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Cystic Fibrosis (Prescription Charges)

Volume 972: debated on Thursday 25 October 1979

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Motion made, and Question proposed, That this House do now adjourn.—[ Mr. Mather.]

5.58 p.m.

I am grateful to the efficient managers of Government business for showing concern for the urgency of my subject and rushing it on four hours ahead of the scheduled time. I am fortunate in that it has nothing to do with paraffin. I am also grateful to Mr. Speaker—as I know thousands of people in Britain will be—for his kindness in personally selecting this subject for debate.

I ask the Government to say that the time has now come to add cystic fibrosis to the list of medical conditions in respect of which sufferers are exempt from paying prescription charges when they reach the age of 16, until they qualify for exemption at the age of 65. I declare an interest. I speak on behalf of the Cystic Fibrosis Research Trust, the organisation that represents sufferers from cystic fibrosis and their parents. It is a reputable body adorned with the patronage of Her Royal Highness Princess Alexandra, the Hon. Mrs. Angus Ogilvie. The charity is dedicated to raising money in order to fund medical and scientific research projects into cystic fibrosis, its causes and treatments, and hopefully one day, its cure. The charity has done wonderful work in the area of disablement without State aid.

Through the efforts of that charity, comfort, education and morale-lifting support are given in an ever-increasing way to those whose suffering is often greater than that of the children, namely, their parents. Apart from the physical burden of caring for disabled children, parents have to live with the knowledge that cystic fibrosis being a genetic disease is passed to the children from the parents.

I receive no payment from the trust, which is too well run a charity to pay anyone for something that it can get for nothing, I have an 11-year-old-daughter who suffers from cystic fibrosis and therefore I would be eligible for any financial relief the Government may give for as long after the age of 16 as my daughter depends upon me.

If cystic fibrosis is not diagnosed and treated early it kills babies and children. Both parents are carriers of the recessive gene. It is thought that one in 20 of the population is a carrier, that there is a 1 in 625 chance of carriers marrying, and a 1 in 4 chance chance of any child they may produce suffering from the disease. The disease primarily affects two areas of the body. The pancreas does not function properly—or at all—and proteins and fats are not properly digested. The treatment for that malfunction is for the child to follow an expensive high protein diet and to swallow several capsules of powdered pig's pancreas with every snack or meal. That more or less does the work that the human pancreas should have done.

Secondly, the lungs are affected. The illness produces a thick mucus, which seals bacterial and viral infections into the bronchial tubes, causing progressive deterioration leading to lung failure. Treatment is in the form of physiotherapy for 20 minutes, twice a day, antibiotics, and occasionally the use of artificial aids such as decoagulating atomisers, and even mist tents. The burden of care and extra responsibility upon parents to keep their child alive and enjoying as near normal a life as possible is very great. If they could be relieved of the worry of ever-inflating regular prescription payments, that would be the wish of most hon. Members in this civilised House.

I concede that the position has been much improved by the introduction of the prepayment certificate—the season ticket—which can be bought for £4.50 for six months and £8 for one year, and parents on very low incomes can be exempted altogether. Nevertheless, hardship is being caused and ought, if possible, to cease. Is it possible?

The case that I am seeking to advance is strong, for two reasons. First, the cost would be small. I know authoritatively and confidently that that is so. My hon. Friend the Minister said as much in a written answer on Tuesday 23 October. The reason is that there are fewer than 1,000 sufferers from cystic fibrosis who have now reached the age of 16.

Secondly, I am not asking the Government to change any rules in order to accommodate cystic fibrosis on the exemption list; I am merely asking them to apply the existing rules. I asked the Minister in a parliamentary question what were the criteria on which a decision may be taken to exempt the sufferers from certain illnesses who are over the age of 16 years from the liability to pay prescription charges. The list includes diabetes, Addison's disease, epilepsy and illnesses of the thyroid, pituitary and adrenalin glands. My hon. Friend replied that these
"have always been that it should be a permanent and clearly identifiable condition requiring continuous medication".—[Official Report, 23 October 1979; Vol. 972, c. 152.]
He added that the general medical services committee must be consulted and agree that a condition satisfies those criteria.

