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Social Services

Volume 889: debated on Tuesday 25 March 1975

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asked the Secretary of State for Social Services whether she will now prescribe emphysema as a scheduled industrial disease for miners, potters and foundrymen.

The Minister of State, Department of Health and Social Security
(Mr. Brian O'Malley)

No, Sir. The available evidence does not enable me to accept that emphysema satisfies the conditions for prescription in respect of any occupational group.

Is my right hon. Friend aware that potters, foundrymen and mineworkers think that the available evidence is false and that there is a direct link between emphysema and the work they do? Will he give further consideration to this matter, as he has done to other matters to the great satisfaction of the people of North Staffordshire?

Coming as I do from a coalmining area, I understand the feelings of the mineworkers. However, the preferential benefits of the Industrial Injuries Scheme can be justified only if a disease or accident can be attributed to an occupation. My hon. Friend will be aware that the Pearson Royal Commission is considering all these matters. It is too soon to say when that report will be completed, but the Government are anxious—as I think my hon. Friend is anxious—that the report should be available as soon as possible so that all these matters can be considered in the light of it.

Is the Minister aware of the considerable suffering from lung diseases, not only in mining, foundry working and potting, but also in the slate quarrying areas? There is considerable feeling that compensation payments should be made to sufferers in the slate quarrying areas similar to those made to workers in the coal industry who suffer lung diseases. Will the Government look into this matter in advance of the conclusions of the Pearson Commission, which might not report for a year or 18 months?

The hon. Gentleman will be aware that the pneumoconiotic scheme in the coal industry is an industry-type scheme for which my Department has no responsibility. The Pearson Commission is considering all matters affecting industrial injuries and we await with keen interest the result of that inquiry.

Is my hon. Friend aware that from time to time over the years as progress and scientific advances have been made several loosely-termed diseases arising out of a process rather than a traumatic incident have been added to the list? Having regard to all the representations that have been made about emphysema in the categories described by my hon. Friend the Member for Newcastle-under-Lyme (Mr. Golding), is it not high time that it was added to the list of industrial diseases? Will the Minister try to formulate his thoughts even more strongly—I know that they are strong at present—by organising a meeting with the heads of the unions concerned so as to get their views before the Pearson Commission reports?

I understand and sympathise with the views expressed by my hon. Friend, who also comes from a coalmining area. The difficulty is that in the present state of medical knowledge it is not possible to distinguish clinically cases which might be due to occupation and so satisfy the requirements for prescription. The best I can say to my hon. Friend, against the background of the considerable research on the whole subject which is going on, is that the Pearson Commission is considering all these matters and it is important that we should receive its report at the earliest possible date.

Crawley Hospital


asked the Secretary of State for Social Services if she will now review the capacity of Crawley Hospital, in view of the expansion of the population now expected in the Horsham and Crawley region.

I would refer the hon. Gentleman to my reply to the hon. Member for Mid-Sussex (Mr. Renton) on 25th February.—[Vol. 887, c. 281.]

Does the Minister recognise that when Crawley Hospital was built it was designed to serve a population of 50,000 and that it is now having to serve a population of 130,000 in my constituency alone? Does he appreciate that the projected increase of population by 1981 will mean that the hospital will have to serve a population of 180,000? What does he propose to do about enlarging the hospital to meet these requirements?

I recognise that there is a problem because of the population that is building up. Plans for the possible provision of a district general hospital to serve this foreseen population increase are being studied as part of the overall review of health care in the area.

Birth Induction


asked the Secretary of State for Social Services how many hospital maternity units are now inducing labour in confinements as an administrative convenience; what guidance is given to mothers in regard to the effects of this procedure on themselves or on their babies; and what provision is made in such units for mothers to decline induction if there is no medical need for it.

Induced births as a percentage of all hospital deliveries in England and Wales have risen from 13·7 per cent. in 1963 to 31·5 per cent. in 1972. The reasons for this increase are being investigated. I would expect the use of this procedure to be fully discussed and agreed with the woman herself, who would have the same right to refuse induction as she has to refuse any other form of treatment offered to her.

I thank my hon. Friend for his reply. Will he consider issuing guidelines to hospitals on the advice and help they should give to mothers who are experiencing the procedure, in view of the great disquiet which is felt among women about this whole process? Will he also consider—I understand that he has a survey in hand—advising hospitals to go slow on the special induction procedure while the survey is being undertaken and until its results are known?

We are hoping to have the initial results from the survey in the middle of the summer. When I receive those results I shall give thought to the question of issuing guidelines and taking the advice of the professional and other advisory committees that are available to us.

As this is a widespread practice even when the condition of mother and baby does not seem to require it, should we not study the side effects even more carefully? Is it not possible that there may be some danger where the skills and facilities available are not necessarily of the very best?

The most important thing to do is to determine the facts. I share the concern of many hon. Members about a superficial trend, but there are many facts and many reasons behind this matter and we need to establish these before we make any definite policy changes.

