asked the Secretary of State for Social Services, whether he will announce details of the methods by which he intends to implement his proposals for the protection of pensioners from the effects of the proposed entry to the European Economic Community.

The Government will review the rates of pensions and related benefits at the appropriate time in accordance with our undertaking in the White Paper "The United Kingdom and the European Communities" (Cmnd. 4715).

In view of the present situation of old-age pensioners, would not the Minister accept that there is a need to do two things—first, to grant an immediate increase to pensioners in order to protect them from the effects of the proposed entry of Britain into the Common Market, and to protect them from the present inflationary trends, and second, especially in view of the reply given by the Prime Minister to my hon. Friend the Member for Birmingham, Northfield (Mr. Carter) on 16th November, to give adequate notice to old-age pensioners' associations of the methods that are to be used by the Government to protect pensions if the worst comes to the worst and Britain enters the European Economic Community?

These are questions which we shall have the opportunity to debate this afternoon. No possible increase due to entry into the Community can come before the middle of 1973, and that is the year in which the biennial review is due to take place.

asked the Secretary of State for Social Services what is his latest estimate of the percentage increase in the purchasing power of the national insurance pension, since the last but one increase in November, 1969.

As measured by the movement of the General Index of Retail Prices to October, 1971, the purchasing power of the standard rate of retirement pension for a single person is 2·4 per cent. higher than in November, 1969. For a pensioner over 80 the increase, including the new age addition, is 6·7 per cent.

Does not that first figure highlight just how inadequate in real terms has been the last increase in pensions? Will the Secretary of State allow hundreds of thousands of pensioners to spend this Christmas on the poverty line? Would he think again and bring forward substantial increases in their pensions?

That, again, is the subject of this afternoon's debate. The hon. Gentleman will know that we managed this time to do marginally better on the increase than the Labour Government did in 1969.

Would the right hon. Gentleman now give his estimate of when the value of the pension increase will have disappeared altogether? We suspect that it will have disappeared altogether in January and that from then on pensioners will be getting steadily poorer.

No, I will not make a guess. But the up-rated pension has always tended to lose value between up-ratings.

asked the Secretary of State for Social Services how much of the £1 increase in retirement pensions is received by persons in receipt of supplementary benefit.

Single supplementary pensioners received an increase of 60p in total income, comprising £1 more in retirement pension and 40p less in supplementary pension.

Is the hon. Gentleman aware of the absolute despair felt by old-age pensioners when they see their money buying less and less? Does he appreciate that this much-vaunted £1 increase, which the Government have vaunted on so many occasions, is nothing more than a shoddy piece of window dressing? Why does he not give pensioners their full £1?

On the contrary, the hon. Gentleman must realise that there is a real increase in the purchasing power of the pension which was introduced in September. Supplementary pensioners have had the same increase as retirement pensioners, but they have had it in two instalments—one last year and one this year.

rose—

Order. I remind hon. Members that we shall be debating this matter for the rest of the day.

asked the Secretary of State for Social Services if he will consider extending the scheme of assistance with the cost of conversion of privately owned cars to hand control for disabled people, to include those who are unable to travel to their place of work on foot or by public transport in a reasonable period of time.

asked the Secretary of State for Social Services if he is now in a position to announce a change in the type of motor vehicle provided for the disabled.

asked the Secretary of State for Social Services whether he can yet state when he expects to complete his review on vehicles for disabled drivers.

The vehicle service review, considering the types of vehicle to be issued and the circumstances in which they may be issued, is very near completion.

I thank my hon. Friend for that reply. I ask him to remember that there are many people, particularly in rural areas, who are not sufficiently disabled to qualify for a conversion grant—when it would cost only about £50 to adapt a clutch—which means that they cannot get to a place of work twelve miles away and, therefore, that they have to suffer the terrible indignity and thorough demoralisation of not working or they have to pay for the conversion themselves. The Government ought to consider extending these provisions considerably.

The question of the more general provision of three-wheelers and possibly four-wheelers is included in the review.