It cannot now be denied that cystic fibrosis is permanent, is a clearly identifiable condition, and requires continuous medication of the kind that I have described. One must then ask why it is not already on the exempted list.

The answer is partly that it was difficult to diagnose the disease with certainty in the 1960s. Insufficient knowledge of the illness existed, but also quite simply, when the list of exemptions was drawn up in 1968, comparatively few sufferers were known to have survived past the age of 16. There was no demand for that measure.

When my daughter was born in 1968, we were told that there was an 80 per cent. mortality rate. Few general practitioners who needed to diagnose the illness soon after birth in order to stop the immediate deterioration of the lungs had ever heard of it, let alone ever knowingly seen a case. Since that time, thanks largely to the work of the Cystic Fibrosis Research Trust and a few dedicated doctors and medical workers in the field, the disease has become more widely recognised, sufferers are mostly identified in time, effective treatments are given and there is every hope that most children born with cystic fibrosis will not only live past 16 but enjoy reasonably normal, full and long lives.

I am not asking the Minister to look again at an old set facts oft considered and reconsidered. I am asking him to reconsider the matter in the light of a wholly changed situation.

I make the plea not only on behalf of the Cystic Fibrosis Research Trust and the thousands of parents it represents, but with the support of such senior consultant paediatricians as Mr. R. D. G. Creery, of the Gloucestershire health authority and a large number of my parliamentary colleagues on both sides of the House.

In particular, the following colleagues have taken the trouble to write personally and tell me of their support: my hon. Friends the Members for Belper (Mrs. Faith) and Stretford (Mr. Churchill), the hon. Member for Hamilton (Mr. Robertson), my hon. Friends the Members for Bristol, North-West (Mr. Colvin) and Essex, South-East (Sir B. Braine), my right hon. and learned Friend the Member for Hertfordshire, East (Sir D. Walker-Smith), my hon. Friend the Member for Ealing, North (Mr. Greenway), the hon. Member for Eccles (Mr. Carter-Jones), my right hon. Friend the Member for Stafford and Stone (Mr. Fraser), my hon. Friends the Members for Abingdon (Mr. Benyon), Chipping Barnet (Mr. Chapman), Kingswood (Mr. Aspinwall), Wells (Mr. Boscawen), Somerset, North (Mr. Dean), Bath (Mr. Patten), Westonsuper-Mare (Mr. Wiggin), Rugby (Mr. Pawsey), Barkston Ash (Mr. Alison), Winchester (Mr. Browne), Reigate (Mr. Gardiner), Bury St. Edmunds (Mr. Griffiths), Cheltenham (Mr. Irving), Cambridge (Mr. Rhodes James), Leeds, North-West (Sir D. Kaberry) and Birmingham, Edgbaston (Mrs. Knight), the hon. Member for Oldham, East (Mr. Lamond), my hon. Friend the Member for Gloucestershire, West (Mr. Marland), the hon. Member for Oldham, West (Mr. Meacher), my hon. Friends the Members for City of Chester (Mr. Morrison), Cirencester and Tewkesbury (Mr. Ridley) and Bristol, West (Mr. Waldegrave) and the hon. Member for Derby, North (Mr. Whitehead). I am confident that there are a number of other letters held up in the post. Furthermore, I know that my hon. Friend the Member for Moray and Nairn (Mr. Pollock) is anxious to catch your eye, Mr. Deputy Speaker.

With such support and strength to my case, and in the cause of disablement, a subject that has always been of particular concern to the Minister, I am confident that my plea will fall on receptive ears and that the Government will continue to pursue their policy of taking speedy action when action is called for.

6.5 p.m.

I am grateful for an opportunity to address the House in this timely debate on a matter of considerable concern to all involved with this tragic illness.

After the election I was approached by the Scottish council of the Cystic Fibrosis Research Trust with a view to speaking on its behalf. I congratulate my hon. Friend the Member for Burton (Mr. Lawrence) for putting so forcefully and cogently the case for exempting sufferers from prescription charges. I merely add that the Scottish council of the trust is also extremely active and deserves admiration for the good work that it does in the North. Perhaps in his reply the Minister will bear in mind that this illness respects no frontiers and causes as much anxiety in Scotland as it does south of the border.

