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Oral Answers To Questions

Volume 530: debated on Thursday 22 July 1954

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Ministry Of Health

Tuberculosis

1.

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.

11.

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.

The Parliamentary Secretary to the Ministry of Health
(Miss Patricia Hornsby-Smith)

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.

13.

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.

30.

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.

Migraine (Research)

3.

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.

Private Patients (Free Medicines And Drugs)

7.

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.

Artificial Limbs

8.

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.

9.

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.

Limbless Persons (Treatment)

10.

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.

Cremation Service Certificate (Charge)

12.

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.

Maternity Home, Reading (Installations)

14.

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.

15.

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.

Prescriptions, Shrewsbury

16.

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.

Hydrosulphosol

17.

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?

Over-Prescribing

21.

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.

22.

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.

Psoriasis (Treatment)

26.

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.

31.

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.

Priority Milk Scheme

28.

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.

New Towns (Health Centres)

29.

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.

Anti-Poliomyelitis Vaccine

32.

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?

Health Service Dental Treatment

33.

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.

Association For The Blind (Affiliations)

34.

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?

Hospitals

City General Hospital, Gloucester

2.

asked the Minister of Health whether his attention has been drawn to the circumstances of hardship endured by patients at the Gloucestershire Royal Hospital known as the City General Hospital, owing to the lack of a covered space between the operating theatre and the hutted wards of the hospital: if he is aware that the accommodation at the hospital is in adequate; and what steps he proposes to take, and when, to remedy these defects.

I am aware of the need for improvements here, but the regional board has not been able to include them in its capital programme this year because of other more urgent demands. They will be undertaken as soon as resources are available.

Will the Minister not agree that this is a rather serious situation? The Chairman, referring to the matter as recently as 3rd July, said, with regard to the absence of this covered space:

"In bad weather in winter time this journey is a hardship which no patient should be permitted to undertake."
Is the Minister also aware that the professional and nursing staffs as well as the management committee of this hospital are doing outstanding service for the City of Gloucester? Does he not think he ought to act as quickly as possible to assist them the more effectively to do their work by removing this defect?

I am aware of those facts. The question of priorities is one for the hospital authorities, and the management committee, as I understand, has not put the scheme first in the priorities it has submitted to the regional board. If it is given the due priority the circumstances may warrant it will be expedited.

Meadow View Hospital, Whitehaven (Subsidence)

4.

asked the Minister of Health the position arising from the subsidence at Meadow View Hospital, Whitehaven, and the evacuation of patients to Carlisle and Sunderland; if he is aware that there is dissatisfaction of relatives and friends owing to the long-distance journeys involved in visiting the patients, both as to cost, and the difficulty of transport; what are the reasons for not transferring the patients to Haverigg Aerodrome, Millom, as soon as the subsidence occurred; and if it is the intention of the hospital authority to restore the hospital for normal use again.

The danger of subsidence forced the regional hospital board to arrange the immediate transfer of patients as an emergency measure to hospitals in Carlisle, Sunderland and Middlesbrough. I know and regret the disadvantages to which the hon. Member refers, and several possible ways of finding nearer accommodation are being examined. Immediate removal to Haverigg Airfield would not have been practicable because of staffing difficulties. A decision on the future of Meadow View House cannot be taken until the final effects are known.

May I ask the right hon. Gentleman, first, whether the availability of the sick quarters at Haverigg Aerodrome has been conveyed to the Special Areas Committee, and, if so, what has been the decision? Secondly, can he use his influence with the Special Areas Committee to make special arrangements for the relatives of these chronic patients to be conveyed to places like Carlisle, Sunderland and Middlesbrough until they can be returned to the West Cumberland area? Thirdly,—[HON. MEMBERS: "Oh."] I should like hon. Members to know that this is a most important question.

The hon. Member should bear in mind that every Member considers that his own Question is very important.

Thirdly, is it the policy of the Special Areas Committee to return these patients to West Cumberland as soon as possible?

