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Volume 655: debated on Monday 12 March 1962

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Cancer (Treatment)


asked the Minister of Health when he expects every regional hospital board to have installed a linear accelerator for the treatment of cancer.

Does this not mean that there has been very dilatory progress in providing this megavoltage apparatus? Does it not mean that many hundreds and possibly thousands of cancer patients recommended for treatment which requires this apparatus are not able to get it now and will not be able to get it for some years?

No, Sir, because megavoltage treatment is also given by the cobalt machine and at least one of these is available in every region which has not got a linear accelerator.


asked the Minister of Health how many hospital units and similar institutions are available under the National Health Service for the specialised treatment of inoperable cancer; and what is the average size of these specialist institutions.

In England and Wales there are 64 hospitals where radiotherapy for cancer can be given. Chemotherapy is available in any larger general hospital.

Will my hon. Friend agree that in specialist institutes which are specialising solely in inoperable cancer there is a great opportunity for practical research by doctors into methods of treatment, and does she agree that we are lagging behind some other countries, notably America and West Germany, in the provision of these facilities, and will she and her right hon. Friend take steps to increase the number of complete specialist units rather than just departments of hospitals?

Medical opinion in this country does not favour concentrating such patients as my hon. Friend has in mind in specialised units. As I have explained, there are facilities within the hospital service for the treatment of these cases.



asked the Minister of Health what representations have been made to the Whitley Council as to the question of the recommendation of increased salaries for nurses and when they were made.


asked the Minister of Health what advice he gave to the management side of the Nurses' and Midwives' Whitley Council prior to 13th February regarding the nurses' pay claim; and why the Whitley Council was not permitted to consider this claim on its merits.

Early in February I asked the Management side to have regard to the terms of Command Paper 1626. I do not accept that this precludes consideration of the claim on merits.

Is the right hon. Gentleman aware that the Parliamentary Secretary told me on 11th December that a claim for increased nurses' remuneration was under consideration at that time by the appropriate Whitley Council; that since then I have been in undated with letters suggesting that pressure had been put on the Whitley Council not to agree to an increase, that the Government's intention had clearly been made known and that a decision had virtually been arrived at before 11th December?

No, Sir. The guidance which I have mentioned was given by me to the Council at the beginning of February when I drew its attention to the Command Paper.

Is the Minister aware that the representatives of the staff side say that this offer of 2½ per cent. was made after taking the Minister's advice? How can he possibly reconcile this with the terms of the circular that he sent to Whitley Council chairmen last August saying that claims should be negotiated on their merits and that there was a reservation solely on the question of the time of the implementation of an award? Why does the right hon. Gentleman single out the nurses for this treatment in view of the disastrous nursing situation in the National Health Service today?

Nurses are not singled out for treatment. The nursing situation is not disastrous in view of the fact that the nursing force today is at its highest point ever. I do not for a moment accept that one can have regard to the merits of a claim in complete isolation from the economic situation, and I am glad that the Whitley Council took account of the terms of the Government's White Paper.


asked the Minister of Health if he has yet received from the appropriate Whitley Council their decision on the claim that was pending, as at 11th December, for an increase in the rates of wages of nurses; and if he will make a statement.

That may be, but is it not ingenuous of the Minister and his Parliamentary Secretary to try to convey to the House that the Whitley Council is considering the whole position of this very under-paid, over-worked and valuable section of the community—at a time when, presumably, nursing sisters in the Army will be having rises—and that it is entirely a matter for the Whitley Council, although he writes to the Council and says that he hopes that the Chancellor's views will be borne in mind in respect of nurses if not in respect of many other classes of the community?

No, Sir; on the contrary, it would be disingenuous to suggest to anyone that wage claims can be considered without regard to the economic circumstances.

Is my right hon. Friend aware that there will be a big nurses' meeting tonight called by the Royal College of Nursing, and is he aware of the reaction among nurses to the offer of 2½ per cent. overall without consideration being given, apparently, to the whole structure of salaries in the nursing profession? Are we to understand that the pay pause—which I have always supported as a basis for Government policy—affects not only just the amount of an increase which should or should not be given but precludes consideration of salary structure? Is my right hon. Friend aware that nurses are thoroughly dissatisfied with their salary structure as a whole? When will something be done about their salary structure so that when the new hospital programme comes into operation there will be the people to staff the hospitals?