6.6 p.m.

I have responded to a number of Adjournment debates in my short career as a Minister, but none at five past six in the evening. I congratulate my hon. Friend the Member for Burton (Mr. Lawrence) on procuring a debate at this early hour. I also congratulate him on a fine and sensitive speech on behalf of sufferers from cystic fibrosis. He has made out a persuasive case for exempting these people from the need to pay prescription charges for the drugs that they require. My hon. Friend the Member for Moray and Nairn (Mr. Pollock) was a worthy seconder.

My hon. Friend the Member for Burton read out an impressive list of support. I hope that he will not mind if I say that it sounded rather like a British Rail announcement.

I would like to take the opportunity to pay tribute to the Cystic Fibrosis Research Trust for the work that it carries out on behalf of cystic fibrosis sufferers and for the active campaign that it has fought on the issue of exemption. I have read with interest some of the literature that it has distributed and have learnt most of what I know from it.

Cystic fibrosis is a truly dreadful condition that must cause a great deal of heartbreak not only to those suffering from the condition but also to the relatives and friends who strive to help. The main feature of the condition, as I understand it, is that the mucus glands secrete abnormal types of mucus. Because of this the lungs can become damaged through the clogging of the bronchial tubes and the digestion system can be seriously impaired through the mucus preventing the flow of digestive enzymes. From that one can readily understand how a cystic fibrosis sufferer can fall prey to bronchitis, pneumonia and other lung and chest infections.

Cystic fibrosis is a genetically determined condition and, though there is no known cure, work is going on to try to pinpoint the exact deficiency or error with a view to finding effective methods of treatment. Again, as I understand it, there are particular problems not the least of which is the fact that because CF affects only humans the condition cannot be studied in animals. The patients themselves have to become the subjects for study.

Cystic fibrosis affects thousands of infants, children and young adults in the United Kingdom. It is a sad fact that until fairly recently very few sufferers survived into adult life. The debate, however, is taking place because with the advances made in treating and caring for patients a greater number of them are surviving to adulthood. We believe that there could be up to 1,000 young adults of whom many, in spite of great difficulties, are employed and are trying to live a nearly normal life. I say "nearly normal life" deliberately as I have read some case histories sent to me and I marvel at the courage and determination shown by these young people. One patient I read about takes approximately 50 tablets and pills per day plus a special diet and physiotherapy twice a day. Another young lady spent most of her holidays in hospital getting fit to attend college during the term.

In addition, there is the courage and patience shown by parents and relatives in caring for young people who do not always wish to adhere to the essential treatment requirements. There are also the people who assist with the daily physiotherapy, which is an essential part of the treatment.

It is clear to me that in this area of treatment and caring the Cystic Fibrosis Research Trust has played a very important part. This body, which was founded in 1964 to finance research to find a complete cure for cystic fibrosis, and meantime seeks to improve current methods of treatment, has a network of branches and groups throughout the country. Through this network it provides helpful advice to parents coping with a child or young adult suffering from cystic fibrosis. In addition, it is supporting research into the condition at many universities and hospitals in the United Kingdom. I am grateful that such an organisation exists, and I feel that great credit is due to it for stimulating interest in the condition and organising help and advice for the patients and their relatives.

The list of specified medical conditions, to which my hon. Friend referred, originated in 1968 when prescription charges were reintroduced. The list was drawn up as a means of exempting the chronic sick from prescription charges. Such a scheme could operate only with the full co-operation of the medical profession, and their representatives made it clear that they could agree to exemption only for readily identifiable medical conditions which called automatically for continuous lifelong medication, in most cases replacement therapy. This list of specified medical conditions which attract exemption has been reviewed by successive Governments, in consultation with the medical profession. The last discussion of the list with the general medical services committee of the BMA was in 1976 and cystic fibrosis was among the conditions mentioned on that occasion. However, it was not possible to reach agreement on any extension of the list. I can well understand the profession's insistence that only conditions about whose diagnosis, lifelong character and need for continuous medication there can be no doubt should be included. No doctor would wish to enter into an argument with a patient about whether his condition was severe or permanent enough to attract exemption, and yet such arguments would be inevitable if ill-defined or complex diseases were added to the list, or conditions so variable in their prognosis and treatment that exemption would not always be justified. The doctor would have to make, and defend, difficult judgments between two patients at different stages of the same disease, and this could put at risk his whole relationship with his patient.

