asked the Minister of Health what are the obstacles to the establishment of complete and effective regional cancer records bureaux; and which regions are still below the desirable level of registration.

This is one of many developments competing for available resources. All regions undertake registration, but the ultimate aim of completeness has nowhere been reached.

Why is it that the hon. Lady's colleagues are always saying that there are adequate funds available for cancer research when here are vital statistics which would go a long way towards making cancer research reliable? Why is not the strong effort which her own Chief Medical Officer recommended in his last annual report being followed?

This expenditure is a matter for the individual hospital boards. We consider it important that the National Cancer Registration Scheme should cover all cases of cancer treated in hospitals, and on 22nd November last my right hon. Friend asked all hospital authorities to make further efforts to achieve complete registration. We propose to review the situation in June.

asked the Minister of Health if he will state the decrease in the distribution of orange juice, cod liver oil and vitamin tablets in the quarter ended 31st December, 1961, compared with the corresponding quarter in the previous year; and if, in view of the Government promise in April, 1961, that they would reconsider the charges then imposed under certian circumstances, he will now so reconsider them.

Sixty-one per cent., 64 per cent. and 48 per cent. I would refer the hon. Member to my reply to him on 26th February.

Were we not told last April that no change was expected in the quantities taken up, but that if a change did occur, then the authorities would reconsider the matter? Is the Minister going to honour that promise, or is he going to dodge it as he did on 26th February when he told us that there was no evidence of any failure to obtain the necessary quantities of vitamin, which is quite a different point?

That is not dodging the undertaking at all. It is the outcome of the continuous review, which I am maintaining.

Would the right hon. Gentleman tell the House what the assurance of his hon. Friend meant? If this decision was taken, as it appears to have been, on the assumption that there would be no change, and if there has in fact been a drop of two-thirds, is the Minister telling us that he refuses to consider it or that he has reconsidered it and proposes to do nothing?

It is the latter, because the evidence that I have is that there is no reason for anxiety about vitamin intake in spite of the movement of the figures since that time.

Does the right hon. Gentleman not realise that changes in a downward direction concerning the health of children would be barely perceptable over a long period? Surely he should do something before he has evidence of deterioration in the health of our young children and mothers and not wait until it is apparent before doing something to reintroduce this free food?

No. What I realise to be the best way of ensuring vitamin intake is by selective methods, such as those applied by health visitors, and not by the indiscriminate subsidy which was abolished last year.

asked the Minister of Health what reduction there has been in the total issues of welfare foods in Newcastle-upon-Tyne in the last quarter of 1961, compared with the last quarter in 1960; to what he attributes this reduction; and what consultation he has had with the local authority on this matter.

With permission I will circulate the figures in the OFFICIAL REPORT. Sales fell after the price

asked the Minister of Health if he will give the total cost to public funds of advertising the nutritive value of welfare foods, since the price of these foods was increased.

I regret no estimate is possible.

Does the right hon. Gentleman realise that his answer will undoubtedly perturb many of us who are interested in this matter? Is he changes on 1st June, 1961. The council has brought the reduction to my right hon. Friend's notice.

On a point of order. I do not understand why three figures must be circulated in the OFFICIAL REPORT and could not be given in the Reply. Is the Parliamentary Secretary aware that the drop represents 27,000 items of welfare food over the same quarter in the previous year? Does her right hon. Friend really suggest that he is happy about this in one of the heavy industrial areas where a high proportion of the families are in the low income group? How much more evidence does the Minister want before he will honour his promise to review the position?

Rather than there being three figures, when the hon. Gentleman reads the answer he will see that there are twelve figures; in any case, it would appear from his supplementary question that he really knew the answer. The relevant indices prove that children are receiving adequate amounts of vitamins.

The point which the hon. Member for Newcastle-upon-Tyne, Central (Mr. Short) raised on a point of order does not give rise to a point of order.

There is no reason why the hon. Gentleman should be perturbed at the impossibility of making an estimate, because so much of the work of bringing these foods to the notice of the public is wrapped up with other work of local health authorities and cannot be disentangled and separately costed.

Why does the right hon. Gentleman persist in what he must now regard, in view of his answer to my hon. Friend the Member for Salford, East (Mr. Frank Allaun) earlier, as a waste of public money? If, as the right hon. Gentleman says, there is no evidence that women and babies are not getting these welfare foods, why spend public money on advertising them?

Because the availability of these foods from local health authority sources should be known to those for whom they are intended. Those who do not get them from the local health authorities can and do obtain the great bulk of such foods from other sources.