Would the hon. Gentleman accept that his answer may be welcomed by some of those involved? Will he accept that I am encountering now—as I am sure are many of my hon. Friends and hon. Members—inquiries being made by people who come under the ambit of the review who are wondering whether something is about to happen, because it could certainly make their lives much more pleasant if there were some amendment to the scheme?

Certainly the main purpose of the review—I hope it will succeed in its objectives—is to increase the satisfaction of those at present using the service and to see in what way we can extend it.

Would my right hon. Friend say how near is "very near"? Surely he must know the approximate date? is it to be before Christmas or in the New Year? Could he give an assurance that before this new policy is announced there will be some consultation with the disabled drivers' organisations which will be so much affected by it?

"Very near" cannot be precisely quantified, and it is always dangerous to use the future tense in politics. I am well aware of the various needs and the views expressed by many interested parties.

I am glad to hear that the result of the review will be available at an early date, but has the hon. Gentleman ever attempted to estimate how much public money is wasted by failing adequately to help disabled people with their mobility problems? Would he agree that it is ludicrous that we should make things difficult for even severely disabled taxpayers who do not want to become supplementary pensioners?

Yes. All these very wide ramifications of disability and the importance of providing for mobility have been included in the review.

When the Minister has this review, will he be kind enough to consider retrospective payment of a grant? Many people receive a large bill, cannot pay it out of their accounts and need the money very quickly. Would the Minister consider trying in this matter so that the money can be paid quickly?

I should want to consider what the hon. Gentleman said when I see it in the OFFICIAL REPORT. Retrospection is a dangerous wedge to include in any financial undertaking.

I ask the hon. Gentleman the simple question whether he will publish in the OFFICIAL REPORT the existing criteria used by his Department for making financial provision for modifying existing vehicles so that we may try to analyse the anomoly which arises in these allocations.

The official forms on which application is made for assistance under the vehicle scheme are already available and set out all details under which assistance is available.

asked the Secretary of State for Social Services what steps are being taken to reduce delays, apparent in some areas, in dealing with complaints made about medical services to executive councils.

Few complaints about avoidable delays have been made to my Department; but if my hon. Friend has any specific cases in mind, perhaps he would let me have particulars of them.

Is my hon. Friend aware that in the urban areas, particularly Greater London, considerable delays are occurring and the occasional delay is occurring in rural areas? A delay of nine or 10 months to settle one of these complaints is distressing both to the patient who is aggrieved and to the doctor who may suffer financially, socially and professionally.

I take my hon. Friend's point. A delay as long as that is exceptional and certainly should be queried. I am sure my hon. Friend appreciates that we have to balance the advantages of rapidity with the need to preserve a proper balance in the system and, above all, fairness to the parties involved.

When the hon. Gentleman is considering complaints about the medical services, would he take into account the fact that there are some areas of Scotland where doctors who are providing medical services finish their consulting hours before the men and women come in from their work? Will he give some instructions to executive councils that when there are complaints about this matter something will be done about it?

I will see that my right hon. Friend the Secretary of State for Scotland notes the hon. Gentleman's points.

asked the Secretary of State for Social Services how many people over 65 years of age received anti-influenza vaccinations last year; and if he intends to increase their numbers this year.

I regret that the information requested is not available. It is for the patient's doctor to decide whether to offer vaccination in any particular case.

If there is an outbreak of influenza this year, will the Minister take steps to avoid a repetition of the deplorable situation last year, when footballers, business men and Members of Parliament were offered vaccination before old people at risk?

We have forwarded the existing professional advice in a new note to general practitioners in Health Trends, pointing out the view taken by the professionals concerned as to the desirability and scope for special vaccination for the elderly.

asked the Secretary of State for Social Services what has been the total cost to public funds of supplementary benefits paid to strikers and their families since the entry into force of the Social Security Act, and the average payment per family per week; and what were the corresponding figures for similar periods in each of the preceding five years.

Section 1(4) of the Social Security Act, 1971, which deals with payments made during strikes for strikers' dependants, did not come into force until 3rd November 1971. The total cost to public funds of larger strikes, of which special records are kept, between that date and 23rd November was £21,273 and the average payment per family £5·29.

