Whitley Councils
2.
asked the Minister of Health what new instructions he has given to his representatives on the Health Service Whitley Councils in the light of Government policy on wages and salaries in the public service; and what limitations he has imposed on the right of arbitration in cases of disagreement between the two sides.
I have informed both sides of the Whitley Councils that the same principles will be applied to the functioning of the Health Service machinery for determining pay as are being applied in the Civil Service.
Since the Minister of Health already has the right to reject any agreement within the Whitley Council with which he disagrees, why does he refuse to permit the Whitley Councils, management and staff sides, to negotiate operative dates of agreements?
It seems to me right that the same principle should be applied in all parts of the Government service.
Is the right hon. Gentleman aware that his unilateral action has gone further to destroy the confidence of National Health Service staffs in their negotiating machinery? Is he further aware that his action has had a serious effect on morale within the Service and on recruitment, particularly to those grades where there are serious staff shortages?
I am not aware of that, but I shall be seeing representatives of the Whitley Councils later this week and, naturally, I shall listen carefully to what they have to say.
Welfare Foods
1.
asked the Minister of Health what amounts of cod liver oil, vitamins A and D tablets, and orange juice were distributed by the Health Department of the County of Middlesex for the eight weeks starting 4th July, 1960, and for a similar period starting 3rd July, 1961, respectively; and what was the percentage of decrease in each welfare food.
I will, with permission, circulate the figures in the OFFICIAL REPORT.
Is the hon. Lady aware that in the Willesden area there has been a decrease of 65 per cent. in this period and that the number of cod liver oil items fell from 2,745 to only 900 and of orange juice from 2,100 to fewer than 700? Will the Ministry reconsider this disincentive with a view to reversing its policy?
I am aware that the published figures will show that there has been a reduction in consumption, but it is probably a little premature to come to any conclusions. There was a considerably increased intake in May when mothers knew that the charges were to be altered.
Following are the figures:
— | Quantities | Percentage Decrease | |
4th July to 27th August, 1960 | 3rd July to 26th August, 1961 | ||
Cod liver oil (bottles) | 15,960 | 5,177 | 68 |
Vitamins A and D tablets (packets) | 18,910 | 9,386 | 50 |
Orange juice (bottles) | 163,526 | 64,160 | 61 |
Chemists (Pay)
4.
asked the Minister of Health when he received the claim of the dispensing chemists for professional fees and increased remuneration; what reply he has made; and what steps he is taking to ensure the dispensing of prescriptions in the event of the chemists giving notice to terminate their contracts and withdraw from the National Health Service.
On 8th June. I am sending the hon. Member a copy of my replies sent on 22nd September and 20th October after full discussions with the chemists. The last part of the Question is hypothetical.
It may be hypothetical, but it may be very important in the fairly near future. May we know what steps the Minister is prepared to take? Is he aware that we recognise his reply to the chemists as being in line with the recommendations of the Public Accounts Committee, and that we also say that it would have been quite impossible in any circumstances to grant the chemists an increase in remuneration at a time when wage and salary earners in he Health Service were subject to the wage freeze?
It would be difficult in any circumstances to grant a claim which involved an increase in profits of that order, but I must decline to answer the hon. Member's hypothetical question.
I am sure my right hon. Friend will recognise that this cut in the chemists' remuneration is coming at a time when the number of prescriptions will already be reduced because of the 2s. charge. Can he tell the House how much he expects the saving effected by this cut to be?
It is between £1½ million and £2 million per annum, but I should point out that the calculation of chemists' profits which is involved takes account of the known effect so far of the increased prescription charges.
Is not the right hon. Gentleman aware that large numbers of chemists are still profoundly dissatisfied with his answer to their claim which he mentioned in his original reply?
19.
asked the Minister of Health what action he has taken following the Third Report of the Committee of Public Accounts relating to chemists' remuneration.
I have arranged for a differential system of remuneration to be introduced next week and have invited the chemists to co-operate in a simpler inquiry into their current costs. I am considering the recommendation as to differential prices in the drug tariff.
Can the Minister tell us whether the principles upon which the chemists are making a claim were investigated in full by the Committee of Public Accounts, which has reported, and whether any new principles are involved in this claim as compared with those which the Committee fully investigated before making its recommendation.
The claim made by the Chemists Contractors' Committee did not involve a differential system such as was recommended by the Public Accounts Committee, and such as I am now bringing into effect.
Births, Lichfield And Tamworth
5.
asked the Minister of Health what was the total number of live births in the area within the control of the Lichfield, Tamworth and Sutton Coldfield Hospital Management Committee for the last accounting period; and how this figure is likely to be adjusted in the light of planned overspill population which has arrived since that accounting period, and which is likely to arrive within the next five years.