On the question of Haverigg Aerodrome, permission has been given by the Air Ministry but that does not overcome the staffing difficulty, which is the accommodation problem, because many nurses at Meadow View were married and lived out and cannot be transferred. I will take note of what the hon. Member said on the other matters. I should like to add that I am very grateful to him for his help.

Barncoose Hospital, Cornwall (Improvements)

5.

asked the Minister of Health what are the principal items of deferred expenditure on improvements to Barncoose Hospital, Cornwall; and when these improvements will be undertaken.

I would refer the hon. Member to my answer to his Question of 15th July.

Is the Minister aware that in the better part of this hospital the aged who are acutely ill have to be manhandled up and down stone stairs because there is no lift and that in the poor part of the building these is no provision for heating in many rooms and dormitories other than portable paraffin stoves? Will he review this decision again and try to sanction the necessary capital expenditure?

I am sorry to repeat this, but any review of this matter is a question for the regional hospital board. Barncoose was put high by the regional board in the list, but not high enough for me to take this as one of the first schemes within the amount of money available.

As the Minister's reply is so unsatisfactory the regional board, acting as it did—

I beg to give notice that I shall raise the matter on the Adjournment at a suitable opportunity.

Out-Patients, Stoke-On-Trent (Waiting Time)

6.

asked the Minister of Health what are now the waiting periods for out-patients at the North Staffordshire Royal Infirmary and the City General Hospital, Stoke-on-Trent, respectively; how they compare with the waiting periods of six months ago; and if he will reconsider the need to appoint an additional consultant physician in this area.

The present waiting periods for medical out-paitents at the North Staffordshire Royal Infirmary and the City General Hospital, Stoke, are respectively two to five weeks and four weeks; six months ago they were 15 weeks and more than four weeks. I am informed that the Stoke-upon-Trent Hospital Management Committee will shortly review the need to appoint an additional consultant physician.

Manchester Ear Hospital (Children's Operations)

18.

asked the Minister of Health what action is being taken to reduce the waiting period of 15 months being experienced by children awaiting tonsil and adenoid operations at the Manchester Ear Hospital, All Saints, Manchester.

I am informed that the regional board have arranged to transfer some of those on the waiting list to Wythenshawe Hospital, where the average waiting time has been considerably reduced in recent months, and are considering similar transfers to other hospitals.

I am obliged to the right hon. Gentleman for that information. Is he aware that children have a longer period of waiting at this hospital than at any other in Manchester and that it is situated in one of the most densely-populated parts of the city? In addition to the action which the regional hospital board propose to take, will he also ask the executive council to consult the general practitioners with a view to their directing patients, in the first place, to some of the hospitals which have a smaller waiting list?

I have tried by the means that I have indicated to get over the difficulty, because I realise that the facilities in Manchester are fully used. I shall be very glad to look into the suggestion which the hon. Gentleman has made.

Is it not time that the Minister took a special and personal interest in this matter, which is causing great anxiety to patients not only in Manchester but in the surrounding areas of Lancashire and also in Heston and Isleworth, as indicated in the next Question. Will he try to expedite earlier treatment of these children?

I do take a personal interest, and I think that the answer I have given indicates that at least some improvements in that area have been made.

New Towns

24.

asked the Minister of Health in which new towns new hospitals have been completed or are under construction; and what provision is being made for adequate hospital treatment in the remaining new towns.

It has not yet been possible to start the construction of any new hospitals in the new towns and their need for hospital services is being met meanwhile by the use of existing hospitals.

Is the right hon. Gentleman aware that there is a serious lag of hospital services in the new towns? About 12 months ago I put a similar question to him on this point, and, in view of the lapse of time, will he look specially into this matter because it is one which should be inquired into?

We do take these considerations into account when we are making the capital allocation and the number of new towns in the different areas is an important factor in the matter.

Unused Beds (Staff Shortages)

25.

asked the Minister of Health how many hospital beds are unusable through shortage of nursing and other staff in each regional board area.

As the reply contains a number of figures, I will, with permission, circulate the information in the OFFICIAL REPORT.

Can the right hon. Gentleman say whether there has been any improvement in this matter in recent years?

I think this is another question. I have given only the details at the present time, and if the hon. Member would like a comparison perhaps he would put a Question on the Order Paper.