I will study the figures with interest. It may not be possible yet, but can my hon. Friend say whether there is evidence to establish that the estimate, given by my right hon. Friend at the time of passage of the Act, that it was likely to reduce the scale of subsidisation of strikes by the taxpayer, during their duration, by between one-third and 50 per cent. has turned out to be justified?

It is too early to be sure, as my hon. Friend himself suggested, but the figures already show a downward trend and there is also the happy fact that during this period—the second half of this year—there have been very few strikes of a length which has brought people into the possibility of getting supplementary benefit.

Will the hon. Gentleman dissociate himself from the sentiments expressed in the Question? Does he recognise that, through the family income supplement, the taxpayer is subsidising employers who are not paying a living wage to many workers? Does not he agree that families of strikers should not become involved because the fathers are fighting for a principle?

There is nothing wrong in the Question. My hon. Friend the Member for South Angus (Mr. Bruce-Gardyne) asked how an Act of Parliament was operating in practice and I have tried to give an answer. The hon. Gentleman mentioned the family income supplement. I remind him that many thousands of families are receiving substantial help which was not available previously.

While it is true that the period covered by this Question is too short to determine any trend—and the hon. Member for South Angus (Mr. Bruce-Gardyne) should have known that—is the Minister not aware that in so far as the Social Security Act hits at the wives and children of men on strike, we on this side are opposed to any proposition that strikes should be broken by starving out the women and children?

The hon. Gentleman knows that that was not the intention of the Act, which was to remove an entirely unjustified preference which strikers' families had over other families.

asked the Secretary of State for Social Services how many women were in the greatest cancer-risk age group in the year 1970–71; and what proportion of these have had cytology tests in this time under the National Health Service.

I assume that my hon. Friend has in mind cancer of the cervix. The likelihood of developing this form of cancer increases sharply with age and women age 35 years and over are known to be most at risk. There are about 13 million women in this age group. Approximately 1,850,000 tests were made in 1970, of which about half were on women aged 35 and over.

Does not my hon. Friend agree that that is hardly a satisfactory answer? Is he aware that 6,000 women contract cervical cancer every year, that 3,000 of these die from it, and that almost all of them could be saved if some funds were allocated for yearly or even biannual tests? Will my hon. Friend assure me that he does not share the total indifference of his chief medical officer on this subject, who does not even deign to mention the subject of cytology in any part of his 1970 annual report?

I must immediately come to the defence of the chief medical officer. He has recently published two articles on cervical cytology in Health Trends, which is circulated free of charge to every general practitioner, and he has urged an increase in the number of women they bring forward for screening.

Is it correct that so much money has been spent on abortions that there is little left for cytology?

As the hon. Lady knows from her wide experience of medicine, the problem in cytology is the difficulty of persuading women that they need to come forward for screening.

On a point of order, Mr. Speaker. That reply was in no way an answer to my supplementary question. May I ask the hon. Gentleman whether he will now reply to it?

That is not a point of order, I am afraid.

Too many times at Question Time Ministers get away with this sort of thing.

Order. The content of an answer is not a matter for the Chair.

It is a matter for the House. It is a disgrace.

Will the hon. Gentleman bear in mind that Health Trends is no substitute for the chief medical officer's report and that we trust that this will not be repeated in future years? Secondly, will he authorise far greater publicity to encourage more women to use this excellent service, which is saving thousands of lives a year? Will he also not remain content with testing those at greatest risk? What about those at lesser risk? After all, the life of a lesser risk patient is just as valuable as the life of someone at greater risk.

The hon. Lady will have noted that half of the tests carried out in 1970 were on women under the age of 35 Publicity is a matter for the Health Education Council, which has plenty of funds and is very active. It is simply a problem of communication in making women who may not have immediate symptoms of which they are aware come forward for screening.

asked the Secretary of State for Social Services how many visits he has made to re-establishment centres since he took office.

Of the 13 centres, my right hon. Friend has visited one and I have visited two.

