in the Question. As compared with last year, the sum of money is not being reduced; it is being increased. Of course it is less than the regions requested but, as I have explained, as far as I know that has happened in every year and under every Government. The important figure, surely, from the summary of estimates this year is that, as the hon. Member knows, £17 million more is being provided for the National Health Service. By no possible use of language can that be called a cut.

Is the Minister aware that for hospitals in the Plymouth area the same amount has been allocated as that for last year and that, as there has been a considerable increase in the salary payments which have to be made, as well as other considerations, in effect that means a cut?

There is a later Question about Plymouth but, as a matter of fact, the hon. Member's assumptions are not accurate.

asked the Minister of Health whether he is aware that a number of mothers in Blackburn are being refused the opportunity of having their babies in hospital or maternity homes; and whether he will instruct hospital management committees that maternity beds should be provided under the National Health Service for all mothers who prefer not to have their babies at home.

I have already written to the hon. Member enclosing a copy of a circular to hospitals which asks them to provide maternity beds for mothers who require them on medical or social grounds. It would not be practicable to provide beds for all mothers who prefer not to have their babies at home. In Blackburn the percentage of confinements in hospitals is much higher than in most other areas, and less than 2 per cent, of those who applied in 1953 were refused admission.

Is the right hon. Gentle man aware that as a result of the recent closing of Springfield Maternity Home in Blackburn, mothers who want to have their second child in hospital or in a maternity home have been told that they cannot and must have it at home, although they have no one to look after them, as, for example, in the case which I have in my hands now? In this case, when the mother was referred to the Manchester Regional Hospital Board they told her they could not do anything be cause the right hon. Gentleman had in structed them to reduce the number of cases of mothers having their babies in hospital—

With regard to Springfield hospital, I call the hon. Lady's attention to the fact that the hon. Member for Accrington (Mr. H. Hynd) has a Motion down on the Adjournment tonight for discussion of that matter. We cannot anticipate that Motion.

On a point of order, Mr. Speaker. Is that going to preclude me from raising the general principle, which I have just referred to, of an instruction by the Minister of Health to the regional hospital board in Manchester to reduce the number of maternity cases in Manchester?

The hon. Lady asked a Question on a general principle and then asked a supplementary question about the closing of Springfield hospital. I was pointing out to her that that would be anticipating the Motion of the hon. Member for Accrington tonight.

This maternity home is in my constituency. I have no guarantee that I shall be able to speak tonight.

I cannot help that. We cannot anticipate the Motion on the Adjournment.

Are you now ruling, Mr. Speaker, that an hon. Member will not be allowed to ask a question about his own constituency if someone else happens to have given notice that at some time, if he is in the Chamber, he will raise that question on the Adjournment?

The question as to one hon. Member asking a Question about another hon. Member's constituency is one between the Members involved. I am only concerned with the rules of order, which prohibit us from anticipating matters, notice of the raising of which on the Adjournment has been given.

On a point of order—

I cannot deal further with that point of order.

asked the Minister of Health how many registered blind persons and partially-sighted persons, respectively, are known to be patients in mental hospitals and institutions; how many of these have been discharged during the past twelve months; and if he is satisfied that the fullest facilities for visits by welfare workers are available.

On 31st December, 1952, the last date for which complete figures are available, there were 1,158 registered blind persons in mental hospitals and 639 in mental deficiency hospitals in England and Wales. The number of partially-sighted patients is not known, nor the number of discharges during the past 12 months. I am not aware of any lack of facilities for visits by welfare workers, but if the hon. Member has particulars of any individual cases I shall be glad to look into them.

In view of the very alarming figures which the Minister has disclosed—1,800 blind people in mental hospitals and institutions—does he not feel anxiety that this number is increased by the possibility that old blind people may be taken to mental hospitals because they suffer from lack of attention at home or because there is not sufficient provision in homes for blind people, and that they therefore have to be taken to these mental hospitals which, I suggest to the right hon. Gentleman, is a very serious position for them?

I discussed this matter at a very helpful all-party meeting under the chairmanship of the right hon. Member for Middlesbrough, East (Mr. Marquand), and this was one of the matters which caused all of us a good deal of concern. I will try to look into this matter now to see whether there is anything that can be done, perhaps along the lines of the hon. Member's suggestion. If the hon. Member, who has particular experience in this field, would like to put some suggestions to me, I should be very grateful to him.

asked the Minister of Health what cuts in services he expects the Plymouth, South Devon and East Cornwall Hospital Management Committee will have to make as a result of the money allocated for 1954–55 by the regional hospital board.

I understand that the board is considering with the committee the possibility of closing two units which are not fully used, but it does not at present appear that there need by any reduction in adequate services.

Is the right hon. Gentleman aware that when he talks about two units not fully used, what he really means is that his policy is to compel the Plymouth board and the area management committee to close down two maternity hospitals and another hospital which have been part of the expansion campaign over the last few years? Indeed, he is compelling the management committee in this area to reverse the policy of previous years and to cut down the hospital services in the whole area?

I do not accept that for one moment. The allocation to this hospital management committee, as I said before, has, in fact, gone up and not down. The first reaction of Mr. Medland, the chairman, was to say that he would be compelled to close two maternity homes, a training school and a hospital for the chronic sick. I fully agree with the hon. Member that if that is the reaction to an offer to increase moneys we must look very carefully into the administration there.

Will my right hon. Friend confirm once again that the money allotted to this hospital management committee for the present year is more, and not less, than the amount allotted last year? Does it not seem that our former, respected colleague, Mr. Medland, is trying to centralise activities in Plymouth, and will my right hon. Friend endeavour to discourage this centralisation?

The answer to the first part of that Question is "Yes." In reply to the second part, these matters are at present under consideration between the South-West Regional Board, in which I have full confidence, and the hospital management committee. Indeed, I believe the board is meeting today. It is far wiser to leave that discussion to go through the usual channels and to see then whether a case has been made for or against the allocation.

Instead of making any reflection upon Mr. Medland, the chairman of the management committee, would the Minister take into account that Mr. Medland has had the full support of his management committee in stating that the amount of money allocated was exactly the same as last year and took no account of the increase of £25,000 which had to go to meet extra charges, partly, as I have said, for salaries? Therefore, will not the right hon. Gentleman withdraw the reflection which he made on the management committee, who are trying to maintain the National Health Service instead of reducing it, as, apparently, is the purpose of the right hon. Gentleman?

I have no intention of withdrawing anything that I said. This matter is one that should be discussed by the regional board and the management committee. It is far better that it should be done that way rather than to hold Press conferences or to make statements in "Tribune," as was done for another purpose.

asked the Prime Minister if he will convene a conference of the appropriate authorities to arrange for the bells of the churches throughout the United Kingdom to be rung at the moment when Her Majesty the Queen sets foot again in her native land.

I have been asked to reply.

My right hon. Friend has communicated with the Archbishop of Canterbury and the Moderator of the General Assembly of the Church of Scotland, both of whom welcome the suggestion. He is sure that the leaders of other Churches will be glad to consider it, and that so far as possible it will be put into effect.

Will the right hon. Gentleman convey to the Prime Minister that his answer will give widespread satisfaction to Her Majesty's loyal and admiring subjects who eagerly await the opportunity to greet her on her return home?

What about the bats in the belfry?