Following is the information:

The numbers of beds unused for lack of staff in both teaching and non-teaching hospitals at 31st December, 1953, were:

Newcastle-upon-Tyne276
Leeds728
Sheffield956
East Anglian481
N.W. Metropolitan1,857
N.E. Metropolitan1,716
S.E. Metropolitan5,172
S.W. Metropolitan1,997
Oxford480
South Western591
Welsh442
Birmingham2,175
Manchester1,729
Liverpool191
Total18,791

Patients (Claims For Damages)

27.

asked the Minister of Health how much money his Department has paid in each year since the health services were nationalised, in damages for neglect or inefficient medical or nursing treatment.

Information in this precise form is not available, but I will circulate in the OFFICIAL REPORT a table showing the total compensation payments of all kinds made by National Health Service hospital authorities in England and Wales in each year to 1952–53, the latest year for which accounts are available. These payments very largely result from claims for damages in the kind of case the hon. Member has in mind.

Will the Minister make sure that the Press get hold of these figures? As he is not willing to give them in open Session, is that not further evidence that under State control the health services break down when people are relieved of personal responsibility?

I both resent and repudiate that supplementary question. I am publishing these figures at once in HANSARD, as is the normal custom, and not reading them out to the House. The Press, of course, will have them at once. I am absolutely certain that there has been no deterioration of any sort in the care which is given since the health services were nationalised.

Can the right hon. Gentleman give an estimate of the cost of the neglect of people's health prior to the existence of the National Health Service?

Following is the table:

TOTAL COMPENSATION PAYMENTS OF ALL KINDS MADE IN ENGLAND AND WALES BY NATIONAL HEALTH SERVICE HOSPITAL AUTHORITIES.

Amount

£
5th July, 1948, to 31st March, 19497,560
Year ended 31st March, 195023,636
Year ended 31st March, 195138,556
Year ended 31st March, 1952106,574
Year ended 31st March, 1953152,590

Mental Hospitals (Capital Allocation)

35.

asked the Minister of Health if he will repeat the special allocation of capital from central funds for mental and mental deficiency hospitals known as the "mental million"; and if he will increase substantially the amount to be made available for this purpose in the next financial year.

I intend that some special allocation shall again be available next year for capital expenditure on mental and mental deficiency hospitals, but it will not be possible to increase the total allocation.

Is the Minister aware that although the "mental million" is a drop in the ocean, it is, nevertheless, a very welcome drop and there is great satisfaction that it will be repeated next year? But will the right hon. Gentleman think again about the possibility of increasing the amount, because so much urgent work needs to be done?

I recognise the need, which is, as I am sure the hon. Member knows, very much in my mind. But it is also true, as the hon. Member said, that the "mental million," which will be repeated again this year, although perhaps a small contribution, is a very valuable one in this field.

Mental Nurses (Recruitment)

36.

asked the Minister of Health what further steps he proposes to take to stimulate the recruitment of mental nurses, in view of the comparative failure of the local recruitment campaigns in most regions.

The Parliamentary Secretary to the Ministry of Labour and National Service
(Mr. Harold Watkinson)

I have been asked to reply. It is too early yet to judge the effect of all the measures taken to stimulate recruitment, but there is some evidence that in areas where the local recruitment campaign was conducted some months ago there has been an improvement in the staffing position of the mental hospitals since then.

The subject continues to receive the close attention of my right hon. and learned Friend in consultation with my right hon. Friend the Minister of Health, and is on the agenda of a meeting of the National Advisory Council on the Recruitment of Nurses and Midwives to be held tomorrow, 23rd July, at which further measures to encourage the recruitment of staff for the mental hospitals will be discussed.

Is the hon. Gentleman aware that this problem will never be solved until certain measures are taken, such as the establishment of the new grade of enrolled assistant nurse and improved pay and conditions for mental nurses? Is he further aware that the local recruitment campaigns—at any rate, in the region with which I am associated—have been an almost complete failure and that his Department was warned of this when the campaign was inaugurated?

If the hon. Member wants to investigate the conditions for mental nurses he should put down a Question to my right hon. Friend.