Will the hon. Gentleman consider increasing the frequency of these visits in order to give more publicity to the valuable work being done by the centres, which exist to bring the long-term unemployed man back to work? Would he emphasise particularly that for the whole of 1970 only 2,308 men attended the country's 13 centres? Does not this give the lie to the idea, fostered on many occasions by the Conservative Party, that half the nation are no-good layabouts? Is he satisfied that the centres are receiving their fair share of resources in premises and skilled and professional personnel?

I am grateful for what the hon. Gentleman said about the centres. They do valuable work, particularly in trying to help those who have got out of the normal routine of work to get back into that routine. I assure him that my right hon. Friend and I will always visit them as opportunity arises.

asked the Secretary of State for Social Services what advice he gives to general practitioners who find that consultant gynaecologists in their local hospitals are refusing to accept their patients whom they recommend for termination of pregnancy.

In general I would expect general practitioners confronted with such problems to take them up with the local hospital authority or with the appropriate regional hospital board. If an individual patient is referred back to her own doctor it will then be for him to consider the situation and make any further arrangements.

Is the right hon. Gentleman aware that in the West Midlands many general practitioners know that there is no point in referring their women patients to consulant gynaecologists because they refuse to carry out these operations? Is he also aware that some gynaecologists in different parts of the country are blackmailing women into agreeing to sterilisation before they will agree to carry out the termination operation? Does not he think that this is a disgraceful state of affairs, which causes great and needless distress to very many women patients? Will he urgently look at this matter, because it is a very serious situation?

Without accepting any specific allegation which the hon. Lady made, I would reply that these are precisely the sort of questions which the Lane Committee exists to try to settle.

asked the Secretary of State for Social Services whether he will publish the names of recipients of consultant distinction awards and also publish the reasons for each individual award.

I would not make changes in the present system without strong evidence that they are desirable and have the support of the professions concerned.

Would not the right hon. Gentleman agree that, as millions of pounds of public money are used to finance consultants' merit awards, the taxpayer has a right to know which doctors have been given awards and on what grounds? Why are Parliament and people not allowed to know the reasons behind these awards? Why is the whole matter shrouded in secrecy?

In the very early days of the National Health Service, it was considered that it was to the advantage of the public that these awards, with the names of those receiving them, should not be made known, because patients might draw fallacious conclusions from them. A review body has confirmed that judgment. The B.M.A., the main professional organisation of the medical profession, is about to canvass once again the views of its members on the whole subject.

If the right hon. Gentleman will not agree to end the nonsense of secrecy which has been allowed to grow up around consultants' merit awards, will he at least consider merit awards for State registered sisters who have reached the highest maximum nursing pay by their middle twenties and must spend the rest of their nursing careers without being able to get any advance unless they go into administration? Will he consider having merit awards for good nurses?

That is another question and it is not on the specific point raised by the hon. Member for Halifax (Dr. Summerskill).

asked the Secretary of State for Social Services why a wait of three months is necessary in Leicester city or county before a patient can be interviewed by a consultant under the National Health Service.

Urgent cases are seen without delay but because of shortage of facilities due to be remedied by hospital building developments, non-urgent cases in three surgical specialties may at present have to wait for 12 weeks or more for an appointment.

Is my hon. Friend aware, so long is the wait for a National Health Service consultation, that many of my constituents are forced to consider having a consultation privately? This practice can do nothing but bring the National Health Service into disrepute.

My hon. Friends knows that urgent cases always receive immediate attention. It is always open to the general practitioner to recategorise as urgent a case which was not urgent if it develops through waiting.

In many specialties the waiting time is very long and very upsetting for the patient. Is the hon. Gentleman aware that we on this side of the House are more and more conscious of the gradual breakdown of the National Health Service and of the growing attractions of private consultancy for that reason?

We regret all delay. As I said, in Leicester the delay is confined to three specialties. In other specialties, the waiting is a great deal less—indeed, better than in many other parts of the country. The situation will improve when building development now in hand is completed.

