asked the Secretary of State for Social Services whether there will be a fall in total public spending on the health and personal social services in 1977–78 compared with the current year.

No, Sir. The total public spending planned for the health and personal social services in England is £7 million greater in 1977–78 than in 1976–77 at 1976 survey prices.

I wonder whether the Secretary of State could reconcile that with the figures in the Public Expenditure White Paper, which indicate a fall.

Yes, indeed. The figures for health and personal social services took account of the estimated revenue from the levy on motorists through vehicle insurers. The net amount of these services will, therefore, be higher by this amount—in England, £15½ million in 1977–78 and £34 million annually thereafter, at 1976 prices. Therefore, that factor was not included in the figures that the hon. Gentleman read.

Does the Minister agree that reduction in public spending is assisted by the income derived from pay beds? What steps is he taking to ensure that the Health Services Board carries out the Goodman proposals, fulfils the undertakings that the Minister gave to the House and carries out the requirements of the Act?

First, the revenue for the year about which we are talking, 1977–78, would have been very modest indeed in terms of pay beds. Secondly, the Health Services Board is, of course, carrying out absolutely to the letter the conditions laid down by the legislation of this House. I have very great confidence in the Chairman and members of the Health Services Board, who are doing their job very well.

asked the Secretary of State for Social Services if he will report on recent meetings between Ministers and representatives of widows' organisations.

On 9th March I spoke at the "Fair Play for Widows" rally organised by the National Association of Widows, and on 11th March my right hon. Friend met the Chairman of the War Widows' Association of Great Britain. In each case we listened with interest to the views of widows on a variety of issues.

Is the Minister aware that we are very disappointed that those representations have clearly had no effect whatsoever? Does he accept that as the personal allowance increase in the Budget is less than 10 per cent. and as widows' pensions seem bound to rise by more than that, the tax position of widows will get even worse later this year than it is now? Will he make sure that his Treasury friends do something about this in the Finance Bill?

I am well aware, as are the hon. Gentleman and his right hon. Friend the Member for Wanstead and Woodford (Mr. Jenkin), that the issue of taxation was raised very strongly by widows at the rally and with my right hon. Friend. Those views were passed on to my right hon. Friend the Chancellor. However, for the fourth time since we took office in 1974, there has been a rise, and the real value of these benefits is now about 15 per cent. higher than it was in October 1973.

No doubt the Minister will recollect that he got a very rough ride indeed at the widows' conference at Central Hall. Will he realise and accept the point made by my hon. Friend the Member for Braintree (Mr. Newton) that the great burden of their complaint was that they now have to pay tax at a ridiculously low level of income—indeed, almost at the same level as their pension? Why has nothing been done about this in the Budget, in view of the very strong representations made by the widows, and presumably made to the Minister at the meeting to which he referred?

As the right hon. Gentleman knows, no one came out of that rally—including himself—smelling of roses. The ladies concerned were very forthright. I make no objection to that. In fact, following the rally I received from Mrs. June Hemer, the honorary general secretary of the National Association of Widows, a very generous letter of thanks for attending the rally. The points that the right hon. Gentleman has raised were passed on to my right hon. Friend the Chancellor.

Will the Minister let the House know how much better off widows with children are because of the new Child Benefit Scheme, and how much administrative expenditure has been involved in implementing that great improvement in their income?

There has been no loss from the transfer to child benefit to the widows.

asked the Secretary of State for Social Services whether he is satisfied with the administration of the Child Benefit Scheme.

asked the Secretary of State for Social Services how many children are still not registered for child benefit purposes.

The Child Benefit Scheme started yesterday, and I am satisfied with the way things have gone. Nearly 14 million children will be within the scope of the scheme. About 11 million of these are in families previously getting family allowances and, therefore, already on the record for child benefit. Of the 2·8 million children in families with only one child, about 2·4 million have claimed the benefit. We are, therefore, only about 400,000 claims short out of nearly 14 million. I hope that many of these will claim now that the scheme has begun.

I wonder whether the Secretary of State can explain to the House and to all single-parent families why Form CH11 for single-parent families was not issued earlier than the middle of March so that these families could claim the additional 50p. In many social security offices and in no post office that I have come across is the form available now that the scheme has started. The situation is an utter disgrace.