Does the Minister realise that many people are worried by the rise in the figures he has given us—namely, from 13 per cent. in 1963 to 31·5 per cent. now? Is it not the case that in some hospitals the figure is high as 50 per cent? Does the Minister recognise that most women believe that the delivering of babies is not a nine-till-five, Monday-to-Friday business? Does he appreciate that pregnant women are worried that their well-being and the well-being of their children is being placed second to social convenience? Are there any statistics to disprove the view that is still held by many doctors that to interfere with the natural process of childbirth can be justified only where medical reasons make induction necessary?

That only reinforces the need for the facts. Women rightly regard childbirth as a natural process. They regard it as a process not without discomfort but as essentially a normal process. Before we intervene we have to judge carefully the grounds for intervention. There is an old physician's prayer which says "From inability to leave well alone, good Lord deliver us".

In view of the very unsatisfactory nature of his reply, does my hon. Friend accept that we must have an urgent inquiry into a situation in which women are being asked to have their babies only during office hours? We do, not know what detrimental effect this will have on the women or on the babies. Does my hon. Friend appreciate that serious concern is felt by many people on this issue? Will he give an assurance that the House will have an opportunity to debate the matter?

I do not know why my hon. Friend is dissatisfied. I have told her that I share the concern that is felt. In fact, I shared that concern even before the programme which aroused a great deal of public controversy appeared on our television screens. We have instigated inquiries and surveys to establish the facts. As my hon. Friend has said, we do not fully know all the facts. We want to examine the situation so that we do not reach conclusions on unsubstantiated foundations. There is justifiable concern about the possibility of induction taking place for administrative convenience. The facts are not yet fully established and it will take time to do this. I share my hon. Friend's concern.

National Insurance Fund


asked the Secretary of State for Social Services what are the present financial reserves of the National Insurance Fund.

The combined market value of the National Insurance Fund and the National Insurance (Reserve) Fund is about £1,500 million. From next month these funds will be merged with the Industrial Injuries Fund, which has a market value of about £300 million, to form a single National Insurance Fund.

Is not that a substantial sum to have in reserve? Does not the right hon. Gentleman think that some of it might be put to good use by relieving some of the iniquitous surcharge levied upon the self-employed?

The balance is not as large as the hon. Gentleman suggests. He might have examined the situation more closely before asking his Question. It represents only about three months' expenditure within the National Insurance Fund. Therefore, it is strictly a working balance.

Will the right hon. Gentleman explain to the House that these are not, and cannot be in any natural sense of the term, "reserves"? They can exist only as an account on paper.

Of course they are an account on paper, but they are more than that in that if at any time the National Insurance Fund runs into deficit, as it did in successive years during the 1960s, the reserve can be immediately mobilised.

Does my right hon. Friend accept that the majority of employed people would greatly regret any suggestion that there should be even further subsidy to the self-employed? Is he aware that we congratulate him on the measures he has taken?

The House will be aware of the arrangement embodied in the Tory Social Security Act 1973 which brought in Class 4 contributions. Under that Act and now the self-employed remain in receipt of a substantial subsidy from the contributions of employers and employees. They also pay their money into the National Insurance Fund.

Does not the Minister accept that there is at present a substantial notional surplus in the fund and that the introduction of earnings-related contributions from April of this year will mean that the surplus is likely to increase in the foreseeable future given the present levels of wage inflation? In the light of that, does not the right hon. Gentleman consider that at least some temporary relief for the self-employed is justified by reducing their contributions until such time as he has completed his studies on the prospect of bringing in earnings-related benefits for them? Does he realise that we would interpret his refusal to do so as merely prejudice on his part which would not be supported by any factual problems of financing the National Insurance Scheme?

The hon. Gentleman should not seek cheap short-term popularity with the self-employed by that kind of question. The ratio between the contributions of Class 1 and Class 2 contributors is exactly as it was set down within the Social Security Act 1973. The hon. Gentleman knows that, and he should begin to behave in a more respon- sible manner than he has displayed so far. After all, he speaks from the Opposition Front Bench on this subject.

Before he starts talking about running down the reserves in the National Insurance Fund, the hon. Gentleman should take into account the additional calls that will arise from the transfer from the present stamp system to a fully earnings-related system of contributions. That will cost the fund on a short-term basis at least £300 million. There will be additional expenditure arising from the second uprating of retirement pensions, which the Government have said they will bring into operation later this year, and for each additional 100,000 unemployed substantial additional sums are needed. The hon. Gentleman should have considered all those matters as a Front Bench spokesman before he started making that kind of comment to me.

Order. I hope we shall have shorter questions and shorter answers, otherwise we shall not get very far.

Countesthorpe Health Centre Project


asked the Secretary of State for Social Services on what grounds she has placed the Countesthorpe health centre project fifteenth in the list of health centre priorities for the Leicester area for 1976 and beyond, after the Leicester Area Health Authority had placed the project at the top of the list and whether she will explain the criteria she uses in determining such priorities.

