asked the Minister of Health if he will investigate the relationship between the incidence of tuberculosis on Tyneside and the pollution of the tidal part of the river.
I am advised that any such relationship is highly improbable.
Is the Minister aware that in spite of the very great improvements since the war the proportion of tuberculosis on Tyneside is still almost twice the national one? Is he further aware that the pollution of the tidal waters of the Tyne is really shocking? It is one of the most heavily-polluted rivers in the country. May there not be some connection between these facts? Will he not at least look into the problem?
It was as a result of doing so that I gave the answer. It is certainly true that the incidence of tuberculosis in this area is much higher than in the rest of the country, but I am advised that of the one or two cases mentioned in medical literature there was only one on the North-East coast, in 1949, which might be linked up with polluted water. Infection is normally passed in the air through the medium of a droplet or of dust and, therefore, would not normally be connected with water pollution.
Is the Minister aware of the proud and important status of the Tyne in the life of the people of the North-East? Is he also aware that we all regret its continued use as an open sewer? It is- having a very detrimental effect in that area. Will he endeavour to influence local authorities to try to introduce a comprehensive sewerage scheme in the area, so as to prevent the Tyne being used as it is at present?
That is the responsibility of my right hon. Friend the Minister of Housing and Local Government, but if any evidence came to me from that area that there was a link between what is admittedly a still high, though a dropping, incidence of tuberculosis and any pollution, I should be very glad to go into the matter.
Mental Nurses (Shortage)
asked the Minister of Health whether, in view of the shortage of mental nurses, he will approve the establishment of a separate Whitley Council for mental nurses.
No, Sir; I do not think that this would help in any way.
Is the Minister aware that his reply will disappoint many people who believe that so long as pay and conditions in the nursing services for the mental and mentally defective are subject to the same conditions as those of the nursing service as a whole there will be very little prospect of attracting new recruits to this extremely exacting branch of the profession?
Although this problem causes us all concern, the solution must be a matter of opinion. It is a much wider affair than a mere change of Whitley machinery. I have given the House figures showing that we are tackling this problem on a much wider front, and I look to results from this rather than from the suggestion contained in the hon. Member's Question.
Does the Minister agree that, in general, the introduction of individual Whitley Councils for individual grades is a retrograde step, and that the larger the Council and the greater the number of grades included the easier it is to make a comparison of the duties performed?
That is a very wide generalisation. I think that the present procedure is right in this respect. There is a special standing committee for mental nurses on the Staff Side of the Whitley Council.
asked the Minister of Health the present shortage of nursing staff in hospitals for mental defectives; whether this is an improvement or otherwise compared with preceding years; how many beds are not used because of the shortage; how many are now waiting admission; what further steps have been taken or considered in order to secure additional trainees and nurses in these hospitals; and what percentage of student nurses do not complete their training.
Estimates in this field vary and are not very reliable. The latest is about 2,300 for December, 1952. The nursing staff of mental deficiency hospitals was, at 30th September, 1953, 6,600 full-time and 2,200 part-time, an increase of 480 full-time and 740 part-time over the figures at 31st December, 1948. At 31st December, 1952, there were 1,587 unstaffed beds. The waiting list at 31st December, 1953, was 8,521.I will send the hon. Member a copy of the memorandum to hospital authorities dealing with measures taken to improve recruitment. Between 60 per cent, and 70 per cent, of student nurses in this field fail to complete training.
While thanking the hon. Lady for her reply, and being gratified that there has been some slight progress, may I ask whether any extra special efforts are being made to recruit nurses for this very important branch of the nursing service, particularly in view of the large number who give up the work after a short time?
The hon. Member will be aware that my right hon. Friend is concentrating on the recruiting of nurses for this work this year. Experiments are taking place under the aegis of the General Nursing Council. We have recommended various measures that are outlined in the memorandum that I will send to the hon. Member.
asked the Minister of Health how often a person may have his sight examined under the supplementary ophthalmic service.
As often as necessary, but ophthalmic medical practitioners and ophthalmic opticians were asked in 1950 not to repeat a test within a year except where there was special reason for doing so.
Is the hon. Lady aware that one large executive council on the South Coast is telling its doctors not to examine patients more than once in 12 months? Will she take action in this matter if I give her particulars of the case?
The general instructions were that practitioners should secure the permission of the Ophthalmic Services Committee where there had been a previous sight test within the year, except in urgent cases, or cases notified to the patient's doctor as subject to further examination. If the cases which the hon. Member has in mind come into that second category I shall be only too happy to look into the matter.
