asked the Minister of Health how many British patients are now being treated for tuberculosis in Swiss sanatoria under the National Health Scheme.

One hundred and forty from England and Wales.

In view of the unqualified success of the scheme and the comparatively small cost involved, and in order to prevent the spreading of the infection in this country, will my right hon. Friend consider sending more patients to Switzerland?

We review the scheme from year to year, and it is due for review in September. The main reason for the scheme was the long waiting lists in this country, but they have been very dramatically reduced in recent years, so much so that from time to time now it is almost difficult to take up the present allocation.

asked the Minister of Health what progress has been made in finding a suitable home for Michael Daniels, aged 7 years, an epileptic needing constant supervision, in view of the medical testimony of the danger to his brother of two years of age and the strain on the parents.

As the hon. Member knows, this boy has high priority for admission, but I am afraid there is no immediate vacancy.

Does not the right hon. Gentleman appreciate that this boy is a mental defective of a vicious type and has tried to choke the young baby, that the young child is in a very serious state and that the mother and father are losing their health? Is it not a terrible position if the right hon. Gentleman cannot find a place for a boy of this type before real tragedy occurs in his home?

I wrote to the hon. Gentleman about the case a couple of weeks ago. He knows the priority that this case has. It is one of 17 in the most urgent category of all. The board knows—it has again been brought to its attention—how urgent the case is. I am certain that the board knows the priority and will do its best.

Cannot the right hon. Gentleman give the mother and father a little hope as to whether it will be one month, two months or three months?

The hon. Gentleman knows perfectly well that the question of which child is to be put at the top of the list must be decided on medical priorities by the board and not by interchange between hon. Members in this manner. All I can do is to make absolutely certain that the board knows the priority that the child has, and the reply which I have given to the hon. Member indicates that.

asked the Minister of Health if he is aware that 12-year-old Brian McCaul, of Leigh, Lancashire, concerning whose case there has been protracted correspondence, has been waiting half of his lifetime for admission to hospital despite a top priority; and if he will give an assurance of admission in the immediate future.

I am well aware of this sad case but regret that the shortage of accommodation for this kind of patient makes it impossible to promise admission to a suitable institution in the immediate future.

In view of the fact that despite his high priority this boy has been waiting six years, can the Minister say how many of these tragic Brian McCauls there are awaiting beds throughout the country? Will he try to arrange additional accommodation in the various regions?

On the second point, as I am sure the hon. Member knows, we are doing a very great deal and in the Liverpool and Manchester regions, which share their accommodation for this purpose, 250 extra beds will be provided in the next two years, quite apart from Greaves Hall, which is going to provide 1,000 beds, of which 300 are for children.

Will the Minister bear in mind that cases of this description, which completely wear out the parents, bring disaster to the family? It is not just the boy who is concerned.

I know that. It is one of the reasons I have consistently tried since I became Minister to give priority to mental health.

asked the Minister of Health the number of farms, formerly run by hospitals, which have been sold or leased within the last two years; what is the total acreage involved; and what proportion of the total is represented by farms formerly run by mental hospitals and mental deficiency institutions.

Three hospital farms, having a total area of 209 acres, have been sold since 1st February, 1953, one of which with 83 acres was at a mental hospital. No information is available about the number of farms leased.

In considering the matter further and developing his policy on the subject, will the Minister have special regard to the position of mental hospitals, not merely because of the occupational therapy involved, which can be overstated, but because of the permanent need in most cases to keep a sort of green belt around mental hospitals?

I will certainly consider the suggestion. The main decisions following on the circular of last year have not yet been taken. The information from the various regions concerned has now been received by my Department.

Is costing carried out on the farms, and has not my right hon. Friend found that in the past the cost of production has been exorbitant? Will he try to get rid of all farms kept by hospitals and mental homes?

The costing has not been adequate in previous years, but a different system has now been introduced and I hope that it will take care of the matter. It is true that in many cases there has been a substantial loss to the Health Service under this heading. It was with that in mind that I sent out the circular of a year ago, but I have no intention, of course, of closing down all farms and gardens.

Will the Minister make it clear that, although there have been some losses, there are many hospital farms which have been very efficiently run and that a great deal of good voluntary service has been put into them?

That is true, but it is not the whole point. Apart from anything else, I am not authorised by the National Health Service Acts to farm. That is one of the main difficulties. I can farm only if the work definitely has therapeutic value for the patients.

asked the Minister of Health in how many regions the recruitment of nurses has been suspended or reduced because of the instruction to hospital management committees that recruitment of nursing staff up to approved establishment can only be made on condition that the salaries of staff so recruited can be met from the approved estimates.

Full information is not available, but it is obvious that improvements and developments, including increases in staff, can only be made if the cost can be met within the allocations.

Does that mean that when the Minister reviews his estimates for next year he will allow for increases in staff, particularly in those hospitals which are at present admittedly understaffed?