The reason for my answering on the question of recruitment is so that the hon. Member gets a verbal answer instead of having his Question go to the bottom of the list I hope he appreciates that. I should not like it to go on record that the recruitment campaigns have been a failure, because they have not. I agree that the results in the South are not as good as those in the Midlands and the North, but the details which I have, and which I can show the hon. Member, reveal that progress has been made.

Education Schools (Pupil-Teacher Ratios)

37.

asked the Minister of Education the pupil-teacher ratios in independent primary schools recognised by her Department as efficient, and in maintained primary schools, respectively.

In January, 1953, the last date for which figures are available, the pupil-teacher ratio for independent primary schools recognised as efficient was 12·3: the comparable figure for maintained primary schools was 32·3.

What steps does the Parliamentary Secretary intend to take to increase the pupil-teacher ratio in maintained primary schools?

The only method is by the number of teachers being increased. My right hon. Friend is confident that the numbers are being increased and that the average size of classes in primary schools should begin to fall appreciably in about three years' time.

Village Institute, Stocksfield (Derequisitioning)

38.

asked the Minister of Education for how many years past the use of the Village Institute at Stocksfield, Northumberland, has been denied to the inhabitants of that village by reason of its compulsory requisition; and, in view of the hardship and annoyance its continued requisitioning is causing locally, when she intends to arrange for this institute to be set free for its proper use.

This Institute has been held under requisition since 1941. My right hon. Friend would like to see it restored to its ordinary use, but if it were released now the supply of school meals to a large number of school children would have to be stopped.

But is that not an entirely unsatisfactory answer? Without trying to apportion blame, may I ask my hon. Friend whether he does not think it is most unreasonable that the 2,000 inhabitants of this village should be denied the use of their village hall, and will he see whether steps can be taken so that it can be freed for their use in the forthcoming winter?

The building is used as a central kitchen which supplies about 1,100 meals daily for 14 schools. I am informed that to build something specifically to take the place of that hall would cost £25,000 or even more. My right hon. Friend is anxiously reviewing the position in this and similar cases, and it is clear that before long some alternative arrangements should be made.

In view of the unsatisfactory and discouraging nature of the reply, I beg to give notice that I shall raise this matter again at the earliest opportunity.

School Meals

39.

asked the Minister of Education whether she will give an assurance that in all cases where the allowance of 11 oz. per week for school meals when reasonably purchased exceeds the former cash allowance, the excess will be recognised by her for unit cost purposes.

School Transport (Inspection)

40.

asked the Minister of Education whether she will make provision that all vehicles hired by local education authorities for the transport of school children shall be subject to some form of inspection to ensure their mechanical fitness for the work.

No, Sir. In the case of those classes of vehicle which are not already subject to periodic statutory inspection, my right hon. Friend thinks it best to leave local education authorities to choose their own method of satisfying themselves that contractors will provide vehicles which are roadworthy.

But is the Minister aware that a constituent of mine was nearly killed in one of these vehicles, because of neglect in this matter, that I have since had a series of buck-passing letters from the Ministry about this case, and that I was assured only three weeks ago that the same vehicle, in which was a party of children, ran downhill backwards owing to the cylinder head blowing off and because the brakes were not working? [Laughter.]

I do not think that road accidents are funny. All motor vehicles are required by regulations made under the Road Traffic Acts to be in roadworthy condition. The Kent local education authority provide, in their contract, that the contractor will be responsible for the safety of the children from the time they enter his vehicle until they are put down by him.

I am not quite sure whether my right hon. Friend is aware of the second case to which the hon. Baronet has referred, but she is aware of the first one and has the deepest sympathy with the child and with the relatives of the child. On the whole, however, she still thinks that these matters are best left to local education authorities, who must be presumed to be able to manage such things.

May I ask the hon. Gentleman, in view of what is, from my point of view as a local government man, the excellent doctrine of leaving it to the local education authority, whether he would be prepared to advise his right hon. Friend that this excellent doctrine might be extended to the London County Council in respect of the Kidbrooke Comprehensive School?

