asked the Minister of Supply what plans have been made in his Department for the change-over to the production of civil goods in Royal Ordnance factories in the light of the declining needs of the Services and improving prospects of international agreement on disarmament.

The Royal Ordnance factories at present undertake civil work on a limited scale as suppliers to other industrial organisations. Although they may take on more work on this basis when it is convenient and economical to do so, there are no plans for their changing over to the manufacture of civil goods on a large scale.

In view of the likelihood of a cut in arms production, which will be very welcome, is not it time that some plans were made, especially as in many areas where there are large Royal Ordnance factories, alternative employment is not easily obtainable and, therefore, there is a danger of unemployment suddenly being increased?

I accept that, in view of a likely reduction in the arms programme, it is desirable to undertake a review of the whole Royal Ordnance capacity, and that I am doing; but to go into civil work on a large scale would, I submit, be inconsistent with the conception of these factories as primarily munitions factories.

asked the Minister of Supply the total number of workers made redundant at the Royal Ordnance factory, Radway Green, in the calendar year 1956; his estimate of the number to be made redundant in the calendar year 1957; and to what extent agreement has been reached with the trade unions about these measures.

Five hundred and seventy workpeople were declared redundant in 1956. Two hundred and ninety-eight of them left the factory in that year. The remainder will have gone by next March. No further redundancy is expected this year. These measures have been fully discussed with the local and headquarter representatives of the trade unions concerned and are being carried out strictly in accordance with the redundancy agreement between the official and the trade union sides of my Department's Joint Industrial Council.

While thanking the Minister for that reply, may I ask him whether he is aware that in North Staffordshire, from which many of these men come, unemployment is already a good deal higher than the average national level? Therefore, when these matters are being considered with the trade unions, will the right hon. Gentleman pay very serious attention to the question of the availability of alternative employment before any further redundancy is created?

The timing and the pace of the redundancy notices is discussed with the trade unions. I have no doubt that the factors which the hon. Gentleman has mentioned are taken into account in the discussions.

As a believer in enterprise, would the right hon. Gentleman say why he is not encouraging these factories under his protection to go out to get contracts to do work?

That supplementary question seems to me to be related to the earlier Question rather than to this one. I think my Answer to the first Question made it clear that limited civil work is not at all excluded, because—and I think I made this perfectly plain in my Answer—the essence of a munitions factory is that it shall undertake munitions work. To undertake civil work on a large scale would militate against its ability to withdraw from it into munitions work quickly.

asked the Minister of Supply why a contract for 20,000 L7A mechanical fuses has been diverted from the Royal Ordnance factory which has been making this type of fuse since 1939 to a private firm which is unable to supply the steel bodies and has sub-let that part of the contract to the original Royal Ordnance factory.

In 1952, requirements for these mechanisms were expected to be very great and it was considered advisable to create additional capacity. No contract was diverted—to use the term used in the Question—from the Royal Ordnance factory, but a small educational order was placed with a private firm. The firm experienced difficulty in supplying the steel bodies, which they had sub-contracted, and that part of the order has been cancelled and replaced by an order on the Royal Ordnance factory.

Can the right hon. Gentleman give an assurance that all normal orders for this article will continue to be placed with the Royal Ordnance factory which has been making it so far?

Assuming the capacity of the Royal Ordnance factories to be adequate, normally all orders would be placed with them.

asked the Minister of Supply if he will make a statement upon the initial steps taken by his Department to provide alternative civil contracts to industrial firms in Coventry in order that the Government's wish to maintain a high and stable level of employment, together with an expanding national economy, may be maintained.

My Department's procurement responsibilities relate in the main to supplies required for defence purposes. Apart from the special consideration given to Development Areas, Government contracts are not allocated on a geographical basis, but firms in Coventry and elsewhere who are on the Ministry's trades lists are given full opportunity to tender.

Is the Minister aware that our unemployment figures in Coventry were worse in January than in December? Further, is he aware that the firm of Armstrong Whitworth Aircraft has said that it would be turning off between 500 and 600 skilled men in the next nine months? Finally, is the right hon. Gentleman aware that the people in Coventry simply do not believe in the Government's statement about an expanding economy when they do nothing at all for places like Coventry? Has the Minister no suggestions at all about civil contracts?

With all respect, the supplementary question seems to me to transcend by far the nature of my Departmental competence. The Question touches the sphere of my right hon. Friend the Minister of Labour. Questions of such a wide ambit should really be directed to him.

asked the Minister of Supply if he will make a statement on the progress made with the jet-powered research aircraft SC-1 designed for vertical take-off and landing; and whether he will estimate when the results of such research are likely to be incorporated in production models for general use.