In 1960 there were 2,885 live births to mothers resident in the area served mainly by this committee. No useful estimate can be made of the corresponding figures during the next five years, but the number of maternity beds will be increased substantially.
Is the Minister satisfied that regional hospital boards in general, and the Birmingham Regional Hospital Board in particular, are provided with adequate statistical information as to the population effects of the overspill transfer?
Regional hospital boards have obtained such information and used it as part of the data for consideration in submitting their ten-year plans to my right hon. Friend, and I believe that the Birmingham Regional Hospital Board has done the same thing.
Midwives
6.
asked the Minister of Health whether he is satisfied that the present organisation of midwives under the National Health Service Act, 1946, Part 3 is operating smoothly in rural areas; and whether he will investigate the suggestion that there should be ambulance midwives in rural areas, in the light of the excessive time spent by midwives on long ambulance journeys to distant hospitals which detracts from the time which should be spent on local cases.
In general, yes. A midwife should very rarely need to accompany patients by ambulance. If the hon. Member has a specific problem in mind, I will gladly consider it.
I will be happy to provide the Minister with the details of a case. Apart from that, as it is the general principle which appears to be involved, will she consider seeking the advice and guidance of the professional organisations concerned?
If by the "general principle" the hon. Gentleman means the principle that a trained midwife should accompany each ambulance, I think it would be an uneconomic use of trained woman-power. In fact, it has been tried by some of the local authorities who are responsible for providing the ambulance service and has been discontinued for that reason; all ambulance personnel are trained in first-aid.
Census Forms
7.
asked the Minister of Health when he intends to destroy the census forms of the 1961 Census.
These forms will be required for some years at least, to complete the census reports.
Cannot my right hon. Friend be a little more definite than that? Is he not aware that there are personal questions on this form about which women in particular have a certain amount of anxiety and considerable fear? They think that these details get into the wrong hands, perhaps by inadvertence.
The confidentiality of these forms is absolute and is not prejudiced by their retention for this purpose.
Can the Minister say approximately when he expects the census to be published? Secondly, would it be possible, without awaiting publication of the full report, for individual questions to be put to him, dealing, for example, with the number of houses without baths?
I do not think that the latter question would be for me, but if the hon. Gentleman puts the first question down I will see that he has an answer to it.
National Health Service Tribunal
8.
asked the Minister of Health which of the recommendations of the Franks Committee relating to the National Health Service Tribunal he intends to implement.
Effect was given to general recommendations affecting the Tribunal by the Tribunals and Inquiries Act, 1958. Of the specific recommendations, the Government's decision not to accept No. 56 was announced on 12th November, 1957, and I have invited the views of the Council on Tribunals on No. 57.
Does the Minister agree that the basic principle that justice should not only be done but should be seen to be done applies in this case? Would not it be fairer, and in the public interest, if appeals were transferred from the Ministry to a tribunal and the hearings made public?
I am ready to receive and consider the Council's views on this, for which I have asked.
Foreign Visitors (Treatment)
9.
asked the Minister of Health what instructions, or guidance, he proposes to give to executive councils to deal with applications made by non-British residents or visitors to the United Kingdom who wish to use the Supplementary Ophthalmic Service, the Dental Service, or the services of a general practitioner who is on the executive councils' list.
I have this matter under consideration.
Is the Minister aware that his speech at the Conservative Party conference in which he yielded to these mean-spirited delegates to throw over the Good Samaritan content of the National Health Service is utterly rejected by hon. Members on this side of the House'? Will he at the earliest possible date lay before the House his proposals on this matter so that we can examine them?
I have not yielded to anybody on this. The National Health Service is for the people of this country, and the practical question is to ensure that it is used by them.
As the Minister told the conference that visitors to this country have no right to the medical services of the National Health Service, what was the authority on which the past practice of granting these facilities rested?
There is no right in a visitor, not being a person of England and Wales, to use the National Health Service; but, since the inception of the Service, it has been the custom to give emergency treatment, commonly called Good Samaritan treatment, even to visitors.
Can the Minister say exactly what he means when he says that the National Health Service is for the people of this country and only for the people of this country? What about the reciprocal agreements with other countries, where we try to meet our obligations, as do the other countries, under those agreements? Is the Minister not in favour of them?
Reciprocal agreements give no right to a person to come to this country for the purpose of obtaining treatment.
That is not what it says in the Question.
Pharmaceutical Manufacturers
10.
asked the Minister of Health what action he is taking to obtain fuller information about production costs, profits margins and sales promotion costs of pharmaceutical manu- facturers in the light of the Third Report from the Committee of Public Accounts.
The industry has been asked for further information on sales promotion costs, and inquiries into costs and profits of a number of firms are being made under the revised voluntary price regulation scheme.