That is quite a different question. [HON. MEMBERS: "Oh!"] Yes, because it is (a) not quite the same principle, and (b) the application of the principle must vary very much according to the matter in hand. My right hon. Friend, or even I myself, would be willing to discuss that question with the right hon. Gentleman at any appropriate time, but not on this Question.

School Building Programme

41.

asked the Minister of Education the total capital sum of the school-building programme allocated to local education authorities for the year 1955–56.

The estimated value of the school building programme for 1955–56 is approximately £45,000,000.

Is the Parliamentary Secretary aware that at a recent conference of the Association of Education Committees, and in a recent statement in the journal of that Association, it was stated that the local authorities had applied for £88 million of school building for that year, and that the allocation provided will not be sufficient to carry out even the meagre provisions of Circular 245? Will the hon. Gentleman urge his right hon. Friend substantially to increase the allocation?

My right hon. Friend is satisfied that, in general, the essential requirements of Circular 245 can be met by local education authorities—[HON. MEMBERS: "No."]—within the limits of the building programme allowed. As to the comparison between the proportion allotted and the amounts asked for, it is fair to remember that not all education authorities are equally scrupulous—[An HON. MEMBER: "Whitehall knows best."]—in putting up their building suggestions within the conditions of Circular 245; also, not all of them have the same form of doing so, so it is not possible to allocate a sum proportionate to that requested.

Secondary School Places

42.

asked the Minister of Education how many secondary school places are now under construction; and what increase this represents on the number being constructed in October, 1951.

On 30th April last there were 215,050 new secondary school places under construction. This is an increase of nearly 56 per cent. over the corresponding figure for 1st October, 1951.

Although any increase of activity under the present Minister is an occasion for surprise and gratitude, is the hon. Gentleman aware that the local authorities are apprehensive about this situation because the Minister has refused to approve their plans of the basic minimum number of places to provide for increasing secondary school population? Will he, therefore, revise the school building programme this year to provide an adequate number of places and an adequate increase for the higher population?

The reply to the last part of that supplementary question is that the assumption cannot be accepted and the answer, therefore, cannot be "yes." The answer to the earlier part is in the figures for contracts completed during the last three years: £251 million in 1951; £35·1 million in 1952; and £42·1 million in 1953.

Order, order. This sounds much more like a question for the Minister of Works.

On a point of order. I thought the question I was asking was absolutely pertinent to this matter, Sir. May I complete my question?

The hon. Gentleman's question was certainly hypothetical. He started with the word "If."

School, Wexham Court Farm Estate

43.

asked the Minister of Education on what grounds permission has been refused to the Buckinghamshire education authority to build a junior school during 1955–56 for 480 children resident on the Wexham Court Farm estate.

The authority did not ask my right hon. Friend to include this school in their 1955–56 building programme or in the reserve list to that programme.

If the Minister is still responsible for this Department, would she be ready to meet the hon. Member for Buckinghamshire, South (Mr. R. Bell) and myself about this matter? Is the hon. Gentleman aware that on the Wexham Court Farm estate no school is being built for 480 children and that on another estate in Slough two schools are to be built where there will only be 100 children? Is it not possible to make some adjustment?

My right hon. Friend is quite aware of what is happening at Wexham Court Farm estate. As I say, this was not asked for on the programme or on the reserve list. My right hon. Friend has been told that this project will be the subject of a future application. When she receives such an application, she will, of course, consider it in the most careful way, and I have no doubt that if the hon. Gentleman and my hon. Friend the Member for Buckinghamshire, South (Mr. R. Bell) desire to meet her to explain matters she will be only too pleased to listen to them.

Grammar School, Keynsham

44.

asked the Minister of Education when it is hoped to start building the new grammar school at Keynsham, Somerset; and the number of pupils it will accommodate.

The Somerset local education authority are designing this school for about 330 children. They hope to start building in the autumn, but the land which they have chosen has been made the subject of a compulsory purchase order, and my right hon. Friend is at present considering what her decision on the order should be.

While ensuring that no more land is taken under the compulsory purchase order than is absolutely necessary for the jab, will my hon. Friend see that the county education authority is urged to press on as quickly as possible with this project, as the need for it is long overdue?