Inoculated Children (Health Effects)
asked the Minister of Health whether he is aware of the dissatisfaction felt by Mr. Bradshaw, particulars of whose case have been submitted to his Department, about the treatment given to his child Jane, who is suffering from speech deformity following the last of a series of four inoculations for diphtheria and whooping cough; that, as Mr. Bradshaw could see no improvement in his child's health following attendance at a public clinic as such attendance affected the nerves of both mother and child, he sent her to a speech therapist with beneficial results; and whether, in view of the special circumstances, he will make some payment to Mr. Bradshaw for the treatment the child is now receiving.
On a point of order. Before the Question is answered I want to emphasise that it relates to the combined inoculations against diphtheria and whooping cough, and not against diphtheria alone. There has been some misunderstanding on the subject.
I have carefully examined the facts of this distressing case, but I do not consider the circumstances are such as would justify a contribution towards the cost of private treatment.
Is my right hon. Friend aware that two doctors have testified that they considered that the defective speech of this child is due to these injections? Is he further aware that teachers under the National Health Service simply have not the time to give proper treatment to this child? Why should these unfortunate parents have to pay large sums of money to try to save this child's life because of what they and certain doctors consider to be the bad treatment of the National Health Service?
I cannot accept that statement. It is certainly a possibility, but it is not certain that this speech defect is due to the inoculations. As far as treatment for Jane is concerned, it has (been suggested—and I make the offer again—that we should, if necessary, give extra time out of ordinary clinic hours, in the babies' hospital, to this very difficult case. I do not think we can do more than that. If the parents accept that offer, or my hon. and gallant Friend will consult me on the matter, I shall see what I can do, but all the conditions of treatment are available for use within the National Health Service.
Will the Minister confirm that his answer means that full facilities for speech therapy treatment are available in the National Health Service for this child?
Yes, Sir. It is fair to say that the parents were rather dissatisfied with the amount of time which could be given to any one child, and, therefore, wanted to have private treatment outside the scheme, which they are quite entitled to do.
asked the Minister of Health the number of children during the last five years whose health was affected by inoculation for diphtheria and whooping cough; how many of these cases received treatment under the National Health Service; in how many cases the children regained their full health; and in how many cases there is permanent injury or deep-seated injury.
I regret that the detailed information asked for is not available, but serious illness attributable to inoculation is known to be extremely rare.
Is my right hon. Friend aware that since I tabled this Question I have received evidence from parents all over the country on this subject? One poor woman has three children out of four whose speech has been affected. If I send him particulars of these cases will my right hon. Friend promise to look into them very carefully and, if necessary, inquire into the whole matter?
It is true that there is a minimal hazard attached to immunisation. We all know that. But it is equally true that the importance which has been attached to such immunisation in recent years has done an enormous amount to lessen the incidence of these diseases.
Can the Minister say what proportion of cases were affected by paralysis of the palate when they suffered from diphtheria before inoculation was invented? Was it not much higher then than it is now?
I have not those figures with me, but I will see whether they are available. Certainly, the number, in relation to the total number of diphtheria inoculations carried out each year—which is more than a million—is tiny.
My right hon. Friend has missed my point. We all admit that these inoculations do a tremendous amount of good. I am complaining that there are cases where the wretched parents are hit very hard. This poor woman has three children out of four—[HON. MEMBERS: "Speech."] Speech my foot. My right hon. Friend cannot explain that away.
I am not trying to explain anything away. This is a very distressing case. I have read all the papers with great care, and I shall be happy to discuss the matter with my hon. and gallant Friend. It still remains true that medicine is not an exact science, and that risks are attached to immunisation or any other form of treatment.
asked the Minister of Health whether, under his regulations, special treatment, outside the National Health Service, is ever given to children in cases where a deterioration in a child's health may be the result of treatment or action by a National Health Service doctor or hospital.
I am "browned off."
Day Nurseries, Harrogate
asked the Minister of Health if he is aware of the proposal to close down one of the two day nurseries in Harrogate; and whether he is satisfied that adequate extra provision will be made in the other for health cases before this proposal is put into effect.
I would refer my hon. Friend to the reply given to the hon. Member for Normanton (Mr. A. Roberts) on 6th May.
asked the Minister of Health how many places there are in each of the two day nurseries in Harrogate; and how many of those who now use them fall into the category of health cases.
Forty in each. The latest available figures show a total of 69 health cases, including cases of housing difficulties.
In view of the preponderance of health cases over industrial cases, can my hon. Friend say what her further policy will be for the accommodation of the health cases?
There is a period of two months after the local health authority has given notice during which interested bodies may lay their considerations or objections before my right hon. Friend, and the closing time is not until 19th May. I think it would be premature now to anticipate what they may be, or my right hon. Friend's decision.