Yes. One of the main items in the new moneys for which the different authorities have asked is, of course, their expectation of increasing the numbers of staff available to them.

asked the Minister of Health, in view of the shortage of nurses and student nurses, what further steps have been taken to increase recruitment, particularly for mental nursing, both from English and also from colonial girls; and, in view of the disproportionate number of nurses and student nurses in traditional London teaching hospitals, what action he is taking to divert their services to other hospitals where a shortage exists.

The action taken both by my right hon. Friend and by my right hon. and learned Friend the Minister of Labour and National Service to increase the recruitment of nurses and improve the staffing of mental hospitals, where the shortage is mainly to be found, covers too wide a field to be dealt with in the limits of a Parliamentary answer. But among other matters he has it in mind to invite the teaching hospitals to consider with him whether more might not be done to second student nurses to mental hospitals as part of their training.

Does the hon. Lady agree that it seems scandalous that many of the traditional teaching hospitals in London are overstaffed compared with many hospitals around London, where there is very grave understaffing? Could not the Department try to transfer some from the overstaffed hospitals to the understaffed hospitals, and vice versa?

A certain amount has been done by the standstill of establishments with just that result. There is an improvement, but not in the mental hospitals. That method has helped the other hospitals. It is fair to say thatthe staffing figures for the general and teaching hospitals are not wholly comparable with the others.

asked the Minister of Health if he will now make a statement giving the results of his circular to hospitals concerningthe registration of cases of cancer; and how the number of cases for 1954 compares with the preceding years since 1950.

Complete figures showing the number of cases of suspected cancer registered in 1954 will not be available before the middle of 1955. The hon. Member will no doubt bear in mind that these figures will not fully reflect the action taken in response to the circular which was issued during the period to which they relate.

Does not the right hon. Gentleman appreciate that his series of answers on this question are very conflicting? Can he not recall that on 18th March he said that he was expecting that a circular which had been sent out would be back by 30th June, when it was anticipated that there would be 58,000 cases? That was 30th June, 1954. Can he not now give further figures that will correspond with what he anticipated?

The cases to which the hon. Gentleman refers were suspected cases for 1953. I can give him the figures if he likes to put down a Question. The answer I gave on 6th December was to say that it would be a few months yet before we had the final figures and that I would let him know at once so that he could ask a Question. I will still do so.

asked the Minister of Health the average cost of maintenance of a general bed and a maternity bed, respectively, in National Health Service hospitals.

The average weekly cost of maintaining a patient in non-teaching general hospitals in England and Wales in 1953–54 was £15 15s. 5d.: and in non-teaching maternity hospitals £18 0s. 5d. For teaching general hospitals the costs were £25 4s. 2d. in London and £19 2s. 9d. in the provinces; and for teaching maternity hospitals £22 10s.

Are not these figures very much higher than the fees paid by the regional hospital boards to private nursing homes and other institutions outside the National Health Service where there are contractual arrangements with those institutions? Will he not encourage such contractual arrangements with institutions outside the Service?

The figures may be higher but, of course, they are not comparable. The care given in nursing homes and the range of service provided are very different from what is given in a big hospital.

Has the right hon. Gentleman seen, among other things, the extraordinary variation in the cost of food per patient in different hospitals? For example, is there any reason why it should cost £3 2s. l0d. to keep a patient in food for a week at Guy's and £4 8s. in St. George's Hospital, when both are in London?

That is one of the reasons I and my predecessors have encouraged the provision of adequate costing returns, which are now coming out, so that these comparisons can be brought out and studied.

asked the Minister of Health why he permits flushing valves to be used at St. Thomas's Hospital, contrary to the regulations of the Metropolitan Water Board.

I am ready to ask the hospital board to replace any of these valves that contravene the relevant byelaw.

Will the Minister confirm that these flushing valves arethoroughly efficient devices? Can he say what steps his Department can take to protect private citizens who are threatened with withdrawal of their water supplies by the Metropolitan Water Board if they do not replace the valves by cisterns?

I am not sure that I do not have a personal interest in this, because the Metropolitan Water Board discovered that I have one of these in my house. Officials asked me to remove it. I did. I am a law-abiding citizen and a law-abiding Minister. This byelaw exists, and in the hospitals I must do my best to carry it out.

asked the Minister of Health how soon he expects to be able to approve the plan to install radio-telephone equipment in the ambulances of the Staffordshire Health Authority.

The authority has not yet submitted its revised proposals.

Can the Parliamentary Secretary say why there is such a great delay and dispute over this matter in view of the greater efficiency and probably greater economy that would be achieved by this improvement of installing radio-telephone devices in the county ambulances? Can she say why so many weeks and even months have passed before some agreed plan could be made?

Staffordshire is divided into nine areas for administering this local health authority service, and the original proposal involved superimposing the system on those nine separate areas. A deputation was received by the Minister and the whole matter gone into by experts on 21st January, when it was recommended that a four-centre system rather than a nine-centre system would be more applicable. As far as I am aware the deputation appeared to accept that, and we are now waiting its revised proposals. There will be no loss of time when we have received them.

asked the Minister of Health how many psychiatric social workers are employed by hospital authorities in England and Wales, and how many by local health authorities; if he is satisfied that those numbers are adequate; and what steps he is taking to encourage the training of more psychiatric social workers.