On a point of order. In view of the unsatisfactory nature of that reply, I beg to give notice that I shall seek to raise this matter on the Adjournment.

asked the Secretary of State for Social Services when he last received a deputation of retirement pensioners.

I received a deputation from the National Federation of Old Age Pensions Associations on Wednesday, 27th October, 1971.

The right hon. Gentleman will be aware of the great anxiety among pensioners about the future, especially with winter drawing on, and that they find it very difficult to believe the figures being given by the Government to show that they are better off now than they were last year. Will he not take advantage of today's debate to announce a new initiative with regard to the care of the elderly, on similar lines to that announced by President Nixon today, with a view to discovering the true nature of the needs of old people so that his Department can do something to meet some of the anxieties and make elderly people look forward to retirement instead of dreading it?

That is more for the debate today, but I accept that the pensioners who came to see me convinced me that they need an assurance about the future.

asked the Secretary of State for Social Services what plans he has to raise the level of disregards for people in receipt of supplementary benefit.

My right hon. Friend has no plans to do so at present.

Is the Minister aware that that is the same answer that I received about this time last year? I have no reason to expect that it would be different from other years. On the basis that, in answer to earlier Questions, his right hon. Friend has made it clear that they will be starving the old-age pensioners into submission this winter, does he not realise that the Government could retain a little credibility by raising the disregards, particularly for those getting some kind of industrial supplementary pension? For instance, is he aware that he would help the 20,000 miners who have lost supplementary benefit and who, when the pension was increased to 30 shillings, lost the 10 shillings on the supplementary benefits? On the basis of the 25 per cent. inflation since the disregards were last increased, is it not time that they were altered?

Since the hon. Gentleman was given that answer 12 months ago, £600 million has been made available to increase pension and other benefits. My right hon. Friend will keep these disregards under review. I must, however, ask the hon. Gentleman to realise that the best way of helping those in need is by putting up pensions.

asked the Secretary of State for Social Services how many applications for attendance allowance in respect of severely disabled people have been approved; and if he will make a statement.

asked the Secretary of State for Social Services how many people he estimates will receive the new attendance allowance.

asked the Secretary of State for Social Services what is, at the latest available date, the number of applications received, granted and still under consideration, respectively, for the new attendance allowance for disabled persons.

asked the Secretary of State for Social Services whether he is satisfied with the progress made in the development of the attendance allowance; and if he will make a statement.

asked the Secretary of State for Social Services how many people are expected to qualify for the constant attendance allowance; and how many successful claims have been registered to date.

asked the Secretary of State for Social Services whether he will make a statement about the introduction of the constant attendance allowance.

asked the Secretary of State for Social Services when he intends to extend the attendance allowance for disabled people to cover a wider range of disablement.

asked the Secretary of State for Social Services what proportion of applications for attendance allowance in respect of severely disabled people has been successful; if he will publicise the appeal procedure; and if he will make a statement.

Over 95,000 claims had been received up to 23rd November. Of these, about 44,000 had been successful, nearly 21,000 were rejected subject to the right to apply for a review of the decision and some 30,000 were still under consideration. The awards up to that date were 32,000 to adults and 12,000 to children. New claims are still coming in at the rate of several thousands a week.

While thanking my right hon. Friend for that encouraging reply, may I ask him whether, in the light of the experience gained by his Department in assessing these applications, he will consider widening the qualifications for eligibility to include some of the very severely disabled people who are excluded at the moment?

We have all the time described this as the first stage, but I cannot today go further than that.

While that is an encouraging start, could my right hon. Friend say, in respect of the applications for children, what the percentage of success has been compared with the overall figures he gave a moment ago?

The overall success rate, to give the background, is 69 per cent. The success rate for children has been 82 per cent.

Is the Minister aware that there are large numbers of severely disabled people who need extra financial assistance but who do not qualify under the present attendance allowance? When will he be able to announce an extension of the range of the allowance to cover the new series of disabled?

When embarking for the first time on trying to help the severely disabled, the House and the Government recognised that we would have to do it by stages. I cannot give the answer today.