On a point of order, Mr. Speaker. I beg to give notice that, in view of the unsatisfactory nature of that reply, I shall seek to raise the matter on the Adjournment at the earliest possible moment.

asked the Minister of Health how many patients requiring long-stay treatment in an epileptic colony are unable to secure admission.

Waiting lists total about 50.

Are there not more patients needing treatment than are actually on the waiting lists? Does the Minister propose to increase the grant and make more facilities available so that more can get these facilities?

It may be that there are more patients than appear on the waiting lists, but it is not only epileptic colonies which provide accommodation and treatment for epileptics: on the one hand, there are local authority arrangements and, on the other, the various kinds of hospitals.

asked the Minister of Health, having regard to the shortage of orthoptists in the North-East, what future plans he has for the area to train more people for this kind of job.

My right hon. Friend proposes to inquire if training requirements ought to be modified so that more orthoptists can be trained.

Is the Parliamentary Secretary aware that this shortage is a very serious matter indeed? Does she realise that one of the main causes for the shortage is the shockingly bad pay, which also applies in other parts of the service? Will she have regard to this urgent matter and try to increase the scales?

The question of salaries is a matter for the Whitley Council. There has been an increase of 55 per cent. in the number of orthoptists in the Health Service since 1949. But we think that we might look again at the training to see whether it is possible to increase the number of students.

asked the Minister of Health what steps are being taken, in view of the present shortage of medical practitioners, to encourage married women doctors available for part-time work to enter the employment of the National Health Service.

I have recently brought this source of recruitment to the attention of hospital boards. Local health authorities are also aware of it.

Since the Minister made a serious error in endorsing the Willink Committee—which means that the shortage of doctors will be even more severe in seven or eight years than it is now—will he look at the matter again to see if it is possible to integrate some of these women into general practice as well as into the hospital service and elsewhere?

There is no reason why a married woman should not be taken on in certain areas as an assistant or partner in general practice, or, apart from the restricted areas, herself set up single-handed. I agree that married women doctors would be a welcome addition to our total doctor force.

asked the Minister of Health whether, under his regulations, it is obligatory on local health authorities to keep a record of mentally retarded people.

No, Sir.

If there is no proper record taken of mentally disabled people, how is it possible for local health authorities to find out what the requirements are in their areas?

Most local authorities do, in fact, keep such a record, but there would be no point in making it obligatory since total ascertainment is a variable concept. But I have no doubt that local health authorities keep the records which they require to carry out their statutory duties.

asked the Minister of Health how many local authority health services are still without provision of centres or other facilities for training or occupation and the equipment and maintenance of such centres, as provided for in Part II, Section 6 (2) (b) of the Mental Health Act, 1959; and if he will make a statement.

None, Sir.

Is it not a national scandal that, in this modern age, children are being born into this world who are mentally retarded and must enter manhood without having had a day's proper training? Is the Minister aware that "training" is the operative word? We have people with the ability to make these youngsters and young men fit to take a proper place in life among the fraternity in general. Will he not do something for them? After all, they are the children of ratepayers and taxpayers, but are, in many instances, receiving no training at all.

As my reply indicated, something is everywhere being done, and in Command Paper 1604 an indication was given of the scope for expansion. I hope that the plans which local health authorities will be putting to me in the coming months will show the way in which they intend to develop this service in the coming years. I share with the hon. Gentleman his view concerning the great importance of this service.

asked the Minister of Health what measures he proposes to introduce to deal with the recent increase in venereal diseases, as shown in the Annual Report of the Chief Medical Officer.

The inquiries now proceeding have not yet indicated any new measures which can usefully be taken.

Is the Minister aware that the increase for 1960 was about 10 per cent. and, particularly for the 19-year-old age group, it is very alarming? Does he realise that it seems almost certain that similar figures will obtain for 1961, and will he consult the Minister of Education with an idea of making some kind of joint endeavour, because this requires to be dealt with both medicinally and educationally? Will his Department again look at this suggestion very seriously? A contribution might at least be made by the compulsory notification of venereal disease?

The question of compulsory notification is a separate one, but I entirely agree that this is very largely an educational question. That is why, both on the education and health sides, an effort is being made; but no new proposals have come out of the current investigations which are proceeding.

Can the Minister say to what extent this increase is due to the development of strains of microorganisms which are resistant to the present antibiotics? What progress has been made for developing new types of antibiotics which will themselves conquer these new strains of micro-organisms?

