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.

asked the Minister of Health whether, in view of the shortage of chiropodists in Staffordshire for the implementation of an extended service for young people there, under the County Council's prophylactic foot-care scheme, he will permit chiropodists who have failed to achieve State registration but who have been in practice for 10 years prior to the beginning of the registration scheme, or who have worked satisfactorily for Government Departments, to be now employed locally by the National Health Service.

No, Sir.

Is the hon. Member aware that in Stafford today we are being denied the extension of a scheme for the foot care of the young and, at the same time, that because of the regulations at least one chiropodist is now on National Assistance pay? Surely this is entirely wrong. One man is being deprived of his livelihood and the whole area is being deprived of his services. Surely the Minister will make the concession that I have asked for.

We are not aware of any shortage of chiropodists in the employment of Staffordshire County Council and I understand that demands for treatment are generally being met. I think that the hon. Member will agree that State registration is desirable. It was introduced by the previous Minister. I am not prepared to comment on a case arising out of a Question of this kind.

asked the Minister of Health if he will withdraw contraceptive pills from general circulation until the investigation of the Dunlop Committee into their possible side-effects has been completed.

I see no ground for asking the manufacturers to do this. The Committee has recently advised that, after reviewing the available evidence, it does not feel justified in objecting to the marketing of oral contraceptives.

Will my right hon. Friend bear in mind that the Interim Report of the Dunlop Committee did not exclude the serious possibility that these drugs may be having serious side-effects? Does he not therefore consider it wise to withdraw them from circulation until a definite verdict has been arrived at?

No, Sir, the Committee is, of course, continuing to watch this position closely, and if it thinks that any further advice is desirable, it will, no doubt, give it. It discovered that there had been 16 deaths due to thrombo-embolic episodes in women taking oral contraceptives in the year ending 31st August. It estimated that the figure of 400,000 represented the number of women who had been taking them with reasonable regularity during that time and the official mortality figures indicated that 13 out of a similar number would normally have been expected to have died from the same cause.

Has the Minister any evidence that sterility has been caused by taking these pills?

No, Sir.

Would my right hon. Friend make it plain that the benefits derived from the widespread use of the pills at the moment clearly outweigh any risk of danger?

Certainly, I should have thought that the benefits are self-evident.

Would the Minister not agree that there is some evidence that if these pills are taken over a very long period the possible danger increases? Is this not something upon which women should be reassured by some evidence which the Dunlop Committee can look into?

I can assure the hon. Gentleman and the House that the Dunlop Committee is very alive to all the possibilities and is looking into them as a matter of urgency.

asked the Minister of Health how many cases of venereal disease were reported among school children in the past school year; and how many have been reported in the current school year.

In 1963 in England and Wales 1,319 new cases of gonorrhoea and 39 cases of syphilis (other than congenital syphilis) were reported in persons under the age of 18, including 233 and 2 respectively in persons under the age of 16. The corresponding figures for 1964 were 1,441, 32, 233 and 6. Figures for school children by school years are not available.

Does the hon. Gentleman realise that, although the figure of 1,400 represents a minor increase in 1964 over the figure for 1963, it is still far too high a figure? Secondly, could he tell the House what special steps his Department is taking to halt this rise, since it is obviously continuing over a period of years and clearly must be tackled as a matter of seriousness and urgency for our young people?

I agree that there has been a very disturbing rise: any rise in these figures is very disturbing. However, it is a very difficult problem, as the hon. Lady will know. It is a question of getting people to enter into treatment voluntarily. We pursue normal health education and normal advertising as far as we can, but this is one of those subjects in which there is some difficulty in knowing precisely how to get people to register and be treated, rather than merely acquainting people with the dangers.

Is it not clear that the presents figures indicate that there is an increasing trend towards venereal disease in schools? Would the hon. Gentleman take some much more dramatic steps to deal with this in the cases when it occurs in schools among children of school age? Is it not possible that some method of checking could be introduced for children at school between the ages of 15 and 19?

It is very easy to talk about taking dramatic action on an issue of this kind. It is doubtful if it would be right to make compulsory the medical examination of school children between 16 and 19 over a small number of days, because the incubation period is so short. It is very difficult to start introducing procedures of this kind without interfering too much with the treatment of the individual.

asked the Minister of Health if he will make a statement on the report of the Brain Committee on Drug Addiction.

