asked the Minister of Health whether, following the report of the Inter-Departmental Committee on Drug Addiction, he will make representations to the Independent Television Authority regarding the need to ensure that false claims are not made for drugs advertised by television.

I understand that drugs of the type referred to in the Report are not advertised on television.

Although the Report, as I understand the Minister has said, refers to prescribed drugs, is there not a case for seeing that drugs which are advertised generally in the Press and on television are examined by some reputable body to make sure that no misleading claims are made on their behalf by the manufacturers and advertisers?

Any general question of limitations and so on on television must be for my right hon. Friend the Postmaster-General, but the Food and Drugs Act prohibits false or misleading descriptions of drugs in advertisements.

asked the Minister of Health if he is aware of the proposal of the local executive council for a change in Upper Weardale, County Durham, from doctors' practice to group practice, the additional mileage in travel involved by this proposal and the local opposition to it; and if he will reconsider the decision.

The executive council has not reached a decision on the doctors' proposal to alter their places and times of attendance.

Will the Minister keep in mind the protest of the local authority, the letter of protest from the vicar on behalf of his parishioners in this area, and many letters of protest I am receiving on behalf of people in Upper Weardale about the proposal of the doctor to move from Upper Weardale to form a joint practice lower down in Weardale? Will he take into consideration the high altitude of this area in the Pennine range and that it is snowbound in winter time, and also the cases of emergency which have to be dealt with?

I am aware of all those points. I think the hon. Member is aware that the executive council responsible in this matter has met the rural district council and the rural district council in turn has had meetings with the doctors. The position now is that the executive council is to review the matter in six months' time.

I have had a communication from the executive council that it came to a decision last Thursday.

There is some difficulty in giving counter-information at Question Time.

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

asked the Minister of Health whether he will refer the Soberette pill to the Poisons Board for advice as to whether such pills should be restricted for issue only on doctor's prescriptions.

No, Sir.

Can nothing be done to stop the distribution of these pills and the stupid and misleading claims which give a false impression to the public? Is there nothing the Government can do?

In my reply to my hon. Friend's Question last week, I said that there is no evidence to suggest that these tablets are medically harmful. Drugs which are limited under the poisons legislation to supply on prescription could all have serious effects unless taken in accordance with medical advice. That does not apply in this case.

Has my hon. Friend seen the advertisements? Will she agree that what they do is to encourage the taking of alcohol before driving? In the circumstances, whether these tablets are technically poisonous or not, is it not important to have an objective assessment of their value and possible dangers? What can be done about it by the Ministry?

I have seen the publicity. The question of the effect of taking these pills in relation to driving is not one for my Department to answer.

asked the Minister of Health what is the average genetically significant dose of ionising rays received by the population as a result of medical X-rays, giving the figure in terms of a percentage of the natural background radiation per generation of 30 years; and how this compares with the figure that could be achieved if all hospitals improved to the standard of the best hospitals.

It is estimated that in 1957 this was about 20 per cent. for all medical radiology, and that a reduction to 6 per cent. or less would be possible by improving techniques.

Since this is a remarkable reduction, will the right hon. Gentleman tell us what he and his Department are doing to make certain that every hospital follows the techniques which are in use in the best of our hospitals?

When the Adrian Report was published last year, I drew the attention of hospital authorities to the need to conform with the code of practice, and that code itself is being further improved in the light of the Adrian Report.

asked the Minister of Health how many children are known to have died in Great Britain during 1960 through the refusal of their parents to consent to operations and blood transfusions.

None, Sir.

asked the Minister of Health if he will make a statement on the effects of rubella during pregnancy; and if he will state approximately the number of new-born babies over a convenient recent period who have been born deaf or otherwise handicapped as a result of their mothers contracting this disease.

A report published last year on children born between July, 1950, and December, 1952, to mothers who had rubella during pregnancy showed that four out of five were normal; 19 per cent. had some degree of deafness. I am sending my hon. Friend a copy.

Does my hon. Friend agree that this innocent disease, more commonly known as German measles, has a most insidious effect? Does not the analysis made, which shows that 20 per cent. of children—which, after all, is another way of putting one out of five—suffer from deafness or another form of disability, indicate a very serious problem?