I thank the Minister for this further action. He is aware that there is still considerable public concern. Will he, in particular, look at the recommendations of the Committee of Public Accounts that he should require more information about the costs and accounts of the British subsidiaries of American firms, particularly these adjustments that previously have been made on unverified information?
Of course I have studied the Committee's recommendation. I think that the most useful line of exploration is in the negotiations under the voluntary price regulation scheme.
Hearing Aids
11.
asked the Minister of Health what provision he makes under the National Health Act for the supply of special aids for deaf children who are unable to use the standard aid supplied through the National Health Service.
If a deaf child's needs are not met by any of the Medresco aids, the aid required may be provided through the school health service.
Is the Minister aware that these provisions do not seem to cover all children? I have sent her the details of a case which has recently arisen. Will she therefore look at these provisions again and consider particularly the case of the child the details of which I have sent her?
It should be possible to meet all but a very few cases through the Medresco service. I have only just received the hon. Gentleman's letter, and I will look at the case he has in mind.
Can the Minister say what the delay is in providing the Medresco Service? Is it rather serious in respect of children?
I cannot answer that without notice, but, as I have had no complaints from hon. Members, I assume that the service is functioning satisfactorily.
Is the Minister aware that a case arose recently in my constituency of a child below school age who could not be fitted with the National Health Service deaf aid—the Medresco deaf aid—and had to have a special deaf aid? The cost of this had to be met by the local authority out of its rate funds. Is not this contrary to the spirit of the National Health Service? Will the Minister look at this problem again? It affects only a very few people, but it is of great importance.
If the hon. Gentleman sends me details of a particular case, I will certainly look at it.
Drugs
13.
asked the Minister of Health if he will make a statement on the steps he has taken to obtain cheaper drugs from abroad.
Contracts have now been placed in accordance with my reply of 17th May to my hon. Friend the Member for Dover (Mr. Arbuthnot) for the supply of five drugs for the hospital service. I estimate the total saving, before payment of royalties, at about Li million in a full year.
That reply is satisfactory as far as it goes, but does not the Minister know that the drug bill is running at the rate of about £14 million a year? As further savings could be made in this very important respect by bringing down the price of many of these drugs which are at present being overcharged, has he met with the friendly co-operation of those of his hon. Friends who are directors of drug companies, whose prices are a little higher than they need be?
I know that my hon. Friends and I believe that the whole House supports me in my desire to get drugs for the National Health Service on the best terms that I can.
Is my right hon. Friend aware that, in spite of the criticism of the hon. Gentleman, there will be general support for his determination to ensure that the National Health Service does not pay more than world prices for the drugs it buys?
indicated assent.
I appreciate that the Minister cannot be as forthcoming as he might be as he is about to be sued by one of the drug manufacturing companies, but will he say whether so far he is satisfied with the outcome of this experiment?
I have told the House that it has been found possible to place these contracts, and there is no question about the quality of the articles which are being obtained at advantageous prices. In due course royalties will either be negotiated or adjudicated.
Cremation And Burial Certificates
15.
asked the Minister of Health what is the difference in fee charged under the National Health Service for medical certification for cremation and for burial; why this difference exists; and if he will take steps to establish uniformity in the medical fees charged.
No such fees are charged under the National Health Service.
Do we understand that the charge for cremation is the same as for ordinary burial?
No, Sir. A practitioner is required to provide a certificate to enable relatives to register the death. That is available free of charge in the case of ordinary burial. In the case of cremation, however, two certificates are required in respect of which no scale of fees is laid down under the Cremation Acts. It therefore follows that this is a private arrangement between relatives and practitioners.
Is not the hon. Lady aware that many people would prefer to have the bodies of their friends and relatives cremated, for hygienic reasons, and yet we charge them extra for seeking to help in maintaining healthy conditions? Will not she look into this matter again?
It is not for me to look into it. The Cremation Acts are the responsibility of my right hon. Friend the Home Secretary.
But does not the hon. Lady know that there is a great difference in the amount of fee charged by the second doctor? There is an understanding that it should be about two guineas, but in some districts it may be as high as six guineas. Will not the hon. Lady look into this side of the problem and consider whether the Ministry should not make a recommendation as to the fee charged by the second doctor?
This is a private matter for the relatives to settle with the general practitioners, although I understand that the British Medical Association gives some guidance.
Health Service (Expenditure)
16.
asked the Minister of Health what was the average amount per person spent within the National Health Service on health in Great Britain for the last three years to a convenient date.
Including local health services and central administration, the figures to the nearest shilling are £15 13s. in the financial year 1958–59, £16 15s. in 1959–60 and £18 10s. in 1960–61.
Is the Minister aware that that figure of £18 compares with a figure of £56 per head in the United States of America, and that if we wish to have parity with the United States we shall need to spend another £325 million a year on the National Health Service? In view of the fact that in the year we lost 282½ million days in production because of ill-health, will the Minister not consider spending more on the National Health Service, especially on things other than the hospital service, to that end?
