asked the Minister of Health whether he will take steps to set up a distribution centre for hearing aids in Eastbourne.

This is a matter for the South East Metropolitan Regional Hospital Board, which I understand does not feel able to give high priority to this development.

Is there any reason against it? I ask that because Eastbourne would serve a very wide area, and it would be a great convenience to a number of people living there.

The Regional Hospital Board considered that Brighton was more appropriate as a hearing aid centre. The hon. Gentleman will know that there is a postal repair service between Eastbourne and Brighton and patients can exchange their batteries at the local hospital at Eastbourne.

asked the Minister of Health why hearing aids of the necessary strength are not available for National Health Service patients who are almost stone deaf, in cases in which such people can be made to hear with aids available elsewhere for under £50; and if he will take steps to expedite the case, details of which he has received from the hon. Member for Ilford, North.

My right hon. Friend is investigating the possibility of designing a National Health Service hearing aid to help the small minority of people who do not benefit from the present range of Medresco aids. I am writing to the hon. Member about the individual case referred to.

asked the Minister of Health if, when an individual buys privately a hearing aid, he will arrange for him to receive an allowance equal to the cost of the National Health Service aid.

My right hon. Friend has no power to give financial assistance towards the cost of hearing aids obtained privately.

What percentage of people obtaining hearing aids pay for them themselves? Secondly, would the hon. Gentleman say whether or not he is satisfied that the National Health Service hearing aids are sufficiently suitable for all people?

All we know about percentages is that, as far as we can ascertain, the vast majority of people are fitted with satisfactory hearing aids under the National Health Service. There are a few who are not and, as I indicated in answer to a previous Question, we are now investigating the possibility of the introduction of an aid which will cater for the remaining few.

Has the Ministry examined the possibility of issuing post-aural aids in place of the Medresco aids?

My right hon. Friend will be investigating each aspect of the matter.

Is there any good reason why, in cases of this kind, arrangements should not be made for the issue of free batteries?

It is questionable whether this is possible technically. We have batteries for our existing range of hearing aids and it is possible that they would not fit the others in any case.

asked the Minister of Health what representations he has received from the Confederation of British Industry or from any other source concerning absenteeism following the introduction of the new medical certification system last January; and what reply he has sent.

The Confederation mentioned its fears about this in exchanges following my appeal for a reduction in the number of medical certificates for employers' purposes. But certification for National Insurance purposes is primarily a matter for my right hon. Friend the Minister of Pensions and National Insurance, who considers that it is much too early to judge the effect, if any, of the new regulations on absenteeism. This view has been conveyed to the Confederation. I have had no other representations.

Will my right hon. Friend consider publishing regularly any figures which might be available on this problem so that we might be able to see whether there is any possible trend one way or the other?

I think that that would not be a matter for me.

asked the Minister of Health what steps he is taking to bring about the establishment of an emergency dental service.

On present advice I do not consider that the establishment of such a service would be justified.

Does the Minister consider that in establishing the health centres that he is talking about there might be some scope for including dental services among those to be provided?

This is done, but not on a very extensive scale. The Estimates Committee considered this question a few years ago but concluded that the setting up of special arrangements, whether financed by the dentists themselves or by the Health Departments, would not be justified.

asked the Minister of Health if he will consider the introduction of legislation to allow local health authorities to provide wider advice and instruction in family planning than they are authorised to do at present.

This matter is under consideration.

Does the right hon. Gentleman agree that wider provision of this service is desirable? If so, does he realise that he can facilitate it by legislation, if he wishes to do so? Will he do so?

As the hon. Gentleman knows, the timing of legislation is not a matter for me. He will also be aware of the fact that I sent a circular to local health authorities on this matter. I believe that certain steps could be taken by many authorities—and in my view authorities should take them—to develop the existing facilities even within the limits of their present powers.

Can my right hon. Friend say what has been the response so far from local health authorities on family planning?

Generally favourable.

Will the right hon. Gentleman be giving any grants towards this service? At present funds have to be raised by voluntary contributions.

If the hon. Lady is thinking of grants for the Family Planning Association, these are channelled through local authorities, and a number of authorities are making these grants, as well as making premises available free of charge.

asked the Minister of Health to what he attributes the rise in the bill for prescriptions since prescription charges were abolished; and whether he will now consider restoring them, subject to exemptions in case of real need.