It was pointed out by my Chief Medical Officer in his last report that there are a large number of contributory factors. There is no major outstanding factor responsible for this phenomenon. I would rather not give an answer off the cuff on the medical point.

asked the Minister of Health by what percentage the number of prescriptions dispensed under the National Health Service in the County Borough of Walsall in the period March-August, 1961, inclusive, differed from the number prescribed in the like period of 1960.

A decrease of 11·7 per cent.

To what factors other than the increase in the Health Service charges does the Minister attribute the drop, and is this fall not greatly in excess of his assessment of a 2 per cent. decrease?

Yes, but it has largely been counterbalanced by the increase in the quantities prescribed, from which it is evident that those in chronic need of medicines are getting them without appreciable additional charges.

Will the right hon. Gentleman indicate more precisely what he means by "largely" in this context?

Yes, if the hon. Gentleman asks me a corresponding question on quantities and costs, I will give him the figures.

asked the Minister of Health what action he is taking to ensure that all new drugs are submitted to immediate, independent and reliable scrutiny before use in the National Health Service.

I have no powers to do this.

Is the Minister aware that there is considerable medical and public concern about the number of drugs which recently have been shown to have very dangerous side effects, particularly the 40 abnormal births which are now believed to have been due to the taking of one particular sedative by expectant mothers? I know that this is a recurring problem, but when it comes to a child being born without limbs because the mother took a sedative during pregnancy, should the Minister not consult the Home Secretary to see if some machinery can be set up to screen drugs before they are made available for public use.

Where side effects are concerned, and that is what the hon. Lady has in mind, the mere scrutiny of a drug would not be enough. What is necessary are clinical tests, and the terms of reference of the Cohen Committee were recently revised to enable it to recommend that there should be clinical tests in cases where it thinks advisable.

Can my right hon. Friend say whether, following the Report of the Cohen Committee and its recommendations, there has been a reduction in the amount of drugs being prescribed outside the British Pharmacopoeia list?

I should be obliged if my noble Friend would put that question down.

asked the Minister of Health what has been the total amount of drugs purchased from foreign sources since he became Minister of Health; what was their total cost; whether similar drugs are available which are manufactured in this country; and what is the actual difference in cost between the home-produced articles and those imported.

I regret that the information is not available.

In the absence of information but from his general knowledge of the subject, will not the Minister agree that a large volume of drugs is imported into this country and this is having a detrimental effect on the manufacturing industry here? If the reason for importing drugs from abroad is that they are cheaper, will he take into account the effect on the drug manufacturing industry in this country and the possibility of unemployment?

I should be loth to agree to any proposition in the absence of information. The major fact is that this country is a very big net exporter of drugs.

Is it not possible for the right hon. Gentleman to obtain information about the importation of drugs? Will he consult his right hon. Friend the President of the Board of Trade who, presumably, has statistics about imports? This information ought to be available.

The right hon. Gentleman's question might have referred to the National Health Service, and, as it was addressed to me, that was how I took it. If he wants the total figures, perhaps he will put a question down to my right hon. Friend.

Is it not a fact that the freer importation of drugs from abroad has helped to keep down the cost of our domestic products, some of which were sold at exorbitant prices in the past?

I cannot believe that it would be practicable for this country, a major exporter of drugs, to prohibit imports.

asked the Minister of Health whether he will now review the prescription charges.

I have nothing to add to my reply to the hon. Member for Wood Green (Mrs. Butler) and for Leicester, North-West (Sir B. Janner) on 11th December.

Is the Minister aware that his predecessor told me two years ago that the Government would review the prescription charges at the end of the two-year period of voluntary limitation recommended by Sir Henry Hinchliffe's Committee? Has that review taken place, and can we have a statement of the result?

The review of the trend of prescriptions and prescribing costs would not be the basis for a change of the present policy. The whole question of prescription charges is continuously being examined. I must tell the House that there is still no reason to think that the yield of these charges cannot be far better spent elsewhere in the National Health Service than by reducing them.

Has not the right hon. Gentleman yet realised that the most obnoxious feature of the prescription charges is that they put a special penal tax on special diseases? Could not he go at least a step towards meeting the Opposition by allowing people such as diabetics to have all their medicaments on one prescription?

This has frequently been considered, but the difficulty of distinguishing one category of disease from another is almost insurmountable. The best way to deal with the matter is by the assistance which can be given in prescribing for a substantial period where the medicines are regularly required. If the hon. Gentleman has a particular case in mind, I will gladly look at it and see whether I can help.