Countesthorpe health centre was not among the list of priority schemes put forward by Trent Regional Health Authority for consideration for inclusion in the 1975–76 programme. Selection of health centre programmes is based upon the criteria which I will, with permission, circulate in the Official Report. The regional health authority has discussed priorities beyond 1975–76 as a basis for planning but no decisions have been taken about the order of starts.

Is the Minister aware that his answer is wholly inadequate? Although I shall wait with interest to see the list of criteria when they are circulated in the Official Report, may I ask whether the hon. Gentleman is also aware that the Department asked the Leicester Area Health Authority to assess priorities for Leicestershire, that it placed the Countesthorpe health centre at the top of the priority list but that this was rescinded, without any reason being given, by the Secretary of State for Social Services? Does the Minister appreciate that this will put the centre down to fifteenth place, despite the fact that the village concerned has a population of 6,000, which is rapidly increasing, and that there are a further 2,000 in the catchment area? Will he bear in mind that all these people are now being served by a surgery in a single room in the private home of the senior doctor of a panel of three? Is not this a disgraceful situation?

The hon. Gentleman speaks for a Government which in December 1973 cut the health service and health centre expenditure by 20 per cent. The present Government have increased expenditure, particularly on the health centre building programme. I repeat that the centre in question was not among the list of priority schemes put forward by Trent Regional Health Authority.

Is my hon. Friend aware that the Secretary of State for Social Services has already assured Leicester Members of Parliament that when the priorities in the National Health Service are being considered the tremendously underprivileged position of Leicester hospitals will be taken into account? Will my hon. Friend give some assurances on health centres and domiciliary services, especially in view of the cuts made in those services by the Conservative Government?

It is part of the present Government's policy to concentrate limited resources on areas of need. In the National Health Service we are trying to define areas of health deprivation. This is one of the most important criteria used in the allocation of health centres. Inasmuch as there are in the Trent Regional Health Authority a number of areas of hospital and health deprivation, the autho- rity can expect to see that situation reflected in allocation policies.

Is it not a fact that the Government are planning cuts in capital expenditure on hospital building between now and 1977? Does the Minister agree that public expenditure is a matter of priority and that some of us believe that the Government's priorities —the present level of food subsidies, nationalisation and municipalisation of land—do not represent the best use of available resources?

Is the hon. Gentleman challenging the priorities for health care and the building of health centres? If he is, perhaps he will give us different priorities. Will he explain how, despite the fact that we inherited considerable financial difficulties, we have still managed to lift the moratorium on the hospital building programme which otherwise would have resulted from the 20 per cent. cut and also how we have been able to restore part of the services which had been cut?

Does the hon. Member for Blaby (Mr. Lawson) now wish to give notice?

Perhaps the hon. Gentleman will do so in the customary form of words.

I am happy to do so, Mr. Deputy Speaker. I am grateful to you for your courtesy. In view of the wholly unsatisfactory nature of the Minister's reply to my question a few moments ago I beg to give notice that I shall seek to raise the matter on the Adjournment at the earliest possible moment.

Following is the information:

Proposals for health centre developments should be based on the following criteria:
  • a. Proposed centre is situated in urban zone where the organisation of primary medical care has so far made little progress.
  • b. General practitioners are committed to leave present premises and are dependent upon a health centre for new premises.
  • c. Proposed centre is part of a larger development (including hospitals university teaching units) progress on which is dependent upon the health centre proceeding.
  • d. Proposed centre is situated in a new town or other new community where delay in provision would seriously hamper the development of family practitioner service.
  • e. General practitioners have strong desire to develop primary health care but are frustrated by lack of suitable accommodation.
  • f. Present general practitioner premises are well below modern standards and other means of improvement are not feasible.
  • g. Proposed centre is sited where there is at present inadequate accommodation for community based nursing staff or for preventive health activities.
  • h. The proposed location is in a "health deprived" area [a health deprived area should for the time being be interpreted as a locality in which the level of primary health care services falls well below the average obtaining in the Region].
  • Residential Care (Cost)


    asked the Secretary of State for Social Services what is the weekly cost of care, both running and capital, in acute hospitals, chronic hospitals, Part III accommodation, and within the person's own home, respectively.

    In 1973–74 average costs per week were £110 in acute hospitals, £87 in long stay hospitals and £22 in Part III accommodation. Costs of care in the home are not available.

    I will, with permission, circulate further information in the Official Report.

    I thank my hon. Friend for that reply. Will he take it from me that evidence exists that caring for the chronically sick at home is much cheaper and is what the patient requires? Will he immediately shift some of the scarce resources away from hospital to local authorities in joint consultation with all concerned? Will he accept that this would result in a substantial number of people who are chronically sick being able to spend the rest of their lives comfortably with their loved ones at home?

    The Government's policy is to enable the elderly, the mentally ill and the mentally handicapped to be cared for as far as possible in the community rather than in hospital and to improve the standard of hospital provision for those who must stay there. It is difficult to achieve this at a time of financial restraint. I agree that a great deal depends on joint planning between local authorities, particularly the social service departments and housing departments, and area health authorities.

