I remind the House that short supplementary questions enable more hon. Members to be called.
National Health Service (Pay)
asked the Secretary of State for Social Services if he will make a statement concerning the current situation in the National Health Service workers' pay dispute.
asked the Secretary of State for Social Services what representations he has received concerning the current situation in the health service workers' pay dispute.
The Royal College of Nursing is balloting its members on the pay offer made in the Nurses and Midwives Whitley Council on 9 November plus the offer by the Government to set up a review body for pay. The council of the Royal College of Nursing has recommended that it be accepted. So far as other staff are concerned, the talks with the TUC health services committee stand adjourned while the union leaders consult their members on a financial framework proposed by the Government that would permit pay increases of 6 per cent. this year and 4½ per cent. for 1983–84. The Government have also offered to enter into discussions on improved long-term arrangements for pay. We expect the results of both the ballot and those consultations by mid-December. I hope that the outcome will be a period of stability to allow the National Health Service to recover from the damage caused by this dispute.
I thank the Secretary of State for his detailed reply. Are the increases that have been offered genuine, or will they be paid for by voluntary or compulsory redundancies?
They are genuine increases. As the hon. Gentleman knows, the Government have increased staff, particularly nurses, in the National Health Service.
Does not the Secretary of State's reply endorse the Government's attack on the NHS workers, and is it not a declaration of war on them? Further, is it not the case that if the Secretary of State does not change his policies and try to get a settlement we shall witness the start of a winter of discontent before the end of the year?
That is an utterly absurd supplementary question. Even the hon. Gentleman should recognise that the review body that has been offered to the nurses has been wanted by nursing leaders for years. I seriously ask the hon. Gentleman and the Opposition to reconsider their attitude to the dispute, because they are giving the impression that they do not want it to end.
Does my right hon. Friend agree that we all want to see proper rewards for nurses for their excellent work? Will not the setting up of the review body lead to a better distribution of resources and increase the status of the nursing profession?
My hon. Friend is right. The nursing review body has been sought by leaders of the nursing profession for many years. In other words, it has wanted a more satisfactory system of determining pay. We have offered that to the nursing profession and I am glad to say that the council of the Royal College of Nursing has accepted it and recommended its acceptance by its members.
Does the Secretary of State consider that his conduct of the dispute so far has been a success?
My conduct of the dispute, as well that of the Government, has been fair. I hope that the hon. Gentleman will support its outcome.
How much of the pay award will come from the budgets of the regional health authorities and how much will come from the Government? As the Secretary of State thinks he has done so tremendously well up to now, what will he do if the Health Service unions turn down the offer?
I shall not answer the hon. Lady's second question. I hope that she will use what little influence she has left in persuading the Health Service unions that this is a reasonable and fair offer and that it is about time, for the sake of everyone in the Health Service and, above all, the patients, that the dispute came to an end.The hon. Lady will know that this year the regional health authorities paid about £67 million. She will also know of the effect of public expenditure decisions. In other words, the money that we provided from the Contingency Fund this year will continue.
Does my right hon. Friend agree that if the nursing profession accepts the award that is offered there will be no justification for other grades to refuse it?
I hope that that is so. I hope, too, that both the nursing profession and all those in the National Health Service will consider not just the pay offer that has been made, but the offer that we have made of a review body for the nursing profession, and—
What if they turn it down?
The hon. Lady should wait. I hope that they will also consider the offer of talks on better long-term arrangements for everyone in the NHS. I should have thought that that was what the NHS wanted.
Pensions And Benefits (Uprating)
asked the Secretary of State for Social Services what representations he has received concerning the clawback to be imposed on the 1983 pension uprating.
asked the Secretary of State for Social Services when he expects to introduce legislation to implement the Chancellor of the Exchequer's adjustment to the November 1983 social security uprating.
asked the Secretary of State for Social Services when he expects to be able to announce the Government's decision as to the amount of the clawback which will be deducted from benefit increases in November 1983.
