asked the Secretary of State for Social Services what is the cost to public funds of the survey carried out by the Office of Population Censuses and Surveys into which types of households are in the greatest need of help from her department.

£60,000.

Is the Minister aware of the widespread feeling that this type of information ought to be readily available from the 1971 census and other sources and that if this information is not already available, there is something wrong with our system? Is he not further aware of particular cases, such as that concerning one of my constituents, a former civil servant, who has already made submissions to the Office of Population Censuses and Surveys pointing out that this is merely management by excuse and that the whole exercise involving a questionnaire and a follow-up letter is a waste of public money? How does he propose to check this kind of expenditure in future?

I disagree with the hon. Gentleman. The problem of the elderly is the biggest social problem that this country faces. There is not enough information about those most in need and those to whom we should be applying public money. The course that the hon. Gentleman is advocating will be best served by having a greater and more effective information base.

Will the survey identify families with disabled people?

Its main aim is to try to identify the type of help needed. Therefore, it will take account of some elements of disability. However, I shall send the hon. Gentleman some of the more detailed information.

asked the Secretary of State for Social Services how many persons drawing supplementary benefit are currently also drawing the extra heating addition (at any of the three rates).

As at May 1975—the latest date for which information is available—792,000.

I am obliged to my hon. Friend for that information. Does he agree that it is time that we got rid of this nonsense of three distinct rates separated by a few pence for this particular form of benefit? Does he also agree that, in view of the immense increases in the prices of gas and electricity, elderly people of retirement age should automatically draw this heating allowance if they are in receipt of supplementary benefit?

The purpose of having three different levels is to take account of differences in health, the type of accommodation and the ease with which that accommodation can be heated. My hon. Friend can be assured that no fewer than 41 per cent. of all supplementary pensioners are in receipt of extra heating additions. Also, to take account of the increase in fuel prices, since the last Conservative increase in Octobr 1973 the pensioner index has risen 50 per cent., the fuel component 65 per cent., and the pension 70 per cent.

Has the Minister given any consideration to the system operating in other countries, such as the Scandinavian countries and Canada, whereby heating costs are included in the rent of a property? Does he not agree that, as more people seem to be aware of rent and rate rebates, this might be a way of catching those who are unaware of the heating allowance? I find that many pensioners in my constituency are unaware of the heating allowances available to them,

The Supplementary Benefits Commission makes every attempt to increase the number of claims from pensioners who might be entitled to extra heating additions and to ensure that those entitled receive them. During the past two or three years the number entitled to extra heating additions has substantially increased. Of the 792,000 who receive such help no fewer than 701,000 are pensioners.

Does the hon. Gentleman accept that many branches of Age Concern—the chairman of the Brighton branch has written to the Secretary of State—are anxious about the levels of heating allowances? Does he accept that in Brighton and many other parts of the country some pensioners have to choose between having adequate temperatures in their homes and having sufficient food? Will he please do his utmost to raise these levels as quickly as possible?

In November last year the Government raised extra heating additions by three-eighths. Since we have been in office these additions have been increased by 83 per cent.—more than the pension increase of 70 per cent. which was itself substantially above the rise in prices.

Does not my hon. Friend feel any sense of injustice that his Department is expected to bear the brunt, on the one hand, of unfair tariff structures in the electricity and gas industries and, on the other, of the dubious behaviour of the electricity boards in the late 1960s in persuading local councils not to fit all-electric flats with a gas supply?

This matter, to which my hon. Friend is right to refer, has caused considerable concern. On behalf of the electricity and gas supply industries, which are the responsibility of another Department, I would say that there are statutes that prevent their giving preferential tariffs to particular groups of clients. Nevertheless, this remains an important problem, particularly as it affects disconnections. I assure my hon. Friend that we are very much aware of it.

Will the hon. Gentleman do something about the lack of take-up among many pensioners? We were due to have a new leaflet in November. Many local offices still do not have it and many pensioners do not know what they may have. Will he also expand the leaflet to explain that they may have prepayment meters if they apply, for many pensioners still do not understand this matter?

