asked the Minister of Health if he will now give relative sales figures for vitamin foods available to children under the National Health Service for comparable periods before and after the recent increases in price; and if he will state the cost, the extent, and the purpose of the campaign now being undertaken by Her Majesty's Government to sell these commodities.

The figures are in the reply I gave to the hon. Member for St. Pancras, North (Mr. K. Robinson) on 1st December. The availability and value of these supplements is brought to the notice of those concerned by local health authorities and others. It is not possible to specify the cost of doing so.

Is the Minister aware that I have here a copy of a poster which has been circulated by the Government at enormous expense throughout the country to most business houses and other people, which clearly shows that the Government are obviously concerned about the enormous drop in the sale of the vitamin foods, which was evidenced by the previous Answer to which she referred? As we are worried about the effect on mothers and babies, and as we are spending a tremendous amount of money on advertising, is not the only sensible solution to take off these charges? Is it not a fact that we are spending as much money advertising these vitamin foods as the Minister tried to save by putting the charges up?

I am surprised that the poster has gone to industrial concerns. It is issued to local authorities, and I think that it is a very good one. One of the purposes behind its issue was to bring home to those mothers who are in the residuary group, the people whom we most want to get at to improve the health of their children, that these supplements are available, and in particular that the orange juice supplement is now available to children up to the age of 5.

Does the hon. Lady recall that a month ago her right hon. Friend said that he had no reason to doubt that the proper vitamin intake was being maintained? In view of that, why have the Government embarked on this publicity campaign? Is not there some conflict here?

No, Sir. As a general statement that is accurate. The hon. Gentleman will remember that during the debate we had on the welfare foods most of us were very concerned about the small minority of cases where we still felt that help could be given.

asked the Minister of Health if without awaiting the full publication of the 1961 census, he will state the number of households it reveals to be without a bath, sharing a bath, without an inside toilet or without hot water, respectively.

These figures will appear in one of the first series of reports for local areas. It would not be practicable to produce them in advance

But as these figures are of such importance to millions of families, and as other figures have already been extracted and published in certain cases, should not this information be given priority?

No, Sir. The processing of all the statistical information arising from the census is in full spate at the moment. To take out one set of figures and produce them at an earlier stage than is proposed in the pattern would delay all the other figures.

asked the Minister of Health what amounts of cod liver oil and orange juice were distributed by the Health Department in Salford for the twelve weeks starting 4th July, 1960, and a similar period starting 3rd July, 1961; and what was the percentage decrease in each welfare food.

asked the Minister of Health what quantities of welfare foods were dispensed in Middlesex during the period 1st July to 30th September in 1960 and 1961, respectively.

I will circulate the figures in the OFFICIAL REPORT.

I am sure that these figures will show the same trend as everywhere else, that they have gone down by about three-quarters. Does the Minister realise that there are many homes where every penny counts, and in which they really do go short of food? Are not these precisely the families whose health is being hit by these miserable, skinflint, charges on cod liver oil and orange juice? Does the Minister think that people drink cod liver oil for fun? They drink it because they need it. Surely the Government should reconsider this? I plead with the Minister to reconsider this miserable business.

There are some Questions on policy later on the Order Paper, and I will not anticipate those, but any family in need, particularly those already receiving National Assistance benefit, can receive these supplements free.

Does the hon. Lady realise that in No. 2 health area of Middlesex, which covers Wood Green, this 70 per cent. drop in the take-up of orange juice, cod liver oil, and A and L) tablets resulted, in a two-month period, in the paltry saving of £142? If the increase in administrative costs is included, there is a loss instead of a profit for the whole period. If this mopping up of the saving for the country as a whole by administrative costs is taken into consideration, what is the purpose of these increases in the charge on welfare foods, when we all know that they are harmful

asked the Minister of Health how many general practitioners have contracted out of the National Health Service from 1955 onwards.

There were 4,350 withdrawals between 1st January, 1955, and 1st July, 1960. Reasons for withdrawals are not notified, but death or retirement account for the majority.

Would not my right hon. Friend agree that there is a growing sense of frustration among many general practitioners in the National Health Service, mainly because of the overladen capacity of the work they have to do, and the frustration of administration? Will my right hon.

I take it that the hon. Lady means that the charges are harmful, and not that the supplements are.

Yes.

As was explained in the debate, although the vitamins are important in nutrition, they are now available through many other sources because of the wide variety of foods available for people in this country, and, as I said earlier, the necessitous cases can obtain these supplements free if they are in receipt of National Assistance benefit.