Decisions on what the 1983 uprating should be will be taken, as usual, at the time of the next Budget. Legislation will be introduced as necessary, but I have no specific timetable in mind at this stage. The Department has received about 160 letters on this subject.
Does the Minister accept that those 160 letters represent the views of millions of people throughout the country? Will he confirm that of the £180 million savings from benefits announced by his right hon. and learned Friend the Chancellor of the Exchequer in his recent financial statement, £90 million will come from pensioners, which means that a married couple will lose 90p and single men and women will lose 55p? Is that not the meanest cut that has ever been perpetrated?
I shall not confirm those figures, for the good reason that the decisions on them have not yet been made.
Yes, they have.
The hon. Gentleman is wrong. I remind the House that the adjustments are a necessary part of the forecast method. That method was introduced not by the Conservative Government, but by the Labour Government, to make a cut in the social security budget.
Is it really the Secretary of State's intention to introduce a Bill to clawback £180 million, which is just one-tenth of the cost of the Falklands war—[Interruption] Yes, it is just one-tenth of the cost of the Falklands war. It is a clawback from pensioners and other people in need. In May 1981 the Minister for Social Security, who is now sitting next to the right hon. Gentleman, as an earnest of his good will when clawing back the last 1 per cent., gave an assurance to the hon. Member for Brighton, Kemptown (Mr. Bowden) that he would never do it again. Is that not duplicity?
The Government have made no decision about the amount of the adjustment of pensions and other benefits. I remind the hon. Gentleman that when the Labour Government introduced the forecast method they introduced it as a saving, but they did not say that they would make good the shortfall and ignore overpayments. That was never their position.
Will the Secretary of State name the occasion when the Labour Government introduced legislation to clawback benefits, as the Conservative Government did in 1981, and as he has forecast he will do in 1983? Will he tell us, because this is crucial for people outside the House, whether, if the legislation comes before the House on a clawback basis, it will include, as it did in 1981, not just old-age pensions but mobility allowance, attendance allowance, pensions for policemen and pensions for military personnel? Will the legislation include a clawback on all those people, as it did in 1981?
The hon. Gentleman knows that those are precisely the issues that are now being considered. It is right that we should consider them in conjunction with the Budget and uprating considerations. The hon. Gentleman has made an important point, which is not generally recognised. The House should remember that, by statute, public service pensions are tied to national insurance retirement pensions as well, so that public service pensioners, whom some would claim are already favourably treated in contrast to private sector pensioners, would receive a bonus if there were no adjustment.
I accept that my right hon. Friend cannot announce a definite decision to the House, but will he assure me and the House that when the matter is being considered he and the Chancellor of the Exchequer will take careful note of the fact that the pensioner index is substantially in front of the retail prices index and is a more accurate assessment of pensioner costs?
Over the lifetime of this Government that has not been so. The RPI has risen further than the pensioner index. The whole purpose of making decisions at the time of the Budget is to enable us to take all those considerations into account. I say frankly to the House that there is no way that we can make improvements in social security benefits, which many of my hon. Friends and Opposition Members would like, and at the same time keep the adjustment to a minimum. Choices will have to be made, but they should be all made simultaneously.
Will the Secretary of State confirm that last November the Government got the inflation rate wrong and, as a result, pensioners lost the equivalent of one week's money. Does he accept, therefore, that they need to have more this year for at least 12 months, if not longer, to make up for the money that they lost during the past 12 months?
The situation that the hon. Gentleman describes is implicit in the forecast method. I repeat that the forecasting method was introduced not by this Government, but by the Labour Government.
Does my right hon. Friend agree that the meanest cuts of all came in the last Parliament when that system of forecasting was brought in and the Christmas bonus was withdrawn for two years? Does he agree that those who, like me, argue that pensioners should in future be able to keep some of the extra benefit that they are having this year would be more likely to get a sympathetic response from the Government if they acknowledged that the Government are doing so well and congratulated them on bringing down inflation and helping the pensioners?