Speaking as a layman I have a great deal of sympathy with the call to add cystic fibrosis to the list, and I would hope that the medical profession, if it were asked, would agree that it seems to satisfy the normal criteria for inclusion.

I am bound to say that it would not cost a great deal to grant exemption. What I have had to ponder over is whether I should ask the doctors to add cystic fibrosis to the list and I have seriously considered doing so, as I personally think that if as many CF patients had survived to adulthood when the list was originally drawn up, that condition might well have been included. I think that there is little disagreement between myself and my hon. Friend on that point.

However, I must take a broader view. When I look at the present list, though I can understand the reasons for limiting the types of conditions that are included, I find the present arrangements hard to defend from the point of view of the patient. My Department is constantly asked to explain why the list of exempt conditions discriminates against patients suffering from various other complaints and many examples are cited of how unfair the system appears to a particular patient.

Let me give one such example. Patient A has his thyroid removed but requires the modest replacement treatment of a thyroid tablet twice a day for the rest of his life. If later he develops a heart condition, arthritis or any other illness he will receive all necessary medicines without paying prescription charges and is in effect exempt for life. By contrast, patient B may have a congenital heart disease from childhood and be kept alive by the drugs he is prescribed—yet once he is an adult he has to pay. I have to ask myself, if sufferers from cystic fibrosis are to be exempt why not those who have phenylketonuria, or coeliac disease? Why should patients suffering from a readily identifiable condition be exempt, but patients needing the same, or even greater, amount of drug therapy have to pay simply because their condition is less clearly defined—or merely more complex. I say "have to pay", but at this point I should remind hon. Members that a scheme already exists whereby patients can limit their outlay on medicines.

I refer to the arrangements by which patients can purchase a pre-payment certificate. These certificates were introduced in 1968 because it was recognised that the list of specified medical conditions excludes many conditions which might require numerous prescriptions. The certificates are like season tickets. They currently cost £450 for six months, or £8 for 12 months. They entitle the holder to obtain as many items on prescription as he needs during those periods of six or 12 months without further charge. The £8 annual certificate represents an outlay of just over 15p per week.

By this means no cystic fibrosis sufferers, or for that matter anyone else, need pay more than the cost of 10 prescriptions in six months or approximately 17 prescriptions in a year. In addition, of course, there is exemption from prescription charges on low-income grounds for anyone, 16 years or over, whose income is not much above supplementary benefit level.

Since some confusion exists about entitlement to low income exemption, I should like to stress that for young people of 16 years and over, whether or not they are working, it is their own income which is taken into account for the purposes of exemption, not that of their parents.

I know that the Cystic Fibrosis Research Trust is aware of the pre-payment certificate arrangements, but I wish further to publicise their availability and that of low income exemption which might be of benefit to the young people we are discussing tonight.

Before my hon. Friend moves on to another aspect of the problem, does he not consider it irrelevant to the question I am asking him to apply his mind to that there are other illnesses which might also be included on the exempt list? There is no reason to say "No" to cystic fibrosis merely because there are other illnesses which might also have a good claim to be on the list.

If the Minister considers that cystic fibrosis should be on the list, and I think that that is what he is saying, is it not his duty to make sure that it goes on the list? Is he saying that the only thing standing in the way of that now is the general medical services committee of the BMA?

I think that my hon. Friend will get a response to the last part of his question in a few minutes' time. Basically, wherever one draws the boundary people will be upset. If one advanced the boundary a little further to include cystic fibrosis, one would also in justice have to conduct a more general review of the whole scheme, and probably put in those who have phenylketonuria or coeliac disease. Therefore, one has to take a slightly broader view of the exemptions than my hon. Friend would like.

I have given this problem a great deal of sympathetic consideration. However, I find myself having to face the realities of the situation in human and financial terms. If I seek to add this condition to the list, can I really defend not going further? Should not I consider whether the list of exempt conditions is the best way of helping the chronic sick, and is it right to go on trying to improve the list as my hon. Friend would wish in a rather piecemeal way, instead of seeking an alternative, within the resource constraints imposed by our present financial circumstances, to help more of the chronic sick? Instead of exempting some and leaving others to pay might it not be better to make the pre-payment certificate available on more favourable terms because that would help everyone upon whom the need for frequent prescriptions imposes a heavy burden?

