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Volume 641: debated on Friday 5 May 1961

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Medical Staffing


asked the Minister of Health when he proposes to instruct regional hospital boards and boards of governors to review the medical staffing of their hospitals in accordance with the recommendations of the Platt Committee.

A decision on these recommendations will be reached when discussions with the professional bodies have taken place.

Is the Minister aware that before he can take action he will need some of this evidence in his hands? Will he ask for it now so that he is prepared to make more consultant posts ready after the discussions have ceased with the profession?

It is essential first to have the profession's view in principle on the recommendations of the Platt Report.

South-East Metropolitan Region (Locum Tenens)


asked the Minister of Health if he is aware that hospital out-patient services in Deptford and neighbouring districts are having to be curtailed as a result of the reduction in locum tenens sessions imposed by the South-East Metropolitan Regional Hospital Board; and what steps he will take to ensure that an adequate out-patient service is provided.


asked the Minister of Health if he is aware of the decision of the South-East Metropolitan Regional Hospital Board to reduce the number of locum tenens available to consultants, senior hospital medical officers and registrars in the Greenwich and Deptford Hospital Group; and if he will ask the Regional Board to reverse their decision so as to avoid a consequent delay in the treatment of patients.

The Board has introduced a scheme to avoid extravagant use of locums. Difficulties have been anticipated over locums for two clinics in Deptford and Greenwich, but steps are being taken to ensure that these difficulties do not arise.

What steps are being taken? Is the hon. Lady aware that the venereal disease clinic is having its locum sessions cut from twenty-four to six, when the national incidence of venereal disease is rising? Also the tuberculosis clinic is having its number of locum sessions cut from thirty to twelve. In view of the fact that her right hon. Friend is so tough with patients, is it not about time that he got tough with the Regional Hospital Board to stop these cheeseparing tricks at a time when the out-patients departments' should be properly staffed for 12 months of the year?

The difficulties the hon. Gentleman mentioned are the anticipated difficulties of those departments because the Hospital Management Committee has not allocated its number of locums in the proportion which the Regional Hospital Board envisaged. Nevertheless, the Regional Hospital Board has increased the number of locums from its original proposal of 170 to 225—as I think the hon. Gentleman knows from his correspondence with the Board—and in turn my right hon. Friend has asked the Board to ensure that there should be no reduction in the amount of service available.

As the total reduction amounts to about 135 sessions in the Hospital Management Committee, can the hon. Lady say how it is possible to reduce medical attention by 135 locum tenen sessions and still have a Hospital Management Committee without causing intense hardship to patients in the Greenwich and Deptford area? Would not she also agree that the allocations which apparently were not to the liking of the Regional Hospital Board were made by the medical committees of this Hospital Management Committee which one would have thought were as capable as the Regional Hospital Board of getting medical staff?

As I say, the Regional Hospital Board has allocated 225 sessions this year for locum duties compared with an estimated 334 last year, but the purpose behind this proposal, which was initiated by the Regional Hospital Board, was to rationalise the provision of locums to combine at the same time as annual leave is envisaged the number of locums required for the job. Nevertheless, as I have said, my right hon. Friend has made clear to the Board that we expect service to be available. May I make one further point? Service in out-patient clinics usually tends to drop during the holiday period.

May I have an assurance that the out-patient clinics or departments for venereal disease and tuberculosis will not be cut this year? Does the hon. Lady not understand that this is most important in crowded areas such as Greenwich and Deptford, particularly when the incidence of both diseases nationally is disturbing?

I understand that, but this is a matter for the Board, working through the appropriate authority, which in this case is the Hospital Management Committee.



asked the Minister of Health in what areas, and in what specialities, there was a shortage of doctors in Great Britain in 1960.

I assume the hon. Member refers to hospital doctors. Vacancies in the grades of registrar and below were slightly under 9 per cent. of posts, varying between 6 per cent. and 17 per cent. in different regions, but some vacancies were filled by locums. In senior grades there were few vacancies apart from those arising in the ordinary course.

What long-term steps are being taken to remedy this state of affairs? In view of the founding of more universities, is the right hon. Gentleman having discussions with the University Grants Committee with a view to founding new medical schools in these universities?

I have referred in Answer to a previous Question to the steps being taken to revise the statistical basis of the estimates of doctor requirements.

But is the right hon. Gentleman taking any particular steps now? Surely with the new universities it would be possible to start one or two new medical schools almost at once?

Starting new schools is not a matter for me but some estimation of the requirements of the Health Service is, and I have referred to that in a previous Answer.

Regarding the shortage of consultant posts, would not the right hon. Gentleman agree that the statement of the number of vacancies is not a fair assessment of the position, since large numbers of regional boards want additional posts established which his own Department does not permit them to establish?

Vacancies are the only statistical figures which I have available to give to the hon. Gentleman. But the number of posts in 1960 for which approval was withheld because there were no applicants available to fill them is comparatively few.



asked the Minister of Health whether he accepts the recommendations of the Platt Report with respect to unrestricted visiting in hospitals.

I thank my hon. Friend for that reply. Will he ensure that the recommendations are brought to the attention of regional hospital boards and by them to the management authority of the hospitals concerned?

Yes, they have been so conveyed, and the evidence is that the great majority of children's wards do allow visits on every day. But I intend to keep up pressure to ensure that there is a full implementation of these recommendations.



asked the Minister of Health what is the overall shortage of hospital almoners; what is this figure expressed as a percentage of the total required; what steps are being taken to overcome the shortage; and how soon he expects the problem to be completely solved.

I understand that about 260 vacancies were recently known to the Institute of Almoners but not all these were in the hospital service. New facilities for training almoners have been provided at six universities in England and Wales in recent years and the numbers employed in the hospital service are slowly increasing.

That does not quite answer the question. I asked the hon. Lady what is that figure, expressed as a percentage of the total required? Can she say, further, whether the trend is towards an improving situation? Can she also say how many of these almoners are among the 300,000 Surtax payers relieved in the last Budget?

Figures are not available to answer the first part of the hon. Gentleman's supplementary question because neither establishment nor recruitment is controlled separately, Nevertheless, the numbers are improving as I indicated. In general, there is no shortage of applicants. One of the difficulties arises because, as part of the training is practical, qualified almoners have to make time to train others, which limits the rate of progress. But it is improving.