What my hon. Friend has said about inflation is crucial. Nothing could be more important. I hope that the social security team on the Opposition Front Bench will agree with this at any rate: inflation should be brought down and, once it is brought down, it should stay down. That cannot be in question. With regard to the figures that my hon. Friend mentioned, when the Labour Government made their saving it was worth £500 million in social security savings. That is the equivalent of £1 billion now. That was a direct cut in the social security budget by the Labour Government.
I shall ignore the fact that the Secretary of State has distorted his answer by not taking into account the fact that he has taken £1,800 million off social security benefits this year. Will he answer this question? Is he proposing to differentiate between the classes of people who are on pensions from whom he will claw back money? He appeared to say that that matter was for the Cabinet's decision. I warn him that our anger at any clawback will be doubled if he ignores public service pensioners and merely goes for the poorest in the land.
The hon. Gentleman has misunderstood the point. I was saying that in the decisions that we make we must take account of public service pensioners. That is why it is right to take those decisions at one and the same time.
On a point of order, Mr. Speaker. In view of the unsatisfactory reply to my question, I beg to give notice that I shall seek to raise this matter on the
asked the Secretary of State for Social Services if he will ensure that his Department's offices pay for removal costs for those on invalidity benefit in the same way as payments are made to those on supplementary benefit.
There is no provision for making single payments to anyone who is not entitled to supplementary benefit, and at present I have no plans for changing these arrangements.
Is it not a fact that at one time DHSS offices had the discretion to pay removal costs for people moving out of their council house to sheltered accommodation and for seriously disabled people in such circumstances? Now, however, councils and organisations for the disabled are inundating us with complaints that the Government, not content with hammering the poor and the sick, have instructed DHSS offices to take away that paltry benefit.
As the House will recall, that matter was fully debated in 1980 when Parliament decided—
The Government decided—
—Parliament decided to remove the discretion when introducing the regulated supplementary benefit scheme. That decision followed a review that was undertaken and completed just before the Labour Government went out of office. It was recognised at the time that the drawing of a firm line at those in receipt of supplementary benefit meant that those just on the wrong side of the line could not be helped by a lump sum payment. I remind the hon. Gentleman that in practice the discretion was exercised in very exceptional circumstances and only when the income was barely above the supplementary level.
Is the Minister aware that in many mining areas there are disabled people who have been on invalidity benefit for 10 or 12 years having to move to special accommodation? It is as important to spend cash on those removals as it is to spend it on the Falklands war. Why can cash be found for operations such as the Falklands war, which kill people, when it cannot be found for helping disabled people?
If those people are in receipt of supplementary benefit, they will be helped under the rules that I have just outlined.
The Minister knows perfectly well that the Social Security Advisory Committee has recommended the restoration of this limited flexibility, which existed under the old rules. Will he act to implement that recommendation, or is this another one of the SSAC's recommendations that will be put in the dustbin by the Government?
We have noted that the SSAC has made a general recommendation that there should be a limited extension of eligibility. The committee is considering the degree of that extension and we will consider its recommendations on the detail when they are received.
Health Authority Funding (Macclesfield)
asked the Secretary of State for Social Services what representations he has received from the Macclesfield district health authority requesting additional funding for the financial year 1983–84.
None, Sir. I am, of course, aware of the local planning that will be necessary to permit the new district general hospital to open next year, and of discussions that are going on between Mersey regional health authority and Macclesfield health authority.
I am somewhat surprised by that answer, because I have made personal representations by letter to the Minister. Is my hon. and learned Friend aware that the Macclesfield district health authority is serving an area with a rapidly growing population and that, in addition to the opening of the first phase of the new nucleus hospital, the area is having to cope with a growing number of elderly people, which takes considerable resources? Will he therefore give sympathetic consideration to any representations for additional resources, even if I request him to meet a delegation representing the district health authority from my constituency?