    In this time of financial restraint, would it not make much more sense to put greater emphasis on some of the domiciliary care allowances such as invalid care allowance, which has recently been introduced? Should not this be spread much more widely and be made available to more people to keep them out of hospital?

    I agree that it would make more sense. We shall bear in mind any positive suggestions that are made. We are constantly looking at ways of improving domiciliary services and of keeping patients in their homes. This is an important matter on which hon. Members on all sides of the House are in agreement.

    Following is the information:

    For acute hospitals the costs per patient week are running costs excluding capital, as the capital costs of hospitals. many of which were constructed before the start of the National Health Service, are not identifiable for costing purposes. The classification "chronic" is not used for hospitals but a figure for long-stay hospitals is provided.
    In 1973–74 costs in Part III accommodation per week per resident were £19 for running expenses and £3 for servicing capital loans, before deduction of the income from charges.
    Care in the community is provided mainly by the Family Practitioner Services, the Community Health Services and Personal Social Services, but the cost of these services, insofar as they are provided in the home, cannot be expressed in terms of a weekly cost.

    House Repairs (Grants)


    asked the Secretary of State for Social Services if she will consider providing a house repairs grant for those people in receipt of supplementary benefit, invalidity pension or retirement pension.

    No, Sir. Any extension of the house repairs provisions of the Housing Act 1974 would in any case be a matter for my right hon. Friend the Secretary of State for the Environment.

    As my hon. Friend is aware, owner-occupiers receiving supplementary benefit have an allowance towards house repairs and insurance included in the calculation of their entitlement. If this does not meet the cost of necessary repairs, a lump sum payment may be made. For the more expensive repairs, a maturity loan be sought from the local council and the commission would normally meet the interest charges on that.

    Is my hon. Friend aware that the assistance he has described is rarely if ever available and that many owner-occupiers, particularly those in older terraced property, find great difficulty at times when they need money to carry out essential maintenance and repairs? Will he given an assurance that he will circulate all local departmental offices with details of the grants he has outlined, with the requirement that they should be made available on a much wide basis than hitherto?

    The Department has no evidence that these grants are not made available or that few people have knowledge of them, but I shall bear in mind my hon. Friend's suggestion.

    How many people are living on supplementary benefit and in sub-standard houses requiring urgent repair?



    asked the Secretary of State for Social Services if she will take steps to promote the dental health of children, following the report by Professor Douglas Jackson on the results of water fluoridation in Anglesey.

    This report provides further evidence of the efficacy of fluoridation of water supplies in protecting children against dental decay. I am sure that health authorities will bear it in mind when exercising their responsibility for deciding whether to introduce fluoridation in their areas.

    As the Anglesey result shows a reduction in decay of over 80 per cent. in front teeth and 40 per cent. for other teeth, will the Minister go further than to say that the result shows efficacy and add that he regards it as proved that fluoridation of about one part per million reduces dental decay dramatically? Will he draw the results to the attention of all health authorities and ask them what action they intend to take?

    I confirm that my feelings accord with those of the hon. Gentleman as to the efficacy of fluoridation. The Government have announced that they will produce later this year a consultative paper on preventive measures, including preventive dentistry. It is likely that the paper will deal with the effects of fluoridation. The information will be made available to health authorities and this House and we can then discuss the issues.

    Does my hon. Friend agree that fluoride can occur naturally in water almost to the level suggested as a health preservative measure for teeth?

    That is the case. That is why research on the safety of fluoridation is probably the most extensive to have been conducted into any public health measure and why health authorities should seriously consider exercising their responsibilities in this matter.

    Does the Minister agree that ingestion of fluoride for the purposes of preventing dental decay is effective only for young children up to the age of about seven years and not for adults? Is there not a less wasteful method of helping to prevent dental decay than to introduce fluoride into the public water supply which everybody has to drink whether he needs fluoride or not?

    Experts in numerous countries who have been considering this matter have concentrated on the school population and the under-five population. However, the advice that one consistently gets is that the most effective way of introducing this preventive health measure is by the fluoridation of all water supplies.

    Vasectomy Clinics


    asked the Secretary of State for Social Services if she has now completed her review of how many area health authorities have established vasectomy clinics for the provision of vasectomies under the National Health Service; and how many have not.

    Not yet, Sir, but a preliminary assessment indicates that 38 area health authorities have vasectomy clinics. Those without have facilities for vasectomy in general surgery and other units in hospitals.

    Will my hon. Friend undertake that this review will be carried out as quickly as possible, because the figures he has given suggest that some area health authorities are not yet honouring either the letter or the spirit of the 1972 legislation?

    I shall let my hon. Friend know as soon as I can. These figures are only provisional, being based on oral inquiries. We have still to receive many of the returns for which we asked. As soon as they are available I shall let my hon. Friend have the breakdown.

    What facilities are available for advising a patient who wishes to have a vasectomy about the serious nature of the operation and the alternative to having it?