The aircraft has recently undergone taxi-ing trials. These will be followed by flight trials to prove the aircraft in conventional forward flight, by hovering trials with the aircraft tethered to test the vertical lift arrangements, leading up finally to unrestricted vertical take-off and landing and transition from hovering to forward flight. It is impossible to forecast when the results of this research work will be embodied in an operational aircraft.

asked the Minister of Supply what steps he is taking to correct the insufficient care of his Department in limiting the number of helicopter research projects, as reported by the Select Committee on Estimates, Second Report. 19th December, 1956; and what financial economy his correction will achieve in this field.

The comments of the Select Committee on Estimates about helicopter projects relate mainly to the programme as it was some time ago. My predecessor announced during the defence debate on 29th February, 1956, that the helicopter programme had been reviewed and three major projects cancelled. There are at present only four helicopters under development.

Is my right hon. Friend satisfied, following his review of the position, that all practical economies are now being made, compatible with efficiency, in the Department within his care, as opposed to the care of his predecessor?

Oh.

To arrive at that degree of satisfaction after only a week in office would be rather much to expect. Although, as I have said, there are now only four helicopters under development, the justification for expenditure on those four will have to be looked at, in the light of the defence programme which will be set out in the White Paper.

A very reasonable answer.

asked the Minister of Supply what steps he is taking to implement the recommendations of the Select Committee on Estimates, Second Report, 19th December, 1956; what financial economies he expects to achieve; and whether he will make a statement.

I am at present studying this Report. A reply will be communicated to the Committee in due course, and, if it is the wish of the House, I will also make a statement.

I hope that my right hon. Friend's study is fruitful. Is it not a fact that this Report reveals most glaring deficiencies in administration—waste and extravagance—on the part of his Department? Is not the House of Commons entitled, following a report of its own Members, to demand a rigid review of expenditure with a view to substantial economies?

And a new Government.

Some of the recommendations of the Report are statements of the ideal, with which nobody will quarrel. Of course it would be wrong to overload the aircraft industry, but the question of practical judgment whether this or that item is justifiable is quite different. That can be decided upon only after much more detailed investigation.

asked the Minister of Health if he is aware that Cathlene Murray, the daughter of Mr. and Mrs. Murray, of 22, Oswald Street, Carlisle, has been detained in various institutions for mental defectives for 23 years; and when she will be released.

I am aware of the position in this case, about which my predecessor wrote to my hon. Friend. With regard to the second part of the Question, this patient is still in need of hospital care and training.

Does my right hon. Friend not agree that the reluctance to discharge this case after so many years' detention implies failure? Will he look at the case with a view to assessing the value of the whole system under which this lady has been treated for so long? In particular, in view of the anxiety of my constituents concerning their daughter, would my right hon. Friend facilitate my making a personal visit to see her at the Moss Side Hospital?

I have examined this case. This particular girl has been treated in a number of hospitals. She was even allowed out on licence two years ago, but had a relapse and had to be brought back again. Therefore, I do not think that an over-cautious attitude has been adopted. My hon. Friend has also raised rather wider issues, and I will look at his last point.

asked the Minister of Health if he is aware of the continuing staff difficulties in our mental hospitals; and whether he will make a statement.

I am aware that there are shortages of staff, particularly of doctors and nurses. In regard to doctors, there has been an increase in numbers in post in recent years. Recruitment of nurses is also improving. For the special measures which have been taken, I would refer the hon. Member to the reply given to the hon. Member for Bristol, Central (Mr. Awbery) on 26th November, 1956.

Did not the Minister's predecessor promise the House that some investigation would be made into this increasing problem of staff difficulties? Up to now we seem to have had no direct statement of Government policy. Would my right hon. Friend be willing to consult the trade unions concerned in dealing with this matter?

My hon. Friend the Member for Chislehurst (Miss Hornsby-Smith), as Parliamentary Secretary, made a statement on 26th November which went into this question fairly fully. During the last year there has been considerable improvement in the staffing position. In regard to nurses alone, the position improved by 8 per cent. in the first nine months of last year. At the moment, I would have thought there was sufficient progress apart from taking any further action.

Would not my right hon. Friend agree that, although there has been progress, it is not fast enough on the nursing side? Will my right hon. Friend look at the too great differential between skilled nurses and the trainee and probationer nurses, who are not being sufficiently attracted to the profession?

I will look at that point.

Will the right hon. Gentleman pay particular attention to the growing age of nurses in mental nursing and to the urgent need to look again at the question of their representation on the Whitley Council, which is a matter of great concern?

asked the Minister of Health what proposals are being examined for the future use of St. Luke's Hospital, Lowestoft; and when a decision as to its use will be arrived at.