Hear, hear.

Yes, it is one in five of the number coming under this particular test. The reaction of hon. Members made me think that my hon. Friend's point may have been misleading. It is important not to alarm mothers. The report of 1960 gave a more reassuring picture. It showed that the risk of congenital defects following rubella in pregnancy was less than had been feared. Many of the defects are now amenable to treatment.

While it is important not to be alarmist, is it not important also not to be complacent? Is it not a fact that rubella contracted during the first month of pregnancy leads to a very much higher incidence of abnormality, which has been estimated by some geneticists as high as 50 to 85 per cent.? In the circumstances, does the hon. Lady think that sufficient research is being done?

Research is continuing in the matter. There is a Question about the medical aspects to be answered next.

asked the Minister of Health what steps he is taking to warn pregnant mothers of the dangers involved in coming into contact with cases of rubella; and whether he will now arrange for this to become a notifiable disease.

I understand that attention is drawn to the nature of this hazard from time to time through the various channels of health education, and I have recently published the report of a special inquiry, but I am advised that notifiability would not help.

Is there close co-operation between my right hon. Friend's Department and the Ministry of Education? Is it not a fact that pregnant mothers are very often put into danger when visiting children in schools?

I believe that special arrangements are in force in respect of teachers. Primarily, it is education by the local health authorities which can help in this matter. I am considering whether there is any further action I can take with them arising out of the report to which I have referred.

I hope I am not doing my right hon. Friend or his Department an injustice, but I feel that there is a slight hint of complacency here. Whether the number of cases be small or large, they represent personal tragedies of a high order. I hope that he will press on with whatever steps he thinks are possible.

My hon. Friend does me an injustice if he thinks that I am complacent in this matter. It is important that mothers should be aware of the risk involved, especially, as the hon. Member for St. Pancras, North (Mr. K. Robinson) said, in the earlier weeks of pregnancy, and that they should take what steps are possible to avoid contact, seeking advice if they have reason to believe that contact has occurred.

asked the Minister of Health what were the population densities of each county in England and Wales at the latest convenient date; and what changes in these densities are indicated by the 1961 census figures.

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

What arrangements is the Ministry making, following the publication of the Interim Census Report, for an urgent examination with the other Departments concerned of the health, housing, planning and employment problems involved in the excessive concentration of the population in south-east England?

These are matters for the respective Departments concerned. In particular, the question of the movement of population is one for the Ministry of Housing and Local Government.

asked the Minister of Health if he is satisfied that the legislation relating to the carrying of scheduled poisons by representatives of the pharmaceutical industry is adequate for the protection of the public; what consideration he has given to the need for amending legislation; and if he will make a statement.

If the hon. Member will let me know what difficulty he has in mind, I will consider it with my right hon. Friend the Home Secretary.

I thank the right hon. Gentleman for that reply, but may I ask whether he is aware that many of these representatives have no special medical knowledge and that frequently these poisons are lost from the representatives' cars? Does he not think that this situation is rather unsatisfactory and that it should be looked into?

I will consider that. The legislation, of course, does not relate at all to the carrying of poisons but to their sale or supply. But I will consider that point.

asked the Minister of Health how many doctors and dentists have, in each of the past three years, had their pay withheld for breach of duty under the National Health Acts; and what were the total sums involved.

The figures are 86, 81 and 120; £3,941, £3,978 and £3,914.

I thank the Minister for that information, which will be very useful in connection with the Adjournment debate I have on Friday about naming guilty doctors and dentists. Pending that debate, will he confirm that although the names of these offending doctors and dentists are supposed to be secret, any newspaper that wants to publish their names is not breaking the law if it does so?

It is not for me to say whether any law is broken by a newspaper doing this or doing that, but I am certainly at the disposal of the hon. Gentleman for information that might be of use to him in an Adjournment debate.

asked the Minister of Health what plans he has for the increased provision of day treatment in hospitals, similar to the experiment being operated by the Chichester Hospital Management Committee at St. Richard's Hospital, Chichester.

Advice on the day treatment of the elderly sick was given to hospital authorities in October, 1957: I am sending the hon. Member a copy.