    Vasectomy would not be undertaken by other than a qualified medical practitioner. It would be up to him to make clear to the patient all the different factors behind making a decision.



    asked the Secretary of State for Social Services whether she is satisfied that each NHS region is adequately staffed by consultants in each of the specialities.

    No, Sir, I am not satisfied, and this is one reason why I have proposed to the medical profession a new system of career structure supplements to replace the present system of distinction awards, so as to improve staffing ratios in some parts of the country and some specialities and to reward consultants who accept a very heavy workload and make a major contribution to the health service.

    Is not this at the heart of the present dispute with the consultants? A deplorable situation has arisen in which resources for the scarce expertise of consultants are badly distributed by specialities and regions because of the extent to which consultants have exercised discretion over merit awards. Will my right hon. Friend persist in ensuring that the community gets full value for money in this respect?

    I certainly agree that a revision of the merit award system, which at present does not have the effect of encouraging people to move into areas and specialities where they are needed, is extremely important, and I am pursuing it.

    Does the Secretary of State realise how welcome is her belated decision to reopen consultations with the hospital consultants? Does she agree that, to regain some of the medical profession's confidence in her, it is desirable that the discussions should be wide-ranging and comprehensive and should cover all the points on which the consultants feel that they are in discord with her?

    I have made it clear all along that I am willing to resume full and detailed negotiations with the consultants as soon as their damaging sanctions are lifted. I have also made it clear that I am willing at any time for discussions to take place to clarify misunderstandings. Therefore, as soon as the BMA wrote and asked for a meeting to clarify certain interpretations of the existing contract—not a new one—I said at once that I should be happy for that meeting to take place.

    Retirement Pensions


    asked the Secretary of State for Social Services what percentage of average industrial earnings the retirement pension for a married couple represented on 1st March 1975; and what was the comparable percentage figure on 1st March 1974.

    I regret that information about earnings in March 1975 is not yet available. In March 1974 the figure was 29·4 per cent. of average gross earnings and 39·4 per cent. of average net earnings.

    Is my right hon. Friend aware that there is a steadily increasing gap between earnings and the pension level? Is he satisfied that the proposed increases, which come into effect in April, will go a sufficient way to restoring the ratio between the average earnings of people at work and the pensions of those who have retired?

    My hon. Friend will recognise that between July 1974 and April 1975 this Government will have put pensions up in money terms by almost 50 per cent. That clearly represents a significant increase in the value of pensions in April this year.

    Will the Minister of State concede that the non-availability of the March 1975 figures has enabled him to obsure the fact that the percentage asked for is probably no greater and may even be less than it was in March 1974? Does he accept that the percentage is likely to get worse because the new uprating is based on out-of-date figures up to August last year which are far below the present level of the increase in earnings? Finally, does he accept that the failure of the social contract will mean that over the coming year the real position of pensioners will deteriorate vis-à-vis the friends of the Labour Party in the big unions in heavy industry?

    I certainly do not accept the hon. Gentleman's general proposition. For the first time in legislation, the present administration have provided that pensioners will receive increases in their pensions by the level of the movement in wages or prices, whichever is the greater. In addition, we are providing two up-ratings this year. We are doing far better than anything that was done by the previous administration. Furthermore the pension, expressed as a percentage of national average earnings, is certainly higher under this administration, comparing October 1973 with July 1974, than anything done by the previous Government.

    Invalid Tricycles


    asked the Secretary of State for Social Services what recent orders she has placed for the supply of invalid tricycles, and for how many.

    The last contracts, signed in August 1974, were for a total of 1,500 vehicles and tenders for necessary further supplies are currently being scrutinised.

    I thank the Minister for that reply. Is he aware that there is growing disquiet among those concerned with social and safety inadequacies of existing three-wheelers? Will he reassure the House that no further orders will be placed for these vehicles and that as soon as possible he will introduce four-wheeled vehicles for the disabled, thereby offering a choice of three- and four-wheeled vehicles and/or the mobility allowance?

    I note the hon. Gentleman's points. The orders to which I have referred are for normal replacements and any necessary additions to the fleet. Without these orders, a large number of severely disabled people would have been immobilised. The hon. Gentleman and the House will appreciate that our decision was for cash, not vehicles. We want more freedom of choice for disabled people than they have had in the past.

    Does my hon. Friend accept that instinctively many hon. Members on both sides of the House would say that they do not like the three-wheeler but that, looking at their mail, they find that a substantial number of people want to retain it? May I urge my hon. Friend to have an independently conducted survey carried out into those who want to retain the three-wheeler and those who do not, so that once and for all we may have clear guidance in this House about the views of the disabled on the three-wheeler?

    There was an unofficial survey during 1974 which showed—this is the best estimate we have—that 20 per cent. of three-wheeler users would be unable in their view to manage a car. As my hon. Friend knows, I was recently in his constituency where I met a deputation of disabled drivers. I am mindful of the points they made about retaining the vehicles. There are many points of view. I am trying to put forward a policy which will give more freedom of choice to severely disabled people.