I would not agree that there is a growing sense of frustration, and in fact the number of general practitioners on National Health Service lists is increasing. Certainly the figures that I have given my hon. and gallant Friend do not contain evidence to support his contention.

asked the Minister of Health how many hearing aids were issued in the years 1959 and 1960; and how many have been issued in 1961 to date.

The figures are: 166,349; 199,943 and about 200,000.

Is my hon. Friend aware that one of my constituents who applied for an advanced hearing aid—she was very deaf and wore the old type—was told by the local authority that because she had no priority, and priority was given to the men and women trying to get jobs, she could not get the new type hearing aid? Bearing in mind that she is living on her own, and that there is the safety aspect of crossing the road in traffic when wearing the old type of hearing aid, is it not outrageous that in this modern age some of these people should not get a higher priority than laid down by the Regulations?

It think that my hon. and gallant Friend's supplementary question shows that he has in mind the transistor hearing aid. The figures that I have given are for Medresco aids generally. The transistor hearing aid which has been introduced within the last two years is being issued on a priority basis, and we are now issuing them at the rate of 200,000 a year. We hope to complete the replacement of all the earlier valve aids by the middle of 1963.

asked the Minister of Health what was the rate of incidence per 1,000 of active pulmonary tuberculosis in West Indian immigrants for each of the past three years.

I regret that this information is not available.

Is the hon. Lady aware that the British Medical Journal recently gave a figure of 1 per thousand? In view of the very low incidence of active pulmonary tuberculosis in the West Indies, is it not nonsense to seek to exclude West Indians from coming to this country on grounds of health? Would not the hon. Lady agree that it would be far better to treat these people and send them out into the world cured than to exclude them from coming to this country?

The question of their entry is, of course, another matter, but it is correct that the incidence of tuberculosis among West Indians is, on the average, not higher than in the rest of the population. It is higher in the case of Asians.

Would my hon. Friend agree that the recent report by the British Medical Association shows that there is a very high incidence of tuberculosis among people coming to this country from Asian countries, and from the West Indies? Will she look into this matter again?

I referred to Asians in my answer to an earlier supplementary question, but I should add that in general I have no reason to believe that immigrants from the Commonwealth have been responsible for bringing infectious disease to this country to an extent likely to involve a risk to public health.

asked the Minister of Health if any decision has yet been reached as to the disposal of £500,000 which, in accepting the recommendations of the Pilkington Committee, Her Majesty's Government agreed to devote to rewarding merit among general practitioners in the National Health Service.

No, Sir. The Joint Working Party on this has met once. A further meeting was postponed at the request of the profession.

Is it not now apparent that the medical profession do not like this idea of singling out G.P.s to have extra money compared with their colleagues? Is this not a dead letter and, if it is a dead letter, are not the Government prepared to consider using the £½ million, which is not to be used for this purpose, in order to buttress the provision of orange juice and cod liver oil which is so urgently needed?

That is a hypothetical question.

Did not the Royal Commission recommend that this £500,000 should revert to the Exchequer if it were not used for the general practitioners' merit award scheme?

Yes, Sir.

asked the Minister of Health how many infectious cases of leprosy there were in Manchester on 31st October, 1961, and 31st October, 1951, respectively; and how many of these cases occurred among the West Indian population.

One and none respectively. Notifications do not give country of origin.

Do not those figures, showing that there is only one case of infectious leprosy in Manchester and providing no evidence that the infection is coming from among the West Indian immigrant population, once again prove that attempts have been made to support the Commonwealth Immigrants Bill on grounds which are quite unfounded and that public opinion was aroused during the Moss Side by-election in favour of the Government Measure with no justification whatever?

That supplementary question does not appear to relate to a matter within the responsibility of the Minister of Health.

asked the Minister of Health if he will take steps to make facilities for the treatment of multiple sclerosis by the Le Gac method available to patients in this country under the National Health Service.

I would refer the hon. Member to the reply given to the hon. Member for Accrington (Mr. H. Hynd) on 4th December.

Is the hon. Lady aware that that reply to my hon. Friend the Member for Accrington (Mr. H. Hynd) was totally inaccurate? Does she not remember that when I raised with her the case of a woman suffering from multiple sclerosis, whose husband wanted this treatment for his wife, the hon. Lady told me that the doctor could apply to the Ministry of Health for particulars of the facilities available? The doctor, having done so, was informed by the principal medical officer of the Department that at present there is no doctor or hospital in this country known to the Department to be using this treatment. In view of this, will the hon. Lady stop misleading hon. Members and get down to providing these facilities under the National Health Service?

That is very different from saying that the treatment should be available. The question of whether a doctor is using it is another and separate question. There is nothing to prevent any doctor using this Le Gac method, as I said in reply to the previous Question.

