asked the Minister of Health whether he has yet received the Report of the public local inquiry into the incidence of tuberculosis at Talgarth, Breconshire; and whether he will make a statement.

I am examining this Report and will write to the authorities concerned as soon as possible.

Would the Minister be good enough to expedite the decision on this Report, because we are going into Recess, I hope, at the end of next week, and I should like the local authorities to have a decision about this inquiry?

I shall do it as quickly as I possibly can. There are one or two other Ministries to be consulted, but there will be no delay.

asked the Minister of Health how soon he is likely to sanction schemes for the establishment of sheltered industry for the rehabilitation of tuberculous patients, outside existing tuberculous colonies.

Such schemes have to be considered in relation to other expenditure under the National Health Service and my right hon. Friend cannot offer any general approval. He will, however, consider any individual scheme which is put to him.

Is the Parliamentary Secretary aware that some areas are more distressed by this problem than others because of the high incidence of pulmonary tuberculosis? In her consideration of any scheme, will that fact be borne in mind, especially in a place like Stoke-on-Trent?

I understand that Stoke-on-Trent has been making inquiries. While, in the present financial position it was thought that immediate approval was unlikely, we asked the council for further information of what its schemes were.

asked the Minister of Health how many local authorities have occupational therapy centres, other than in hospitals or settlements, for tuberculous patients.

According to the annual reports of Medical Officers of Health for 1952, occupational therapy was provided by 11 local health authorities at centres or clinics and by 44 authorities at patients' homes.

asked the Minister of Health whether he will make mandatory the recommendations of his Circular 32/51; and how many local authorities have submitted schemes for the employment of tubercular patients.

My right hon. Friend does not feel that it is opportune to make mandatory the submission of schemes by local authorities under Section 29 of the National Assistance Act, 1948. No authorities have submitted proposals for the employment of the tuberculous under National Assistance Act powers, but four authorities provide employment directly under the National Health Service Act and others use facilities offered by voluntary organisations.

Does the Parliamentary Secretary agree that whereas we all accept that the medical officer of health and the chest physician are the people who know best what sort of work is suitable for the tuberculous patient who has treatment, after they have come to a decision work is not necessarily available? Will the hon. Lady ask her right hon. Friend to consult his colleague the Minister of Labour to see whether industry can absorb these 20,000 or 30,000 people in the way that other handicapped people are absorbed by industry?

The response to the invitation to submit schemes for improving the welfare and employment of the handicapped is going ahead and is under the close attention of my right hon. Friend and his colleagues.

asked the Minister of Health what research is being made into migraine; and what facilities exist within the National Health Service for specialist treatment of this malady.

I understand that a clinical trial of remedies used in migraine is being undertaken at one centre and that headaches of various types are being investigated empirically at a number of others. Facilities for the treatment of migraine by specialists are available in the normal way through the National Health Service.

Is the Minister aware of the increasing interest in this malady and of the difference of opinion expressed by medical writers on the cause and treatment of it? Is be also aware of the work of the migraine clinic at Putney Health Centre? Is there anything there his advisers should study and extend?

I shall be very glad to look at the particular experiment to which the hon. Gentleman refers, but there is a good deal of work going on, mostly under the Medical Research Council.

asked the Minister of Health if in view of the conflict of opinion between the British Medical Association and the Central Health Service Council's Committee on the question of the free issue of medicines and drugs to private patients, he will make a statement.

In the present situation my right hon. Friend would not feel justified in proposing any amendment of the National Health Service Acts in this matter.

Is my hon. Friend aware that, quite apart from the B.M.A., the medical members of the committee which published this report also dissociate themselves from this part of the report, which denies to private patients the same rights to receive medicine under the National Health Service Act as are given to others? Does she not think it unjust that a citizen should be denied the right to a service for which he has paid?

I think my hon. Friend is misinformed. The report of the Committee on General Practice was unanimous; 19 of the 23 members were medical practitioners and 11 of those 19 were general medical practitioners. The particular difficulty in any suggestion of this kind is that of trying to exercise any proper control over excessive prescribing if doctors are not also providing general medical services.

asked the Minister of Health what recent improvements have been made in the design, performance and comfort of artificial arms and artificial legs for below knee amputees now in the approved list for general issue to war pensioners and National Health Service patients.

Various improvements have been made, and others are under trial. New features are incorporated into current production as soon as they are approved.

Having regard to the international reputation of Roehampton, can the Minister give an assurance that no reduction will be made in the amount spent on research in these matters in order to maintain progress?

