asked the Minister of Health if he will conduct an inquiry into the psychological effects upon adolescent mental patients of placing them in adult wards and into the moral and physical dangers to which they are exposed.

No, Sir. Hospital authorities have already been advised that separate units are preferable for most adolescents.

Is my right hon. Friend aware of the disquieting rumours that are circulating concerning assaults on young persons in adult wards? Does not he agree that it should be the policy of his Department to secure separate self-contained adolescent units in all hospitals in the future?

That is the Department's policy. I have not had brought to my attention any individual cases of exposure to moral or physical danger. If my hon. Friend has any evidence I hope that he will pass it on either to the hospital board concerned or to me.

asked the Minister of Health how much has been spent on new adolescent in-patient psychiatric units during each of the last ten years; and how much it is proposed to spend during each of the next ten years.

Before April 1961, about £1,000; in the four following years, £29,000, £26,000, £10,000 and £5,000 respectively. These are figures for capital expenditure. Future provision is subject to the current review of the hospital building programme.

Is my right hon. Friend aware that in spite of that rather limited expenditure there is a scandalous situation, in that there is not a single inpatient psychiatric adolescent unit in the whole area of the Manchester Regional Board? Is he further aware that plans were put forward six years ago with regard to Springfield Hospital, and that plans with regard to Prestwich Hospital seem to have been stopped? Will he treat this as a matter of urgent priority?

I am aware that of the ten units specifically for adolescents there is not one in the Manchester region. I am sure that all the points mentioned by my hon. Friend will be taken into account in the current review of the hospital building programme.

asked the Minister of Health if he is aware that certain hospitals require student nurses to do three consecutive months on night duty on the wards and that such students do 10 to 11 hours duty for eight consecutive nights before getting any time off; and what steps he will take to end this state of affairs.

A maximum of three months' night duty in the year is acceptable to the General Nursing Council, and to the Nurses' and Midwives' Whitley Council. Our evidence suggests that most student nurses prefer duty on a number of consecutive nights.

Can my hon. Friend give me any evidence for that statement? Is he aware that the existence of these conditions is quite scandalous? Can he tell me of a single industrial worker in the whole of the United Kingdom who works for eight or in some cases ten hours on consecutive nights, with no overtime rates and at less than 2s. 6d. an hour?

The Whitley Council agreement provides that for student nurses the maximum period on night duty should not normally exceed three months in any twelve. I am not prepared to make comparisons with other types of worker. I know that the General Nursing Council is watching this position closely. In respect of nurses who work for eight consecutive nights, my hon. Friend should be fair and point out that they get six nights off immediately afterwards.

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

asked the Minister of Health whether he will reconsider the formula for the provision of geriatric beds in general hopsitals so as to reflect the population structure of the locality, rather than continue to use a regional or national formula which does not reflect local need.

The ratio of geriatric beds to population recommended to hospital authorities is 10 for every 1,000 persons aged 65 and over, which provides for the differing needs of particular localities.

Is the right hon. Gentleman aware that this does not entirely meet differing needs for differing localities and that in some cases the oddest anomalies occur?

This is only guidance. Hospital authorities are aware that local factors—for example, the local population structure and the stage of development of complementary services—have to be taken into account in assessing the needs of each locality.

asked the Minister of Health what plans he has for providing additional hospital facilities in the West Suffolk towns of Bury St. Edmunds and Haverhill in order to meet the needs of their town expansion programmes.

The needs of Bury St. Edmunds and Haverhill and their districts will be taken into account in the current review of the Hospital Plan.

Will the hon. Gentleman take it from me that the casualty department of the West Suffolk Hospital is grossly overworked and badly needs expansion, and also that, in Haverhill, there are many hundreds of young families who are deeply disturbed about the lack of maternity facilities and about accidents arising from industrial work?

In the first place, there is appreciation by the East Anglian Regional Hospital Board of some deficiencies in the West Suffolk General Hospital. Improvements are being considered: I can go no further than that. In Haverhill, it is doubtful whether the population increase will for many years justify a viable maternity unit in that area.

asked the Minister of Health whether he will give an assurance that the plans for rebuilding St. Thomas's Hospital, London, will proceed as planned and without delay.

asked the Minister of Health why work on the building of St. Thomas's Hospital has ceased; what cost has been incurred to date; and what have been the total architects' fees on the current and earlier schemes.

Stage 1 of the rebuilding of St. Thomas's Hospital (costing over £2 million) is continuing and is expected to be completed next year. I am discussing the next stage with the Board of Governors and have not yet made a decision. Architects' fees have not yet been determined.

Is the Minister aware that there will be considerable disappointment that he is even considering the possibility of not going ahead with Stage II? Is he aware that this hospital is not only of importance to London but also of national and international importance, both in its site and in its work? May we have an assurance from him that this work will proceed, since it is the biggest rebuilding of a major London hospital since the war and we ought to complete it?