I accept that this would mean that some of those who now pay nothing for the drugs they need would in future have to find the cost of a pre-payment certificate, and that is not an easy choice.

I have exposed my thoughts on this matter in order that the House may understand why it is not a simple matter to take the course that sympathy demands and add cystic fibrosis to the list of exempt conditions. If I have decided to make no approach to the representatives of the medical profession at present it is because I feel that we must first see whether it is possible to work out some fairer way within our present financial constraints to help all the chronic sick with the costs of the drugs they need than this present method of listing specified medical conditions.

If we conclude that there is no better way than the present, I will return again to the request of my hon. Friend that we should consider, with the representatives of the medical profession, whether the list is fully up to date and whether there is a case for adding cystic fibrosis to it and perhaps some other similar conditions. I hope that the House will understand why I have had to give a reply which is not as favourable as hon. Members might have expected. I hope that I have explained the reasons why I am unable to do this. Over the next few months my hon. Friends and I will bear in mind what has been said and see how we can best meet the problems which my hon. Friend has described so graphically.

We are on the Adjournment, Mr. Deputy Speaker, and as I understand it, under our rules of order, it is permissible to raise any subject on the Adjournment. While the Minister is here I would like, before I start on the subject of the assisted places scheme in education, to put the point very fairly. I understand that it is in order—

Before the hon. Gentleman proceeds, may I say that he was good enough to indicate to me that he intended to follow this procedure. I remind him that Mr. Speaker has deprecated, in very strong terms, the raising of Adjournment debates without due notice. The hon. Gentleman has a right to do what he is doing, but rights also carry obligations. This Chamber cannot run unless people remind themselves of their obligations. May I, in supporting what Mr. Speaker has said in the past, ask the hon. Gentleman, though he is within his rights to do what he is doing, to consider whether he is being completely fair to ask a Minister to reply to something about which he has not been warned and could not have been aware. Perhaps I could ask him if he would consider leaving this until later to see whether the necessary arrangements can be made for him to raise his Adjournment debate when the necessary formalities have been proceeded with.

Further to that point of order, Mr. Deputy Speaker. Assuming we are on a point of order now, I think that the suggestion you have made might well be a sensible way to proceed, in the end. I understand that Mr. Speaker has deprecated the use of Adjournment time when the relevant Minister for that debate is not present. However, I and my hon. Friends have many times deprecated the way in which, increasingly, the Civil Service, the private office and Ministers treat this House. I gave the Department of Education and Science substantial notice that I intended to raise this subject. I also gave Mr. Speaker's Secretary notice that I would raise it.

I think that a protest needs to be made that the tradition, which used to obtain, under which there was always a Minister on duty in every Department who could come to the House at short notice and respond to the clear desire of Members to raise a point, when a rare and unusual event in this House took place, ought to be brought back. We should use opportunities of this kind to remind Ministers that their first duty is to this House, when an indication is given to them that Adjournment time which has arisen at short notice is desired to be used for discussion on the Floor of the House, and that that takes precedence over any other meeting outside this House that they have arranged.

I see a Government Whip on the edge of his seat. If I could get some indication, Mr. Deputy Speaker, from the Government Benches where two Ministers of the Crown are sitting—indeed, the House is suddenly full of them—I should be prepared—

Order. I made a suggestion to the hon. Gentleman. The hon. Gentleman can accept that suggestion and proceed later, but I do not intend him to proceed now and ask Ministers questions. He either accepts my suggestion or not.

If I may continue for one moment, the Adjournment debate began early tonight because it was obvious that busines was collapsing. As the hon. Gentleman knows, we are not due to start private business until 7 o'clock. The Chair thought that it was for the convenience of the House that the Adjournment debate should start earlier. Because it was known who was to speak in the Adjournment debate and who was to reply, it was possible to arrange it at a few moments' notice. It was not until a few moments before, however, that it was possible to know that it would take place. Knowing the hon. Gentleman, I am sure that he would wish, having made his point, to leave the matter until later in the evening.