As far as I am aware no reduction has been made, and certainly this work has a very high priority.

Is the Minister aware that at the recent annual conference of B.L.E.S.M.A. disappointment was expressed at the lack of progress in improving artificial limbs? Will he count this matter as really important?

Yes. About 35 projects are under trial at present. A great number of improvements are being made, although we should all like to see faster progress.

asked the Minister of Health when the trials of suction socket fittings and anatomically shaped sockets for artificial legs first commenced; how many legless persons have now been supplied with these fittings: and what other improvements to artificial legs are under consideration or likely to become available in the near future.

Since these experiments began in 1945 nearly 500 artificial legs fitted with suction sockets have been supplied, and in addition several thousand shaped sockets have been issued. Other improvements, including new types of knee joints, pelvic band joints and new materials are still undergoing trial and development, but I cannot say yet when these will be generally available.

What proportion of the suction socket wearers are Service patients and what proportion are National Health Service patients?

I must have notice of that question. Perhaps I may be permitted to write to the hon. Member about this matter.

asked the Minister of Health what several forms of treatment are now readily available to limbless persons who suffer from painful amputation stumps and phantom limbs; the degree of success met with in surgical and alternative forms of treatment and the extent and results of research into causes and remedies for this complaint; and to what extent experiences of physiotherapists, osteopaths and all who have knowledge of this special problem are being studied.

Both surgical treatment and percussion therapy are widely available and the degree of success varies with different patients. Research is being continued in conjunction with the Medical Research Council and other organisations throughout the world, but no final conclusions have yet been reached.

asked the Minister of Health if he will take action to include in the National Health Service the charges made by medical practitioners for the second certification required by law in cases of cremation.

No, Sir. I do not think it would be appropriate to include this in the duties of a medical practitioner under the National Health Service.

Does the Minister not agree that this certification examination, by the very nature of things, must be very cursory and superficial and that in the case of poor people the imposition of the two guineas charge is intolerable.

The reasons for the examination are well known. I would not agree that it is necessarily a cursory examination. It entails a separate visit and a separate examination by a doctor who has not attended the patient before death and it is, therefore, not a service of treatment in the ordinary sense of the words.

asked the Minister of Health if he is aware that a smoke pipe was inserted in the Dellwood Maternity Home, Reading, within 8¼ inches of a timber wallplate, in defiance of a byelaw which specifies that the minimum distance shall be nine inches; and what action he proposes to take in the matter.

It is by no means clear that the byelaw specifying a minimum distance of nine inches was applicable to this particular case. As I said in answer to a Question by my hon. Friend the Member for Reading, North (Mr. F. M. Bennett), on 8th July, my right hon. Friend the Minister of Housing and Local Government is considering possible strengthening of the relevant byelaws.

Can the Minister say what is the source of doubt about whether it is applicable because, as I read it, subsection 1 of byelaw 63 of the Reading Borough Council would apply.

Perhaps the hon. Member would like to talk to me about this later. I understand that there is another byelaw which says that the byelaw to which he has referred shall not apply in certain circumstances which, as I read it, include the circumstances of this installation.

asked the Minister of Health if he will ensure that installations of small domestic hot water supply boilers in buildings within the hospital service shall conform to the British Code of Practice No. CP 403.101 (1952).

I am advised that it would not be appropriate to require compliance with this Code of Practice in all circumstances, but I am considering what guidance should be given to hospital authorities.

While I thank the Minister for that reply and appreciate that retroactive action would sometimes be very expensive, may I ask whether he will have a look at the possibility of applying it to future buildings as is done, for example, by the London County Council?

Yes. I think it is probably appropriate that I should draw the attention of my right hon. Friend the Minister of Housing and Local Government to what the hon. Member has said.

asked the Minister of Health the numbers of prescriptions which have been executed under the health scheme in Shrewsbury during each year since the scheme's beginning.

My right hon. Friend regrets that the information is not available.

asked the Minister of Health if he will make arrangements to have available in this country a supply of the American preparation for skin complaints known as hydrosulphosol.

No, Sir. My right hon. Friend is not aware of any general demand for this substance from the medical profession in this country, where preparations with similar therapeutic effect to that claimed for hydrosulphosol are available at a fraction of the cost.

Can the hon. Lady explain why it was that in a recent case, in order to provide a single prescription under the National Health Service, a supply of this preparation was obtained from America at a cost of over £130?