With regard to the increase put on prescription charges last February, did not the Minister tell the House that he would look at the matter after he had had twelve months' experience? Has not that period of twelve months now expired and has there not been a considerably larger fall in the number of prescriptions than he expected, and is it not a fact that this fall is not nearly balanced by the increase in the average cost of prescriptions, indicating that quantities prescribed have not increased commensurately with the drop in number?

The fall in numbers is due not only to the increase in prescribing for a longer period but also to the elimination of prescriptions which can be obtained for under 2s. There can be no exactitude in this matter, but the evidence is that the increase in quantities prescribed does substantially counterbalance the fall in the numbers.

asked the Minister of Health whether he is aware that the most recent statistics issued by the medical officer of health in Manchester show an increase in the infant mortality figures which are 50 per cent. above the national average; to what factor he attributes this increase; and what action he is taking to help to reverse the trend.

Yes, Sir, approximately. The specific causes of the recent increase have still to be shown.

Is the hon. Lady aware that the medical officer of health of Manchester and all the best informed people know more about the matter than she does, because they attribute the increase, first, to lamentably bad housing in the city of Manchester and, second, to the shortage of maternity beds? Does not she think that it is an indictment of the Government of which she is a member that, in 1962, more infants are being put in the grave and more stockbrokers and take-over bidders are growing fatter?

I do not think that the hon. Gentleman betrays a true concern for the Service in making comments of that kind. There was a sharp drop in the infant mortality figures for Manchester in 1957. I admit that the Manchester figures are higher than the national average, but, if there was a sharp drop in 1957, I cannot believe that the reasons for the increase which the hon. Gentleman adduces are the right ones. We are looking into the matter with the Medical Officer of Health for Manchester, who has prime responsibility, because we want to know the reasons. It is too early yet to talk of specific action.

asked the Minister of Health if he will make a statement on the progress of the malaria eradication campaign which is being conducted by the World Health Organisation; and what has been the effect of transferring the costs of the campaign to the regular budget of the Organisation; and whether this transfer has caused the United Kingdom Government to make a higher contribution to the budget.

The Organisation's budget for 1963, of which Her Majesty's Government will bear their due share, has been increased by the inclusion of $4 million towards the field costs of the campaign, which is expected to achieve considerable progress this year.

Will the right hon. Gentleman confirm that, between now and 1964—the transitional period—at least part of the cost of the campaign will be borne by the special fund to which the British Government refuse to contribute? Can he assure us that none of this vital work will be held up during the interim period because of lack of funds?

Yes, Sir. The hon. Gentleman is aware of the decision of the World Health Organisation to transfer this work to the General Budget. Her Majesty's Government have always thought that that was the right decision, and the result will be that we shall bear, with other nations, our fair and full share of the cost of this work.

Can the right hon. Gentleman precisely answer my question? I asked for an assurance that, between now and 1964—when the regular budget takes over the whole cost—the field work will not be held up through lack of funds.

It need not necessarily be held up. It is the policy of the W.H.O. that this work should be transferred to the general budget. The result of that will be that we shall be contributing to it as and when it is so transferred.

asked the Minister of Health what consideration has been given to the effects on the National Health Service if Great Britain joins the Common Market.

Nothing in the Treaty of Rome would involve alteration of our National Health Service.

Is the right hon. Gentleman aware that in the six Common Market countries the health system operates on an insurance basis and in many cases on part-payment at the time of service, and that that is a different system from our own National Health Service? Is he further aware that there is a school of thought in this country which is anxious to convert the National Health Service to an insurance basis? Will he make representations to the Lord Privy Seal to ensure that the National Health Service is retained on its present principles if we join the Common Market?

All that is concerned in this Question is that our joining the Common Market would not involve any decision one way or another by this country on the future of the National Health Service.

Has my right hon. Friend been in consultation with the British Medical Association and the British Dental Association about their anxieties that signing the Rome Treaty would have an effect on professional standards in this country and might also affect National Health Service standards?

I have had consultations with those two bodies and will have them in future, but there are specific safeguards about these matters in the Rome Treaty.

asked the Minister of Health when the new Senior Dental Officer of his Department was appointed; who he is, what his qualifications are; and how many applications he received after the vacancy was advertised.

The last appointment, of Mr. R. A. Campbell, was in October, 1959, by promotion within the Department.

I am referring to the question of the Senior Dental Officer of the right hon. Gentleman's Ministry, Admiral Holgate, and I want to know why he was appointed and why the job was not advertised before he was appointed.

The hon. Gentleman appears to be giving information and not asking for it. His information is inaccurate. He has confused the Senior Dental Officer with the Chief Dental Officer. I have written to him giving him all the particulars about the Chief Dental Officer.