A copy of the leaflet to which the hon. Lady has referred—OC2, "Help with Heating Costs"—is available in the Library. It sets out the criteria for awarding extra heating additions. The revised print, which is already available, will be circulated within the next few days.

asked the Secretary of State for Social Services what is the number of families with children who are theoretically subject to a marginal tax rate of 75 per cent. and over, bearing in mind loss of entitlement to FIS, rent allowances, rate rebates and other means tested benefits upon any increase in income.

In August 1974, the latest date for which figures are available, the number of families with children which were theoretically subject to a marginal tax rate of 75 per cent. or over on a pay rise of £1 was about 200,000. This is about 3 per cent. of such families.

Are the Government aware that this is purely the result of their inability to take on board the importance of the tax credit scheme and of putting off the child benefit action for two years and probably for another four years? Are they further aware that we shall not get out of this appalling situation, which gives no incentives to many families—1 million people are involved in the 200,000 families to whom the Minister referred—until we have a new Beveridge Report and take firm action?

Lastly, will the Minister comment on how long we shall go on having incomes policies totally unrelated to people's family responsibilities? The sort of incomes policy that we now have—

Order. This is becoming argument.

If the hon. Gentleman is seeking tax credits as a way out of this admitted dilemma, he should be aware that the cost in current price terms is about £3 billion. The Tory Government's scheme of a few years ago had a cost tag on it of £1·3 billion. They did not tell us then how they proposed to pay for it and they have not yet told us how they would pay for the present cost of £3 billion. I do not see how they would pay for it when the Leader of the Opposition seems hell bent on increasing defence expenditure on tanks and rockets.

The root cause of this problem lies in the interaction between means tests and the low tax threshold. As to means tests, the hon. Gentleman should bear in mind that the Conservative Government introduced the two main causes of the poverty trap—the family income supplement and the big increase in means-tested rents under the Housing Finance Act 1972.

What action do the Government intend to take to remedy the poverty trap? Is the hon. Gentleman aware that families are being taxed at levels below the social security benefit level and that in some instances the same amount is being taken in tax as is being paid in FIS? That is a totally absurd situation. May I remind the hon. Gentleman how vocal he was on the subject when in opposition and how quiet he is at the moment?

The tax threshold is a matter for my right hon. Friend the Chancellor of the Exchequer. We have not introduced any new means tests since we have been in office compared with the two significant means tests introduced by the Conservative Government. We have relied on the new non-means tested benefits that we have introduced—the non-contributory invalidity benefit, the mobility allowance, the child benefit and the child interim benefit. Far from being silent, that is a very vocal testimony to our belief that the way out of the poverty trap is to avoid means testing.

asked the Secretary of State for Social Services if she will make a statement on the number of doctors emigrating from the United Kingdom to other EEC countries.

The latest information available relates to 1971–72 when 40 British doctors left for other member States of the EEC. I am, however, arranging for special monitoring of movement to and from the EEC so as to provide more up-to-date information on a regular basis and to assess the effect of the directives on free movement which come into effect on 1st January 1977.

I am grateful to the Secretary of State for that reply. Are not these figures likely to increase as qualifications inside the Community are harmonised and as uncertainty about our National Health Service increases? Will the right hon. Lady do something about that uncertainty by getting on with setting up the Royal Commission? Why is it that, three months after the original announcement, we still have no chairman, no members, no board, nothing?

It is impossible for any of us to predict the effect of the directives. All kinds of factors are at work here. For instance, there is the language barrier. I should not like to try to prophesy what the effect of the directives will be.

I assure the hon. Gentleman that satisfactory progress is being made with the Royal Commission.

On the subject of the emigration of doctors, has the Secretary of State noticed the extreme concern and caution about the Government's devolution and Assembly plans shown by the Scottish BMA and other doctors' organisations in Scotland?

I must be honest and tell my hon. Friend that I have not yet had the opportunity of studying that problem.

Does the Secretary of State agree that fewer doctors would be emigrating and medical morale would be higher if, for example, she could explain how she justifies bringing patients from overseas direct into NHS beds, thereby jumping queues, and supplying a different standard of service for people in this country?

As usual, the hon. and medical Gentleman is inaccurate. I should love to be able to answer that question in detail. Unfortunately, there is a later Question on that subject and I must restrain myself.