Will the hon. Lady have another look at the Answer which she gave me last week, because my constituent raised the question with me and assured me that he had been unable to get this treatment?

It is up to the doctor, not to my right hon. Friend, to say what method of treatment shall be used in a particular case. There is nothing to prevent doctors making use of the method advocated.

Is not the hon. Lady aware that the doctor in the case of my constituent was advised to get into touch with her Department for advice as to how he should give the treatment, what form it should take and where facilities could be sought and made available? He has had a reply from the Department which, in effect, gets him nowhere at all. Where is the doctor to turn when he wants to give the Le Gac treatment to a patient?

My Department will be able to arrange to give to any doctor the information, which has been published, about the Le Gac method of treatment, but it is for the doctor himself to say whether he wishes to use it.

Is there not also some responsibility on the Minister to assess this treatment, to find what its value is and, if necessary, to see that the treatment is available in this country?

No, Sir, that is not the responsibility of the Minister of Health.

asked the Minister of Health if he has now completed his review of the 2s. prescription charge; and if he will make a statement.

asked the Minister of Health whether he is aware that the 2s. prescription charge is continuing to cause hardship and whether he is prepared to reconsider the position with a view to removing the charge.

I am watching the position continuously, but find no ground for altering the charge.

Is the Minister aware that a constituent of mine paid 1s. for eye ointment when buying it over the counter and subsequently she had to pay 2s. prescription charge for an identical tube of eye ointment obtained on a doctor's prescription? Does he realise that busy chemists cannot possibly operate two systems of prescribing? Is it not time that this money-wasting, time-wasting and temper-fraying stupidity was removed altogether?

I have no reason to believe that this is wasting money, but, if the hon. Lady will let me have particulars of the incident she has mentioned, I will look into it.

Is not the Minister aware that there is a considerable amount of feeling in regard to the charge, which is preventing a large number of people from getting by prescription the medicaments which they need? Why does he impose a charge of this nature when he knows that it will cause hardship to a large number of people?

I have no reason to believe that this charge is preventing people from getting the treatment or medicines which they need, but I believe that it is widely recognised that the money which the charge yields is used to better effect in the National Health Service.

Is the Minister not concerned about the waste of money on the part of my constituent who had to pay twice as much for the second tube of ointment?

I have promised to look at that particular case.

Is not the Minister aware that on the first seven months' experience there has been a drop in the number of prescriptions of 24 million per year, which is three times the rate which he estimated when he drew up the Estimates for the current year? In view of that, is there not prima facie evidence that people are suffering hardship and are not getting the medicines they need? Will he review the whole arrangement?

There was bound to be a fall in the number of prescriptions, if only because of the increase in prescribing for a longer period, which was very desirable. I still would not consider that we have had anything like enough experience of the working of the charge to assess the overall effect.

asked the Minister of Health what steps are being taken to provide a 24-hour emergency ambulance service in the Borough of Rowley Regis.

I am informed that 24-hour emergency cover for the Borough of Rowley Regis is provided from Tipton, Brierley Hill and Halesowen.

Is the Parliamentary Secretary aware that cases have occurred where ambulances have taken 20 and 25 minutes to reach an injured person? There is widespread dissatisfaction in the borough, and the borough council has expressed great anxiety at the inadequacy of the service. Will the Minister look at this whole question again and consult with Staffordshire County Council and Rowley Regis Borough Council on the matter?

If the right hon. and learned Gentleman has details of any particular case in which a delay of that length has occurred I will be glad to look into it. But in general, as the right hon. and learned Gentleman knows, the county council is responsible for the ambulance service in this area. It went into the matter thoroughly and was satisfied that the service is adequate.

asked the Minister of Health whether, in view of the Scottish practice for the training of health visitors and social workers, he will take steps to arrange for direct grants to be made from the Ministry of Education.

No, Sir.

Can my right hon. Friend state categorically which system he thinks is the best, bearing in mind that the Secretary of State for Scotland is in the Cabinet and has all the facts while the Minister of Health is not in the Cabinet and has limited horizons?

As I explained in the debate on Second Reading of the Health Visitors and Social Workers Training Bill, the arrangement which the Bill contemplates is in accordance with the general arrangements in England and Wales for grants for further education.

Perhaps my right hon. Friend will look at this matter again, for was it not a very strong recommendation of the Younghusband Report that grants should be paid? As apparently the practice is different in Scotland, is it not desirable to bring the two countries into line?

If so, that would go beyond the question of grants for social workers' training and would be a question for my right hon. Friend the Minister of Education.

Question No. 25—Mr. Robinson.