Further to that point of order, Mr. Deputy Speaker. As you know, I sat through proceedings on the Bail Etc. (Scotland) Bill and subsequently through the very interesting debate on cystic fibrosis, in the hope that there would be some time before private business for other issues to be raised. It would seem appropriate that when we do have the time in the House we should take the opportunity of debating an issue which is of concern not just to my colleagues south of the border but also to us in Scotland. I would appreciate an indication either that an appropriate Minister can be brought to the House to answer the points raised by my hon. Friend the Member for Lewisham, West (Mr. Price), myself and anyone else who wishes to participate in this debate, or else that we have a clear indication that at some time later tonight there will be a structured debate when we will get that opportunity.

Further to that point of order, Mr. Deputy Speaker. It seems to me that there is an easy way out of this dilemma. That would be for the Ministers who are present to indicate that the appropriate Minister will be in the House later this evening so that my hon. Friend can have the debate of which he has given notice. It would have been a different situation had my hon. Friend not been in contact with the Department of Education and Science earlier this evening and had he not given the Department an indication that he intended to raise this subject.

If this is not done and no indication is given that a Minister will be present later, I think that my hon. Friend might well feel that the subject of the assisted places scheme and the money to be spent on it is a matter that is relevant to the DHSS because it means that its budget will be so much the less.

Concerning those last points of order, hon. Members have the right to raise those matters if they so wish. I want to make that point quite clear. What I wished to point out—indeed, I thought I had pointed it out—was that Mr. Speaker strongly deprecated the raising of Adjournment debates at very short notice when it was not possible to get Ministers to answer. It is not for me to answer for Ministers. I have made the point. Hon. Members have their rights and I will make sure that their rights are protected, but I, too, deprecate hon. Members raising Adjournment debates and expecting Ministers suddenly to appear in the House. It is not for me to answer for them. I have made the point and I call the hon. Gentleman again.

Further to the point of order, Mr. Deputy Speaker. I do not wish to go against Mr. Speaker's deprecation by purporting at this time to be speaking on an Adjournment debate. I fully accept that your suggestion that these matters should be left now and pursued at 10 o'clock is the correct way to proceed. At this moment there are two Ministers of the Crown who, simply by getting up and indicating that Government Ministers do have respect for the House of Commons and are not just going to hide their heads and stay away because they are frightened to answer debates of this nature, could answer that question.

The situation we find ourselves in, Mr. Deputy Speaker, is the result of the absolute refusal of this new Government to accord with what have been traditional practices when business has collapsed in the past. Because of that, we are having to pursue the matter through points of order to try to obtain some indication from the Government Benches of how they wish to proceed at 10 o'clock when there will be half an hour left for an Adjournment debate. We might have such a debate earlier because the GLC Bill might collapse. My hon. Friend the Member for South Ayrshire (Mr. Foulkes) also has very crucial matters to discuss.

It costs a lot of money to run this House and we want to give the public value for money. If every time business collapses we merely pack up and go home, leaving a great empty swathe of Benches, when there are hundreds of crucial issues still to be discussed, and if the public see that the House is so unaware of the thousands of problems in the country which need discussing, the standing of Parliament may fall even lower. It is up to Ministers to respond to this situation and indicate, rather than sitting there like stuffed dummies, how they intend to proceed at 10 o'clock.

Further to that point of order, Mr. Deputy Speaker. Surely the hon. Member for Lewisham, West (Mr. Price) is abusing the procedure of the point of order in a typical way. However, those who have heard him will hardly have been surprised. Surely the point at issue is not whether he can raise a point of order so as to make a hysterical partisan harangue but whether the business of this House can be ordered in the best possible way. As far as his synthetic concern goes, I understand that he wants to talk about education, on which, no doubt, he will make a long and boring speech on the Second Reading of the Education (No. 2) Bill during the week after next. Of course, if he goes on now, he may not catch your eye on that occasion, and that would be a blessing to us all. But why does he not shut up on his bogus point of order now and let us get on with something else?