I do not think that international comparisons of this sort are much of an indication of the amount of service which is being given per head in the respective countries.
Private Nursing Homes
22.
asked the Minister of Health if he has yet given consideration to the Report on Private Nursing Homes sent to him on behalf of the National Corporation for the Care of Old People; and what action he contemplates taking to deal with the present situation.
Yes, Sir: and the problems of registering authorities have recently been discussed with the local authority associations.
In view of the very disturbing report, and the fact that when the Minister answered my Question on 5th December, 1960, he said:
does not he appreciate the vital importance of doing something very quickly to protect these forgotten people, in respect of whom the report shows a scandalous state of affairs?"I am at present considering suggestions for strengthening the powers of the registration authorities."—[OFFICIAL REPORT, 5th December, 1960; Vol. 631, c. 853.]
I regard this as an important matter. That is why I have been discussing it with the local authority associations.
Rabies
25.
asked the Minister of Health whether he is satisfied that there is now a vaccine which is an effective prophylactic against rabies; and whether he is reducing the present six months' quarantine required for dogs and cats entering this country.
My right hon. Friend is advised that the two vaccines available for humans give a high degree of protection though neither can be guaranteed completely effective. The second part of the Question is for my right hon. Friend the Minister of Agriculture, Fisheries and Food.
Can my hon. Friend hold out any hope of the period being reduced, because six months is a very long time?
It is not for my Department.
Would not my hon. Friend make representations to her right hon. Friend about a special type of case—guide dogs for the blind?
Animals have nothing to do with this Minister.
I thought it appropriate to ask the Minister of Health, because the care of the blind comes under the Ministry of Health.
I thought that this Question was not about blind dogs but about dogs in peril of rabies which are leading blind people. It is the other way round.
With great respect, Mr. Speaker, I think that the welfare of the blind comes under the responsibility of the Ministry of Health, and I should have thought—
Order. The hon. Baronet's question began by inviting Minister A to make representations to Minister B, which did not seem to be a profitable line within the rules of order.
Staff Vacancies(Advertising Expenditure)
28.
asked the Minister of Health if he will state the cost of advertising staff vacancies in the National Health Service for the most recent period of 12 months for which figures are available.
I regret that this information is not available.
Is it unreasonable to ask the Minister just how much money—since the figure appears to be running into tens of thousands of pounds—is spent on advertising for staff who are not normally obtainable for the Health Service, because of the Minister's miserly policy?
The figures are not kept separately—
Why not?
—and it would take an undue amount of time to obtain the figures centrally, but the short answer to the hon. Gentleman's question is that generally we have asked hospital management committees to keep advertising costs as low as possible.
In view of the large amount probably involved and the Minister's totally unsatisfactory reply, I beg to give notice that I shall seek to raise this matter at the earliest opportunity on the Motion for the Adjournment.
Radioactivity (Ussr Nuclear Tests)
29.
asked the Minister of Health in view of his Department's responsibility for the health of the people of this country, what information he has received from the Minister of Science regarding the danger to health inherent in the gradual fall-out of radioactive Strontium 90 and radio iodine over this country as a result of the twenty nuclear and thermo-nuclear tests of the Union of Soviet Socialist Republics; and what information he has received regarding the extent to which this would be aggravated by an addition of a 50-megaton nuclear test.
I would ask the hon. Member to await a statement which will be made tomorrow.
Why wait until tomorrow? Is not the Minister himself responsible for the health of the people of these islands? Surely, he must have been the first person to have been consulted? Has he nothing to say about the plans which he has in mind for protecting the health of young children particularly, who are bound to be affected if radioactive Strontium 90 is falling in large degree? Is not the Minister consulting his right hon. Friend the Minister of Agriculture to see to what extent the consumption of milk and other foods which may become contaminated will be curtailed?
The statement which will be made tomorrow will be on behalf of the whole Government.
Referring to the Minister's last reply, may I ask him whether it is intended that the statement to be made tomorrow shall be made by a senior Minister on behalf of the whole Government? The right hon. Gentleman will be aware of a suggestion this morning that it will be made by the Parliamentary Secretary for Science. In view of the fact that it affects a number of Departments, we consider it should be made by a senior Minister of the Government. In view of the statement coming from Sweden that the 50-megaton weapon has already been let off, will he bear in mind that this is of tremendous importance now? Will he represent to the Leader of the House that we would wish the statement to be made by a senior Minister tomorrow before the House rises?
The question by whom the statement is to be made is not for me.
May I ask the Minister, since he is currently answering the Question and since the Leader of the House is not here, whether he will represent to the Leader of the House, which I think is the proper form in which to put it, our desire that the statement to be made tomorrow should be made by a senior Minister?
The right hon. Gentleman's remarks are now on the record.