I would refer my hon. Friend to my reply to my hon. Friend the Member for South Shields (Mr. Blenkinsop) on 25th November.

While I understand the need for consultation in dealing with this spreading sore of drug addiction, does my right hon. Friend understand the extent of public anger at the ease with which young people can obtain drugs from drug addicts and the need for quick action on this? How soon will he be making a statement on measures he intends to take to implement the Report, and how quickly will he take them?

I agree with my hon. Friend that this Report discloses a disturbing situation. However, I think that it would be premature for me to make a statement of the Government's intentions before the consultations with the medical profession are completed. But I am fully aware of the urgency of the matter.

While understanding that the right hon. Gentleman cannot make a statement at the moment, can he say how long it will take to complete these discussions and whether he will be able to make a statement early in the New Year to allay some of the disquiet which is felt?

Certainly, I hope that early in the New Year at least I can make a further statement. The consultations are already under way and we are treating them as a matter of urgency.

asked the Minister of Health what discussions he has had about the immediate setting up of an advisory committee to review the whole problem of drug addiction, as recommended in the Second Report of the Interdepartmental Committee, published on 25th November, 1965.

The consultations referred to in my reply of 25th November to my hon. Friend the Member for South Shields cover this as well as the Committee's other recommendations.

asked the Minister of Health what progress has been made with a national cervical cancer screening service for all women at risk.

By June this year almost 51,000 women a month were being tested in hospital, local authority and family planning clinics and by general practitioners. There were 283 pathologists and 383 technicians trained in cytology working in hospital laboratories and another 29 pathologists and 131 technicians undergoing training. About a third of the laboratories which propose to provide a cytological service should be able to support routine screening in the areas they serve by the end of this year.

While I thank my hon. Friend for the figures and appreciate his interest in this question, is it not a fact that progress is still much too slow in dealing with this scourge which could be eliminated entirely, and which is so disturbing? In view of the wastage from marriage and other causes, could he launch a drive to encourage fully qualified married women laboratory technicians to return on a part-time basis to their local hospitals?

I will consider what my hon. Friend said about part-time married women technicians. We need a great many more part-time women in many branches of the Health Service. We need about 500 whole-time equivalent technicians for the national screening service. The 514 I mentioned in my Reply do not spend all their time in cytology and I understand that they represent the equivalent of 310 working full time.

asked the Minister of Health what progress has been made in Kent in obtaining qualified staff for routine screening for cervical cancer.

Progress continues. All the hospital management committees in Kent, save Tunbridge Wells, have extra staff trained or nominated for training.

While thanking my hon. Friend for that reply, may I ask him if he will now consider the possibility of organising mobile clinics where clinics cannot be provided in set centres in Kent?

I understand that there would be considerable difficulty in providing mobile clinics for this purpose.

asked the Minister of Health if he will review Ministry of Health Circulars H.M. (68) 104 and H.M. (63) 37 and remove the discrimination contained therein against second-year nursing cadets.

I do not think there is unfair discrimination, but I will keep the matter under review.

Is my right hon. Friend aware that a second-year nursing cadet loses some £30 a year from her salary if she spends two days in college and three and a half days in hospital? Does he not think that this is an unfair discrimination against the older nursing cadets—the girl who already has one year's experience and who presumably is doing more responsible work in the hospital? In view of the need to encourage more girls to come forward into nursing, does he not think that this niggardly deduction could be removed at very little cost to the National Health Service?

I am aware of the situation which my hon. Friend has described, but I regard it rather differently. I would say that it is discrimination in favour of certain categories of first-year nursing cadets who enjoy a concession which is extended to no other young staff. But, as I have said, I am keeping the matter under review.

asked the Minister of Health in view of the misleading and inaccurate information distributed widely by opponents of fluoridation of water supplies, whether he will grant sufficient money to the Central Council for Health Education to allow the Council to correct this effectively.

I fully accept the need for wide dissemination of factual and objective information about fluoridation, but I am not satisfied that this would be the most effective method in present circumstances.

Is the Minister aware that no fewer than 50 local authorities have already gone on record against fluoridation, misled by this kind of rubbish from otherwise well-meaning people? If he is not prepared to use the services of the Central Council for Health Education, would he please tell the House at an early date which service he proposes to use?