The question asked what representations I had received from the health authority. For that reason I said "None". I have of course, received a powerful letter from my hon. Friend. I will meet any delegation that he chooses to bring to me to discuss the question.I take on board all his points about Macclesfield. It is because of its needs that Macclesfield is about to get a new district general hospital, which will be handed over to the health authority a month ahead of time in March of next year. We are providing £1 million in new growth money over the next two years to help the authority to plan for the opening of the hospital. I shall be glad to discuss the problems further when I meet my hon. Friend.
As the Minister has given a wrong answer, will he give me a factual one? How much of the Macclesfield budget will be used to pay for the paltry salary offers, and how much of other district budgets will be used in that way? Those budgets are already inadequate. Surely it should be a national responsibility to pay for the salary increases.
That point has just been dealt with in a more relevant question. Had we conceded grossly excessive pay claims in the National Health Service there would not have been room for the degree of growth in the Health Service provision for patients with which the Government are pressing ahead.
Chronically Sick And Disabled Persons Act
asked the Secretary of State for Social Services if he monitors the circumstances in which, under the Chronically Sick and Disabled Persons Act, local authorities withdraw or reduce services to registered disabled people without diminution of need; and if he will make a statement.
No, Sir. Such monitoring would involve obtaining details of services provided to each of the several hundred thousand individuals under the Chronically Sick and Disabled Persons Act 1970. This is clearly impracticable. However, if the hon. Gentleman has any particular case in mind I should be grateful if he would send me the details.
If, as the Minister said, to monitor is impracticable, he can only deal, for example, with individual named cases, which imposes a tremendous burden on hon. Members wishing to raise the question as a general matter. Nor has the Minister touched on the fact that some authorities have used up their budgets.
Order. The hon. Gentleman, like everyone else, must ask a question.
Perhaps I may help the House. The hon. Gentleman is correct when he says that the Act requires individual cases to be examined.
Where a need has been established, will the hon. Gentleman allow an appeals procedure to come before him and Parliament?
I do not quite follow the hon. Gentleman. If a need has been established and the local authority has not satisfied that need, the individual concerned is entitled to make representations to my right hon. Friend the Secretary of State who has certain reserve powers to give directions in the matter.
Does the Minister agree that there will always be unfair disparities in the provision of services by local authorities until we have specific grants for disabled people? Will he undertake to discuss that matter with the Department of the Environment.
In any case where local decisions have to be taken and local authorities are given a discretion by Parliament, different local authorities are bound to exercise their discretion in different ways according to the local circumstances. That is the basis of local government. We are reluctant to impose conditions upon local authorities and to remove a discretion that Parliament has seen fit to give them.
Does the Minister recall that the Royal Association for Disability and Rehabilitation raised with me the specific complaint of a cut in home help hours by the borough of Trafford without any change in the circumstances of the disabled people involved? Will he now make it pikestaff plain that his legal advice is the same as that given to me—that it is illegal to cut or withdraw services to disabled people under the Chronically Sick and Disabled Persons Act without any diminution of need?
I am a little puzzled by the right hon. Gentleman's persistence on this matter. He wrote to me about the matter and I replied on 11 November. I do not know whether he has received my letter, but after making inquiries I made it quite clear that the local authority concerned was making no change in its home help service.
Health Districts (Medical Manpower)
asked the Secretary of State for Social Services how the medical manpower needs of health districts are determined.
District health authorities are responsible for assessing medical manpower needs as part of their overall responsibilities for service planning.
The Minister has not referred to the decision. Does he agree that difficulties arise where the medical manpower committee agrees that there is a need for a consultant appointment—for example, in the case of the Bromsgrove and Redditch health disrict to prepare for the accident and emergency unit in the new hospital—but there is no revenue support? Is he aware that those difficulties are made much worse in a health district such as Bromsgrove and Redditch where there is underfunding on the RAWP formula?
There is obviously sometimes competition for resources to fund what every district health authority would like to do. Overall, there is enough medical manpower to go round and it is left to districts and regions to assess their own priorities and provide for particular districts. I know that Bromsgrove is behind by the RAWP formula, and so is the West Midlands region. That is why both are getting above average growth. The building of a new district general hospital has just commenced in Bromsgrove to meet its needs.