That is rubbish, because people were able to make their claim, they have made their claim, and we have written to all those who have not made their claim to make certain that they get their full entitlement.

Will the right hon. Gentleman please tell the House when every post office will have the relevant form for every category of both parents and children who wish to claim any of these benefits?

I assure the hon. Gentleman that almost every post office has those forms. [HON. MEMBERS: "That is not true."] It is true. We have made a careful check of the Post Office. I know that every now and again it has been possible to find a post office that has run out of supplies of the leaflet, but by dint of the fact that up to yesterday only 400,000 people out of a total of 14 million had not claimed one can see the extent to which people have known of their entitlement. I have no doubt as a result of the publicity that has been given to the launching of the scheme, and of Press conferences held by my right hon. Friend and by myself, many of the 400,000 who have not claimed will now do so. I believe that we shall achieve almost 100 per cent. take-up within the next few weeks.

The right hon. Gentleman must not mislead the House. The fact is that it is 400,000 out of the 2,800,000 who had to claim. The rest did not have to make a claim. Is not the fact that one person in seven has not claimed a universal benefit of this sort a disgrace and a real reflection on the way in which the Child Benefit Scheme has been bungled from its very start?

Some of the 400,000 who have not claimed will be children who will be leaving school at Easter—they have probably left this week—and others will be leaving school in June. They have 10 weeks in which to claim, and I hope that they will do so. That accounts for a large number of those who have not claimed.

asked the Secretary of State for Social Services what recent consultations he has had with organisations representing the disabled.

My hon. Friend the Minister with responsibility for the disabled is in close and constant touch with organisations representing disabled people. I myself had a meeting earlier this month with representatives of the Central Council for the Disabled and have also recently met the ex-Service organisations concerned with helping the war disabled and representatives of the Queen Elizabeth Foundation. I shall be addressing the annual conference of BLESMA in May and, with my hon. Friend, will be maintaining the closest possible contact with all the voluntary organisations in the disablement field.

What answer does the right hon. Gentleman have for young people newly and severely disabled with no hope of providing a vehicle from their own resources? What chance have they of anything remotely approaching a normal mobile way of life under the right hon. Gentleman's present policy?

I have said that it is our anxiety to ensure that no one is immobilised as a result of the withdrawal of the tricycles. As the hon. Gentleman knows, the number of people who receive that assistance will be increased greatly as a result of the mobility allowance.

Has my right hon. Friend, or our hon. Friend the Under-Secretary of State with responsibility for the disabled, had any discussions with organisations of dentists that are trying to do something for those who are mentally or physically handicapped? Is my right hon. Friend aware that it is a disgraceful blot on the Government's otherwise first-class record that those who are either mentally or physically disabled are not able to get dental treatment under the National Health Service?

My hon. Friend the Under-Secretary of State has received a deputation on precisely this subject from my hon. Friend and some of his colleagues. I assure my hon. Friend that we are giving the matter careful consideration.

Has the right hon. Gentleman had discussions with the Chancellor of the Exchequer following his Budget? The imposition of the tax on petrol means that many of the disabled who still have a vehicle will be less mobile than before.

This is a matter about which there is consultation. The mobility allowance will be uprated when we come to November of this year, and it will not be long before I shall announce the uprating figure.

Is my right hon. Friend satisfied that the criteria for mobility allowance are being applied consistently?

I know that this problem has been worrying my hon. Friend, and I believe that he is in correspondence with our hon. Friend the Under-Secretary of State with responsibility for the disabled. If there are ways in which it is thought that we can make the criteria more acceptable, I assure my hon. Friend that we shall do that.

Is the right hon. Gentleman satisfied with the operation of the orange dot parking scheme for the disabled?

I think the hon. Gentleman will know that this scheme has recently been extended. Perhaps it would help if I were to write to the hon. Gentleman giving him the full details.

I thank the Minister.

asked the Secretary of State for Social Services if he plans to introduce further legislation to assist the disabled.