Figures for 1954 are not yet available, but in 1953 the number employed by hospital authorities was 280 full-time and 36 part-time; and by local authorities approximately 140 full-time and 13 part-time. The supply falls short of needs, and special grants are available for students.

Would not the right hon. Gentleman agree that the psychiatric social worker is an essential link in any comprehensive mental hospital service, and will not he further agree that the numbers will never be adequate until the salary scales are substantially revised and until additional training facilities are provided?

I agree that they are most important workers. On the question of salaries, there is at the moment a claim before the Whitley Council.

asked the Minister of Health what proportion of the increased expenditure on hospital accommodation which he recently announced will be spent in the West Midlands; and what plans for improved hospital accommodation for North Staffordshire are contemplated.

Until I have received and considered the proposals of all hospital boards, I cannot say how much of the new programme will be devoted to any particular area.

Is the right hon. Gentleman bearing in mind the prime importance of the West Midlands or, in particular, North Staffordshire, in the economy of the country, and will he indicate that an adequate proportion of the increased expenditure which is very much needed in the great industrial area of the West Midlands will go to that area? Will the right hon. Gentlemanmake an announcement shortly about that?

I will give the full information to the House as soon as I have got the details and allotted the necessary priorities for all areas. Of course I understand the importance of the area to which the hon. Member refers. There are many other areas of great importance, too, and we must do as best we may to balance their conflicting claims.

asked the Minister of Health if he will arrange for an investigation to be held to ascertain the extent to which expenditure in respect of food for patients and staff in mental hospitals in the Dartford district enables adequate and suitably varied diets to be provided.

One of my catering advisers visited two of the hospitals concerned last year, and the third has recently been investigated by the catering adviser to the regional hospital board.

Does the right hon. Gentleman recollect that, when I asked Questions before, he mentioned the 26s. per patient allowed in general hospitals but could not give any figure for the mental hospitals? Is he aware that there is deep concern that in the mental hospitals in the Dartford area the food is totally inadequate for people sick in mind but healthy in body? Can the hon. Member for Dartford be allowed to see some of the meals without his visit being announced in advance?

I should be very ready to help the hon. Member on the last point. Perhaps we can have a word about that. So far as the amounts in the mental hospitals are concerned, it is because the board was concerned at the low charge in the Bexley Hospital that it ordered the most recent inquiry which is taking place this week, and to which I have referred. There are special reasons why the cost per patient—the cost per head, because it includes the staff as well—is very much lower than in other hospitals, the two main ones being the very large number of patients and the relative absence of special diets.

asked the Minister of Health if he is aware of the concern in Rugby over the shortage of hospital accommodation for the chronic sick; and what steps he is taking to remedy this deficiency.

I understand that this matter was raised with the Birmingham Regional Hospital Board recently, and that they are considering it.

While bearing in mind the difficulties of the hospital board in this connection, may I ask the Minister whether he is aware that the public health committee has almost got to the end of its tether in this matter, which is causing a lot of domestic unhappiness and distress in the borough? Will he use his good offices and give the hospital board special dispensation to build accommodation in the town?

I have seen the letter from the town clerk of Rugby to which, I think, the hon. Member is referring. It has gone to the regional hospital board, and the board must be the judge of what priority it assigns to any particular claim.

asked the Minister of Health why the Board of Governors of St. Mary's Teaching Hospital Group, Paddington, decided to convert the Children's Hospital to adult use.

I understand that the principal reason is that the board considers that there is a surplus of staffed children's beds and not enough adult beds in the hospitals in this group.

Does not the Minister realise that this will mean that the specialised assistance necessary for children will now be more widely dispersed; and as Paddington, Kensington and Hammersmith are densely populated areas with a large number of children, will not he see whether the decision can be reversed?

The decision has not yet been taken; indeed, it is quite a long way in front. These are proposals put forward because the board consider that on the whole the need for children's beds has diminished, which, as a general proposition, is a true one, I am happy to say. We should beware of trying to freeze the pattern of hospital provision as it happened to be in 1948 when the scheme came in. There may well be very good reasons for a change of use, but I emphasise that no final decision in this matter has been taken.

asked the Minister of Health what decision he has reached concerning the proposal of the Western Area Committee that a new hospital shall be built to serve the Poole-Bournemouth area.

asked the Minister of Health what steps he intends to take to relieve the present shortage of hospital beds in the Bournemouth and East Dorset area.

I have approved schemes at three hospitals in the Bournemouth and East Dorset area which during the next 18 months are expected to provide nearly 100 additional beds. The proposal for a new hospital in the Poole-Bournemouth area must be considered along with all other similar proposals now being submitted to me by hospital boards.