Will my right hon. Friend not worry too much about British doctors emigrating to other parts of the EEC? Is she aware that some British doctors who emigrated to that other Shangri-La of medicine—the United States—are finding conditions very much less attractive there than here, that to insure themselves against possible litigation by patients is costing them almost as much as they are earning in fees, and that many of them would be happy to return to the relative security of the National Health Service?

I think my hon. Friend is right. During all this discussion on emigration and intentions to emigrate—there has been a rising trend, I agree—it has been significant that our preliminary surveys have shown that in September 1975 there were more hospital doctors in post in this country than in September 1974.

On a point of order. As progress is so slow that my Question No. 38 on pay beds will not be reached, may I forgo my Question so that the Secretary of State may reply to it now?

I would much rather have points of order at the end of Question Time.

asked the Secretary of State for Social Services what proposals she has for simplifying the current regulations governing the payment of social security benefits.

Statutory regulations are expressed as simply as is consistent with the need for legal provisions. The substance of them is set out in everyday English in free information leaflets which are readily available to the public.

Is the right hon. Gentleman aware that at present more than 120 separate leaflets are in force giving details of entitlement to supplementary benefit and war pensions? Has the Minister read any of those 120 documents issued by his Department? Does he not think that the level of take-up of supplementary benefits might be increased significantly if those leaflets were simplified and streamlined?

I have read them. Recent editions of leaflets that have come out of my Department are far simpler and better presented than anything published in earlier years. The hon. Gentleman is right when he says that with means-tested benefits there is inevitably a major question of take-up. This Government have done everything possible to encourage the maximum possible take-up of means-tested benefits, but of course the solution, as my hon. Friend the Under-Secretary explained earlier, is flatly in contradiction to the policies of the previous Government, who sought to extend means-testing rather than reduce it, as we are doing, for example, under the Social Security Pensions Act 1975.

Will my right hon. Friend give his attention to the difficulties that can be caused to those receiving supplementary benefits when the Giro draft is either lost in the post or stolen? The recipient then has to wait seven or more weeks before he can claim the benefit. Is there not a way in which that amount could be credited and, if the form later shows up, any benefits received repaid?

Although only a tiny proportion of benefits paid by Giro is lost in the post, or lost for any other reason, such a loss presents a problem for individuals. I am prepared to consider any suggestions that my hon. Friend has on the matter.

asked the Secretary of State for Social Services what has been the increase in annual expenditure on supplementary benefits from 1961–62 to the latest available date.

Expenditure increased from £168 million in 1961–62 to an estimated £1,125 million in the calendar year 1975.

Is the right hon. hon. Gentleman aware that in a recent article quoting similar figures the Chairman of the Supplementary Benefits Commission has referred to the fact that the climate in which social security benefits are being considered in the country at large is changing and that often poor hardworking people are making the most complaints about it? It is causing great resentment among them that, because benefits are overtaking our very low tax thresholds, there is often little incentive to be in work and that frequently it is better to be out of work. In view of the remarks made earlier today about tax thresholds, will he ask the Secretary of State to consider setting up a working party with the Chancellor of the Exchequer urgently to sort out this whole confusing, often nonsensical and potentially damaging interaction between the tax systems and benefits?

I have read the article by Professor Donnison to which the hon. Gentleman refers and I agree with its contents. I will bring the hon. Gentleman's second observation to the attention of the Chancellor.

Is my right hon. Friend aware that there is an area of great need for further expenditure on supplementary benefits, that of one-parent families? Does he agree that many such families dependent on supplementary benefit have been disappointed about the child interim benefit? Having done something for those families not dependent on supplementary benefit, will he now look as a matter of urgency at the two main recommendations that the Finer Committee made for lone parents on supplementary benefit—a shorter qualifying time for the long-term addition and a special cash addition for lone parents and their children?

The Secretary of State has made clear the Government's position on what my hon. Friend described as the principal recommendation of the Finer Committee which was, of course, for a means-tested benefit. We have made clear our objections to any extension of the principle of means testing. My hon. Friend may be aware that between 1961 and 1975 the number of one-parent families helped through the supplementary benefit system increased from 76,000 to 245,000. However, I will certainly consider any other outstanding matters that my hon. Friend has raised.

asked the Secretary of State for Social Services if she is satisfied with the criteria applied to the distribution of supplementary benefit.