I am aware of many of the facts which the hon. Member has given to the House. It is true that Stage II is a very large scheme indeed which will cost a very considerable sum of money, and that makes it right that it should be balanced against other priorities in the hospital building programme. The assurance which I can give to the House is that this matter will be considered as one of urgency and that a decision will be reached as soon as possible.

Is my right hon. Friend aware that regional hospitals feel that perhaps the teaching hospitals have had more than their fair share in the hospital programme? Will he bear that in mind when reviewing this expensive second scheme?

I know that that view is taken by some regional hospital boards and certainly I will take it into consideration, together with all other factors.

I am glad to hear that the Minister is still considering this matter because to a casual observer it looks as though work has stopped. Will he bear in mind the First Secretary's assurance that the moratorium on capital expenditure in the public sector did not apply to hospitals? As this scheme had been agreed, would not the Minister agree, in view of the large amount of expenditure which has already occurred, particularly on architects' fees, that it would be more economical to carry on than to stop?

The House is certainly aware that hospital building projects were exempt from the capital expenditure moratorium. But I would differ from the hon. Member in his statement that this was a scheme which had been agreed. This is not so.

asked the Minister of Health how many teaching hospitals and regional hospital boards have sent replies to questionnaires by the Law Commission on Waste as between Landlord and Tenant and on Distress for Rent, which he forwarded to them on 30th September, 1965.

In all, 29 boards of governors of teaching hospitals and 13 regional hospital boards.

Why did the Minister send this lengthy, detailed and highly technical document which is concerned with nothing but points of Chancery law to the hospitals, which have plenty to do doing their own job? Will the hon. Gentleman let the Law Commission know that this kind of activity will bring it the reputation for nothing except bumbledom?

The answer is simply that the hospitals are managers of a considerable amount of property, both for hospital and endowment fund purposes. It was felt that the hospitals were in a position to provide useful information to the Law Commissioners, and I do not think that there was anything wrong in what was done.

asked the Minister of Health what plans exist to overcome the shortage of hospital beds and staff in the Newcastle Regional Hospital Board area.

Plans for the development of hospital services in the Newcastle Region, which include proposals for overcoming bed shortages, are now under consideration as part of the review of the hospital programme. To meet shortages of staff, the board uses the normal methods of recruitment and, in addition, has established many local training schemes.

While thanking the Parliamentary Secretary for that reply, may I ask him to bear in mind that the grossly excessive hours being worked by much of the staff in this area is, I suggest, virtually as dangerous as it is scandalous? While appreciating that he inherited this shortage of beds and staff from his predecessor, will he do his best to see that some priority is given to this area in future?

The question of recruitment and the allocation of beds is largely the business of the regional hospital board. We appreciate that in many hospitals the staff is having to work under extremely difficult conditions. Being mindful of this, we are giving the whole matter our active consideration.

asked the Minister of Heath when the second and later stages of construction of the new South Shields General Hospital are to be started.

This is one of the matters to be considered in the course of the current review of the hospital building programme.

Is my right hon. Friend aware that there has been very considerable anxiety in South Shields and district because of some reported statements about possible starting dates? Will he keep in mind, as regional boards do, the rapid heavy industrial development which is taking place in the area and which involves a large increase in the number of men at risk?

I will certainly take that consideration into account, as I am sure the regional board will have done.

asked the Minister of Health if he will now make a statement on his review of the hospital building programme.

Many hospital boards have already submitted to me their provisional proposals, and I expect the remainder shortly. It is necessary to study these in detail with the boards, but I hope to publish the results of the review in the first half of next year.

Is the Minister aware that, meanwhile, the country has no facts on which to judge whether the confident promises made in October, 1964, are being broken or are being carried out, and that we are anxious to reach a judgment as soon as possible? In the meantime, news of disappointment and postponement is coming in. Can we be assured that by the time of the next election we shall be able to judge whether the Labour Party has kept its promises?

Long before then. The right hon. Gentleman can rest assured that the promises made in October are not being broken, but it was important to give the boards time to produce their plans and consult other authorities. My Department also must have adequate time to study the programme. We are seized of the urgent need to review the plan and publish our findings, but we are not prepared to produce a hurried, ill-thought-out revision.

Does the Minister realise that when the plans of the local authorities were published it was stated by the previous Government that it was important that those plans should be considered in conjunction with those of the hospitals. Can the right hon. Gentleman now give a similar undertaking that a review is taking place in respect of local authority health and welfare plans, and that they, too, will be published in the first half of next year?

That is my present intention, and I hope very much that the two plans will reflect closer consultation between the two sets of authorities than has been the case hitherto.

In considering the review, will my right hon. Friend ensure that much needed extensions of existing hospitals, which are required to carry out their ordinary duties, are not held up in any way? In particular, I ask my right hon. Friend to think of extensions for surgical and other facilities which, at the moment, are apparently awaiting the review of hospital building plans.