A number of factors including the removal of the financial barrier to seeking treatment; the heavier incidence of sickness in 1965; and continuance of the long term trends towards the use of more powerful but more costly drugs and towards an increase both in the population and in the proportion of the elderly. The re-introduction of the charges would be a retrograde step.

The right hon. Gentleman has listed a number of other causes, but does he not agree that with a rise in costs of £23 million in the first year, which is a rise of about 22 per cent., the abolition of these charges must at any rate have been a substantial factor? Does he really think that this is a wise sense of priorities, even within the Health Service itself—wiser than the provision of new hospitals, or the improvement of others?

I have never denied that abolition was a substantial factor. All I have said was that it is quite impossible to quantify the various factors involved. I think that abolition was a wise step.

Does my right hon. Friend realise that this withdrawal of the tax on sickness is welcomed in the country? Does he recall that when the party opposite doubled the charge the Lancet showed that this meant that although they were imposing a charge they were increasing expenditure?

I am also aware that for most of the time when charges were in operation the medical profession was categorically against them.

asked the Minister of Health what improvements and extensions have been made since the publication in August of the White Paper, Immigration from the Commonwealth, to the facilities for making checks, including X-rays, on the health of immigrants at ports of entry; and to what proportion of Commonwealth immigrants health checks at the port of entry are currently being applied.

As I informed the hon. Member on 20th December, the existing facilities have not changed but they are being more comprehensively used. Virtually all voucher holders, and some others, are medically examined at the ports of entry but entitled dependants, who in the first three months of this year made up about three quarters of those admitted for settlement, are not subject to medical examination under the Commonwealth Immigrants Act.

Would the right hon. Gentleman agree that it is very important that there should be full medical checking at the port of entry, from the point of view both of public health in this country and of inducing confidence towards Commonwealth immigrants among people living here? Is not his reply disappointing, in that the White Paper said that there would be further improvements in the health checks at the port of entry

We do not feel that elaborate facilities at the port of entry would be justified, in view of the fact that we are actively consulting Commonwealth Governments about more comprehensive checks in the countries of origin. We think that that is the best way of handling the matter, but certainly, within the limits of the statutory powers, we are examining the great majority of immigrants.

Are equally thorough health checks being applied to the much greater number of aliens coming into the country?

The same provisions apply to both.

asked the Minister of Health how much support is being given by Her Majesty's Government to Mental Health Week; and if he will make a statement.

Mental Health Weeks for 1966, 1967, and 1968 are being planned by a group of voluntary associations. It is not normal practice for the Government to sponsor such weeks, but with my encouragement the organisers are seeking the co-operation locally of hospitals and local authorities.

Would not the Minister agree that every effort should be made to help people back to normal health and to be accepted by the community, in view of the shortage of labour in this country? Would he not agree that the Chancellor's statement on his "poll tax" is not helping these voluntary associations one bit?

The latter point is hardly one for me, but the fact that I do not officially sponsor these weeks does not, of course, mean that I am not fully in sympathy with their objectives.

asked the Minister of Health if he will set up an inquiry into the conditions under which registrars of births, deaths and marriages are employed; and if he will make a statement.

I am informed that the salary claim on behalf of registration officers is still before the National Joint Council, which is considering it, in relation to a general salary review for local government officers. It would therefore be inappropriate for me to set up such an inquiry at present.

Does not the Minister agree that these people do not really know who their employer is and that, in a highly inflationary time like the present, it is difficult to know to whom to put in a wage claim? Will he, after this one is disposed of, look at this problem, which is a question of employer-employee relationships?

I have looked at this question and, as I told my hon. Friend the Member for Norwich, South (Mr. Norwood) on 30th July, last year, I do not consider that it is necessary to introduce legislation to define the actual legal employer of registration officers. When the present matter is out of the way, I will gladly look at the general question again. However, I will tell the hon. Member that the claim has been remitted to a working party set up by the National Joint Council.

asked the Minister of Health whether he will give an assurance that the 10 per cent. census meant that one person in 10 was selected as a sample; and, in view of the fact that those selected to receive the census forms also received a pamphlet from the Registrar General stating that they had been selected out of millions, if he is satisfied that this pamphlet was not misleading to the public.

The answer to both parts of the question is "Yes, Sir".