Is my right hon. Friend aware that the need there is very acute and that the number on the waiting list has gone up over the last two years; and can he expedite consideration of the matter?

I will look at it as soon as it comes in. My information is that the new hospital in the Poole and Bournemouth area is placed fifth by the regional board concerned in its projects. If my hon. Friend chooses to take up that matter with the board and claims that that is a lower position than is warranted, that might be his most effective step.

Can my right hon. Friend say whether any additional money will be made available in this area for capital expenditure? Does he realise that there are about 5,000 people already on the waiting list for hospital treatment in the area and that the site for the new hospital has already been agreed?

Over the course of the next three years, in the programme which I have announced, we are more or less doubling the capital provision in England and Wales. No doubt all areas will benefit from that. Whether any particular new hospital will be built, apart from that which I have already indicated in my statement, is a matter on which I cannot pronounce until I have seen all the detailed proposals.

asked the Minister of Health what extra sum has been granted to the Newcastle Regional Hospital Board in addition to the original capital allocation for 1954–55; and whether similar additional provision can be made for 1955–56.

About £250,000. Ido not expect to be able to make a similar supplementary allocation next year.

Does the right hon. Gentleman realise that if additional sums are made available towards the end of the financial year it is very difficult to make full use of them? If he can make them available at the beginning of the financial year, we can guarantee to get the work done.

If there is any possibility of under-spending, I shall do what I can to allocate the money available to the boards who can take it as soon as I can in the financial year, but I should have thought it unlikely that there would be the amount of under-spending this year that there was last year owingto the slow progress made with centrally financed schemes.

Can we assume that, in addition to the original capital allocation for schemes which are going forward the board, will get, say, £150,000 extra?

Of course not. The hon. Members knows perfectly well that I must keep within the budget. But if moneys become available, I shall consider the claims of all regions equally when the time comes.

asked the Minister of Health approximately how many mentally defective adults are employed by private firms outside the institutions in which they live; what are the terms and conditions of such employment, and to what exent they are agreed with the appropriate trade unions; what proportion of the wages paid in such cases is issued or credited to the patients who earn them; and what proportion is retained by the institutions to cover these patients'board and lodging.

No figures are available of the numbers involved. Employment of this kind is essentially a part of treatment and its nature and remuneration therefore depend on individual circumstances. Any special problem is a matter for discussion with the local representatives of the trade union concerned. The deductions made for board and lodging vary and are calculated in accordance with advice given to hospital authorities, of which I am sending a copy to the hon. Member.

Does that mean that the right hon. Gentleman does not lay down any general standards which should be conformed to? Is he aware that contractors sometimes get away with paying less than £3 a week for a hard and presumably useful week's work by physically fit high-grade mental defectives? Is not such exploitation grossly unfair both to the patients—who cannot argue for themselves—and to other workers whose pay is thereby undercut?

As the hon. Gentleman will see from the circulars which I am sending to him, I lay down how various calculations should be made in relation to the pay which a patient obtains. I do not think that it is practicable to have central discussions with trade unions in this matter because the cases vary so enormously, but local difficulties often are rightly discussed with the local branches of the trade unions concerned. If the hon. Member knows of any case where he thinks there is any element of exploitation or which is not essentially related to the welfare of the patient, I shall be glad if he will let me have particulars.

I appreciate that hospital authorities themselves have the best of intentions, and do this for the patients' welfare, but will the right hon. Gentleman consider suggesting to them that they ought always to discuss these cases with the local trade unions concerned and not only often, as he says they do?

I shall certainly look into that. Part of the difficulty is that there is such an enormous variety of cases. So far as I know, no particular difficulties have arisen in relation to trade unions.

asked the Minister of Health how many hospitals are economising in the use of butter for hospital meals by substituting a blend of butter and margarine.

I regret that this information isnot available.

Will the right hon. Gentleman investigate what has happened in at least three hospitals in West London, where an attempt is being made to save a few miserable hundred pounds at the expense of 1,300 patients and staff?Does he think that we are so hard up that we have to have that kind of economy?

I always look at anything which the hon. and gallant Gentleman chooses to put before me, but details of this sort cannot be laid down by the Ministry of Health and must be left to the hospitals.

asked the Minister of Health what steps he is taking to reduce the shortage of domestic staff in hospitals.

I am aware that difficulties arise locally, but in general the position has been improving in recent years. If the hon. and gallant Member has any particular case in mind I shall be glad to look into it.

Is the right hon. Gentleman aware that there is an immense turnover per year in the ancillary staffs of hospitals? Does he really think that he can get female cooks for 2s. 5d. an hour in London hospitals?

As I say, although there are difficulties, which I think are part of the general shortage from which hospitals and everyone else suffers, the total number of whole-time and part-time staff has been going steadily up.

asked the Minister of Health what portion of the sums he announced on 9th February for new hospital building represented interest charges; and how much extra the schemes will now cost, in view of the higher interest rates now in force.