As I have explained before, the new hospital programme should in itself assist rather than otherwise the nursing position. There is no reason at all why the salary structure should not be taken into account within the terms of the Government's White Paper.

Is the Minister aware that, quite apart from the meeting this evening at the Royal College of Nursing which is to be chaired by his hon. Friend the Member for Tynemouth (Dame Irene Ward), the nurses' trade union is under great pressure from its members and branches to take action following the Minister's decision, and will he bear in mind when the claim comes forward again to the Whitley Council, as it undoubtedly will, that his past decision has caused considerable disturbance within the profession?

Yes, but what has to be borne in mind by everyone is the overriding necessity and common sense of the Government's policy as set out in the White Paper.

Does not the Minister realise that his attitude has caused the gravest concern among nursing staffs? Are we to take it that when the management side meets tomorrow it will be faced with exactly the same position as on the previous occasion?

As I have told the House, I have given my advice to the management side, who took it into account.


asked the Minister of Health the present ancillary basic rate of pay for a male ward orderly in a London hospital; what additional payments are made above the basic rate; and what is the pay of a third year student nurse and of a staff nurse in charge of a award after seven years' experience.

The rate is £10 0s. 8d. a week; additions for overtime, shift, weekend and night duty; £346 or £356 a year, if non-resident. Staff nurses are normally in charge of wards only in the absence of the ward sister.

Does not that Answer show clearly that ancillary workers who were brought in as dilutees are getting inevitably higher remuneration than the skilled workers in the service? In view of this, will not the hon. Lady and her right hon. Friend take heed of those of us who urge that there should be a review of the scales for all nurses in the profession?

The hon. Member makes the common mistake of people who compare salaries of ancillary workers with those of trained workers. The ancillary worker has a different scale. Men and women, for instance, do not have equal pay. The hon. Member put down his Question in relation to male ward order lies, but female ward orderlies get less than males. In any event, by comparison with the nurse or the nurse in training, the nurse is on a progressive incremental scale. She also enjoys better holidays and better sick pay conditions. That is the real comparison which should be made.

Is the hon. Lady aware that, however she juggles the figures, they point clearly to one thing: that there can be no justification whatever for an offer as low as a 2½ per cent. increase in the salaries of nurses at the present time?


asked the Minister of Health what consideration he has given to the need for a reserve of nurses to be available to the Health Service; and if he will take steps to provide for this.

Hospital authorities are asked to keep lists of nurses willing to return at times of difficulty. Members of the National Hospital Service Reserve often give help in emergency.

Would the Minister not agree that it would be a good thing if centres were set up within certain areas or regions where the reserve could be kept and that in times of emergency or when nursing staff were needed they could be drawn from this reserve?

It seems to me that the present arrangements have the effect which the hon. Member has in mind.


asked the Minister of Health the cost now being incurred in advertising vacancies in the nursing services; and what was the total cost during 1961.

While the hon. Lady regrets that the information is not available, would she not agree that the amount of money that is spent on advertisements for nursing personnel for our hospitals must be tremendous? Would it not meet the position if the salaries of the nursing profession were made more attractive, so that there would be no need for so much advertising?

Hospitals are not required to show the figure separately; that is why I am not able to give it. In reply to the main point of the hon. Member's supplementary question, in a country where there is full employment and where there is great competition for girls and young men with the right educational qualifications, it is necessary to advertise so that the opportunities may be made known to them.


asked the Minister of Health whether he is aware that the excess of student nurses over qualified nurses has been reduced from a figure of 5,000 on the appointed day in 1948 to approximately nil at the present time; and if he will institute an inquiry into the recruitment position of the nursing profession.


asked the Minister of Health if, in view of the present number of 25,000 vacancies for nurses in the hospital service, he will institute an inquiry into recruitment problems.

Trained nurses are now a larger proportion of a bigger total. I do not think an inquiry is called for.

Does the right hon. Gentleman think, as he said previously, that the production of his hospital plan is sufficient to attract sufficient student nurses to the profession, or does he not rather agree that the present salaries are so low that girls—and men even, but girls in particular—are certainly not going to be attracted to the nursing profession, and that the old idea of Florence Nightingale and the angels and all that sort of thing is no longer operative?