Is the Minister aware that much of the medical manpower works in the private sector as well as in the National Health Service? In determining the manpower requirements of the National Health service, does he bear in mind that many of those people are filling their pockets, as it is lucrative to be in the private sector at the expense of the National Health Service. That is why the medical manpower requirements are not met.
We undertake careful medical manpower planning for the National Health Service. I do not accept that there is a serious shortage of medical manpower. The new contracts, which have been introduced to enable consultants to work part-time in the private sector, have worked wholly to the benefit of the National Health Service and have helped to keep skilled medical manpower in this country.
Whatever the vested interest in the existing handout under the RAWP formula, will my hon. and learned Friend examine the gross iniquity whereby population statistics are out of date and expanding areas such as Northampton and Macclesfield are left behind year after year, with a cumulative deficit. It is time something was done about this.
I promised my hon. Friend when I met a deputation that included him that I would examine the population statistics. I also received representations from London districts that the population figures were unfair from their point of view. There is a certain conflict between the claims I receive. Northamptonshire, as part of the Oxford regional health authority, is underfunded in terms of RAWP, which is why it gets higher than average growth compared with other districts. We have to examine competing claims to see how far we can go in redistributing resources.
asked the Secretary of State for Social Services if he will make a statement on the new arrangements whereby the responsibility for identifying children in clothing need has been passed to teaching staff.
The statutory provision for assistance with school clothing needs in Scotland is contained in section 54 of the Education (Scotland) Act 1980, which is the responsibility of my right hon. Friend the Secretary of State for Scotland. So far as the responsibilities of this Department are concerned, single payments for children's clothing under the supplementary benefit scheme can be made only where the need arises for reasons other than normal wear and tear.
The Minister is probably unaware that some Scottish local authorities have delegated responsibility for dealing with school clothing needs to teachers and that the teachers' organisations have said that they do not possess the skills or ability to assess those needs. In those circumstances, does the Minister agree that his Department should reintroduce the scheme, under which skilled DHSS visitors can go to the house concerned and make provision for children in need?
No, I do not. The powers provided to education authorities in Scotland are appropriate, and it is not for me to tell the authorities how to interpret those powers or how to negotiate with the teachers' unions. That must be a matter for the local education authorities.
Does the Minister recognise that when this responsibility was transferred from his Department to the Scottish local authorities there was much hostility from the teaching profession and from the EIS in particular? Is he aware that if this money was properly spent by local authorities 130 additional teachers could be employed to educate children in the Strathclyde region—an area that is very much in need of employment, especially for the teaching profession?
There is no question of transferring a particular responsibility from the DHSS to Scottish education authorities. Under the regulated supplementary benefit scheme, single payments for children's clothing have been awarded more evenly across the country, and that has affected Scotland. However, as I told the hon. Member for Dundee, East (Mr. Wilson), the application of the powers of Scottish education authorities and the negotiations with the unions are matters for the Scottish education authorities themselves to sort out.
Should we not ensure that children who are genuinely in need are cared for? One is therefore at a loss to understand why teachers cannot tell whether shoes are leaking or clothes are inadequate.
I have some sympathy with my hon. Friend's opinion. He confirms my view that this is a matter for the Scottish education authorities, in conjunction with the teaching unions, parents and anyone else whom they ought to consult.
Voluntary Organisations (Ministerial Visits)
asked the Secretary of State for Social Services how many visits were made by Ministers in his Department to voluntary organisations in 1982.
Over 100 so far.
I congratulate my hon. Friend on the number of such visits that he has made. It is a pleasure to see him involved with so many organisations. I pass on to him the great welcome for the opportunities for volunteering scheme. Will this programme be expanded?
I return the compliment by saying that it is a pleasure to see my hon. Friend at many of these functions. He is right to say that the opportunities for volunteering scheme have been warmly welcomed and that it has been a great success. I am pleased to confirm that we shall make additional resources available to continue the scheme at about the same level next year.