Important advances have been made in legislative provision in recent years. Further improvements are necessary to help disabled people and will be carried through when resources allow. Regulations to extend the non-contributory invalidity pension to disabled housewives from November of this year are now before the National Insurance Advisory Committee. We shall also be making regulations this summer to provide the attendance allowance for foster-parents caring for severely handicapped children.

Is it not clear that the mobility of the disabled will be affected adversely by the increase of 5½p per gallon in petrol tax? Instead of introducing new legislation, is the Minister prepared to listen not only to Liberal Party Members but to those representing the disabled, with a view either to an interim increase in the mobility allowance or to finding a way in which the disabled will not have to pay the additional 5½p?

My right hon. Friend has already commented on that. We appreciate the importance of mobility costs to disabled people. We are in the process of trebling my Department's expenditure on mobility for the disabled. At the same time we have said that we shall increase the mobility allowance, not only in amount but in value, this year. The hon. Member can be assured that his request will be considered carefully.

Does my hon. Friend agree that much can be done for disabled people, particularly those confined to their homes, within the confines of present legislation? Having seen the scheme in Rossendale for decorating the homes of the disabled, will the Minister approach voluntary groups and local authorities in other areas and suggest that they use job creation schemes to ensure that projects such as that in Rossendale are extended to other parts of the country?

I visited my hon. Friend's constituency recently. The Disablement Income Group in that area has, with the help of the job creation scheme, operated a remarkable programme of help for disabled people. I agree that the scheme is one that could be studied with profit in localities throughout the country. I congratulate my hon. Friend on his part in the making of the scheme.

Will the Minister make it clear that the word "disabled" is not confined to people with handicaps and problems of movement but includes people such as the deaf and the blind?

I am aware of the hon. Member's senior office in one of the main organisations helping the blind. I agree with him that people believe that there is such a being as a standard disabled person. It would sometimes help employers to meet their commitments if they realised that we were talking not only of people in wheelchairs but about those who are blind or deaf or who have other severe handicaps.

Will my hon. Friend give a progess report to the House about the modern hearing aid provided privately and perhaps under the National Health Service?

We are making good progress with the new behind-the-ear hearing aid. We estimate that there will be about 1 million beneficiaries of this new provision when the phasing-in programme is complete. As the latest date for which figures are available, 175,000 people in England had received the new aid. The figure for the United Kingdom at 31st December 1976 was 215,000. That is a remarkable achievement for people who are hard of hearing.

Will the Minister reconsider his answers to the Leader of the Scottish National Party and to my hon. Friend the Member for Brentwood and Ongar (Mr. McCrindle) about the increase in petrol tax? Is he aware that for seven months disabled drivers must pay the increased cost of petrol because the Liberal Party did not oppose it last night? Is it not time for this to be reconsidered? I know that it may require legislation, but why should disabled drivers have to pay for seven months?

The hon. Member must appreciate that this is a matter for my right hon. Friend the Chancellor of the Exchequer. My right hon. Friend the Secretary of State for Social Services has already said that we are in consultation. There is nothing that I can add at present, other than to say that it was the present Government who restored the petrol allowance for disabled drivers and who doubled it in 1975.

asked the Secretary of State for Social Services whether he is satisfied with the working of paragraph 10 of the terms of service for general medical practitioners, under which a practitioner is not required to assign any reason for the removal of a patient from his list; and whether he has any evidence of anxiety caused to elderly people, in certain cases, by the operation of this paragraph.

I recognise that removal from a doctor's list may sometimes be upsetting, particularly to elderly people, but general practitioners are independent contractors who have a freedom to choose their patients, as patients have the freedom to choose their doctors.

Does my hon. Friend agree that there are at least grounds for suspicion that a minority of general practitioners rather resent having elderly people on their lists because, naturally, they take up more time and attention of the doctor than do younger people, and that such patients are removed from the list without justifiable cause?

If there are general practitioners who take the attitude that my hon. Friend describes, the evidence indicates that they are a small minority. If my hon. Friend has a particular allegation to make, I shall be grateful for the details so that I can look into the case.

Is the Minister ready to condemn the slur on doctors by the hon. Member for Rotherham (Mr. Crowther)? Will he accept that the really important point in this matter is that there should be a foolproof arrangement for patients who have been asked to leave a doctor's list to be covered by some other doctor, and would not the arrangement between a doctor and a patient whom he did not wish to have on his list be intolerable if it were forced to continue?