The present criteria for entitlement to supplementary benefit have been operated under successive Governments. I am always willing to consider constructive suggestions for improvements to the system.

Does the Minister realise that there is a practice among certain types of claimant of drawing supplementary benefit to meet some or all of the costs of their rent and then either keeping the money or spending it on themselves? Does he not agree that this is a fraud on the Exchequer, a fraud on all those who work and pay rent out of their own resources, and a fraud on the landlord, and yet it is not legally culpable? What steps is the Minister taking to remedy this situation?

I am grateful to the hon. Gentleman for giving me prior notice of his supplementary question with the sting in the tail—as it was called in the Sunday Independent of 18th January. It was very useful to me. Seriously, however, I think that the most sensible way to deal with this problem is through the powers, which the Supplementary Benefit Commission already has, whereby in cases of persistent default in rent payment arrangements can be made for the rent to be paid directly by the Commission's officers either to the local authority or to the landlord. That is the most sensible way of dealing with the problem.

asked the Secretary of State for Social Services whether she will make a statement on the level of morale and job-satisfaction within the medical side of the hospital service; and what steps she is taking to improve the present position.

I would refer the hon. Member to the statements made in the House by my right hon. Friend on 12th and 15th December.—{Vol. 902, c. 828–39; Vol. 902, c. 971–79.]

Is not the simple truth that morale is appalling and that it is not being made any better by the depressing sight of the right hon. Lady hawking our pay beds around the courts of Persia and Arabia?

That is not what my right hon. Friend did. On the general question of morale, I do not believe that it is anywhere near as bad as Conservative Members seem to think. They would do the National Health Service a great deal of good if they occasionally spoke up for the remarkable amount of activity which goes on in the NHS in helping patients in many areas and spent a little less time sniping at the Service.

But does not the right hon. Gentleman recognise the dismay and anger that his right hon. Friend has caused by refusing to refer the pay beds issue to the Royal Commission and now being forced to admit to a consultant practising in the St. Mary's group of hospitals that it is impossible to say whether there will be any speeding up of the making of appointments or hospital admissions for National Health Service patients following the abolition of pay beds?

I do not think that many people would deny that the freeing of some pay beds in some hospitals for the National Health Service will help to reduce waiting lists, particularly when they are associated with new, modern hospitals. As for the hon. Gentleman's other remark, I gather that we cannot find any evidence of this, but if he has a copy of the letter, I shall be interested to look at it.

asked the Secretary of State for Social Services whether she plans to introduce proposals to change the administrative structure of the reorganised National Health Service so as to make it more accountable to the community and to reduce its administrative costs.

I do not intend to make any sudden drastic change in the structure of the reorganised NHS in England so soon after the major changes in 1974 but we will continue to consider and introduce where appropriate evolutionary changes so as to minimise some of the disadvantages of the 1974 reorganisation. I believe our decisions to increase the proportion of local authority members on health authorities and to strengthen the role of community health councils, which are being implemented within the structure we inherited from our predecessors, will make the service more responsive to the views of the community. I have already asked health authorities in England to review their administrative costs in all disciplines.

I thank the right hon. Lady for that reply and recognise that this costly, over-administered and undemocratic structure was bequeathed to her by the previous Government. However, does she not agree that when we are talking of devolution, the redemocratisation of the National Health Service should be a priority and that even more of a priority is to deal with the number of administrative and supervisory posts which were created, many of them taken up by people whose professional skills would be better used at the bedside and in medical facilities? Does she not agree that the Health Service is one of the main areas which has more Chiefs than Indians?

I am grateful to the hon. Gentleman for recognising that I have been bound by the administrative structure that I inherited from my predecessors. It was impossible for me to reverse all their work within a matter of weeks of taking over my new responsibilities. All that we could do, as I have explained, was to take democratisation as far as we could within the legislative and administrative structure that we inherited. As for the administrative top-heaviness of our predecessors' structure, I have been in touch with the health authorities to do what we can to streamline without turning the whole new system upside down. I therefore told the health authorities that the filling of vacancies or additional posts should take place only after full consideration of both the need for the post relative to a specific job of work and the real priority of that job of work. We have also been trying to cut out unnecessary duplication through tiers and to secure the maximum devolution, thereby streamlining within the existing structure.