Can my right hon. Friend say when he is likely to be able to relax the day-and-night rule, in particular, on these allowances?

My hon. Friend has put again, rather ingeniously, and in another way, the question put by two other hon. Members. I cannot answer that.

While I appreciate the right hon. Gentleman's point about the need for attendance allowance to get under way, will the right hon. Gentleman not agree that a tremendous number of families are involved in this? In my own constituency three cases have been reversed on appeal. Would he agree that it is difficult to appreciate why certain categories have to appeal in any case? I can give an example from my own constituency, that of a lady who lost both legs and had three strokes, who had been turned down for constant attendance allowance.

I hope that all hon. Members who come across cases which they feel are anomalous will advise constituents to ask for a review by the Board. We are faced with the inevitability of varied standards by general practitioners up and down the country. That is why we want to encourage reviews of any marginal cases. The Board has so far dealt with 4,100 reviews, of which 83 per cent. have been successful.

Is my right hon. Friend aware that the pattern of acceptances and rejections, particularly for mentally handicapped children, in some areas is bewildering and that a large percentage have had to be submitted for a second time? Can he make it known that these second applications may succeed and try to eliminate the need for them?

I do not see how I can eliminate the need for them when we are bringing into payment a new benefit which depends ultimately on a combination of objective and subjective criteria and when the first line of agents of decision consists of a mass of intensely hard-worked general practitioners.

How soon will the Minister be able to remove the condition that severely disabled people should need constant attention, day and night? This is an abysmal condition and unduly restrictive. Can the Minister give these allowances to those who may require attention during the day?

Even to the hon. Gentleman I cannot give the answer that he and many other hon. Members wish to have. I am sorry.

Is my right hon. Friend aware that his Department, on great humanitarian grounds, have already overruled the original negative decision and given people this attendance allowance, notably Mrs. Gregory in my constituency—an allowance originally refused. We are truly grateful.

I do not normally refuse any expressions of gratitude, but any credit must go to the Attendance Allowance Board, which is entirely independent.

Is the right hon. Gentleman aware that there have been many disturbing cases of refusal of entitled applicants being reversed only after strong representations from their Members of Parliament? Is it not time that we had an urgent review of procedure?

That is entirely unwarranted. The Attendance Allowance Board is composed of devoted individuals who have very busy professional lives of their own and who have made time to carry out this relatively invidious task. They do not need strong representations from Members of Parliament; they simply need names of constituents whose cases need reviewing.

asked the Secretary of State for Social Services what encouragement he is giving to local authorities to expand the day nursery service.

As the available resources and the demands of other services permit I am continuing to recommend loan sanction for day nurseries where the majority of the children for whom they are intended are in special need of care. I estimate that new expenditure approved this financial year will be up by nearly a third compared with last year. This is a large increase from admittedly a rather modest level.

Is the right hon. Gentleman not aware of the fact that the recent small survey carried out by Sonia Jackson backs up evidence produced by the late Dr. Simon Yudkin and others eminent in this area, namely, that the complete lack of day nurseries and childminding facilities in the country means that large numbers of pre-school children are being looked after in totally inadequate and even dangerous conditions? Merely catering for those children in special need, as he says, does not meet this urgent problem. We need an immediate expansion in day nursery schools.

I do not need convincing of the need for more services for the under-fives. That is why I have asked the voluntary bodies concerned to submit their views to me, and why the Government seek to expand the appropriate services, within the resources available.

asked the Secretary of State for Social Services if he will carry out a survey to establish what sort of families who are eligible for help under the Family Income Supplement Act have not claimed their entitlement, and why.

At my request the Office of Population Censuses and Surveys conducted a survey in September in which a number of respondents to recent Family Expenditure and General Household Surveys were reinterviewed with a view to obtaining this information. I expect to receive the results shortly.

While thanking the right hon. Gentleman for that reply, and expressing the hope that the survey will produce the results which the Question was intended to produce, will the Secretary of State accept that nearly 100,000 out of the 185,000 families estimated to be eligible for F.I.S. have not claimed it? Is he aware that many of us are deeply concerned that among those 100,000 are the most needy people?