I did not understand my hon. Friend to be making any slur about doctors in general. However, I do not accept that all doctors are beyond criticism. There are procedures whereby someone who is removed from a doctor's list and experiences difficulty in finding another doctor may apply to the family practitioners committee for help.

asked the Secretary of State for Social Services if he will issue guidance to the area health authorities covering their responsibility for the elderly mentally infirm, and the balance of responsibility between area health authorities and local government.

Guidance on the provision of services for mental illness related to old age was issued to statutory health and local authorities in 1972. I am considering whether further advice is needed.

I am grateful to my right hon. Friend for that reply. Is he aware that an argument is developing in Sheffield between the local authority and the area health authority about the care of the elderly mentally infirm? Is he aware that the health authority claims that they do not need medical treatment and that the local authority claims that they are beyond basic care? Should not the position be clarified?

One thing that pleases me about the dispute is that a joint working party has been established between the Sheffield Area Health Authority (Teaching) and the Sheffield Metropolitan District Council to see how they can improve the services for the elderly mentally infirm in the area. They have recently accepted the recommendation of their joint consultation committee and a joint working party has been set up to try to work out an agreement. It held its first meeting on 11th March, and I hope that an agreement will be reached on this difficult issue.

Does the Secretary of State accept that this, sadly, is an increasing problem? Is he satisfied that sufficient resources are allocated tinder the National Health Service for mental health care, particularly for the elderly?

It is a problem in many parts of the country. In the consultation document that was sent out last year we emphasised that priority should be given to services for the mentally ill and mentally handicapped, and particularly to the elderly mentally ill. In many regions that priority has been fully accepted. In some areas it has not been accepted as fully. I am investigating the situation as it applies region by region because it is one of the services to which priority should be given even at a time when the growth of resources is admittedly modest.

When looking at the situation region by region, will the Secretary of State give guidance to the area health authorities, because there is some evidence that psychiatrists and geriatricians find it difficult to deal with elderly psychiatric patients because they believe that geriatric patients should be treated as psychiatric patients and that in some instances psychiatric patients should be treated as geriatric patients? Will he look at this situation, because many elderly people are suffering unnecessarily?

I understand that there is some dispute. Our anxiety is to ensure that the elderly mentally infirm should be able to live as long as possible in the community and not in our hospitals. We lay great stress on domiciliary services to minimise the number of people who have to be admitted to psycho-geriatric wards.

Does the Secretary of State agree that, despite his guidance to area health authorities, the funds available to deal with this problem are completely inadequate? Is it not a fact that this is unlikely to be overcome until we increase our gross national product and have more money to spare?

I cannot disagree with that. It is true that if there was more money in general we could allocate more funds for this purpose. Conservative Members are very insistent on limiting public expenditure, and we cannot exclude even the Health Service from such limitation. However, what we can do, within our limited resources, is to get our priorities right, and our principal priority must be to give help to the Cinderella services, which include those for elderly people, the mentally ill and the mentally handicapped. This is the policy that I am pursuing.

asked the Secretary of State for Social Services what further representations he has received regarding the extension of the mobility allowance to older persons; and if he will make a statement.

I have had a number of representations about extending the allowance to people over pensionable age. The problem is one of cost. An extra annual sum of the order of £125 million would be required to make the allowance payable beyond pensionable age. Our immediate priority for older people has been to increase the level of retirement pensions, and this has already been done four times in the past three years. Altogether, the improvements to date in pensions and benefits since we took office have cost about £1,500 million.

Will the Minister, who has done so much in this House for the disabled, bear in mind that many of the disabled persons who do not get the benefits of the mobility allowance suffer from regressive illnesses and may never receive any such benefit unless the age category is extended as soon as possible? I appeal to the Minister to do his best as soon as the resources are available to extend the scheme and so enable other disabled people to enjoy these benefits.

We hope to build on the present scheme as soon as we can. No one knows more than my hon. Friend the Member for Coatbridge and Airdrie (Mr. Dempsey) that there is a strong claim on behalf of blind people to be included in the mobility allowance scheme. Unfortunately, we have an infinite number of claims but finite resources.