Will my right hon. Friend give an undertaking to the House that she will respond favourably to the growing number of community health councils, including every one in Birmingham, which are demanding greater facilities for the termination of pregnancy in NHS hospitals now that they have reviewed the inadequacies in different parts of the country?

The community health councils bring pressure to bear upon their appropriate health authorities. This is going on all the time. I am glad that many health authorities are increasingly paying attention to and co-operating with the community health councils over a large number of issues.

asked the Secretary of State for Social Services if she will investigate the reasons why hospitals are understaffed during periods of widespread unemployment.

Hospital staffing levels are determined primarily by the financial resources approved by Parliament and the availability of professionally qualified staff.

Is my hon. Friend aware, however, that the National Health Service is certainly still the Cinderella service of all the public services in the sense that over the last 20 years—at any rate, until the end of 1974—the percentage of gross domestic product donated to the Health Service was estimated at about 3·6 per cent? As a result, the situation is now somewhat ludicrous, because hospital boards cannot encourage people to take jobs in hospitals when their take-home pay, in the absence of excessive overtime, is less than they could receive if they were drawing supplementary benefit. When the take-home pay of portering and catering staffs in hospitals is compared with benefits of the kind I have mentioned, it will be appreciated that that is a deterrent to working in the Service. Does this not illustrate not that social benefits are too high but that the blessed wages paid in the Service are too low?

No one would say that the wage structure in the Health Service was perfect by any means. However, in the last two wage settlements my right hon. Friend has been able to achieve a very considerable improvement in the very low wages among some of the ancillary workers. The £6 settlement has helped them relative to other sections of the community. However, as my hon. Friend pointed out, this has been achieved only by a conscious decision to increase the percentage of the gross national product devoted to the Service—for example by 0·5 per cent. last year.

Does the Minister agree that the policy of closing down small local hospitals that are both economic and fairly easy to staff will increase staffing problems for nurses considerably?

It depends on which hospitals are involved. Some small hospitals are economic and easy to staff and they should be retained. Some small hospitals are uneconomic, expensive and often situated in areas where there are already many more beds per head of population than in other areas. Some of these hospitals ought to be closed. That is particularly true of some of the bigger centres and the cities.

asked the Secretary of State for Social Services if she will publish the statistics relating to services provided under Section 2 of the Chronically Sick and Disabled Persons Act 1970 by local authorities in the last financial year; and if she will make a statement.

As the Answer is in the form of a table of figures, I will circulate the information in the Official Report. The tables showing provision by individual local authorities are being printed and copies will be placed in the Library of the House shortly. My hon. Friend will be pleased to learn that in 1974–75 there was an increase of nearly 18 per cent. in the number of households helped under Section 2 of the Act compared with the previous year.

Will my hon. Friend take it from me that we are delighted that there has been an increase in average spending, but that this is an average figure and means that some local authorities have done extremely well and that others have done very badly? Will he congratulate those local authorities which have done well under Section 2. Will he please remind the laggards that this section went through without a vote in the House and with the full approval of Parliament? Will he bring that home to the laggard authorities?

I am grateful to my hon. Friend. The whole House appreciates my hon. Friend's active, sustained and wholly genuine concern to ensure full and humane implementation of the Act. He will appreciate that I am deeply concerned also to see that the Act is applied in the interests of all disabled people. The figures reveal differences in provision. The increase of 18 per cent., however, is notable. We must also bear in mind that 136,000 names of severely disabled people were added to the registers of local authorities in 1974–75. This was a notable achievement by many local authorities in widely different parts of Britain.

Do not the present financial restrictions render much of the very desirable practical help which the Act obliges local authorities to undertake ineffective and impossible for many local authorities? Would it not be better if the Secretary of State considered an amendment to the Act so as to narrow the field in which local authorities are obliged to undertake these desirable measures so that the authorities can attend to the most vital areas of need, such as help in education for austistic children, much more thoroughly than now?