Leaving aside the statements of mutual admiration, did the Minister discuss with the voluntary organisations the effect of the doubling of VAT on their activities? Is he aware that the Spastics Society last year paid £350,000 in VAT and that the Royal National Institute for the Deaf paid £100,000? What representations is he making to the Treasury to end that burden?
The right hon. Gentleman will be aware that a meeting on this subject will be held tomorrow and that this is a matter for my right hon. and learned Friend the Chancellor of the Exchequer. I hope that hon. Members will bear in mind the substantial improvements introduced by my right hon. and learned Friend to increase the flow of money to voluntary organisations—for example, through covenants. In fact, many voluntary organisations regard the support from this Government as the most helpful that they have received for a long time.
I congratulate my hon. Friend on his interest in the voluntary organisations. Has he given any directions to local authority social services committees to pump prime local voluntary organisations?
I am not in a position to instruct them to do so, but we hope to issue shortly the new circular on joint finance entitled "Care in the Community". I assure my hon. Friend that that circular will lay heavy emphasis on the need to work with and through the voluntary organisations.
asked the Secretary of State for Social Services if he will introduce twice-yearly reviews of retirement pensions and other benefits.
Does the Secretary of State realise that by introducing more frequent reviews he would at a stroke eliminate the feeling of injustice among pensioners because they must wait from March until November for their promised increase? Many of them feel that they will never get it, as they may die in the meantime. Secondly, more frequent reviews would allow the right hon. Gentleman more accurately to forecast the rate of inflation, thereby eliminating his embarrassment at having to steal from pensioners' purses and wallets the paltry sums that he claims to have overpaid them.
I remind the hon. Gentleman that when that suggestion was put to the Labour Government after November 1976 it was always resisted. The only justification for six-monthly reviews would be runaway inflation, which is what we had in the first years of the Labour Government. Fortunately, that is no longer the case.
Does my right hon. Friend agree that pensioners would not welcome such a proposal in the current year, because, if accepted, they would not enjoy the full additional benefit of 2½ per cent. in 1982–83?
My hon. Friend is right. Between 1974 and 1976, when the Labour Government introduced such frequent reviews, inflation was running at a rate of no less than 26 per cent.
Given that inflation under this Government reached 22 per cent., why is the right hon. Gentleman so coy about this proposal? Will he admit that there is nothing technically impossible about a twice-yearly uprating when inflation is in double figures? There is nothing wrong in that. The Labour Government proved that it could be done. As my hon. Friend the Member for Oldham, East (Mr. Lamond) said, it would not then be necessary for the Government to introduce these clawback measures.
No one is challenging whether it is technically feasible. The hon. Gentleman has just said that it could be done if inflation were in double figures, and that was so when Labour was in power. Fortunately, under this Government inflation is not in double figures.
asked the Secretary of State for Social Services if he will take steps to publicise the regional breakdown of the perinatal mortality rates for 1981 in England and Wales when they are available.
The figures the hon. Gentleman refers to were published last week. They show that regional differences persist, but there has been a remarkable overall improvement. Five years ago, only one English region had less than 14 perinatal deaths per thousand births. Now, every region is below this figure, and the two best regions are below 10 per thousand—a figure which bears comparison with any country in Europe. This achievement reflects great credit on all the health professionals whose sustained efforts have helped to bring it about.
I welcome that improvement. Does the Minister recognise that it is still sad that even now babies at risk cannot be taken into intensive care units? What action does he propose to take? Does he accept the findings of the Select Committee and the observation of the Spastics Society that in the event of a young baby's death an intensive and careful post mortem could reveal the causes and might further reduce perinatal death and handicap rates?
The hon. Gentleman will be well aware that we appointed the Maternity Services Advisory Committee to advise us on all aspects of this important matter. We look forward to receiving its reports from time to time and to reporting our conclusions to the House.