None, Sir, so the second part of the Question does not arise.

Does that answer mean that the increased interest charges will make no difference to the amount of building to be performed? Does the Treasury not impose a ceiling on expenditure of this kind?

That has nothing to do with the Question, because this matter is financed by the Exchequer out of revenue.

asked the Minister of Health whether he is aware that at some hospitals trainee nurses are engaged for long periods on night duty; and what are the exact recommendations laid down by his regulations on this point.

The Nurses Salaries Committee recommended that student nurses should not be employed continously on night duty for longer than three months. My right hon. Friend is aware that it may not always be possible to observe this recommendation. There are no other requirements on the subject.

Is the hon. Lady aware that the recommendation represents a sort of minimum? Will she take note of the fact that in some hospitals night nurses are working very many months more than three? They work three months, rest for a while, and then go on for another three months. Does the hon. Lady not agree that that is rather unsatisfactory?

If the hon. Gentleman has any particular case in mind, we shall be glad to look into it. Under the regulations, there is a maximum of three months. They say that no student nurse should be employed on continuous night duty for longer than three months.

asked the Minister of Health the recommendations laid down by his regulations as to the time that is allocated for student nurses to attend lectures; and to what extent student nurses are expected to attend lectures in their free time.

My right hon. Friend has made no regulation on the subject and thinks it best to leave the arrangements to the discretion of hospital management committees and boards of governors; but whenever possible student nurses should not, in his view, be expected to attend lectures in their free time.

Is the hon. Lady aware that some student nurses come off night duty and have to go on to lectures in their free time after a long night, and that in fact means that they are doing about 15 hours' duty out of the 24, both voluntary and involuntary? Will she not agree that this is unsatisfactory, as she has suggested?

I quite agree that it is unsatisfactory if it happens too often. Sometimes there are very special lectures that these nurses have to attend for examination purposes. For some of the students those lectures must come in the off-duty hours, and it is unavoidable in those cases. We would like this to be kept to the minimum.

asked the Minister of Health to what extent it is customary for regional hospital boards, hospital group committees, or matrons to consult employees of any grade before considering new appointments to their staffs; and, where this is the practice, what steps he has taken to recommend that it be discontinued.

Joint machinery is widely used for consultation on matters affecting management and staff, and I would greatly deplore any narrowing of its proper scope.

Is the right hon. Gentleman not aware that this goes far beyond those terms of reference, because staff have been asked whether they would be prepared to accept other staff even though they happen to be coloured themselves? Surely that goes far beyond the case to which he has referred?

No, I do not think so. The individual case has been happily settled now. The fact that a particular piece of advice is open to criticism, if it is, does not mean that there is anything wrong with the principle of consultation.

Does the Minister encourage consultation with the staff regarding the employment of staff? Does it apply right through the medical staff, down to orderlies?

Obviously there would be no consultation on individual appointments, but on very wide matters it is perfectly proper that there should be consultation.

I do not agree at all.

asked the Minister of Health whether he is satisfied with the amount of dental research work at present being undertaken in dental hospitals; and if he will make a statement.

Dental research is in progress not only at these hospitals but in a number of other centres. If the hon. Member has any particular difficulty in mind, perhaps he will let me know.

Is the Minister satisfied that this work is properly coordinated? Would he agree to make recommendations to set up a special committee for this work under the Medical Research Council?

I should like to look at that proposal, particularly in the context of the Medical Research Board which has recently been set up.

asked the Minister of Health if he is aware that many doctors charge 2s. for medical certificates issued to the National Health Service patients; and if he will make a regulation to prohibit this charge.

General practitioners in the National Health Service are not required to provide free medical certificates other than those required under the National Insurance Acts and certain other enactments which are set out in regulations. My right hon. Friend sees no reason, on the information at present before him, for altering this system.

Is the hon. Lady aware that the certificates have very often to be paid for after a period of unemployment when people are least able to afford extras? If the per capita charge does not cover the issue of certificates, will she have a word with her right hon. Friend to see whether it can be adjusted so that they can be issued free?

Certificates which are required in order to obtain benefits under any of the regulations are obtainable free, and if a doctor charged for such a certificate it would be against the regulations; but other types of certificates-school authority certificates and the like—are not covered by the regulations.

asked the Minister of Health if he has considered the recent case, to which his attention has been drawn, of a baby's death from mercury poisoning; and what action he will take concerning the supply of tablets containing mercury to infants.

Yes, Sir. While my right hon. Friend is advised that mercurial preparations have a proper place in medical treatment, his medical officers have already suggestedto medical officers of health that powders containing mercury should be issued from child welfare clinics only on medical advice and with precise instructions. He will consider further whether to suggest that these preparations should cease to be available at clinics at all.

While thanking the Parliamentary Secretary for that reply, is she aware that there have been several disturbing cases of babies' deaths from mercury poisoning in the last 18 months, sometimes mercury derived from teething powders and sometimes tablets? In addition to the action proposed, does she not agree that some general public warning might be sent out by the Minister's medical advisers in view of the public concern created by recent inquests?