We have no plans whatever to amend the Act. We have made the mandatory nature of Section 2 clear to local authorities. Our legal advice is that once a local authority accepts that need exists in respect of one of the services listed in the section, it is incumbent upon it to make arrangements to meet that need. In the present economic situation there are, of course, difficulties about balancing the discharge of the duty with due exercise of financial restraint. There has, however, been a remarkable amount of progress in the past year. There was an article in The Times yesterday showing what superb results can be achieved by local authorities. I hope that all right hon. and hon. Members will read that article.

asked the Secretary of State for Social Services what is the current purchasing power of the retirement pension, compared with March 1974.

On the basis of the movement in the General Index of Retail Prices between March 1974 and December 1975 the purchasing power of the retirement pension is currently about 20 per cent. higher than in March 1974.

I recognise the very laudable achievements of the Government in raising the retirement pension by some 70 per cent. since Labour took office. However, is it not a fact, bearing in mind what the Minister has just said, that much of that increase has been eroded by increased prices for essentials such as food and fuel? Does my right hon. Friend accept that we have still a long way to go to achieve adequate standards of social justice for our senior citizens? Will he begin by giving serious consideration to the efforts of Jack Jones and others in the Labour movement and the trade union movement to get pensions increased by this spring to a level of £18·50 for a single person and £28 for a married couple?

My hon. Friend is wrong to assume that the value of the pension has been significantly eroded. As a result of the November uprating, the real value of the pension was higher than its value when we increased it significantly to £10 in July 1974. That was a far greater increase than anything which had been achieved by the previous Conservative Administration.

My hon. Friend is right and the whole of the Labour movement is right in believing in and implementing better pensions. That is precisely what our new long-term pension scheme will achieve. It will mean an end to the massive dependence on means testing in old age, which is a characteristic of the present system.

As regards future upratings, my hon. Friend will recognise that the last uprating took place in November. The record of this Administration demonstrates that we have introduced upratings within as brief a period as has been necessary. We shall do everything in future to protect the pensioner against the erosion of the pension by inflation.

Does the right hon. Gentleman accept that we have waited a long time for the announcement of the operative date of uprating? Will the right hon. Gentleman concede that while we have been waiting for the announcement of the uprating to protect pensions against the effects of inflation—namely, since March 1975—we have seen the highest rate of inflation that has taken place even under this Government? Is the delay due to the fact that the buoyant revenues from earnings-related national insurance contributions are being entirely consumed by the present disgraceful level of unemployment?

I shall take representations for better pensions from my hon. Friends, but not from Opposition Front Bench spokesmen. The record of the Opposition on the subject of pensions is absolutely appalling. The figures demonstrate that. For example, when their upratings occurred in October 1972 and 1973, their real value was respectively £8·42 and £8·80. The present Administration, in the face of considerable economic and financial difficulties, has raised the real value to £10. We have increased and improved pensions since coming into office.

asked the Secretary of State for Social Services what action she intends to take in connection with the report on fluoridation.

I welcome the recent report of the Royal College of Physicians as further authoritative independent medical endorsement of the safety and efficacy of fluoridation as a community health measure for protection against dental decay.

I am writing to all area health authorities, in the light of this report, asking them to give very urgent consideration to the issue as part of their preventive health responsibilities.

I am obliged to my hon. Friend for that reply. In view of the cost to the nation's health of dental caries, will my hon. Friend also undertake to consult his right hon. Friend the Secretary of State for Education and Science to ascertain what urgent action can be taken to help both parents and their children to look after their teeth by taking fluoride voluntarily until such time as the water authorities are able to act?

I gladly undertake to enter into those discussions, but I must reiterate that the tablets taken to help with the fluoride problem are only one measure. A more satisfactory measure would be general fluoridation. However, my hon. Friend is right to express her concern. The general dental practitioners' service costs some £140 million a year.

Instead of encouraging compulsory mass medication through the water supply, would not the Department do better to encourage the sale of suitably medicated sweets and toothpastes as a way of introducing fluoride?