—and the number in post in the Service whole-time and part-time is higher than ever it has been. The number of student nurses is not quite at its peak. The peak so far was in March, 1960, but the latest figures I have suggest that the numbers are rising again.

When the Minister says that trained nurses constitute a higher proportion, surely he does not mean a higher proportion of the nursing staff including unskilled nursing assistants? Because, if so, I would submit to him that the proportion has dropped steadily since the appointed day.

The hon. Lady's Question referred to the ratio of student nurses to qualified nurses. I am glad to say—and it is a natural concomitant of an expanding total of the nursing force-that that proportion has fallen.

I did not mean to imply that nurses were not angels. I think they are. They are marvellous people to come into such a difficult profession. However, the fact does remain, does not the right hon. Gentleman think, that something more will have to be done to attract young girls, who have many more jobs available to them today besides nursing? So that the only way to get them is to give them a higher salary for the training which they have to undertake and for the very difficult job with very difficult, long hours which they have to undertake. Will he not again look at this question of salaries for the nursing profession?

There is nothing in the trend of recruitment to indicate that salary scales are a deterrent to the recruitment and staffing up of the service. There are a good many aspects to the recruitment of nurses and a great many things quite apart from salaries in which the profession can and ought to be made more attractive.

Is the right hon. Gentleman aware that angels in the Kingdom of Heaven neither buy, sell, eat nor drink—

—and while he may say they are angels, may we give up this angelic humbug and pay them the salaries they deserve?

I do not recollect the text from which the hon. Member was quoting, but I must point out again that the general conditions of the nursing profession are such as are consistent with a steady increase in staffing.

Overseas Doctors


asked the Minister of Health how many doctors from overseas are employed in the British hospital service.

On 30th September, 1961, there were in England and Wales 3,503 junior hospital medical and dental staff, including part-time staff, who were born overseas. There is no information for the senior staff.

Has the Minister any idea what the likelihood is of these doctors staying in England? Has he any experience to go on to show what that number really represents as an addition to our total medical staffs?

The figures I have given represent something under 40 per cent. of the junior hospital medical staff. I have no reason to think that the desire of doctors from overseas to serve and gain experience in these appointments will fall off at any rate at all rapidly.



asked the Minister of Health how many new hospitals will have been built, and how many hospitals will have been rebuilt or remodelled, by 1975 in the Nottingham area, under his hospital plan for England and Wales.

I am not surprised that the hon. Lady is ashamed to give the answer in public. Is she aware that the answer to the first part of the Question is "None" and that the answer to the second part of the Question is "None"? Because the Minister has chosen to list in his Blue Book a whole series of desirable and necessary projects for building and rebuilding hospitals which are not to be included in his plan, many people, including members of hospital management committees, have been misled. Will the hon. Lady ensure that the true facts are made public so that the nature of the callous and cruel fraud on the people of south Nottinghamshire, many thousands of whom are waiting to get into hospital beds, is made known and understood?

That is a nonsensical statement. My right hon. Friend and I are very proud of the Hospital Plan. Far from deserving the terms which the hon. Gentleman has used, it is a progressive and stimulating document. I do not propose to take up the time of the House in saying what is being done in Nottingham, because all that is contained in the document.



asked the Minister of Health what steps are being taken to overcome the present shortage of physiotherapists in the Nottingham hospitals.

The regional hospital board intends to open a school of physiotherapy in Nottingham.

Is there not something very wrong when in Nottingham we have posts which have been vacant for up to three years and when wounded ex-Service men, who are supposed to have priority treatment, are unable to get it? Would not the hon. Lady agree that, however successful the hospital building programme and the new projects may be, they will be of no avail unless we build up the essential human fabric of the hospital service, and that this means a drastic overhaul of the system of the remuneration of people in professions supplementary to medicine?

The shortage of physiotherapists is not confined to Nottingham, but it does affect that region. It is the case that the numbers in post have fallen in the last few years in that region in spite of the general increase of physiotherapists throughout the country. We are looking into the matter, and we believe that a training school is part of the answer. I have already dealt extensively with the question of salaries.