Would the hon. Gentleman agree that, particularly in official communications, accuracy is to be preferred to flattery, and that, to send forms to people saying that they have been selected out of millions when they have been selected out of tens, is grossly inaccurate, though very flattering?

I cannot understand why the hon. Gentleman is being pernickety. There are about 15 million heads of households and if one is chosen as one in 10, he is in fact chosen as one in millions.

Is the hon. Gentleman aware that, as one selected, I feel very honoured to be one in a million?

It so happens that I was in a hotel at the time and I also was one selected.

asked the Minister of Health when the cervical cancer smear test will be made available to women in the Selby area of Yorkshire.

Arrangements are at present being made to extend the service to the Selby area, where it should be fully in operation by the end of the year.

Is the hon. Member aware that the local medical officer of health said that it would be a much longer delay? Can he confirm that it will certainly be available at the end of the current year?

If we ask for information for use in the Houses of Parliament, I hope that no one would give us the wrong information. I stand by the Answer.

asked the Minister of Health what progress he has made in implementing the recommendations of the Brain Committee on drug addiction; and when the necessary legislation will be introduced.

I cannot yet add to my reply to the Question by the right hon. Member for Ashford (Mr. Deedes) on 28th April. Any necessary legislation will be introduced as soon as Parliamentary time permits.

As I am sure the right hon. Gentleman wishes to avoid any suggestion that he is dragging his feet in the matter, will he say what progress is being made in setting up treatment centres, which does not require legislation? Can he give some indication when legislation on this distressing social problem is likely to be introduced?

As the right hon. Gentleman knows, the timing of legislation is not a matter for me. I assure him that I am in no way dragging my feet. These are serious matters involving extensive consultation. Professional interests are involved. As for treatment, the hon. Member knows from his past experience at the Ministry of Health that treatment for addicts is already available at a number of hospitals.

Is the Minister aware that in the earlier reply which he made to me he indicated that a committee was to be set up in order to look further into the matter? In view of the profound public anxiety on the subject, can he say when this committee will go into action and who will comprise it?

All I can tell the hon. Member is that the composition of this committee and its terms of reference are urgently being considered at this moment.

asked the Minister of Health what steps he is taking to remedy the shortage of fully qualified electroencephalograph technicians in the National Health Service.

Hospital authorities are responsible for recruitment. My Department has given advice to them on the organisation and content of training courses and distributes career literature. Total numbers continue to increase steadily, and I am not aware of a general shortage.

But the Minister is aware that there is general dissatisfaction among medical auxiliaries, especially electroencephalograph technicians. Is he aware that these are among new categories of skilled workers not even properly represented on the Whitley Council machinery? Will he conduct a survey to see what improvements in pay structure and career structure can be introduced for these people?

I do not think that a survey of this kind is called for in this instance. This group, which is a small group, received an 11·2 per cent. overall increase in August, 1963, a 3 per cent. increase in August, 1964, and a 3 per cent. increase in August, 1965. The numbers have increased from 119 in 1961 to 160 in 1964 and 172 last year.

asked the Minister of Health what plans he has to provide better health facilities for elderly people, and in particular more hospital beds for acute illness, and more local authority accommodation for chronic illness.

I have asked regional hospital boards in reviewing their programmes to give due priority to the expansion of hospital geriatric services. I have also asked local authorities in revising their health and welfare plans to have regard to the adequacy of residential accommodation for elderly people not in need of continuous nursing care.

I thank the Minister for that reply. Will he bear in mind that, from the point of view of the hospital services, old people tend to be at the bottom of the queue because of the pressures on hospitals and that, from the point of view of the local authority services, what one might call the mildly chronically ill tend to fall between the two stools—the hospital services on the one hand and the local authority services on the other?

It is to deal with these two points, in so far as they are generally applicable, that, firstly, I asked the hospital authorities to concentrate on the services for old people in the review of the plan and, secondly, I asked hospital authorities and local health authorities to get together and plan in liaison with each other.

Since Newcastle Regional Hospital Board has been arguing with the Ministry of Health for a very long time, can the right hon. Gentleman say, in view of his Answer, whether permission has now been given to that board to get on with the provision of, at any rate, a day geriatric hospital which has been wanted for such a long time?