Is the Minister aware that there is a progressively greater need for the allowance among elderly groups? These people are worse off under the current Government proposals than they were under the previous plan. Will he extend the scheme in some way in order to help these unfortunate people?

I appreciate the problems of elderly people who are disabled. Under the terms of the Social Security (Miscellaneous Provisions) Bill, we have been able to take some elderly disabled people across retirement age while retaining the benefits of the allowance. I shall bear in mind the points that have been made in this series of questions.

Does my hon. Friend agree that there is something rather ridiculous about the present arrangements, which mean that a constituent of mine in his twenties who needs a tricycle to get to work—in all other respects he is self-supporting—cannot have such a vehicle, but that if he were 51 years old he could?

My hon. Friend has put his finger on one of the transitional problems. It is because people are not entitled to a mobility allowance if they are over 50 that they may still apply for vehicles. There is an implication that his constituent is a person who needs extra help to get to and from work, and I shall have the particular case looked at in conjunction with my colleagues at the Department of Employment.

Is the Minister aware that the average weekly travel-to-work payment of the Department of Employment is £9·04? This is nearly double the mobility allowance. Would it not be sensible, in order to release more money for pensioners to receive the mobility allowance, to look at what further mobility allowance might be made to the disabled so that they may be made self-supporting by provision of additional help for travelling to work?

I am in very close contact with my ministerial colleagues at the Department of Employment on this matter. I emphasise that the sum is not less than its parts. Those who want to increase public expenditure in every particular item yet depress it in totality should realise that to govern is to choose. I am arguing for the claims of disabled people. I know the interests of the hon. Member for Wallasey (Mrs. Chalker) and I am doing everything I can to help disabled people, in consultation with my colleagues.

asked the Secretary of State for Social Services by what percentage the parental take-up of whooping-cough vaccine has dropped in the last year.

Complete figures for 1976 are not yet available, but returns from 68 of the 90 area health authorities in England suggest that the number of whooping-cough vaccinations for children under 16 was 4 per cent. lower than in 1975. A much more serious drop occurred in 1974 and 1975.

Does the Secretary of State agree that one factor in the continuing fall in take-up is the uncertainty engendered by the refusal of the Government to take liability for whooping-cough vaccine damage and to pay compensation? The United States Congress has passed into law the swine flu Act under which the American Government accept full liability for the damaging side effects of swine flu vaccination. Is he aware that a document, sent to me by Senator Edward Kennedy a few days ago, indicates that the relationship between the American Department of Health, Education and Welfare and its public is similar to that between the British Social Services Department and its public, and has similar responsibilities?

I am prepared to read carefully any document from any distinguished friend that the hon. Member has in the United States. On the question of compensation, this is not uppermost in the minds of parents. The questions they most consider are whether to get their children vaccinated, and the risks and the advantages. However, following representations from the Association of Parents of Vaccine-Damaged Children, I shall give further consideration to reaching a quick and early decision on the question of compensation. The issues are very complex and are being considered by the Royal Commission on Civil Liabilities and Personal Injury. I am not yet in a position to make a further statement.

Will my right hon. Friend undertake to remind parents of the positive advantages of vaccination? One of the dangers of the present campaign, with which I sympathise, is that people have forgotten what whooping cough is really like and the damage that it can do to small children.

I very much agree, and I deplore statements that have been made that throw doubt on the wisdom of vaccination. The Joint Committee on Vaccination and Immunisation at its meeting on 29th March issued a statement saying that the continuing decline in the uptake of vaccination, in particular of whooping-cough vaccination, must be viewed with grave concern. The committee stressed that if this trend continued it could only lead to a recurrence of serious communicable diseases, such as diphtheria and polio, on a scale that has not been seen for many years. Already there have been more cases of polio in the past six months than in any similar period in this decade. I honestly hope that young parents will be guided by this expert advice which I have at my disposal.

Does the Secretary of State agree that the most important thing here is the future of the vaccination programme as a whole? Is it correct that his committee is about to make a further report to him, and, if so, will he publish that report?