I share my hon. Friend's disappointment, but I remind him that about 90 authorities have decided in favour of fluoridation. I feel that fluoridation is one of the most useful preventive health measures which medical and dental science has so far made available to us in our fight against dental decay. In those circumstances, I feel it right that I as Minister should take the initiative and accept full responsibility for ensuring that the true facts are disseminated as widely as possible.

Will the Minister tell the House which methods he is using to make the advice which he is giving to the House known to the public and the nation at large?

My advice is primarily directed towards the local health authorities. I have acquainted them with all the scientific information in favour of fluoridation. My Department has produced a considerable amount of material to counter the irresponsible propaganda against fluoridation which has received an unduly wide circulation.

Dr. Kerr.

On a point of order. May I have your guidance, Mr. Speaker? In view of the fact that I described fluoridation as sodium fluoride, which is a virulent poison, being added to our water, am I guilty of misleading the nation?

Order. The hon. Member is wasting time at Question Time by arguing under the guise of raising a point of order.

asked the Minister of Health if he will give an estimate of the extent of anti-fluoridation opinion in the country.

The lists circulated with my reply to the hon. Member for Chigwell (Mr. Biggs-Davison) on 22nd November indicate that among local authorities the weight of opinion is predominantly in support of fluoridation. Leading professional opinion is almost entirety in favour.

Is the right hon. Gentleman aware that although personally I am fully in favour of fluoridation and a great supporter of his policy, I find that a considerable number of my constituents are not? In fact, an unofficial local poll revealed 85 per cent. against it. In view of this—which may be common throughout the country—is there any way by which people can express a personal opinion on a very personal matter?

I do not know whether the hon. Member is suggesting that there should be something in the nature of a referendum in local authorities. That would be a new constitutional departure. The fact is that almost all existing opposition to this proposal stems from the very small but very vocal group of people who bombard local councillors with propaganda which is both unscientific and irresponsible.

asked the Minister of Health to what extent it is the policy of Her Majesty's Government that decision by individual local authorities is the best way of implementing the fluoridation of water policy.

The statutory function of making arrangements for fluoridation of water supplies rests with the local health authorities under Section 28 of the National Health Service Act, 1946. In my view it is best that the decision should be theirs.

What bothers me a little is that local authorities have no mandate to decide the matter as far as I am aware. Does not the right hon. Gentleman agree that it has never been fully debated in the House and that therefore there has been no express approval by Parliament of it—although, I say again, personally I am greatly in favour of it.

I would welcome a debate in the House on fluoridation and I very much hope that some private Member who is lucky in the Ballot will put it forward as a subject for debate.

Is the Minister aware that we on this side of the House wish him the best of luck in his campaign and hope that it is thoroughly successful?

asked the Minister of Health what representations he has received from local health authorities on the compilation and use of an At Risk register; and what advice he has offered on the subject.

We have had no representations and issued no recent advice.

Is my hon. Friend aware that at the recent conference of the Health Visitors Association at Cheltenham some very critical observations were made about the use in certain local authorities of the At Risk Register? While the principle was in no way discounted, it was felt that some guidance might be needed in certain areas.

We are not aware of the criticism which was made. If my hon. Friend will let me have details I will look at it.

asked the Minister of Health what plans he has for the provision of birth control appliances and advice as part of the National Health Service.

This matter is under review, but I am not yet in a position to make a statement.

Is my right hon. Friend aware that there would be widespread approval of a decision by the Minister to make this advice and treatment available through the National Health Service?

I have already said in the House that I regard family planning as a proper and important part of health education. However, to provide advice and treatment free of charge generally in cases where there is no medical need would require changes in the present statutory provision and, of course, would be costly.

asked the Minister of Health if he will undertake a national campaign against obesity.

I am not satisfied that any such campaign is likely to be effective.

Is the Parliamentary Secretary aware that about two-thirds of the people in this country are overweight and that this leads to heart disease, arthritis, postural backache and flat feet? Does he not think that it would pay dividends if his Department undertook a campaign of this kind, which would relieve the National Health Service of a good deal of the problems which are caused by overweight? Is he also aware that large numbers of children are overweight and that if he were to——

Order. The hon. Lady must learn to slim her questions.

I fear that you anticipated the very comment I was about to make, Mr. Sneaker. After the points made in question form by my hon. Friend, perhaps I now know the reason why I sometimes feel so ill. Experience of obesity clinics, both in this country and the United States, has proved very disappointing indeed. It is not just a question of getting off weight. It has been found that people who reduce their weight often do not have the same strength of character as my hon. Friend to continue with the slimming process.