Would the hon. Lady agree that this is a very valuable form of treatment in that it allows elderly people to go home at night and for their relatives to look after them, which is a great saving in nursing staff? Is she satisfied that hospitals are experimenting sufficiently with this form of treatment?

I agree with the first point made by the hon. Member, that it is valuable for the individual and cuts short the in-patient time in hospitals. The question of provision of this type is for the hospitals themselves. It is developing.

asked the Minister of Health if he will make a statement about the closing of the out-patient dispensary in the pharmaceutical department of St. Thomas's Hospital, London, because of the shortage of pharmacists on the staff.

I understand that difficulty arose because several of the dispensing staff left simultaneously, but I am asking the board to arrange for the dispensary to be reopened with as little delay as possible.

Is not this an example of a tendency in the hospital pharmaceutical service of which my right hon. Friend has had warning? Can my right hon. Friend give any indication of action being taken by his Ministry so to improve the conditions of service as to prevent this drift away from that part of the service?

During the last year or so, the number of hospital pharmacists increased very sharply, and experience elsewhere suggests that the difficulties which arose at St. Thomas's were quite exceptional.

Is the Minister aware that there is a developing problem here caused by the great demand in industry for qualified pharmacists, not only retail pharmacists but pharmacists in industry itself, and is there not a possibility that the provision being made in the pharmaceutical schools is just not adequate for the situation which is developing?

There is the call from industry, and I believe that industry itself is finding considerable difficulty in recruiting all the people it needs. However, it is encouraging that there has been such a sharp recent increase in the number of hospital pharmacists.

Are there difficulties peculiar to the London area? My information is that this is by no means the only teaching hospital experiencing difficulty and, as the Minister knows, in the ordinary way teaching hospitals find it easier to recruit staff than do regional board hospitals.

Obviously, there are special factors operating in the London area which may make the matter difficult, but this is the only hospital which has found itself confronted with the acute and, I think, quite special problem which arose a month ago at St. Thomas's.

asked the Minister of Health why he has instructed hospital authorities to discontinue the purchase of all patented drugs from unlicensed sources, in view of the fact that he proposes to invite tenders centrally for only three groups of such drugs.

Because it is better that the procedure should be applied centrally.

Do I take it from that reply that it is the Minister's intention to invite tenders for all the drugs which some hospital authorities have been buying from Continental sources in the past?

I have not limited my action in advance to the three drugs for which I have asked for tenders, and, whenever I see reason to think that the procedure would be appropriate, I shall consider its application.

There are other groups of drugs which are being bought now. Is the Minister aware that he has now said that the action taken by individual hospital authorities was perfectly proper and within the terms of the Patents Act? In that case, why has he stopped them purchasing in advance of his taking centralised action himself?

In the Government's view, this is the only appropriate way in which drugs could be purchased from unlicensed sources. In reply to the first part of the hon. Gentleman's supplementary question, whenever it is brought to my attention that there is a case for applying Section 46, I shall consider it, without prejudice.

Is the Minister aware that, of course, his method of buying drugs from unlicensed sources will give justice to the patent holders, for it assures them that they receive their royalties, and that it is a proper thing to do; but will he say why he included in the first three groups the drug called hydrochlorothiazide which has not yet been patented?

Because it belongs to the same group as another drug which it was desired to cover, and it was thought proper to call for tenders for both at the same time.

asked the Minister of Health on what date he received a letter from the Aldershot Borough Council in relation to the provision of a new general hospital; when he expects to be in a position to reply; and whether he will be able to give a date for the commencement of the building of this hospital.

On 31st May, and a reply was sent on 7th June. I cannot yet say when this scheme can start.

Does my right hon. Friend realise that this hospital is to be built with a view to covering not only Aldershot but districts quite a considerable distance away in the surrounding neighbourhood?

Yes. I share my hon. Friend's disappointment at not being able to include it in my list of central schemes which could be started by 1964–65. I must now look at schemes for later years in the context of the ten-year plan.

asked the Minister of Health how many medical posts in the Newcastle Regional Hospital Board area remain unfilled; and how many posts have been vacant for longer than two months.

Thirty-three and 24, excluding non-teaching hospital posts below registrar, for which the figures are not available.