All the evidence shows that that is nowhere near as effective as fluoridation. We are not encouraging compulsory mass fluoridation. This is a decision to be taken by area health authorities in the light of their preventive health responsibilities. I hope that they will consider the evidence. The report from the Royal College of Physicians is authoritative.

asked the Secretary of State for Social Services what percentage of immigrant doctors sitting examinations for eligibility to practise in the United Kingdom have passed on the last three occasions when the examinations have been taken.

The test arranged by the General Medical Council applies only to overseas doctors who are seeking temporary registration in this country for the first time. In the last three tests the percentage pass rate was 29 per cent., 31 per cent. and 38 per cent.

Does the Secretary of State agree that the figures show that the number of doctors coming into the country will drop quite drastically? If that happens, how will she honour her promise to the junior doctors to reduce their hours of work, bearing in mind what she told the House in December? Is it not true that to honour that promise she will have to rely on British doctors and that we shall have to pay them proper rates of overtime?

I think that it is too early to assess the effects of these examinations and tests on future manpower in the National Health Service. We are monitoring the situation very closely. We recognise the valuable contribution that overseas doctors have made to the Service, but we are determined to expand the intakes of our own medical schools. That expansion programme is going ahead and it will go ahead whatever economic stringencies may prevail.

asked the Prime Minister whether the statements by the Chancellor of the Exchequer on economic policy in his London Weekend Television interview on 4th January represent Government policy.

Yes, Sir.

I ask the Prime Minister specifically whether he agrees with two statements made by the Chancellor of the Exchequer in the course of that interview. First, his right hon. Friend said that there could be no question of replacing the present £6 pay limit with another flat rate and that there must be more flexibility so as to allow for differentials. Secondly, he said that there was a special case for giving some tax relief to middle income earners. The right hon. Gentleman confessed that he had given them quite a caning. Does the right hon. Gentleman agree with those two statements?

My right hon. Friend did not use quite the expression the hon. Gentleman has mentioned. He indicated the case for more flexibility, but this issue has not yet been decided, as my right hon. Friend made clear at the time. My right hon. Friend was speaking on behalf of Her Majesty's Government in that second statement.

Is my right hon. Friend aware that since the Chancellor's broadcast, when he talked about giving some element of tax relief to the middle class—namely, those earning between £4,000 and £8,000 per annum—the Secretary of State for the Home Department has said—quite alarmingly, most people in the PLP would think—that when public expenditure as a proportion of national income reaches 60 per cent. and beyond, the result is that a pluralist democracy is in danger?

Taking into account the two restrictions mentioned by the Chancellor and the Home Secretary and today's ministerial replies about pensions, how are we to observe what my right hon. Friends have said and at the same time get better pensions, more hospitals and more housing? Does my right hon. Friend agree that he should get these people together?

My right hon. Friends are together. The Question on the Order Paper relates to a broadcast by my right hon. Friend the Chancellor of the Exchequer. If my hon. Friend wishes to table a Question about the speech of my right hon. Friend the Secretary of State for the Home Department, I shall be delighted to answer it.

Is my right hon. Friend aware of the conclusion drawn in the latest report of the Price Commission—that inflation is now slowing down, but that it is still relatively too high for pressure to be significantly eased on the exchange rate and, therefore, on import costs, and that much the greater part of the improvement is attributed to the almost universal observance of the £6 voluntary limit on pay increases?

Yes, the current report of the Price Commission is an extremely important document and marks a very important stage in the fight against inflation. I am sure that its conclusions will be as welcome to Opposition Members as it is clearly welcome to my hon. Friend and myself. He will be aware of course, that the Commission's own index and other published indices show a very significant fall in the rate of inflation.

asked the Prime Minister whether the television interview given by the Chancellor of the Exchequer on 4th January on the economy represents Government policy.

I refer the hon. Member to the reply which I gave earlier today to the hon. Member for Reigate (Mr. Gardiner).

Will the Prime Minister give his own views about the restoration of differentials? Will he support the attempts of the Chancellor of the Exchequer to resist the pressure from his left wing to reflate the economy?