If my original estimate were correct the hon. Gentleman's figure would follow. What the House must recognise is that a much higher percentage of those whom we expected to be entitled to £2 a week or more have received awards. The sharp short-fall has been in those entitled to relatively small awards. We regret this, however, because even with the small award, the pass-book that goes with F.I.S. would have given those families automatic free health and sickness benefits.

Can the right hon. Gentleman tell us the types of reason for which applications for F.I.S. are turned down?

I have answered this before. Two-thirds are turned down because their earnings are too high and one-third because they are not technically in full-time work.

Can the right hon. Gentleman tell the House what proportion of those receiving family income supplement are civil servants or public employees and what proportion of their applications are successful?

It is a good question, to which I cannot give the answer. If the hon. Lady likes to put down a Question, I will try to find out.

asked the Secretary of State for Social Services if he is satisfied that reorganisation of the social services since he was appointed is working to the satisfaction of the poor, and meeting their need; and if he will make a statement.

Yes, Sir. As regards cash benefits I would refer the hon. Member to the recent substantial uprating, achieved for the first time without any increase in National Insurance contributions by the low paid, and the introduction of family income supplement and selective improvements for the chronic sick and the over-80s. But the reorganisation of local authority social services into Seebohm departments and the greatly increased load on their staffs due to Government pressure to help neglected groups is causing unavoidable transitional difficulties and revealing deficiencies in services in some cases.

Is the right hon. Gentleman aware that my main concern, like the editorial in today's Evening Standard, is for the old in need? Is he aware that I welcome his recently-announced extra provision for hospital facilities for the old and mentally sick? Is he further aware that there are still big gaps in services for the old in need and the disabled at home? Will he, first, pressurise local authorities into using their powers on behalf of the disabled and, secondly, pressurise other local authorities into seeing to it that the old apply for financial help where they are entitled to it, and especially for heating grants?

At a certain stage pressure might become counter-productive. Local authority social service departments are coping with a massive reorganisation and the requirement by Government to try to make good the short-fall of generations in dealing not only with the elderly but with the mentally ill, the mentally handicapped and the physically disabled. It is a huge task and there are bound to be deficiencies.

asked the Secretary of State for Social Services having regard to discontent among pensioners, continuous inflation especially affecting food and fuel, and levels of unemployment, whether he will raise to £15 per week the maximum under the earnings rule which a pensioner may earn, and £30 per week for man and wife, before retirement pensions are mulcted; and what other plans he has from 1st January, 1972, for bringing up to date the earnings rule.

The earnings rule limits were raised substantially last September. Further changes are not contemplated at the moment.

Have not prices and wages overtaken this level of £9·50 of today and would it not be more realistic to allow these people to earn £15 a week from 1st January, as this would have a proper relationship to the correct level of wages and prices? Have we to wait another 12 months before it can be adjusted?

No, Sir. Neither earnings nor prices have overtaken the figure. The increase was no less than £2. In addition, the maximum permitted earnings of a wife of a retirement pensioner, being herself under the age of 60, are now £9·50, in comparison with only £3·20 before September. These are substantial improvements.

asked the Secretary of State for Social Services what is the monthly gross pay of a fully qualified State registered nurse, also fully qualified in midwifery, on the basis that she is living outside the hospital.

The monthly gross pay of a qualified nurse or midwife depends on her grade and seniority. For nurses it varies from £84 at the minimum of the staff nurse scale to £140·50 at the maximum of the ward sister scale. For those practising midwifery the corresponding figures are £86·50 and £140·50.

Does the hon. Gentleman recognise that these figures compare extremely unfavourably with average industrial earnings today and that this is one of the principal reasons for the decline in the quality of the Health Service in that these girls, dedicated as they are, know that they are being exploited by the community at large? When are the Government to take some initiative and pay these girls the money to which they are entitled?

The increase in nurse recruitment in 1970 was the largest we have known. The Whitley Council is about to receive a further pay claim and the proper negotiating machinery will then be put into operation.