I think that the general publicity, particularly in professional journals, and advice given by the Minister's medical officers of health made this clear. I should like to make it plain that if they were not given by clinics that would not interfere with the right of a doctor to prescribe a preparation in which it was included.

Has the hon. Lady any information to give to the House as to whether there is a definite association between the giving of these powders and tablets containing mercury and the disease called "Pink Disease," which is so often lethal to children?

I think that the hon. Member had better put down another Question. So far as this particular case was concerned, the coroner's verdict was "Accidental death caused by Pink Disease," but it was not certain that it was attributable to the particular tablets given.

asked the Minister of Health whether he will make a statement concerning the distribution of welfare foods by local authorities for the first six months following the transfer to them of responsibility for this service.

I would refer the right hon. Member to the returns which I have called for from local health authorities and to which I made reference in my answer to him of the 4th March.

Would the right hon. Gentleman be willing to collaborate with me in arranging in some way for an oral answer to this Question at a later date when he has the information?

Yes, certainly.

asked the Minister of Healt what action he intends to take in respect of the unqualified eye-specialist, details of whom have been sent to him, who has advertised his services in an Essex newspaper.

None, Sir, as the material so far seen does not suggest that he is breaking the law.

While appreciating that there is no illegality, may I ask the hon. Lady whether she would agree that it is unfortunate that these advertisements should appear containing glowing testimonials which may raise false hopes? Will she give an assurance that there is no treatment that this man can provide which my constituents could not get equally, or better, under the National Health Service?

I agree with the hon. Member that the type of advertisement is most undesirable, but we are concerned only with infringement of the law, and it is, shall we say, cleverly drafted so as to not infringe the law. I agree that any necessary treatment for this type of disease is more fully, and better, provided under the National Health Service.

asked the Minister of Health when the Central Midwives Board will make available the new machines for administering trilene to ease pain in childbirth.

The board has approved two types of machines for use by midwives, and these are now in production.

asked the Minister of Health if he is aware of the shortage of sanitary inspectors and the consequent difficulties of some local authorities in fulfilling their statutory duties under the Housing and Public Health Acts; and if he will make a statement.

Neither my right hon. Friend nor the Minister of Housing and Local Government, who has been consulted, have reason for thinking that local authorities are being seriously held up in discharging these duties by a shortage of sanitary inspectors, although they are aware of cases in which a local authority have not been able to recruit as many as they would like.

Has the hon. Lady or her right hon. Friend studied the Report of the Working Party which reported about 18 months ago—I think the figures were for 1951—that there was a shortage of 250 in the country? Will the hon. Lady bear in mind that if Parliament places upon local authorities added burdens and duties, then Parliament must help to devise the means by which the duties may be carried out? The reply is most unsatisfactory.

The hon. Member should be aware from answers to previous Questions that my right hon. Friend has accepted in principle the findings of the Working Party, and that discussions are already taking place with the many interested bodies which are very much concerned in this problem.

Is not that contradictory to the Minister's first reply? In the first reply it was said that there was no cause for concern and that the authorities were not very anxious. If the hon. Lady goes into the overcrowded areas, which are now getting on with slum clearance and having to deal with bombed and blitzed properties, she will find that there is a great shortage and a great need. Will she do something to assist them?

The hon. Member is confusing the issue. The Working Party dealt with recruitment and the coming necessity for increasing recruitment and getting a larger intake each year. That we accept. The Question put now was whether at this moment local government was apparently breaking down because of the shortage—

I did not say "breaking down."

Perhaps the hon. Gentleman did not say that, but that is just as accurate a paraphrase as the one used by the hon. Gentleman. From the evidence we have received from local authorities, the existing services are not seriously put out, and I do not see that that conflicts in any way with the investigations being made about future recruitment for the service.

asked the Minister of Health if he will give a current estimate of the number of sanitary inspectors short of establishment, and of the number of vacancies; and which are the areas most affected.

I am afraid that my right hon. Friend cannot give any reliable estimate.

Has the Minister studied this matter, and can the hon. Lady explain why the Department is not in possession of this information?

All the figures given in the Report, and, indeed, in the records, were pure estimates. The one estimate was of a shortage of 240, but we have not the details of every position advertised and estimated by local authorities.

Is the Minister aware, that, in spite of what she is saying, there are many houses, in London, in particular, and inmany other areas, which ought to be inspected by sanitary inspectors, but which cannot be so inspected because there is not a sufficient staff of inspectors, with the result that many houses which ought to be condemned are still being lived in?

I quite agree with the hon. Gentleman that this question of sanitary inspectors is an important one, but that does not detract from the fact that the Working Party Report has to be thoroughly investigated and discussed with many bodies, which is something that is being carried out by the Department at this moment.

Is the hon. Lady aware that earlier her right hon. Friend gave information about vacancies for psychiatric social workers? Why is it more difficult to get information about vacancies for sanitary inspectors?

indicated dissent.