The subject of differentials and the next stage of the anti-inflation policy will have to be discussed with all concerned. At this stage it is impossible to forecast the right answer. There must be discussions. During the greater part of last summer I was badgered by the Opposition to do something, presumably statutory. We have achieved the right answer, it is working, and the hon. Gentleman should wait for the progress of further consultations.

Is it not hypocritical for Opposition Members to press for cuts in public expenditure and at the same time to press for increased expenditure on armaments in the spirit of the cold war?

The speech made last week, which has been the subject of some comment this afternoon, contained a complaint about a cut of £4·8 billion in the defence review last year. Any party that claims to want to cut Government expenditure overall must start by replacing that £4·8 billion as well as dealing with Maplin, the Channel Tunnel and all its other commitments.

On the subject of public expenditure, I was interested to note the forthcoming and frank statement by the right hon. and learned Member for Surrey, East (Sir G. Howe), who advocated cuts in expenditure this year rather than three years ahead. He admitted that this would cause additional unemployment this year. The House should know whether the Leader of the Opposition supports that view.

asked the Prime Minister when he next intends to visit Portsmouth.

I have at present no plans to do so, Sir.

Is the Prime Minister aware from his visits to naval and other military bases of the ever-increasing Russian military strength? Does he realise that the Russian Socialists are realistic and appreciate not only military strength but willpower? Although they undoubtedly wish to see a Socialist Government here, they will respect Britain more if we are led by an iron lady rather than by a plasticine man.

The Soviet Union, which is composed of realists, pays less attention to the odd speech here or there than it pays to the record of Her Majestys' Government's support of NATO and our determination to maintain its strength.

Is the Prime Minister aware of the even greater military strength of the United States? Do not both great Powers possess the ability to overkill? Is there any sense in the United Kingdom's indulging further in this nonsense, because there is no defence against nuclear weapons?

Anybody in my position must be fully aware of the great contribution made by the United States, together with other European countries, to NATO. The balance of military power and of ability in nuclear matters—the balance of terror, as my hon. Friend might prefer to put it—has been significant in achieving detente between the two super blocs, and therefore between NATO and the Warsaw Pact countries. Because of this situation, the achievements of Helsinki, which I believe to have been real, were possible, although not every Conservative Member welcomes that.

In view of the hysterical outburst from Moscow and the somewhat trivial response of the Secretary of State for Defence to the factual and balanced speeches made by the right hon. Gentleman the Foreign Secretary and myself, will the Prime Minister speak up for the effective defence of Britain and for our way of life against those who permit freedom of neither speech nor travel and who have to build a wall to keep their people in?

I agree with the right hon. Lady about the outbursts from Moscow. I thought the best comments on the whole business came from my noble Friend the Minister of State for Foreign and Commonwealth Affairs, who told the Russians that this was a country of free speech and that anybody was free to make speeches—including my right hon. Friend the Secretary of State for Defence and those Russians who wished to enter the argument. It was quite wrong of the right hon. Lady to refer to any comparison between her speech and that made by my right hon. Friend the Foreign Secretary in relation to what was said by my right hon. Friend the Secretary of State for Defence, who spoke from real knowledge of these matters. The right hon. Lady's analysis contained a considerable number of long accepted truths which she has just discovered, but it contained nothing new. The difference between the right hon. Lady and my right hon. Friend the Secretary of State for Defence is that he has been dealing with these matters from great knowledge, whereas the right hon. Lady has suddenly began to make speeches about them.

If the Prime Minister accepts the analysis and accepts that, if our defence is to be effective, it must bear some relation to the forces ranged against us, will he say "No" to further defence cuts?

We have a responsibility, as had the Conservative Government of which the right hon. Lady was a member, in making our contribution to NATO. We are making a full contribution and NATO is extremely satisfied with our contribution. I have made clear in the House that any review of defence expenditure will not affect the effectiveness of that contribution. We have said this to our NATO allies. I am sure that the right hon. Lady will be satisfied with the figures when they are published. I agree with the right hon. Lady's comments about the Berlin wall. I recall a visit made by 40 hon. Members in a Labour Party mission to Berlin many years ago. Some of my hon. Friends who were involved in that visit are still in the House and they will remember the line taken by that mission and its leader in 1962.