I have listened to what the hon. Member for Lewisham, West (Mr. Price) has said. In the past, Mr. Speaker has deprecated the raising of Adjournment topics at such short notice because he and others feel that it is unreasonable to expect a Minister to attend at a moment's notice. The hon. Gentleman is entitled to stand up and speak. It was my intention to suspend the sitting, and it would still be within my right to do so, until seven o'clock. But that would be depriving the hon. Gentleman of a right, and therefore I do not intend to do it if he still persists in wishing to speak. But Mr. Speaker has made it quite clear that hon. Members cannot necessarily expect a Minister to be here to answer at such short notice. If the hon. Gentleman wishes to make his speech whether the Minister is here or not, that has nothing to do with the Chair. If he wishes to make his speech, I will call him.

Further to that point of order, Mr. Deputy Speaker. I understand that, contrary to what you said earlier, advance notice was given to the appropriate Minister, and for some reason, about which we can only speculate, he has chosen not to be present. As my hon. Friend speculated, the Minister is not prepared to answer on this crucial issue—

Order. The hon. Gentleman is not entitled to say that a Minister is not prepared to answer unless he has some justification for saying so. I do not know whether the Minister is prepared to answer or not. What I am saying is that the Chair deprecates attempts to initiate Adjournment debates at short notice because it is unreasonable to expect a Minister suddenly to appear in the House.

If I may continue, Mr. Deputy Speaker. It would be simple, as my hon. Friend has already indicated, if the Ministers now present were to indicate that it was within their responsibility to enable us to have a Minister of the appropriate Department here at a later stage to deal with this debate. That would solve our problem. You would be able to suspend the sitting and private business could start at seven o'clock. We would know that later in the day we would have a debate on this subject. Otherwise, I think that there is no alternative but for my hon. Friend to continue with the subject in the hope that some member of the Government will be able to answer the points raised.

Order. I have made the point. If the hon. Member for Lewisham, West (Mr. Price) wishes to proceed, he may do so. I do not think that Ministers present are in a position to say whether colleagues or anyone else will be here. If the hon. Member for Lewisham, West accepts what I have suggested, I am sure that everyone will be satisfied. He will able able to make his speech and get a reply as well. I doubt whether he will get a reply if he proceeds now.

Further to that point of order, Mr. Deputy Speaker. I live in hope that those doors will open at any second and a Minister from the Department of Education and Science will issue forth. It has been stated a number of times that I did not give the Department notice. That is contrary to the truth. I gave the Department quite adequate notice to get the Minister who is on duty to come to the House and answer this debate. [HON. MEMBERS: "When?"] I gave quite adequate notice. [HON. MEMBERS: "When?"] At about 10 minutes to six.

Order. I do not intend to listen to any further points of order on this matter. I am calling the hon. Gentleman if he wishes to address the House on the Adjournment.

I regret that I am not able to pursue the point of order on this matter because it is not a party matter. It is a matter very deep at the heart of our procedures and the answerability and accountability of Ministers to the House of Commons. I am sad that the Ministers present are not willing to give any indication. I have had an assurance from you, Mr. Deputy Speaker, and I hope that I can accept that, as a result of your assurance from the Chair—

Order. I have given no assurance whatever. I said that the hon. Gentleman can raise the subject at 10 o'clock on the Adjournment if he so wishes. I cannot say whether a Minister will be here then. I hope that the hon. Gentleman will not proceed on this matter. If he wishes to make a speech now on the Adjournment, will he please make it?

I withdraw the word "assurance", Mr. Deputy Speaker. I have had a suggestion from you. I do not consider the situation satisfactory, but, rather than proceed without a Minister in face of Mr. Speaker's deprecation, I hope to raise the matter at 10 o'clock, and I desist from speaking now.

6.36 p.m.

Sitting suspended.

On resuming

It being Seven o'clock, and there being private business set down by The CHAIRMAN OF WAYS AND MEANS under Standing Order No. 7 (Time for taking private business), further proceeding stood postponed.

7.0 p.m.

Before the House proceeds to debate the three Private Bills set down for consideration this evening, it might be helpful for me to remind hon. Members that the debate on the consideration stage of Private Bills is restricted to the matters contained in the Bill and may not extend to general policy questions or to particular matters not included in the Bill.