I thought that the right hon. Gentleman gave the number of vacancies. He certainly gave the numbers employed and an indication that there was a shortage of such people. Surely, it ought to be possible to get the information from the local authorities. Would the hon. Lady get it within a week or two if we put down a Question?

The only figure given was that of 240, which was assessed by the Working Party on the basis of the total of authorised establishments and the number of inspectors at present in employment. [HON. MEMBERS: "In 1951?"] Yes, in 1951. That was a survey carried out by the Working Party at the time. But as the Report has been accepted in principle, and as action is now under way to try to remedy the situation, to go through another complete analysis would not, I feel, serve any purpose.

asked the Minister of Health if he will confer with the Sanitary Inspectors Association with a view to speeding the training and recruitment of sanitary inspectors.

The matter is under discussion with the bodies concerned, including the association.

Can the hon. Lady say how far advanced are the discussions with the Sanitary Inspectors Association?

Discussions have already taken place with six of the bodies concerned with this Working Party Report and a deputation from the Sanitary Inspectors Association is to be received at the Ministry on 11th March.

Is the hon. Lady aware that in Newcastle, for example, residents are having to wait some months before they can get their certificates of disrepair issued because of the lack of sanitary inspectors?

I quite accept that point, but the hon. Gentleman will appreciate that there are probably eight or 10 organisations, all very important in this sphere, which have to be consulted, and which, in order to get their members to attend such deputations, require adequate notice. When some agreement has been reached in general form between all the interested parties, the matter will be referred to them in order to get an agreed programme. There is no delay on our part.

I wish to give notice that, owing to the unsatisfactory nature of the replies, I shall take an early opportunity to raise the matter on the Adjournment.

asked the Minister of Health (1) how many disabled ex-Service men are at present using cars supplied to them under the Ministry of Pensions scheme now administered by his Department;

One thousand nine hundred and thirty-seven war pensioners are using motor cars and 405 new cars have been delivered since 1st January, 1951. No figures are available of the number of war pensioners with disabilities like those in the case mentioned who have been refused motor cars.

Can the Minister say how many of these category C cases, or cases making a claim under category C, have been turned down and whether his supply of cars meets not only the official need, but also the potential need, if humanity were displayed towards such people as Mr. John Kennedy Macleod?

As regards the individual case mentioned, the hon. Gentleman will realise, I am sure, that I merely act as the agent for the supply of the car and that the question of eligibility is one for my right hon. Friend the Secretary of State for Scotland. As far as the general supply of cars is concerned, as I said to the hon. Gentleman in answer to a Question last week, every case that is considered eligible can be met. The difficulty in the case mentioned—as I understand it from reading the Adjournment debate, and so on—was that although that case has been reviewed many times, it was not considered to come within the standard rules.

Is the right hon. Gentleman still authorised to go up to 2,000, because I noted that he is rather short of that number?

The figures which I have given are short of that number, but there are, in fact, a number of new cars available and cars from other sources which bring the total number to 2,002.

Is my right hon. Friend aware that Mr. John Kennedy Macleod is a constituent of mine, that he has a double amputation and, in addition, other very serious wounds? Is my right hon. Friend also aware that Mr. Macleod was granted a motor-tricycle under Category C. but that under the same category he is refused a car?

My hon. Friend will, I am sure, realise that if Mr. Macleod were considered eligible, a car could be provided for him. But the question of eligibility is not one for me; I merely act as the agent for supply only.

Am I right in inferring from what the right hon. Gentleman has said that there are two Ministers responsible for these matters in Scotland, that the right hon. Gentleman is the supplying Minister and that the Secretary of State for Scotland is the allocating Minister? Does it not tend to create a muddle if two Ministers are doing the same thing in Scotland? I do not remember another such case. If that be so, to what Minister ought Questions to be addressed?

The question of eligibility is entirely a matter for my right hon. Friend the Secretary of State for Scotland. It does not create a muddle, because, as a matter of fact, exactly similar arrangements were in operation when my Ministry acted as agent for the old Ministry of Pensions. All that I am saying is that my job is to act only as the agent of supply. Any question regarding the case ventilated this afternoon is a matter for my right hon. Friend the Secretary of State for Scotland.

In that case, is this Question on the Order Paper not one about eligibility, and, therefore, whose responsibility is it, the Secretary of State for Scotland or the Minister of Health? Why is the right hon. Gentleman answering Questions about Scotland?

I am not, and if the right hon. Gentleman will study the Question a little more closely he will see that the hon. Member for Brierley Hill (Mr. Simmons) asks whether I have information about "borderline cases similar to" a particular one. I have no responsibility at all for that case. Of course, I should have to answer Questions about similar cases if they came within the purview of England and Wales.

Will the Minister say whether he is in favour of this delay and, sometimes, treble control of the welfare of ex-Service men? Is it not an outcome of the ill-advised merger of the Ministry of Pensions that we now have three Departments all fighting each other as to whose responsibility it is and "passing the buck" to each other when these problems are under discussion?