    Will the hon. Gentleman assure the House that every order which is placed has his personal blessing?

    I said that the order was principally for normal replacement. For my part, I look very carefully at these matters. The hon. Gentleman knows that I do not take the question of safety complacently. I have given a great deal of information about modifications which are being carried through. I shall certainly do whatever I can to scrutinise closely every new order in this area.

    Does my hon. Friend intend to introduce legislation this year to increase the mobility allowance?

    It is our firm resolve, not merely this year but during this parliamentary Session, to legislate for the new mobility allowance. That allowance will benefit both disabled drivers and non-drivers. We expect that it will bring in 100,000 additional people who at present receive no mobility help.

    Supplementary Benefit (Long-Term Addition)


    asked the Secretary of State for Social Services what it would cost to reduce the waiting time for longterm addition to supplementary allowance from two years to one year for claimants with children.

    As I told my hon. Friend the Member for Hemel Hempstead (Mr. Corbett) on 6th March—[Vol. 887, c. 503]—the estimated cost for all eligible families with children would be about £7 million.

    Will my hon. Friend acknowledge that two years is a long time for a family with children to be on the poverty line in view of the requirements of children's growth and development? In view of the importance placed by his hon. Friend at an earlier stage this afternoon on the reports of commissions of inquiry into industrial diseases, may I remind my hon. Friend that the Finer Commission of Inquiry reported on this point and recommended reduction of the waiting time?

    The hon. Lady is supplying information. The question was contained in the first part of her remarks.

    I assure my hon. Friend that we take very much to heart the point she makes regarding the needs of this group of people. That is why we have already said that consideration will be given to reducing the qualifying period, along with other improvements in supplementary benefits suggested in the Finer Report, as soon as resources permit.

    Rents And Rates Payments


    asked the Secretary of State for Social Services if she will take steps to ensure that all long-term recipients of supplementary benefit who request that rent and rates payments be paid direct to the owners of the property should have this facility made available to them.

    Although direct payment will now be authorised more freely, it is not practicable to provide such a service to all who request it, irrespective of difficulty in paying their rent.

    Since the Minister has obviously studied the point, can he say how many council and private tenants were evicted last year on grounds of nonpayment of rent? Is he aware of the views which have been expressed by housing departments and by social work departments that we could avoid an enormous amount of misery and distress, as well as cost to public funds, if every person on long-term supplementary benefit was given the right to have his rent paid direct if he so requested?

    The answer to the first part of the hon. Gentleman's question would be for the local authority concerned and not for me. On the second part of the question, I cannot load the staff throughout the country, or even in the hon. Gentleman's locality, by undertaking in all circumstances to pay rent direct. There has been a change in the policy on the conditions recently laid down for the payment of rent by the Supplementary Benefits Commission. I hope that the hon. Gentleman will find this helpful. I hope he will continue to examine the matter closely to see whether these improvements bring about an amelioration of the situation which he has described.



    asked the Secretary of State for Social Services if she will set up a national survey of the circumstances of the elderly whose lives are at risk from exposure to conditions of cold in their own homes.

    I would refer the hon. Member to my reply to my hon. Friend the Member for Hemel Hempstead (Mr. Corbett) on 13th March.—Vol. 888, c. 239]

    I am at a loss to know what that reply was. Has the Under-Secretary read the excellent pamphlet issued by Help the Aged called "Death in Winter"? Is he aware of my series of Questions to the Secretary of State for the Environment, the answers to most of which amount to passing the buck to local authorities? There is a need for the Department to take the lead in this matter, to establish a national survey and to come forward with solutions which are mandatory on local authorities.

    My Department and I have seen that report, which we are considering carefully. We should like to have time for its consideration before commenting on some of the facts and figures contained in it. My Department is very much aware of this problem. On 2nd December it issued a circular to all health authorities drawing their attention to the needs of these people, who may or may not be at risk.

    Is not my hon. Friend aware that were he to undertake this research, which is badly needed, he would discover that the bills we pay for keeping people in hospital longer, and for taking them into hospital earlier when they become ill because their homes are inadequately heated, are enormous? There is an overwhelming case for some sort of free electricity allowance to enable this problem to be alleviated.

    No one disputes the need to help these people. The suggestion regarding the survey may well not be the best way forward, since by the time the survey had been conducted and published it would be out of date and would not be of much help in identifying these people.

    Housing (Prime Minister'speech)


    asked the Prime Minister if he will place in the Library a copy of his public speech made in Islington on 8th March on housing.


    asked the Prime Minister if he will place in the Library a copy of his public speech on housing made in Islington on 8th March.

    The Lord President of the Council and Leader of the House of Commons
    (Mr. Edward Short)

    In the absence of my right hon. Friend in Belfast, I have been asked to reply.

    My right hon. Friend did so on 10th March, Sir.