Does not the hon. Lady think that one of the main reasons why there are long waiting lists in the North-East is that the establishment is quite inadequate? Will she therefore make inquiries into this aspect to try to make the establishment fit the needs of the area?

I will certainly make further inquiries in order to try to satisfy the hon. Gentleman, but on 31st March, 1960, which is the latest date for which we have figures, vacancies in the grades of registrar and below for Great Britain averaged 9 per cent. The average for Newcastle was slightly below the Great Britain average, so by comparison it is slightly better off.

asked the Minister of Health how many psychiatrists are required in the Newcastle Regional Hospital Board area; and when he expects these doctors to be available.

The Board has proposed to create four additional consultant posts. My right hon. Friend has approved two, which the Board expects to fill in the next two months.

Is the hon. Lady aware of the widespread belief that there is a great shortage of psychiatrists and that they are being rationed out to every region? What steps are being taken to train more doctors of this kind?

The hon. Gentleman is correct. There is a nation-wide shortage of consultant psychiatrists. That is why it is necessary to limit the posts in some areas. The numbers in posts in England and Wales increased by 19·5 per cent. between 1955 and 1960, and the corresponding increase in the Newcastle region was 33 per cent.

asked the Minister of Health what additional recruitment of architectural and engineering staff he expects will be required by the hospital building programme in 1962–63, 1963–64 and 1964–65, respectively; and what steps are being taken by his Department to secure the necessary trained staff.

This will depend upon the proportion of their work which hospital boards decide should be undertaken by their own staff in each year. Every opportunity is taken of publicising the scope and interest of this expanding field.

Has not the Minister had consultations with the appropriate education authorities to see what he can do to stimulate the training of architects, engineers, and so on? Within his own control, why does he not increase the number of apprentices articled to architects and engineers on the staff of regional hospitals?

The latter part of the question is one for regional hospital boards, which are the employers. They are preparing the plans which will involve this increased demand. In general, I think that one of the many advantages which flow from a clear long-term plan will be the evident demonstration of the need for architects in this field.

Does the Minister agree that at present the lack of architects and engineering staff constitutes one of the serious bottlenecks in his own programme?

Yes.

asked the Minister of Health if he is aware that the governors of the United Teaching Hospitals have decided to reduce the number of confinement cases at the Birmingham Maternity Hospital by 500 a year; what consultations took place with the Birmingham Regional Hospital Board before this decision was taken; and if he will make a statement.

I am informed that the reduction aimed at is about 300. It would not be in the interest of the hospital service to disclose communications between boards.

Is the hon. Lady aware that that is a very disquieting reply? One of the very great difficulties in the hospital service, particularly in the Birmingham area, is the complete lack of liaison between the governors of teaching hospitals and the Birmingham Regional Hospital Board and the hospital management committees? Does she not think that to take this action unilaterally, whether it be 300 or 500—some of us were told in the first place that it was to be 500—is an act of social irresponsibility? Will the Minister take some steps to get greater co-ordination in these matters?

No. I cannot agree with the hon. Gentleman that this is an act of social irresponsibility. It was because the board of governors feels responsible for this maternity hospital—which, as the hon. Gentleman knows as well as I do, takes the difficult cases—and in order to allow it to cater for emergencies that it felt it necessary to take this step.

Does not the hon. Lady appreciate that it is quite impossible for a regional hospital board to carry out its planning responsibilities unless there is the closest possible liaison with boards of governors? Is she aware that this liaison is certainly nonexistent in the Birmingham region referred to by my hon. Friend?

The answer to the hon. Gentleman's first point is "Yes", but I do not agree with the second one.

I beg to give notice that I shall raise this matter on the Adjournment.

asked the Minister of Health, in view of the effect of his proposals for a post-graduate medical school in Chelsea on St. Luke's Hospital and Western Hospital, what provision will be made for the future care of elderly and chronic sick patients in the Fulham, Chelsea, and Kensington neighbourhood.

asked the Minister of Health which existing postgraduate medical schools will be incorporated into the proposed new postgraduate teaching hospital in Chelsea; how many beds it will contain; if he will define the site of the buildings to be erected; what are his intentions regarding the sites which this plan will make redundant; and if he will make a statement.