Would the Parliamentary Secretary agree that the hon. Lady's campaign got off to a good start as a result of the activities of the bakers' union?

asked the Minister of Health whether in the interests of encouraging economy in prescribing, he will put a limit on the period covered by any one prescription, save in exceptional circumstances.

While I do not think it would be right to impose a fixed limit, I wrote to all family doctors at the beginning of the year reminding them of the advice of an independent committee that no more than one week's supply of drugs should be prescribed at a time during the first two weeks of illness and thereafter no more than a fortnight's supply, save for certain chronic illnesses.

I thank the Minister for that reply. Is he able to indicate any further action which he may be able to take to reduce the area of waste in prescribing?

I am watching the position. There is some evidence to show that the doctors have taken note of my suggestion in that while the number of prescriptions went up following the abolition of prescription charges, the quantity of drugs per prescription decreased compared with the average in 1964.

asked the Minister of Health how many merit awards to consultants have been withdrawn since the inception of the awards scheme.

None, Sir.

Is the Minister satisfied that a system which appoints a considerable number of people to a position of advantage and yet removes none of them is working satisfactorily?

If the work of a consultant deteriorates unacceptably the question which surely arises is that of fitness for further employment rather than that of his continuing to hold an award. The put back The award continuing after the consultant remains in his post beyond the normal retiring age has been the subject of discussion with the profession, but no decision has yet been reached.

asked the Minister of Health if he will review the present methods employed by his Department to keep general practitioners fully informed of new drugs.

Various methods are in use and they are under constant review.

Would my right hon. Friend give serious thought to the possibility of making available an adequately financed central information service? Is he aware that although in 1962–63 the drug houses spent £8·3 million on research they spent considerably more than that on the promotion of medicines, which, in the end, the Exchequer must pay?

The question of the sales promotion activities of the pharmaceutical manufacturers is firmly within the terms of reference of the Sainsbury Committee, and I am sure that that Committee will give urgent attention to the matter.

asked the Minister of Health what representations he has received regarding the delay in building a new junior training centre for mentally-handicapped children in the Wellingborough area; and if he will authorise the building of the centre to proceed as planned without delay.

The county council has asked for authority to proceed with this scheme at once, but my right hon. Friend is not satisfied that the circumstances justify exemption from the current general deferment of local authority capital projects.

Is the Parliamentary Secretary aware that there has been delay in building this centre, which was planned previously? Is he aware that this was put back behind other centres in the Northamptonshire area because of questions involving the acquiring of land. As this is now designated, will he now reconsider his decision on this matter?

We recognise that this is an eminently desirable project in itself, but other factors must be considered, particularly that of its urgency in relation to the Government's policy of deferring health and welfare building projects generally. However, I wish to impress on my hon. Friend that the deferment is only of a temporary kind.

asked the Minister of Health what action he proposes to take to protect general practitioners from formal complaints made against a deputy acting within authorised arrangements.

Agreement with the profession on a new contract for general practitioners will result in new arrangements for accountability of deputies on the lines set out in Section 5 of the first report of my discussions with general practitioner representatives on the Family Doctors' Charter. A copy of this report is in the Library.

I thank my right hon. Friend for that reply, which will be greatly welcomed in places like Ilford, where the emergency services are being threatened by the fact that if a deputy fails to do his duty the patient is reluctant to take action against the principal.

asked the Minister of Health how many residential homes for mentally-subnormal children are under the charge of his Department; where they are located; how many children were in them at the latest convenient date; and what number of staff, qualified and unqualified, were employed at that date.

On 31st December, 1964, local health authorities in England and Wales provided 42 such homes, and 564 mentally subnormal children were resident. Four new homes have been opened this year with 80 places. As the list is long, I will with permission, circulate it in the OFFICIAL REPORT. I regret that the information about staff is not available.

As the hon. Gentleman says that the list is long, will he now

asked the Minister of Health whether he will take steps, in the case of disabled National Health Service patients who buy cars at their own expense without surrendering the invalid tricycles issued to them by the National Health Service, to pay them maintenance grants for such cars as well as the cost of adaptation.

No, Sir. My right hon. Friend does not intend to introduce

I am very sorry, but I cannot do that without delaying the House too greatly at Question Time.

