Psychiatry
11.
asked the Minister of Health if his attention has been drawn to the Ninth Report of the United Nations World Health Organisation Expert Committee on Mental Health, which deals with the under graduate teaching of psychiatry; and what steps he proposes to take to bring its conclusions to the notice of those responsible for the medical curriculum.
I have no responsibility in this field.
Well, whether the Minister has direct responsibility or not, would he not appreciate that some action along the very modest lines which this Report recommends is an essential prerequisite to getting the psychiatric manpower which he will need in order to man the mental health services of this country, and could he not do something, at any rate in an informal way, in bringing this Report to the attention of those responsible for medical education?
I recognise the importance of strengthening in the National Health Service the element of psychiatric treatment and the psychiatric professional element, but that does not entitle me as Minister of Health to express an opinion—and I am sure that this is a right principle—upon the medical curriculum.
Prescription Charges
12.
asked the Minister of Health how many executive councils have protested to him about the increase in prescription charges.
Forty-eight.
In view of the fact that the Minister now admits that he has had representations from 48 executive councils protesting against the increase in prescription charges, is he not prepared to reconsider his decision to impose these charges, particularly in view of the fact that these people represent persons who have no particular political axe to grind, and have called attention to the hardship and disservice which his measures are doing to the welfare and health of patients?
No. This has been fully considered by the House, which has taken its decision. The executive councils know that I am ready to receive any evidence which they wish to put before me of ways in which the present arrangements are not working satisfactorily.
As the Minister has received representations from 48 different executive councils, is it unreasonable to ask him how many he has to have before he really reconsiders the whole scheme?
They contain no evidence.
14.
asked the Minister of Health if he has studied the protest made by the Glamorgan Executive Council of the National Health Service against the increased prescription charges; and, in view of the matters contained therein, if he will reconsider his policy in this respect.
The answer to the first part of the hon. Member's Question is "Yes", and to the second, "No".
How does the Minister expect to get evidence when it largely lies in the absence of old people visiting their doctors or taking up prescriptions? Does he realise that he is condemning himself as a Minister without compassion or mercy by his attitude on these matters?
I am sure that there could not be any appreciable or widespread hardship without its coming to the notice of the doctors or the executive councils.
Is it not the case, as the Minister admitted, in answering Question No. 12, that he has knowledge of 48 executive councils who have protested, and who are entitled to say this to the Minister? What other evidence does he need, what better opinion can he get, than that of expert people engaged in administering this Service on his behalf and that of the patients?
I can only say that these bodies are well aware of my repeated undertaking to consider evidence of hardship and difficulty which is arising, but they have not so far put before me evidence to that effect.
Does not the Minister consider the drop of more than 20 per cent. in the number of prescriptions between February and March when the increased charge came in as evidence? What other evidence does he require before he will change his policy?
There is a Question on that on the Order Paper.
17.
asked the Minister of Health if he will now reconsider the amount charged for items of prescription in the light of the 20 per cent. decrease shown by the fall from 22,200,000 items in February, 1961 to 17,500,000 items in March, 1961.
No, Sir.
Is not this adequate evidence of the failure of the policy with regard to the prescription charge? Has the Minister considered the additional evidence which I submitted to him of dispensing chemists in the Willesden area, where a chemist has been asked several times, when there are three items on the prescription list, which one is important because the mother cannot afford the other two until the end of the week? Has the Minister considered that letter? What further evidence does he require before he changes this appalling policy?
The second part of the supplementary question appears to relate to a different matter. As regards the fall between February and March, there are a great number of factors which no doubt played a part in this and which made the figure for March in itself of very little help and guidance. For example, the influenza epidemic came to an end before the end of February, and in this year March was an exceptionally fine month.
The Minister estimated a 2 per cent. fall in prescriptions. He has here a 20 per cent. drop. Does he not appreciate that this compares not only with the 2 per cent. that he estimated, but with the actual increase between February and March of last year? Is not this abundant evidence that people are not getting the prescriptions they need?
No, Sir. One cannot take individual months without regard to the circumstances, and certainly nothing less than the experience round the whole year can disclose any trends which are capable of being interpreted in a useful way.
In view of the differing evidence and opinions which have been expressed, and the fact that we have had some months' experience of the new charge, might it not be wise for the Minister to initiate some inquiry to try to find out what the situation is today?
I still think that it is too early for anything of that sort, but I am sure that the professions and the bodies which administer the Service will bring to my attention any evidence which comes their way.