I would ask the hon. Members to await a full statement on this matter which I intend to make shortly.

Does the Minister remember that I wrote to him some weeks ago about this matter? I received no reply until I tabled a Question, when a reply came saying that I would like to see a copy of a letter he had sent to certain other hon. Members, but in fact he omitted to enclose such a copy? [Laughter.] I do not regard this as a laughing matter. Does the Minister realise that there is a great deal of anxiety in Fulham about the shrinking accommodation for chronic and elderly sick patients? We regard this as a very serious matter.

I apologise for the clerical oversight, which I will have put right at the earliest moment. I quite understand the importance of this matter, both generally and locally, and that is why I think it right that a statement should be made at an early moment.

A statement has already been made by the regional board concerned. Can the Minister indicate when "shortly" will be?

Not later than the end of the month, and it might be a little before that.

asked the Minister of Health what improvements in the hospital service in north Staffordshire are at present being undertaken or planned.

A new casualty department and a new outpatient department at the North Staffordshire Royal Infirmary and a new maternity unit at the City General Hospital, as well as a number of smaller schemes.

In view of controversy in the recent past, can the Minister tell us whether the priorities for the improvement of the hospital service in North Staffordshire are now agreed between his Department and local representatives? Is proper account being taken of the fact that north Staffordshire has been worse off for a long time past in comparison with other areas of similar size?

The particulars I gave in my Answer are those of schemes which are actually in hand, which I thought was the object of the hon. Gentleman's Question. I am considering the long-term development programme, which has been submitted to me by the Birmingham Regional Board, in the light of circumstances in North Staffordshire.

Will the right hon. Gentleman bear in mind that from the long-term planning point of view great care should be taken to ensure that the priorities are correct? Some of us are a little uncertain as to whether enough time has yet elapsed strictly to formalise them.

Yes. I think that it will be some months before this study can be completed. One of the main purposes of such an operation is to try to get the priorities right over a considerable period.

asked the Minister of Health if he is aware of growing concern about the lack of recruitment to the nursing profession; and what action he intends taking to safeguard the future of the hospital service.

More nurses are employed in the hospital service than ever before. My right hon. Friend supports the recruitment efforts of hospital authorities by giving widespread publicity to nursing as a career.

Is the hon. Lady aware that the administrators of many hospitals, who are looking well ahead into the future, are extremely concerned that pro rata to the population, and particularly pro rata to the number of school-leavers, the number of new entrants to the nursing profession is very unsatisfactory and in certain areas—to be specific, in certain hospitals dealing with the chronic and mentally sick—is likely to reach a state of crisis? We have the opportunity with the bulge in the number of school-leavers to do something dramatic. I ask the Minister to examine this problem and consider initiating a nation-wide campaign to get young suitable girls into the nursing profession.

There is continuous publicity through the media of the Press, television, radio and all the journals; posters are available; exhibitions are held. I agree that it is important to attract a number of school-leavers into the nursing profession, but there is another aspect. Happily last year the number of part-time nurses rose considerably. We think that a special effort directed towards the trained woman who can come back part-time might also help.

Is my hon. Friend aware that this is a very worrying problem indeed? Last Saturday morning I went over a nursing home in which half the beds could not be used because of the shortage of nurses. This is a serious matter. Will she do everything in her power to alleviate the position?

Yes. If my hon. Friend really means that it was a nursing home, it would not come under the National Health Service.

Is the hon. Lady aware that this kind of publicity will be of little effect if she does not take the initiative in seeing that the nurses are paid adequately? This seems to me, and to many others who are interested, to be the crux of the matter. Will not the Parliamentary Secretary and her Department take the initiative to see that these people get paid adequately for their wonderful work?

As I have explained before, this is a matter for the nurses' and midwives' Whitley Council. There was a considerable improvement in 1959, both in pay and conditions, and there was a modest increase in pay last December.

asked the Minister of Health whether he intends to provide a new general hospital in south-east Durham; and whether the new town of Peterlee will be considered for its location in view of its suitability for this purpose.

A new general hospital is to be built at Stockton-on-Tees. There is no present intention of building a hospital at Peterlee.