If, as I think, I am right in believing that the concession described in my Question is already made to war disabled patients, what justification can there be, 20 years after the war, for not extending it to all National Health Service patients?

The point is that the cases referred to by the hon. Gentleman in his Question come under the National Health Service Acts, which do not empower the Minister to make cash grants, or to improve upon the vehicles, as an alternative to the present arrangements. We are looking very closely at the problem, but I do not of necessity say that we shall be able to accept what the hon. Gentleman wants, as other problems are involved.

Is the Parliamentary Secretary aware that there is a great deal of hardship under the present regulations, and a great deal of distress, particularly among married families in this category? Can he assure the House that this is an urgent review, which will report as speedily as possible on what action can be taken to alleviate those cases of hardship of which I know the Parliamentary Secretary is aware?

It is not necessary for the hon. Gentleman to impress upon me the difficulties that arise from this problem. How quickly we shall be able to review the position, in the light of the improvements made last year, I am not too sure, but the hon. Member can rest assured that, if it is humanly possible, we shall improve the position. The difficulty is that we have to assess the relative priorities not merely for the allocation of vehicles of this kind but also for that of monetary resources.

asked the Minister of Health what is the total sum now outstanding for the ultimate settlement of all claims for medical practices compensation under Section 36 of the National Health Service Act 1946; and how many practitioners entitled to compensation are over the age of 70, between the ages of 65 and 70, and between the ages of 60 and 65, respectively.

At 31st October, 1965, the total sum for Great Britain was £23·1 million. Of those entitled to compensation, 448 doctors will, at the end of this year, be aged 70 or over, 931 aged 65 to 69, and 1,644 aged 60 to 64.

Is my right hon. Friend aware that these figures indicate that a considerable number of elderly doctors have not yet been paid this compensation; and that, in many cases, payment would mean that very straitened circumstances might be improved?

The National Health Service Acts provide that compensation shall be paid only on retirement or death, except in such circumstances as may be prescribed. The regulations provide for advance payments on grounds of hardship, and these payments are made where the doctor makes an application and I am satisfied that the payment is justified.

asked the Minister of Health if he will inquire into the reason why an ambulance from Whiston, a distance of some five miles away, was sent to a motor cyclist injured during the weekend of 12th November, 1965, at Penketh Lane Ends, Warrington, when there was an ambulance depot nearby at Longshaw Street, Warrington.

I am informed that this area is normally covered from Widnes, but their ambulance was already out. Lancashire ambulance control then judged it would be as quick to send the ambulance from Whiston as to invoke their mutual aid arrangements with Warrington.

Has the Minister been told that this man as a result lay for 20 minutes in the frost? Does he appreciate that this is a problem of general application? Will he do what lies in his power to end the nonsense by which authorities which have ambulances near to the scene of accident make use of ambulances from a much further distance because of the cost factor? Will he see that in future the nearest ambulance is sent and trouble about payment shall he settled between the authorities after the person has been taken to hospital?

I am perfectly sure that the cost factor did not enter into this matter at all. In view of what my hon. and learned Friend has said, the House had better hear what actually took place. A 999 call was received at one minute past midnight and the ambulance from Whiston station arrived at 12 minutes past midnight. Both the motor-cyclist and the passenger arrived at Warrington Hospital at 22 minutes past midnight. Both were slightly injured and neither was detained.

asked the Minister of Health what action is being taken to support the research into the refinement of large and expensive hospital kidney-treatment machines into small, compact and cheap home units.

I am giving financial support to research aimed at assessing the conditions in which artificial kidney treatment can be provided safely in a patient's home. My officers are keeping in close touch with this research.

I thank my right hon. Friend for that reply. Will he give all encouragement to doctors in Queen Elizabeth Hospital, Birmingham, in particular those working with a local firm to produce a small compact home unit, because this would assist those cases and relieve pressure for demand for beds?

Yes, I certainly will, but I should point out that it is not right to assume that a small compact edition of expensive equipment would necessarily be cheaper. The reverse frequently applies.

asked the Minister of Health how many applications for group practice building grants he has received within the area of the South-West Regional Hospital Board; and how many of these he has accepted or refused in the last 12 months.

I take it the hon. Member is referring to group practice loans. On that assumption the Answer is 95, of which seven were approved and three refused in the last 12 months.