I have just said that my right hon. Friend is in a kind of quasi-judicial position in the matter, and I do not think I should add anything to my original answer.

Germany (Princess Margaret's Visit)

45.

asked the Prime Minister which Government Department was responsible for the detailed arrangements in connection with the Royal visit last week to the British-occupied zone in Germany.

It was arranged last February for Her Royal Highness to visit British Forces in Germany, in particular the members and families of regiments of which she is colonel-in-chief. The detailed arrangements were made by the Service Departments. It was natural that the President of the Federal Republic should receive and honour Her Royal Highness and arrangements in this connection were made through the Foreign Office.

Is the Prime Minister aware that various social and political aspects of those detailed arrangements have caused controversy in which Her Majesty's Government should not have implicated any member of the Royal Family?

The text of the speech made by Princess Margaret was approved beforehand by the Foreign Office.

Ministerial Statements (News Leakages)

46.

asked the Prime Minister whether he is now in a position to make a statement arising from his investigations into how the mid-day editions of three London newspapers on Thursday, 15th July, contained full details of the statement that he subsequently made to the House of Commons, concerning the abolition of the Ministry of Materials.

I heard both that statement and the original statement that the Prime Minister made. But would he look again at "The Times" and the three mid-day papers, when he will see that they give full details of the statement which he made later that afternoon?

I have been looking into the past history of these matters and I find that the Leader of the Opposition, who is not in his place this afternoon, said, on 8th November, 1945, that the Labour Government could not be held responsible for intelligent or unintelligent anticipation or imagination in any section of the Press.

In the Prime Minister's reply and in his original reply he said that his Department bad informed the Press. Are we to take it that his Department is now responsible for giving, prior information to the Press?

When questions are asked about a subject, I think it is perfectly proper that the officer in charge of Press relations should say that a statement would be made in the afternoon. There is nothing in that.

If the right hon. Gentleman has still some unused material or ammunition left would he be good enough to let me know so that I can advise my hon. Friend to put down another Question?

Anglo-Egyptian Negotiations

47.

asked the Prime Minister whether, in view of the divergence of opinion held concerning the question of the Suez Canal Zone, he will give an assurance that before Her Majesty's Government reaches agreement with the Government of the Republic of Egypt on the withdrawal of British troops from the Canal Zone, Parliament will have an opportunity of debating any proposed agreement, and that, in the event of the House of Commons being on Summer Recess when the proposed agreement is made, he will take steps for the recall of Parliament so that this may be debated.

I have nothing to add to the answer I gave to the hon. Member on Tuesday.

As there has already been one resignation from the Conservative Party, and the Chairman of the Conservative Services and Defence Commitee, the right hon. and gallant Gentleman the Member for Leicester, South-East (Captain Waterhouse) has resigned from that office, and there is a wide divergence of opinion, is it not right and proper that there should be a full and frank debate in this House so that we can see what the views of the Government are, whether they have got the support of their back benchers and whether the 40 Members will revolt and resign as they have threatened?

Is the Prime Minister aware that I can ask my own questions on this subject without any assistance from the hon. Member opposite? In view of the fact that the Foreign Secretary, in December of last year, gave an assurance that the heads of agreement would be brought to the notice of the House and, also, that he would not feel himself precluded from proceeding to negotiate the main Treaty, now that we are going into recess for 10 weeks does the Prime Minister not agree that it would be desirable to give us an assurance that the House would be recalled if an agreement were reached on this extremely important issue, which affects not only this country but the whole Commonwealth?

The Lord Privy Seal will refer to that matter when he answers a question on the business for next week.

Agriculture Marketing Boards

48.

asked the Prime Minister whether he will include producer marketing boards set up under the Agricultural Marketing Acts, 1931–49, in the terms of reference of the Select Committee to be set up to examine the running of nationalised industries.

No, Sir. The problems, character and organisation of agriculture marketing boards are quite different from those of the nationalised industries.

Is the Prime Minister aware that the object of this Question is to prevent the spread of the Crichel Down disease?