On a point of order. May I know what happened to Question No. 22?

It was answered, but the hon. Lady made no effort to rise.

On a point of order. When my noble Friend the Member for Hertford (Lord Balniel) rose to ask a supplementary question I sat down, but I did not hear you call Question No. 22, Sir.

The hon. Lady is under an illusion. Question No. 22 was answered with Question No. 4.

asked the Minister of Health if, in view of official figures showing a drop of more than 70 per cent. in the take-up of orange juice and cod liver oil at the new prices, he will reconsider his policy regarding subsidy on vitamin supplements and now introduce regulations to amend the Welfare Foods (Amendment) Orders, 1961.

asked the Minister of Health if he will investigate the causes of the 77 per cent. drop in the distribution of cod liver oil and the 71 per cent. drop in the distribution of orange juice in Newcastle-under-Lyme between the summer of 1960 and the summer of 1961; and if he will take steps to increase the distribution of these welfare foods.

asked the Minister of Health whether, in view of the marked reduction in the uptake of cod liver oil and orange juice since new charges were imposed, he will revert to the former charges.

asked the Minister of Health what steps he proposes to take to safeguard the health of young children in Stoke-on-Trent, in view of the decrease in the distribution of orange juice and cod liver oil.

No, Sir. Welfare foods remain a cheap source of vitamins along with the many other sources now available. They can be supplied free if necessary. Their availability has been further publicised.

But is the Minister really saying that he is not concerned at the size of this fall? Does he not really think now that there are mothers and children who are not getting the vitamin supplements they need? What did his hon. Friend mean in the debate on 19th April when she said that if there was a substantial fall the matter would have to be reconsidered by the Government? Why has that pledge not been implemented?

The problem is one of individual and particular families. That is not best dealt with by a general subsidy but by the work of the health visitors who can get at actual families where there is a deficiency of intake. Generally speaking, there is no reason to believe that there is a deficiency of intake of these vitamins.

Would the Minister be more candid? Is it his view that there was extravagance in the consumption of cod liver oil and orange juice in 1960, or that there has been a grave drop which is a serious loss to the health of the children in 1961—a drop of 70 per cent.? In these days of market research, what steps have the right hon. Gentleman's Department taken to discover the real reasons for such a startling fall in such a short period of time?

The reason for this Measure was given in debates earlier this year, and was that there was no longer any reason for an overall subsidy to every recipient of these foods. They are available free where there is need.

Mrs. Slater.

On a point of order. Would you be so kind, Mr. Speaker, to look at Question No. 4 and No. 22, which bear no relation to each other?

We really cannot probe the misfortunes of the hon. Lady in the middle of Question Time. From my recollection her Question was answered with the other Question, and I took great care to see if the hon. Lady desired to ask a supplementary question, but she had no physical appearance of doing so. Mrs. Slater.

On a point of order. Question No. 4 relates to Cardiff and Question No. 22 to the Newcastle Regional Hospital Board and its report. Might I ask the Minister to explain—

No, the hon. Lady may not do so. If she experiences difficulty about it, I will explain to her in private, but the Chair has no opportunity of dictating to the Minister what answer he should give or which Questions he should group together.

The right hon. Gentleman is a dictator and not a democratic Minister.

Order.

I do not like dictators. I like democratic Ministers— [Interruption.]—I am not feeling that way at all.

Order.

Why should Newcastle be done out of a reply? It is absolute nonsense.

I think that it was in 1693 that this House first resolved that hon. Members who were not speaking should keep quiet.

I was not born in 1693.

May I bring the House back to a serious matter? Does not the right hon. Gentleman realise that local authority social workers are deeply concerned about this 70 per cent. drop in the intake of welfare foods? These are the people who visit the homes and who know that the people who need them most are those who are failing to get them? Does the right hon. Gentleman not think that in 1961—nearly 1962—it is about time that his Government and his party stopped this cheeseparing in relation to the children of working-class people and realised that the health of the children matters most?

I am sure that in 1961 the vast majority of parents and families are able and willing to pay for this supplement for their families. The problem concerns a very small minority and a general subsidy is not justified.

asked the Minister of Health if he will give figures showing the distribution and purchase of welfare foods, cod liver oil and orange juice in the towns of Leek, Kidsgrove, Cheadle and Biddulph in the years 1958, 1959, 1960, and 1961.

asked the Minister of Health what quantities of cod liver oil and orange juice, respectively, were distributed in Leicester in the years 1958, 1959, 1960 and 1961 and what quantities were distributed in Leicestershire in the same years.

I will circulate the figures in the OFFICIAL REPORT.