If the hon. Lady wants an answer to a question relating to a specific hospital I hope that she will be good enough to put a Question down.

asked the Minister of Health what representations his department has received about the method used to diagnose pneumoconiosis and other chest diseases associated with industrial dust; what changes he will make; and it he will make a statement.

None, Sir. The method of diagnosis of chest diseases under the National Health Service is a matter for the judgment of the responsible clinician.

Is my hon. Friend aware that hundreds of thousands of industrial workers are suffering with chest diseases, many of which, upon post mortems being conducted, prove the doctors to be wrong; and will he treat this matter more seriously?

I assure my hon. Friend that I treat the matter very seriously indeed. However, the responsibility for diagnosing chest complaints, and particularly pneumoconiosis—which, I think, my hon. Friend has particularly in mind—for the purposes of industrial injuries benefit and pension, is a matter for my right hon. Friend the Minister of Pensions and National Insurance.

Would not my hon. Friend agree that the time is long overdue for this question to be thoroughly examined again? Is he aware that all of us, certainly hon. Members who represent industrial constituencies, have cases on our books where no satisfaction has been given, although evidence of dust was there? Would he not agree that a wider sphere, so to speak, should be covered in this connection?

This is a question of clinical opinion. I assure my hon. Friend that I am not unaware of it, and he will appreciate that I mean that because I represent one of the oldest mining areas in the country.

asked the Minister of Health what advice he is offering to local authorities seeking to make grants to the Brook Advisory Centres Limited.

asked the Minister of Health how many local authorities have applied to him for permission to make a grant to Brook Advisory Centres Limited.

Contributions by local authorities to voluntary bodies providing services for the prevention of illness through family planning advice do not require my approval; and I am, therefore, advising inquirers that they should satisfy themselves that this is such a body.

I am grateful to my right hon. Friend for his reply, but would he not agree that the more widely this view is known in advance of applications from the Brook Advisory Centre, the more likely the constructive, if experimental, work of the group is likely to prosper?

indicated assent.

asked the Minister of Health whether he is aware that the new right granted to the family doctor to make charges to a patient for prescribing oral contraceptives and for prescribing or fitting of contraceptive appliances is a discouragement to family planning and in conflict with the recommendation of the Royal Commission on Population that general facilities for family planning advice and treatment should be available under the National Health Service; whether he is aware that this new right will fall more onerously upon parents with large families and low incomes; and what are the reasons that have prompted him at this time to permit doctors to charge these fees.

No, Sir. The Royal Commission said that advice on contraception should be given under the National Health Service, and no charge is proposed for this. The prescribing or fitting of contraceptives on social as opposed to medical grounds is not, however, part of medical care under the Health Service, and a small charge in such cases is therefore reasonable. I do not believe this will discourage family planning, but the arrangement is subject to review.

Is it not a most retrogressive step, and in complete breach of our election pledges, that prescriptions should be charged? Is it not, indeed, quite in conflict with all the urging the Minister has done through the local authorities to get on with family planning when we are creating a system under which the more people are in need but least able to afford this attention, the less opportunity they will have for it? Why has my right hon. Friend capitulated to the doctors, who have already had this large increase?

There is no question of any capitulation here. My hon. Friend must have misunderstood, because in such circumstances a doctor may already issue—indeed, always has issued—a private prescription. The only difference here is that for issuing a private prescription the doctor is entitled to make a small charge. This seems to be reasonable and logical. I do not for one moment believe that it will discourage family planning. Indeed, I think that it will encourage people to go to the family doctor on this matter, which I want them to do.

Can the Minister say how he reconciles the introduction of this new charge with his declared policy to abolish all charges within the Health Service?

It seems that the hon. Gentleman, too, does not appreciate the distinction between the private prescription and a National Health Service prescription.

May not this provision of a premium from the doctors' point of view—to make it more profitable to prescribe this form of treatment—have some distorting effect?

I do not honestly think that doctors will be guided in the kind of advice they give to their patients by whether they get a fee of half a crown or so for writing out a prescription—[Interruption.] If I do not know the doctors, I do not know who does. I can assure my hon. and learned Friend that I have made it quite clear to the doctors that this move is experimental, and that if it were to act to the disadvantage of a patient who required the service on medical grounds it would be subject to review in the light of experience, and the doctors have accepted that.

In view of the unsatisfactory nature of the reply, I beg to give notice that I will seek to raise the matter on the Adjournment at the earliest opportunity.