    Does my right hon. Friend agree that, despite our inheriting a desperate housing situation, the improvement in the housing figures for the most recent quarter for the number of starts, and completions in the public and private sectors reflects a response to the constructive short-term measures which the Government have already applied? Does he further agree that the situation could be further improved if the Government rapidly implemented the section of the manifesto which advocated allowing local authorities to supply unified services for estate agency work, surveying, conveyancing and mortgages?

    As regards the first part of my hon. Friend's question, the Prime Minister made that point in his speech. He pointed out that when the Labour Government came to office in March the indications were that housing starts would be about 200,000 in 1974. The past three months show that they are, until now, running at a rate of 225,000 for the year. There has, therefore, been a considerable improvement.

    As regards the last point, my right hon. Friend the Secretary of State and my right hon. and learned Friend the Secretary of State for Wales will be sending a circular to local authorities tomorrow giving advice on a great many points but not, I think, on all the points included by my hon. Friend in his supplementary question.

    Is the right hon. Gentleman aware that to the man on an average wage a generous mortgage would be something in the region of £7,500? Assuming that to be a 90 per cent. Mortgage, would the right hon. Gentleman care to place on the official record a list of areas, especially those around London, where the average price of property to be purchased for the first time by a young married couple is £8,350?

    I agree with the hon. Gentleman. This is the state of affairs which we inherited when we came to office. We made £500 million available to the building societies to keep their interest rates down, but interest rates are now generally falling.



    I have been asked to reply.

    I refer the hon. Member to the reply which my right hon. Friend gave to the hon. Member for Banbury (Mr. Marten) on 20th March.

    Will the Lord President ask this of his right hon. Friend, whether or not he goes to Brussels to find the answer? It would be helpful if he could refer to Brussels the speech wade during the weekend by the Secretary of State for Industry in which he told workers in the Midlands that entry into the EEC under the negotiated terms would render the Government unable to protect jobs in British industry. Does he realise that the people of this country, in making up their minds about the referendum, are seeking hard, clear facts? Will the right hon. Gentleman say, therefore, whether that is a fact and, if so, whether it is the view of the Government? They are not, of course, the same.

    Of course that is what the Government intend to provide—hard, clear facts. We shall do so in the White Paper on the renegotiated terms, which is a long and full document and which will be published on Thursday of this week.

    Could my right hon. Friend advise the Prime Minister that, since it is a fact that among the absurd behaviour of the Common Market administrators has been the deliberate creation of mountains of butter and beef which are then sold to places outside the Community at knock-down prices, it might be possible, for example, for a place like Lundy Island to be taken out of the Common Market? The mountains of beef and butter could be sent there, purchased by the British Government and sold at knock-down prices to the lower income groups and British old-age pensioners.

    Yes, Sir, but the terms which my right hon. Friend negotiated will ensure that that does not happen in future.

    Social Contract


    asked the Prime Minister if he will place in the Library a transcript of his television broadcast of 3rd March on the social contract.

    I have been asked to reply.

    I refer the hon. Member to the reply which my right hon. Friend gave to my hon. Friend the Member for Bolsover (Mr. Skinner) on 14th March.

    While the Prime Minister and his right hon. Friends gaze in admiration at their social contract, has any of them noticed that the nation is sliding inexorably towards bankruptcy? When will the Government learn the lesson on inflation that they seem slowly but painfully to have learned over Europe—namely, that running away from difficult decisions does not solve them and that, on inflation as on Europe, the country is waiting for the moment when the Government will give priority to the national interest over the interests of the Labour Party?

    In view of all that, I am sure that the hon. Member and his hon. Friends wish to help. Perhaps they will now tell us and the country what their policy is on incomes. Now that they have abolished the policy of statutory restraint and control of incomes, perhaps they will tell us what their policy is.

    Is my right hon. Friend aware that part of the social contract includes a commitment to both municipalisation and improvement of housing? Is he aware that there is deep concern among Labour authorities throughout the country about the very serious cut-backs in resources being devoted to this purpose? Will he take steps to restore these cuts so that confidence in this aspect of the social contract can be maintained?

    My hon. Friend, who has great interest in these matters, will know that the bids by local authorities far exceed the resources available. The Government are therefore concentrating on the worst stress areas in this part of their policy.

    The hon. Gentleman should examine the engineers' settlement very closely—[HON. MEMBERS: "What is it?"] We do not know yet. [HON. MEMBERS: "Why?"] Because there is no settlement yet; that is why. We do not know, but certainly the present indications are that it will be.


    asked the Prime Minister if he will place in the Library a copy of his speech on the social contract at Taunton on 8th March.

    I have been asked to reply.

    My right hon. Friend did so on 10th March, Sir.

    Is the right hon. Gentleman aware that in that speech the Prime Minister singled out the railways and said that if the burden of their costs became unreasonable there would have to be a cut in services? In view of today's statement that British Rail is "bust and bankrupt" as never before, will he give the House an assurance that the Government will not bail out British Rail to satisfy the unreasonable demands of the railwaymen, even if that means a reduction in services?