Can the hon. Lady say whether or not the figures show that there has been a considerable reduction in the consumption of these foods, and does she herself not consider it scandalous that this measure was steamrollered through the House by a huge majority when at the same time massive rebates were being given to Surtax payers and investment allowances were being extended? Is not this disgusting and a reflection of the attitude of the Government towards people in the industrial areas?

The figures show a reduction. The other points that the hon. Gentleman makes were all made in the debate that we had on this subject last April.

Is the hon. Lady aware that I have been listening very carefully to the replies which have been given to various Questions asked on this subject and that I find it entirely impossible to understand those replies? Does she really think that if there is no hard

asked the Minister of Health, if he is aware that the management side of the Administrative and Clerical Whitley Council have proposed additional increments for entrants to the clerical grade who possess certain educational qualifications, but insist that on account of the pay pause the increments cannot apply to existing staff; and if he will approve the payment of such increments to all basic grade clerical staff who qualify, as required by the staff side.

These supplements, at cost price, are still a very cheap way of obtaining valuable vitamins.

I have not been asked to approve any proposals.

Is the right hon. Gentleman aware that these facts reveal a very ridiculous situation, that if the pay pause is insisted on in this way it is a standing invitation to existing clerical staff to resign their posts and then reapply for them so that they can get the additional increments which are proposed by the Whitley Council? Will not he do something about the pay pause in connection with the Health Service staffs, most of whom are underpaid in relation to comparable occupations elsewhere?

The Health Service, as well as other parts of the public service, must be governed by the policy of my right hon. and learned Friend the Chancellor of the Exchequer, but in this case, while I understand that the matter has been under discussion in the Whitley Council, no proposal has come to me.

asked the Minister of Health if he will state the cost to the National Health Service of the employment of radiographers supplied by a private company as against their direct employment by his Department.

I regret no useful estimate can be made.

Does not the hon. Lady think that this is a positively disgusting situation? We have just been told that we cannot afford to reduce the price of welfare foods, but here a private company has been set up to employ radiographers who are at present employed by the National Health Service, who leave the National Health Service and go to the private company and there get more salary than they had previously, at an added cost, one supposes, to the Ministry of Health? How ridiculous is this situation? Apparently, we cannot afford to give children the food supplements that they require but we can afford to "feed" private profits in this way.

There is a shortage of radiographers, but it is a diminishing problem. The number of radiographers who qualified in 1960 was 436 compared with 359 in 1959—[HON. MEMBERS: "Answer the question."]—and the number who commenced training in that year rose from 594 to 727. The larger numbers now being trained should mean that there will be more radiographers in the Service in the years ahead and that there will be no need to employ outside people.

That does not answer my supplementary question I did not ask how many people had been trained this year I asked a simple, logical question whether it was reasonable to allow a private company to supply radiographers to the National Health Service at a higher salary than the Ministry is prepared to pay them? That is my question, and it is to that that I want an answer.

It may be reasonable as a temporary measure when there is pressure or need.

Would not the hon. Lady agree that it is wrong that a hospital authority should be forced to go outside the National Health Service to a private company to get radiographers? Does not the hon. Lady appreciate that unless the Ministry does something about this, it will lead to a vicious circle because more and more radiographers will leave the hospital service and go to private firms which can pay them more?

It is essential to the Service that a radiographer should be available, and while there is a shortage, I see no reason why hospitals should not employ an outside service, provided that it is a temporary measure.

asked the Minister of Health in how many cases married couples were each provided with a powered tricycle by his Department in 1960 and to the latest convenient date in 1961; what is the cost of two such tricycles; and what would be the cost of a two-seater car as supplied to the war disabled.

Four in 1960 and two this year. In addition, twelve tricycles were supplied in 1960 and five this year to persons whose spouses already had tricycles.

As the numbers involved are very small indeed, and as the price of two tricycles, as my hon. Friend said in answer to a Question last week, is more than the price of one car, can she give me any possible reason, other than the principle of giving a preference to the disabled, why the Minister should not seek powers to allow married couples to have a car instead of tricycles, should they so desire?

I answered a Question on this subject last week, and I would emphasise the point that I made then, which is a serious one. It is better in many circumstances for two disabled people to have two vehicles, because they are then both independent.

I do not think my hon. Friend can have heard my supplementary question. I asked her whether my right hon. Friend should not take powers to let couples have a car instead of tricycles if they so desire—so that they may have a choice between the two?

No, Sir. My right hon. Friend is not prepared to make an exception.

Why not?

On a point of order, Mr. Speaker. Owing to the unsatisfactory nature of the reply, I beg to give notice that I shall seek an early opportunity to raise the matter on the Adjournment.