May I ask my hon. Friend, when she is opening this new school in the Nottingham area, how she will provide teachers for the school? If she is opening a new school in Nottingham, why is it that the school in the northern region of the Newcastle Regional Hospital Board is to be closed down because we have not the teachers?

A shortened course for teachers was started last autumn in conjunction with the Chartered Society for Physiotherapists. It should produce more teachers quite quickly. We hope that this will help in due course with the project in the Nottingham region, and I hope that it may help in the region in which my hon. Friend is interested.

Oldham Boundary Park Hospital (Mrs Watson)

22 and 23.

asked the Minister of Health (1) if he will institute an independent inquiry into the circumstances in which. Mrs. Watson, an inpatient of Oldham Boundary Park Hospital, was missing from the hospital from Wednesday, 20th December to Wednesday, 28th December last, when she was found by the police in a seriously distressed and frost-bitten condition; and if he will make a statement;

(2) why Mr. Watson was not kept informed of the circumstances of Mr. Watson's absence as an in-patient from Oldham Boundary Park Hospital from 20th December to 28th December last; if he is satisfied with the internal security arrangements at the hospital; and whether there is effective and expeditious machinery, where it is necessary, to seek the help of the police and other outside agencies.

Is the Minister aware that this unfortunate lady has now lost both feet by amputation, that until Friday afternoon last her husband had not been informed of any of these circumstances, and that there is physical evidence, as recorded by the doctors, of this lady being molested during the time that she was missing from the hospital? Does the Minister think that public anxiety arising in this case will be satisfied with an internal hospital management board inquiry? Does he not think that at least an inspector from his Department might be added to the inquiry so that the public anxiety will be allayed?

The inquiry is not by the hospital management committee; it is by the board, which would be the normal form of inquiry in these circumstances, and obviously I must not comment, in view of this, on what the hon. Gentleman has said.

Laboratory Technicians And Medical Photographers


asked the Minister of Health what will be the remuneration of a medical laboratory technician and a medical photographer after 1st April as compared with the matron of the same hospital.

Is it not a fact that in many hospitals the remuneration of a laboratory technician, and certainly of a medical photographer, would be higher than that which is received by the matron?

There are so many variables that it is extremely difficult to make a comparison. The matron's salary depends on the number of beds in the hospital. The salary of the senior grade of medical photographer depends on the size of the department. The hon. Member asks me whether it would happen in the same hospital. The answer is, "No".

Does not the whole situation as revealed by Questions this afternoon show how very haphazard the whole of these scales are? Does not this prove beyond doubt that there is need for an inquiry into the whole basis of the scales in the whole of the medical services?

No, Sir. This is properly a matter for the machinery which has been set up to deal with it—the Whitley Council.

North East Metropolitan Hospital Board


asked the Minister of Health what progress has been made in providing adequate convalescent accommodation for patients in the North East Metropolitan Hospital Board area during the last five years; how many patients have been refused immediate convalescent treatment because of lack of accommodation; what further steps are being taken to provide adequate accommodation; and to what extent the difficulty is that of securing staff.

I am not aware of difficulties in finding staffed beds for patients from this area who need convalescent treatment.

Would the hon. Lady make further inquiry into this matter, for the information which I have received is that there is a certain amount of delay in certain cases in giving adequate convalescent treatment to patients who have been recommended for it? In these circumstances, would she not make further inquiry?

If the hon. Gentleman has a particular problem in mind, I shall be very glad to look into it, but in fact a standing joint advisory committee on convalescence was set up by the four Metropolitan hospital boards some time ago to look into this question of convalescent facilities. The committee is examining the position at present. It is looking for the potential demand in two hospitals and is prepared to extend that to other hospitals. In general, the demand is falling.


asked the Minister of Health what relation the proposed internal administrative reorganisation of the North East Metropolitan Hospital Board has to the proposed Greater London local government reorganisation; and when the regional board's re organisation is to be initiated and completed.

None, Sir. I am considering proposals for regrouping which the board has just submitted.

Do I understand from the Minister that it is purely a coincidence that this regrouping and reorganisation is taking place at the same time as consideration of the local government reorganisation now taking place?