    I answered a question on this matter, I think, the week before last. My right hon. Friend was making exactly the same point as my right hon. Friend the Secretary of State for the Environment made in his constituency—that pressing the burden of costs beyond what the traffic could bear would inevitably lead to a cut in services.

    Will my right hon. Friend think again about the Government's proposal of the calamitous cut in improvement grants referred to by my hon. Friend the Member for Ilford, North (Mrs. Miller)? It is particularly in the worst areas like Islington that these cuts are being made. Is he aware, for instance, that unless this proposal is dropped many councils will be forced to keep old houses empty because they do not have the money to repair them—including houses which they were encouraged to buy and resell—and that many thousands of tenants will be forced to remain in houses without a bath, hot water or an inside lavatory?

    As I was saying, government is a matter of priorities. As my hon. Friend knows, the bids put in by the local authorities far exceed the resources available for this. Therefore, it is a matter of priorities and the Government are giving priority to the very worst areas. But if my hon. Friend has any special point, I should be very glad to bring it to my right hon. Friend's attention.

    Does the right hon. Gentleman accept that it is time to replace the social contract with a work contract, one that will recognise the need to increase productivity and put an end to stoppages like that of the dustcart drivers in Glasgow and the electricians at Glasgow Airport who have closed that airport for several weeks? Exactly what steps do the Government propose to take to end those disputes?

    We very much regret those stoppages; my right hon. Friend the Secretary of State made a statement recently in the House. What we want to know, I repeat, is what is the policy of the Conservative Party—

    Yes, but the Conservative Party aspires to be the Government. It has abandoned its statutory incomes policy and the country is entitled to know what its policy is.

    Would it be news to the right hon. Gentleman to hear that he is responsible now?

    I should have thought that our present economic situation demanded the support of all parties in this House —[HON. MEMBERS: "NO."] If hon. Members opposite are saying "No", meaning that it does not demand their support, the country knows where we stand.



    asked the Prime Minister if he will make an official visit to Southend.

    I have been asked to reply.

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

    If the Prime Minister should go to Southend, would my right hon. Friend ask him to visit the headquarters of the VAT administration? In the conditions which Her Majesty's Government have negotiated, we are told that they will not place value added tax on essentials should we remain in the Common Market. Is my right hon. Friend aware, however, that five of the nine members of the EEC put VAT on food, fuel and travel? If, in the convergency of the economies, we are to avoid that, what extra and additional costs must we pay and how will my right hon. Friend guarantee that we shall not have to fall into line?

    May I repeat what the Prime Minister said on 18th March? He said:

    "The proposals now being discussed in the Community are concerned with agreeing a uniform assessment base for VAT. They provide for our system of zero rating. We will be able to resist any proposals which are unacceptable to us."—[Official Report, 18th March 1975; Vol. 888, c. 1464.]

    Accepting the view of the hon. Member for Newham, South (Mr. Spearing) that we retain our own discretion in fixing the rates of VAT which is open to all the Nine, is the right hon. Gentleman aware that we are delighted that there is therefore no occasion for the Prime Minister to go to Southend on this matter? Is he also aware that since the Prime Minister is a busy man and has successfully renegotiated all the matters in the manifesto—at least, that was the collective view of the Cabinet at 3.30 last Tuesday—there is no need for him to go to Brussels either, so that we applaud both those decisions? Would the right hon. Gentleman suggest that, if a visit to Southend cannot be arranged, it would be instructive to the British people if the seven defecting Cabinet Ministers went to Brussels or Southend for a television con- frontation with those in Europe who know the facts?

    That is a very good idea, although I hope that they do not go by hovercraft.

    While we all share the disappointment of the worthy citizens of Southend that the Prime Minister is not to visit them, may I ask my right hon. Friend to note that the Prime Minister is also being invited to Newcastle-under-Lyme, Glasgow, Hunterston, the Isle of Ely and St. Albans? If he visits all those places, who will look after the shop?

    The shop is looked after quite effectively, I can assure my hon. Friend. My right hon. Friend the Prime Minister has a tremendous capacity for getting around the place, and I am sure that he will get to those places.

    On a point of order, Mr. Deputy Speaker. As the Prime Minister was invited to visit my constituency, may I put a supplementary question?

    Is the right hon. Gentleman aware that if he or the Prime Minister visit my constituency they will be very welcome? If, however, they are to visit the VAT offices, will the right hon. Gentleman give an absolute assurance that they will not take that opportunity to introduce multi-rate VAT, which would be extremely damaging to the shopkeepers and other business men in my constituency and elsewhere?

    The hon. Gentleman knows that all we have done is to ask for study to be carried out on that.

    On a point of order, Mr. Deputy Speaker. As it will be impossible for the Prime Minister to visit Southend without passing through South-East Essex—

    Order. We all know the delights of Southend, but there is urgent business awaiting us, and unless it is a very serious point of order—

    I am much obliged to you, Mr. Deputy Speaker. You will know that anything touching upon South-East Essex and Southend is of the highest importance. It will be physically impossible for the Prime Minister to reach Southend unless—