Is the Minister acquainted with the geography of the district? Is he aware that Stockton is 20 miles away; that the facilities at Sunderland and West Hartlepool are most inadequate; that the population of the Easington district is over 80,000, and that the target population for the new town, Peterlee, is 30,000? Does not that necessitate a general hospital?

I am aware of the desirability of the improvement of the hospital facilities serving the area, but the prospective population of Peterlee would not form the basis for a general hospital of the appropriate size.

asked the Minister of Health what is the approximate proportion of nurses and domestic staff to private fee-paying patients and to ordinary patients respectively in hospitals within the North-East Metropolitan Region compared with other regions; and whether in that region the number of part-time trained nurses has increased during the past two years.

I regret that the information requested in the first part of the Question is not available. The Answer to the second part is "Yes".

Does not the Parliamentary Secretary think it rather necessary to get this information? Could she not initiate investigations to see what information is available to answer not only my request but the request of many other people? On the second point, is she satisfied, seeing that we are now bound to have a very large number of part-time nurses, that everything is done to consider domestic circumstances?

Without considerable expenditure and effort, we could not get individual figures of the allocation of nurses to private beds. In fact, I wonder whether it would serve any useful purpose because, in general, the same nurses undertake duties at pay beds and National Health Service beds. I agree that it is important to consider the domestic circumstances of part-time nurses; it is for individual matrons, of course, to try to accommodate them in arranging the rota of duties, and matrons are well aware of that.

Returning to the hon. Lady's reply to the first part of my Question, could she not at least make one or two sample investigations into the circumstances at particular hospitals? I am well aware of the difficulties, but I feel that there will be a tendency in certain hospitals to give more service to patients in pay beds than to those in National Health Service beds.

I will certainly inquire as to whether it is possible to do any sampling, but I would be surprised if the answer showed anything different from what I have suggested.

asked the Minister of Health what information he has to show the beneficial or the adverse consequences ensuing from the increase in the number of voluntary mental patients; and, approximately, what is the number or percentage of those patients who curtail such treatment against medical advice.

There is wide agreement that the removal of unnecessary restrictions on psychiatric patients is beneficial to them. I regret that the information asked for in the second part of the Question is not available.

In this case, also, does not the Minister think it worth finding out the information I seek? Is he quite satisfied about the release of patients with psychopathic tendencies in present circumstances?

On the first part of the hon. Gentleman's supplementary question, I do not think that any purpose will be served by doing as he asks, because, of course, many of these people would not be able to be compulsorily detained. The duties of review and so on laid down by the Mental Health Act do impose on those carrying them out the duty of taking into account the risks involved.

Is my right hon. Friend aware of the very serious implications of the question asked by the hon. Member for Leyton (Mr. Sorensen)? Is he aware, that, for example, Ronald Derek Sowle, who was charged on 27th April with murdering a 17-year-old girl in Bristol, had just discharged himself from custody in circumstances in which he was, in fact, detainable under the Mental Deficiency Act; and that if we get this wrong and the new Act is wrongly administered the public will lose confidence in the new Act?

I am afraid that I must not refer to the specific matter in my hon. Friend's supplementary question because that is sub judice, but, in general, I recognise that attention to security must be the price one pays for the opportunity to carry out a liberal and enlightened policy.

asked the Minister of Health if he will require the regional hospital boards to arrange for notices to be placed in the out-patient departments of hospitals stating the amount that may be charged to casualties under the Road Traffic Act of 1934, and informing those who hold accident insurance policies that they can make a claim for a refund on the company concerned.

The emergency treatment charge is payable by the vehicle user, not by casualties as such. I cannot advise patients of their rights against insurance companies.

Then why is the actual patient quite often asked to pay 12s. 6d. before he leaves the hospital?

There is no right to ask anyone but the vehicle user to pay 12s. 6d. If my hon. Friend has a case in mind I shall he delighted to look at it.

Is it not worth while reconsidering this charge, which is made at a very awkward time and is very much resented?

Yes, Sir. In logic, I think that this charge is probably not entirely consistent with legislation since it was first imposed, but it does, of course, involve legislation to alter it.