Is the right hon. Gentleman implying that he has to wait 12 months or longer before he is prepared to take any action? Does he mean that he wants something drastic and outstanding to happen, such as people perhaps dying because they have not received medical attention, before he will take action?
I am sure that that would be brought to my attention, but the estimate to which the hon. Member for St. Pancras, North (Mr. K. Robinson) referred was an estimate for 12 months. All I said was that one could not judge how it was working out on a single month.
On a point of order, Mr. Speaker. In view of the unsatisfactory nature of that reply, I beg to give notice that I will seek to raise this matter on the Adjournment at the earliest possible opportunity.
Medical Students (Intake)
13.
asked the Minister of Health whether he is reviewing, in the light of the current and future needs of the National Health Service, the conclusions of the Willink Committee on the intake of medical students, and if he will make a statement on future policy in this respect.
18.
asked the Minister of Health how many general medical practitioners are needed in England and Wales to bring the service up to the strength that he estimates is now required.
21.
asked the Minister of Health if the recommendation of the Willink Committee that student intake by British medical schools should be reduced by 10 per cent. in 1962 is still in accordance with Government policy.
The Secretary of State for Scotland and I are reviewing the data and calculations which under lie the estimates in the Willink Committee's Report. The student intake is larger now than when the Committee reported.
I am very glad indeed to know that the Minister is reviewing this, but would he now appreciate that this was one of the most disastrous reports upon the Health Service ever acted upon by his Department, and will he now agree with the view of eminent people that there is a shortage of doctors in the National Health Service?
So far from a reduction of student intake following upon that Report, the intake is higher now than it was four years ago.
Can the right hon. Gentleman say how much overcrowding in medical schools is due to the acceptance of some part of the Willink Report? Can the right hon. Gentleman say how many schools are overcrowded and what steps he has in mind for the future to diminish this overcrowding?
Not without notice, but I do not think the Report and its conclusions can have contributed to whatever may be the present state of overcrowding.
Would not the Minister agree that if the young registrars who help to staff particularly our provincial hospitals and who come from the Commonwealth were to be withdrawn—who may well not come in great numbers in the future—we should be in very great difficulty indeed?
I quite agree that this is an important factor in the statistical picture.
Effects Of Alcohol (Tablets)
15.
asked the Minister of Health if he will introduce legislation to prevent the sale of tablets purporting to modify the effects of alcohol.
No, Sir.
Is my hon. Friend aware that pills called "Soberettes" are on sale in pubs and sweet shops, which are banned by the Pharmaceutical Society from being sold in chemists' shops, which might give the impression that drunken motorists can cure themselves from alcoholism by taking these pills? Is it not wrong that this sort of pill, which gives no evidence of any content, should be on sale giving a false assurance to people that they might be cured?
I am aware that such tablets are on sale. It is not quite correct to say that the Pharmaceutical Society has banned them. It has issued a notice advising chemists
they should not stock or sell these preparations, but the evidence available does not suggest that they are medically harmful."…in view of the possibility of misuse and the consequent danger to the public…"
Mental Health Workers
26.
asked the Minister of Health what is the current shortage of mental health workers; what is this figure as a percentage of the total required; and what steps are being taken to remedy the shortage.
The unfilled need for mental health workers, though it cannot be estimated precisely, is certainly very large. The establishment of a National Council for Social Work Training, and the provision of additional training courses, ought to help.
Is the hon. Lady aware that the Mental Health Act recently put on the Statute Book will be largely ineffective so far as local authorities are concerned if we do not solve these problems? Can she say what steps are being taken to encourage these people by means of wage increases, improved working conditions and the like?
I agree with the first part of the hon. Gentleman's supplementary question. Practical steps are being taken. Two-year full-time training courses are being started in September at the London County Council North-West Polytechnic, at the City of Birmingham College of Commerce and the Liverpool College of Commerce. I understand that there has been an excellent response from would-be applicants, and the hon. Gentleman might like to know that a course is being arranged for Scotland too.
Can the hon. Lady give an assurance that legislation to set up a national council for social work training will be introduced early in the next Session of Parliament?
Legislation is to be introduced. For obvious reasons, I cannot give the undertaking which the hon. Gentleman seeks.
Will the hon. Lady reply to the last part of the supplementary question from my hon. Friend the Member for Fife, West (Mr. Hamilton)? Is the Minister taking any initiative in the matter of pay and conditions? Has not it been shown in the case of other public servants that unless pay and conditions are improved, although recruits may be obtained, they cannot be retained?
As the hon. Gentleman should know, that is a matter for the appropriate Whitley Council.
But is the Ministry taking any initiative?