I can sympathise with the complaint of the hon. and gallant Member, but the very fact that the information became public was due to the vigilance of the particular committee in having the matter investigated.

Will the hon. Lady guard against these continuous and rather ambitious claims from America concerning new drugs, the results of which do not always bear out the individual claims?

asked the Minister of Health the administrative cost of investigations under Regulation 12 (1) of Statutory Instrument, 1948, No. 507, investigation of excessive prescribing, during the past 12 months; and in how many instances, as a result of such investigations, he referred a matter to a local medical committee.

The administrative cost includes some items which cannot be exactly determined, but is estimated to be under £15,000 for the past 12 months; during that period eight cases were referred to local medical committees.

Is my hon. Friend satisfied that this rather elaborate investigation is producing results which are worth while?

I would point out to the hon. Member that the investigations are in two stages. In the first place, the regional medical officer goes to the doctor who is responsible for over-prescribing and endeavours to point out to him the effect of his over-prescribing and to obtain his co-operation. In that respect about 200 doctors have been interviewed at a saving, as near as we can estimate it, of £300,000 a year. It is only in extreme cases, where doctors refuse co-operation, that they are referred to the committee, and that accounts for the low number of eight.

How is it that the hon. Lady was able to arrive at the answer which she has just given when she was unable to give any figures in reply to my Question No. 16?

I cannot go back to Question No. 16, but I shall be only too happy to tell the hon. Member the very simple answer afterwards.

asked the Minister of Health in how many instances during the past 12 months he has, under Regulation 12 (7) of Statutory Instrument, 1948, No. 507, directed executive councils to withhold money from a practitioner; the total sum so withheld; and the total of the excessive cost of prescriptions incurred in these instances.

My right hon. Friend directed the withholding of a total of £500 from three doctors in partnership. Independent referees estimated the excess cost of their prescribing to be £232 in a single month and remarked that they appeared to have been over-prescribing for a long time.

Will my hon. Friend look into the procedure in those cases, in which it often results that a doctor is fined merely for a medical opinion which does not coincide with the majority of medical opinion?

I cannot accept the hon. Member's findings on that. These committees are properly constituted under the Act, and the evidence is put to my right hon. Friend, who comes to a decision of this nature only in comparatively grave cases.

asked the Minister of Health what arrangements are being made to improve hospital facilities for the treatment of out-patients suffering from psoriasis.

Facilities for the treatment of skin diseases, including psoriasis, have shared in the general improvement in out-patient services. Such treatment by baths, light, or other applications as is considered necessary by the dermatologist concerned is generally available in the larger hospital clinics for skin diseases.

Is the right hon. Gentleman aware that very good work has been done in this field for some years at Leeds, and will he do what he can to extend that work to other regions?

I am aware of the work to which the hon. and gallant Member refers and such treatment can be obtained at any large skin centre if the dermatologists think it appropriate to give it. I would not think it right for me to recommend a particular form of treatment because that would be interfering in medical matters, which should be no concern of the Minister.

asked the Minister of Health what information he has as to the number of people in England and Wales who suffer from psoriasis; and what specific research is being conducted on this skin disease.

Statistics of the incidence of psoriasis in England and Wales are not available. Research on skin diseases forms part of the programme of the Medical Research Council.

Is the Minister aware that probably about half a million people are suffering from this condition and that whereas the right hon. Gentleman gives the impression that everything can be available at the out-patient departments, the facts are that more money is needed for the provision of special baths and the special kind of treatment that is needed? Will the Minister, if asked, see that the regional hospital boards get this extra money when they ask for it?

I do not think it is a good system of allocating moneys that it should be done on regional board requests for a particular service. I should have thought that the best system was to give what can be allocated to the regional boards and to leave it to them to decide what should be given to this or to any other purpose. I do not want to claim that facilities for this treatment are available in all out-patient departments, but what I said to the hon. and gallant Member for Brixton (Lieut.-Colonel Lipton) was that in all large centres such skin treatment was available.

asked the Minister of Health whether he will consult with the 'Departments concerned with a view to arranging for the priority milk scheme to be operated by the local authorities in conjunction with the distribution of welfare foods.

No, Sir. My right hon. Friend is informed by my right hon. and gallant Friend the Minister of Food, that the machinery of the welfare milk scheme makes it unsuitable for operation by local authorities.

Is my hon. Friend aware that the closure of the food offices has resulted in pregnant mothers having to go long distances for registration for priority milk? Would it not be more convenient if this registration were done in the local authorities' clinics where the welfare foods are being issued?