It is my intention, and I have already told the House, that the review shall not be allowed to affect the progress of schemes that were planned to start in the very near future, and, as far as I know, boards have carried out this advice.

asked the Minister of Health what factors determine the percentage of pay beds allocated to the general hospitals now being built.

I decide the number of pay beds for each hospital shortly before it is opened, taking into account all relevant factors, including the needs of non-paying patients and the probable demand for pay beds.

Whether there should be any pay beds in the National Health Service is debatable, certainly on this side, but will my right hon. Friend accept the fact that, while we do not want pay beds, if we are to have any in the new hospital in Hull, there should be a lower percentage of them there than in, say, Cheltenham, Bournemouth or Scarborough, where there are factors other than political factors?

I think that my hon. Friend is aware that I have approved no pay beds in the new Western General Hospital at Hull, because the existing pay beds have not been fully used and in other hospitals there are long waiting lists for non-paying beds. But I shall be making a statement on pay beds as soon as possible.

In order to put the matter in perspective, will the Minister give the figure of the contribution that payers in pay beds have made to the National Health Service? At the same time, will he issue figures to show whether any serious cases have been refused admission because only pay beds were available?

I shall be very happy to provide those figures, but, I am afraid, not without notice. The statistics of occupancy of pay beds certainly suggest that in many areas where the waiting lists for non-paying patients are very long, they are, perhaps, non-existent for paying patients, which has had the effect of delaying the admission to hospital of non-paying patients.

asked the Minister of Health if he will give details of circumstances since the publication of the 10-year plan for hospital development for Wales which will eliminate the proposed closure of smaller hospitals in the Welsh Region.

The closure of a hospital is decided according to the circumstances at the time, and I cannot give any forecast of hypothetical circumstances which might affect particular closures.

While thanking my right hon. Friend for that reply, may I ask him whether, prior to any proposed closure on the development of any new hospital within the region, he will see that ample time is given for consideration with all the proper authorities, particularly local health authorities?

Yes, Sir. I would readily give that assurance. There is very extensive consultation with all local interests whenever a proposal is made to close a particular hospital.

Is the right hon. Gentleman aware that small hospitals are very popular not only in Wales, but all over the country, and will he bear that fact in mind?

Yes, Sir.

asked the Minister of Health how many persons in the Midland region are registered in need of treatment provided by the artificial kidney unit at Queen Elizabeth Hospital, Birmingham; how many have been refused treatment during the past 12 months; and what is the total number of persons throughout the country in need of this treatment.

There is no regional register; no suitable case of acute renal failure has been refused by this unit but five patients known to the hospital to be suffering from chronic renal failure who might have benefited could not be treated. The answer to the last part of the question is that no reliable figures are available.

Is the Minister aware that the two doctors who operate this kidney machine at Queen Elizabeth Hospital, Birmingham, have themselves estimated that no fewer than 200 patients are being turned away annually to die within a few weeks, and 2,000 in the country? Will my right hon. Friend look into this again and check these figures, because this has caused grave apprehension in the Midlands?

A distinction needs to be made between the treatment by artificial kidneys of acute renal failure and of chronic renal failure. There is no shortage of facilities for the former, but treatment of chronic renal failure by intermittent dialysis has recently been regarded as acceptable. I agree that much needs to be done to extend existing facilities, but only a minority of sufferers from chronic renal failure are likely to benefit from treatment by intermittent dialysis.

asked the Minister of Health to what extent the provision of private beds in the general hospitals in North-East Essex reflects the high percentage of retired people within the area, or to what extent they are provided on a regional or national formula which does not reflect local need.

There are 21 such beds; the number is kept under review in the light of local conditions, and no specific formula is applied.

Is the Minister concerned about the growing number of elderly awaiting admission to hospital? What are the Government doing over and above what was done by the last Conservative Government to deal with this problem?

I hardly see how the fact that elderly people are awaiting admission to hospital is related to pay beds. It may well be that many of the elderly to whom the hon. Member has referred are pensioners. I should have thought it more desirable that they should not be forced to pay for beds.

asked the Minister of Health to what extent the cutback in the Government's review of the hospital building programme is reflected in current and planned capital projects for North-East Essex.

There has been no reduction in the total amount of money expected to be available for hospital building, and in the current year £5 million more has been provided than was included in my predecessor's plans. As regards projects in North-East Essex, I would ask the hon. Member to await my review of the hospital plan.

Will the Minister assure the House that there will be no cut-back in the programme for North-East Essex, particularly because of the increase of elderly in that area? Will he see that provision will be made for future projects because of the very serious problem in that part of the world?

It is for the North-East Metropolitan Regional Hospital Board to settle the priorities of the capital programme within the resources which I can make available. I have already received the Board's review of the programme and I shall consider it with reviews of other boards.