That is quite untrue. In fact, a similar responsibility existed before.

asked the Minister of Health how many food poisoning incidents due to processed and made-up meats were recorded in the years 1950, 1951, 1952 and 1953; what percentage of the total incidents resulted from such causes in each of the four years; and what advice is being given to those responsible for avoiding such incidents.

As the answer contains a number of figures, I will, with permission, circulate these in the OFFICIAL REPORT. The Minister of Food and I continually encourage local authorities in their efforts to secure a high standard of food hygiene, and the particular dangers associated with processed and made-up meats are emphasised. Where an outbreak has occurred the medical officer of health usually gives advice to those concerned on how to avoid a recurrence.

Can the right hon. Gentleman say whether the proportion of these cases which are due to meat and meat products is increasing? Does not he agree that almost every one of them would be completely eliminated if the principles of elementary cleanliness were adhered to? Will not he have an inquiry made, because these epidemics—which in my view and in the view of many others could be almost completely eliminated—are causing great inconvenience and some loss of life?

The hon. Member will see from the figures that the number of outbreaks goes up and down from year to year, and that the percentage of food poisoning outbreaks where we can trace the infection is about 50 per cent., and has increased very slightly. As far as the second part of the Question is concerned, I and my colleagues do everything we can in these matters, and I shall be very glad to have any detailed suggestions from the hon. Member for getting rid of more of these outbreaks.

asked the Minister of Health when he proposes to introduce legislation for the registration of ophthalmic and dispensing opticians.

I fear that my right hon. Friend can hold out no hope of legislation on this subject at present.

Will the Parliamentary Secretary discuss this matter with her right hon. Friend? As the Crook Committee's Report has now been standing for some three years, and as I understand the opticians themselves have got together upon the matter and there are now no professional difficulties, cannot we have some promise of legislation?

I quite agree, but the difficulty is with the time-table of the House and not with the profession at the present moment.

Will the hon. Lady assure the Leader of the House that legislation of this kind will be morefavourably received than the Dentists' Bill, which we are still awaiting?

asked the Minister of Health if he will request the committee which he has set up to consider medical manpower problems to consider the question of recruitment in relation to colonial needs as well as to the needs of the United Kingdom.

The committee's terms of reference cover all branches of the profession, and it will therefore take account of doctors who go overseas as well as those who remain in this country.

In view of the fact that there is an urgent need for doctors in the Colonies—where often there is only one doctor for 30,000 people, compared with one doctor for 1,000 people in this country—will the right hon. Gentleman consult the Secretary of State for the Colonies with a view to seeing that opportunities are made available both for British citizens and colonial subjects to enter medical schools for this purpose?

Yes. I am in touch with my right hon. Friend upon that matter. The medical committee which has been set up will be concerned only with medical training in this country, but it must take into account all the possible places to which qualified doctors may go from their universities, and that includes the Colonies.

Is the Minister aware that the only permanent solution to this problem is to expand the medical faculties at Ibadan, Makerere and all universities in the Colonies? Will he use his good offices with the Secretary of State for the Colonies and do something in this matter?

That is not a question for me in the first instance.

asked the Minister of Health what steps are being taken to improve the stocks held by blood banks by hospitals in North-East England.

I understand that the cold weather of the last fortnight has led to a falling off in the response of donors asked to attend bleeding sessions, and that local publicity to counteract this has been undertaken. So far, stocks have been adequate to meet all demands.

In view of the fact that the regional officer called attention to the position as being very grave, and suggested that the position in the North-East England Region is worse than that of other regions, will he keep this matter under review and see what response he obtains?

Yes. I shall look into that matter. I saw a report in a local paper—about which the hon. Member probably knows—saying that the blood banks were more or less dry. It is worth assuring people in the area that that is not true. We have what I am told are adequate stocks, and we always try to keep a safety margin. I will, however, review the matter in the light of what he has said.

Can the Minister say what steps are taken to see that adequate liaison exists between this and other regions in cases of shortage?

I shall look into that matter, although I am informed that there is not a shortage, and arrangements exist by which, in an emergency, supplies could be obtained.

asked the Minister of Health what factors have caused the increase in the number of persons suffering from tuberculosis in the county borough of Sunderland from 839 at 31st December, 1938, to 1,695 at 31st December, 1954.

Much of this increase is almost certainly due to the better facilities and methods in diagnosis and treatment which enable a higher proportion of cases to be discovered and successfully treated. The number of new cases notified is declining.

Recognising the importance of diagnosis, would not the hon. Lady agree that these figures are somewhat disturbing, as there has been no sign of a fall in the number of those suffering from tuberculosis? Will she keep this matter under review, because we are very concerned at the high rate?

I agree with the hon. Gentleman that certainly in the area in which he is interested the figures have permanently been higher than the average for the country. They are showing a good decline now, but my right hon. Friend is watching the question throughout the country.