This is a most difficult and complicated scheme in respect of milk, particularly as the dairymen distribute direct to the consumer, the Ministry of Pensions and National Insurance issue the documents, and the Milk Marketing Board recoups the dairyman the difference in price and reclaims from the Ministry of Food. It is by no means certain that the existing powers of local authorities would be adequate to allow them to take over this particular work.

asked the Minister of Health which of the new town corporations have sought approval for the establishment of health centres.

Responsibility for providing health centres under the National Health Service Acts rests with local health authorities. My Department has been approached regarding health centres in the new towns at Aycliffe, Peterlee and Basildon and understands that sites have been reserved at Hatfield, Hemel Hempstead and Welwyn.

Does the right hon. Gentleman agree that the new towns present peculiarly favourable opportunities for experimenting in health centres and, moreover, that it is urgent to get on with health centres there lest private practice be so built up that at a later date it is difficult to introduce them?

I agree that the new towns and some of the very large housing estates offer the best field for experiment in this direction. We have that very much in mind and we look at the applications as they come in.

asked the Minister of Health if he is aware that a successful anti-poliomyelitis vaccine has been developed in South Africa; and if such a vaccine will soon be available in this country.

No, Sir. My right hon. Friend is aware of attempts to produce a satisfactory vaccine in South Africa and elsewhere, and investigations with the same purpose are in progress in this country. These experimental approaches to a difficult problem are expected to be protracted.

I thank my hon. Friend for that answer. While we are all aware that reports in the Press are usually years ahead of the facts, can my hon. Friend give an assurance that everything that is humanly possible is being done in this country?

I assure my hon. Friend that the most intensive research into this disease is being conducted but, as my hon. Friend has said, it is highly dangerous to have advance publicity on something which is not fully tried and which our medical advisers do not consider should be generally used.

Does the hon. Lady agree that it would be most unfortunate if the general public gained the impression that there was a vaccine available in other countries that was not available here? Is it not correct that while most encouraging progress has been made in research, we have not yet reached the stage at which we can claim to have a successful vaccine?

I quite agree with the hon. Member.

asked the Minister of Health what steps he has taken to ensure that patients receiving dental treatment under the National Health Service should be given a certificate to the effect that such treatment is accepted under the service.

Dentists providing such treatment undertake to conform to certain terms of service which include a requirement to give a signed statement of acceptance to patients. Penalties may be imposed for a breach of these terms, following a complaint to the executive council.

While that may be the case, the facts are that in most instances the certificate does not pass to the patient. I agree that in many cases the relationship is so intimate that a certificate is not necessary, but will the hon. Lady bring to the notice of dentists that this requirement is still in force? At present, it is being overlooked.

This Question and answer will give publicity to the point raised by the hon. Member, but the fact remains that if the patient has a complaint his proper recourse is to the executive council. The method by which the patient can make his complaints in that direction is stated on his medical card.

The hon. Lady knows from the case that I have sent to her that by the time the issue arises the records have been destroyed and court action has subsequently followed. Will the Parliamentary Secretary therefore see whether she can do a little more?

In the case to which the hon. Member has referred and of which I have had details from him, the patient did not take the method open to him and refer the matter to the executive council, which was his right He could have taken that method of lodging his complaint.

asked the Minister of Health if he is aware that the Southern Regional Association for the Blind, unlike the other regional associations, has refused the applications for affiliation of the appropriate District Councils of the National League of the Blind; and, in view of the fact that the Southern Regional Association is in receipt of public funds, if he will make representations as to the advisability of affiliation of the District Councils of the National League of the Blind.

It is for the Association to determine what bodies should be affiliated to it and my right hon. Friend does not consider that it would be appropriate for him to intervene in an issue of this kind.

Is the hon. Lady's right hon. Friend also aware that all the other regional associations accept the affiliation of the National League of the Blind and that the Southern Region cannot do its best work because the appropriate district of the National League is not affiliated to it? In view of the fact that this Association has public funds, will the hon. Lady ask it to look into the matter again?

In reply to the hon. Member's plea, which on the face of it sounds plausible, I remind him that hundreds of voluntary bodies work with the Ministry. It would be a grave departure from our practice to tell those bodies how to run their affairs beyond the fact that we associate with them and work with them when we are satisfied that their affairs are properly conducted. It would be a grave departure from precedent if we told a body that it must or must not take any particular organisation into membership.

Why is the Association not ready to accept affiliation? Why should it discriminate?

I must leave membership to the Association.