I am a member of that Select Committee. We welcome the improvement in the perinatal and neonatal mortality rates and hope that they will continue, but does my hon. Friend agree that closing down the maternity units in cottage hospitals such as the Congleton war memorial hospital is not a way of further improving those figures? Is he aware that that hospital is in an area of growing population and that the regional health authority and the district health authority should be considering upgrading those wards rather than closing them and reducing services?
If my hon. Friend cares to write to me about that case, I shall examine it. He is well aware that responsibility lies with regional health authorities to order their priorities in these matters.
Does the Minister agree that smoking by pregnant women is one of the most frequent causes of perinatal mortality? When will the Government do something about the problem, rather than expect the tobacco industry to discourage the sale of cigarettes, at the expense of its own profits?
The hon. Gentleman confuses the issue. Every Minister has made it clear that smoking puts people at risk. Unlike the Government whom the hon. Gentleman supported, we have made a dramatic increase in the size of the health warning on the cigarette packet and obtained £11 million for research into health matters.
Family Practitioner Authorities (Appointments)
asked the Secretary of State for Social Services what representations he has received concerning his proposals for all appointments to the new family practitioners authorities to be made by himself.
As there is widespread doubt about the Government's motives behind the proposal to reconstitute family practitioner committees, and in the light of a recent written answer by the Under-Secretary of State for Health and Social Security that no attempt would be made to ascertain the political allegiance of members of such committees, will the Minister come clean and confirm—or deny—that at least three administrations of family practitioner committees have been approached by officials of the DHSS to ascertain the political allegiance of their members?
I am not aware of any such approaches. I have not authorised any. Appointments to the new family practitioner committees will be made as they always have been—by the Secretary of State—on the nomination of a wide range of interested bodies, both professional and lay.
Will my hon. and learned Friend assure the House that there will be a minority of medically qualified people on each of these authorities?
We intend to preserve broadly the existing balance between professionally qualified and lay members. We will ensure that in the appointments that we make.
Spectacle Purchases (Financial Assistance)
asked the Secretary of State for Social Services how many people now receive Government help towards the purchase of spectacles; and what was the number receiving assistance in 1978.
During the financial year 1981–82, 825,000 adult patients in England—17 per cent. of the total—received help with optical charges. This compares with 737,000—16 per cent. of the total—in 1978–79. In addition, 402,000 pairs of spectacles were supplied free to children in 1981–82, compared with 335,000 pairs in 1978–79.
Does the Minister agree that that is because the price of spectacles has rocketed under the present Government? Will he give the percentages of people who have applied for a free test and answer the question in those terms?
With this amount of notice I cannot do that. If the hon. Gentleman ever became a Minister, he would know that.
Is my hon. Friend satisfied that there is sufficient publicity in opticians' premises for National Health Service frames? Is he satisfied that there is sufficient price competition for private frames?
My hon. Friend will be aware that the Office of Fair Trading expects to publish its report on competition in the optical service before the end of the year. My hon. and learned Friend the Minister for Health is discussing with the frame manufacturers ways of introducing a variety of new frames into the NHS.
Is the Minister aware that when the charges were first introduced many years ago they were a temporary measure? How long have they been a temporary measure, and when will they be removed?
I recall the party of which the hon. Gentleman is a member frequently saying that it would remove those charges, but when it became the Government it reneged on that promise, as it has on so many other things.
Regional Health Authorities (Resources)
asked the Secretary of State for Social Services if he will seek to ensure that in future regional health authorities will be provided with resources based on assumptions for periods longer than the present two-year period, in order that such authorities may implement existing plans for hospital development.
We hope in the new year to issue to health authorities revised long-term guidance on resources which will provide a sustainable and realistic basis for forward planning.
Although the commissions on capital expenditure are now satisfactory, is my right hon. Friend aware that advantage cannot always be taken of them because the revenue implications cannot be guaranteed? Does he agree that if the two-year period were extended some of those difficulties would be removed?
I understand my hon. and learned Friend's point. He will know that we have issued guidance on the matter, so that when authorities are planning capital spending they also have resource implications in mind.