The committee issued the statement that I have just read to the House. I have asked it to prepare a more substantial report, to review all the evidence that has been brought to its attention and to publish a report indicating the basis of its advice to me. I anticipate that this report will be available in the next few weeks.

Is the Secretary of State aware that the responsibility for the decline in the immunisation programme must rest clearly with the Government and not with the mothers asking for compensation? A week last Saturday, those parents decided that they would approach the Prime Minister and take the campaign into higher gear. However, they accepted a recommendation that they should stop campaigning for a fortnight in order to allow the Secretary of State to consult his colleagues in the hope that he will grant compensation.

I have told the House that at the earliest possible moment I shall see whether it is possible to make a further statement about compensation. The issues are very difficult indeed, and are not just for me to decide. I think that there are two main reasons for a fall in the level of vaccinations. The first is that too many people think that these diseases have been wiped out for ever and, therefore, they need not worry. The second is that there have been so many statements which cast doubt on the wisdom of the vaccination policy, in spite of all the advice which is brought to bear on me by my most expert advisers.

asked the Secretary of State for Social Services whether within the plans for Preston Hospital provision has been made for a social gynaecology unit.

Provision for the social aspect of gynaecology is included in the general provision for that specialty in the Preston district.

Does that mean that the Lancashire Area Health Authority is prepared to establish an abortion unit at the hospital? If not, how would my hon. Friend seek to advise it in this sphere? Secondly, will he say whether the consultations that the authority is having will include consultation with community organisations concerned with health matters?

The Select Committee on Abortion recommended that there could be separate abortion units, to be established on an experimental basis. We are considering this as a way to solve the particular problems in different parts of the country. But it should be borne in mind that many people share the view expressed by the Lane Committee that abortion should not be separated from other gynaecological services, for reasons of safety. I certainly hope that the authority will consult community groups on its plans in my hon. Friend's part of Lancashire. My right hon. Friend and I are very anxious to promote the position of community health councils, and I hope that the consultation can be channelled through them in order to bring about the best results.

asked the Secretary of State for Social Services when he last met representatives of the pension funds.

In recent months I have had many meetings with those concerned with the provision of occupational pensions.

What has happened to the proposal to hand over half of the positions among occupational pension fund trustees only to employees nominated by the trade unions? Will it be a casualty of the new parliamentary situation, or will the right hon. Gentleman persist with this illiberal measure with the consent of the Liberal Party, despite the strong opposition in the industry and among many employees?

I have had widespread consultation—which has included the CBI, many pensions interests and many trustees—based on the White Paper. Those consultations are continuing.

Is the right hon. Gentleman aware that many married women will undoubtedly find it very difficult to make decisions about their own pension arrangements next May until they know what their employers will do under these schemes? Is he satisfied with progress? Does he not think that the deadline for married women's decisions should be extended?

I am aware of some of the consternation that has been caused in this area. I shall certainly have another look at the matter. I believe that the time scale is satisfactory, but I give that undertaking.

asked the Secretary of State for Social Services whether he is satisfied with the social security arrangements for unemployed students.

I am satisfied that unemployed students will be able to claim supplementary benefit in the vacations, if their resources fall short of their requirements. As regards unemployment benefit, the Government have announced their intention of making regulations to remove the entitlement of students to unemployment benefit in the short vacations.

Is the hon. Gentleman aware of the difficulties that have been caused by the change in the supplementary benefit rules for students midway through the Easter vacation?

I am well aware that there have been some difficulties, but they were caused by a decision of the Court of Appeal, which reversed the long-standing operation of the Supplementary Benefits Scheme. This is a temporary difficulty, which will be overcome as a result of regulations which came into effect on 1st April.

When does the Minister intend to change the regulations affecting claims for unemployment pay in short vacations? How many mature students does he estimate have paid-up contribution records entitling them to claim? If he has not liaised with the Department of Education and Science, is there not a great risk that many mature students will now not go into higher education, as the money is an important topping-up of their living grant?

The regulations have to go to the National Insurance Advisory Committee, and then they will be made and laid before the House. We hope to bring them into operation from the start of the Christmas vacation this year. We are in close touch with the Department of Education and Science. The points that the hon. Gentleman has made will naturally emerge when the House debates the regulations in due course.