The revised estimated cost of adapting this building is so high that the regional hospital board has asked me to dispose of it. I propose to do so and am considering proposals from the board for meeting the need elsewhere.

Is the right hon. Gentleman aware that this fine building occupies one of the most advantageous sites on the East Coast? Is it not a tragic waste of capital assets that it is not being used? Will the right hon. Gentleman consult the Minister of Works about the utilisation of the building for a Government Department or in any other way?

My initial reaction when I examined the case was similar to that of the hon. Member, but it would cost an enormous sum to make this an economically efficient hospital. I am, however, prepared to look at the matter and discuss it with the hon. Member, if he is so inclined.

asked the Minister of Health whether he will cause an inquiry to be set up to investigate the circumstances relating to the recent escape of two male patients from the Rampton State Institution.

Two Senior Commissioners of the Board of Control have carried out an investigation at Rampton Hospital, and I am awaiting a report from the Board.

asked the Minister of Health to what extent Rampton State Institution is understaffed.

I assume the Question refers to nursing staff. Out of a complement of 140 male and 105 female staff, there are seven and 12 vacancies, respectively.

Would the right hon. Gentleman say whether the improvement which he announced this afternoon in answer to Question No. 10—an 8 per cent. increase in recruiting over the nine months of last year—applies to this hospital?

I am afraid that I have not available the previous staffing figures for Rampton, but I should have thought that there had been an improvement. There was a full complement of staff in the ward from which the two patients escaped.

Can the Minister say anything about other kinds of staff? In particular, is Rampton so staffed that the patients there can not only be kept under restraint and looked after in the ordinary way, but can be given treatment appropriate to their condition?

The inference behind that question, presumably, is that the staffing complement of Rampton is inadequate. I have no reason to think that that may be the case.

asked the Minister of Health whether he is aware of the local apprehension caused by the recent escapes from Rampton State Institution and the subsequent terrorising of peaceful citizens; and if he will therefore make arrangements to ensure that immediate warning shall be given to local inhabitants in the event of future escapes.

Yes, Sir; as regards the second part of the Question, I am awaiting a report from the Board of Control.

asked the Minister of Health which officials of mental hospitals are responsible for the discharge of patients; on what basis they are remunerated; and whether their remuneration is related in any way to the number of patients in the hospital.

No official is authorised to discharge a patient in a mental hospital, but any two members of the hospital management committee, when ordering the discharge of a temporary or certified patient, must do so with the advice in writing of the medical superintendent. The salary of medical superintendents is generally based on length of service in their clinical grade and not on the number of patients.

It therefore follows, does it not, that if beds in a mental hospital are empty, the officials responsible for the discharge of patients suffer no financial loss?

Yes, that is true.

asked the Minister of Health what arrangements he has made for displaying the Fearnley Cup for 1956, awarded to the Stoke Mandeville Hospital by the International Olympic Committee in recognition of its work in promoting amateur sports among the seriously disabled.

This award has been made, not to Stoke Mandeville Hospital, but, I understand, to the organisers of the Stoke Mandeville Games. It is for them to decide how it should be displayed.

Is not the right hon. Gentleman of the opinion that this is a tribute to the work of the British Ministry of Pensions and National Insurance in pioneering this service over many years, and to Stoke Mandeville and Dr. Guttmann, who have made this possible? Surely such an award, made for the first time to an English-speaking nation and for the first time to disabled persons, is worth more publicity and recognition from the Government than the right hon. Member appears to give it?

I should like to be associated with the tribute which my predecessor conveyed to Dr. Guttmann; but this is a matter for a local trust to decide, as I understand it, and no application has been made to me. If the right hon. Gentleman has any positive suggestion to make, I will, of course consider it.

One suggestion which I could make is that the Minister might be good enough to have this trophy placed in the Library so that we can all see it.

I understand that the trophy itself does not leave Switzerland and that only a replica is presented in this country.

asked the Minister of Health (1) in view of the evidence submitted by the hon. Member for Erith and Crayford indicating that Miss Mary Betteridge had been certified and detained in a mental home on evidence that applied to another person, and also in view of the testimony that before certification she was above the normal standard of intelligence, on what grounds Miss Betteridge was certified; and what consideration has been given to the testimony submitted;

(2) in view of the testimony by the physician in charge, psychiatric department, Bromley Hospital, that he has examined Miss Mary Betteridge at St. Mary's Mental Hospital, Birmingham, and in his opinion there do not appear to be any grounds upon which she can be certified under the Mental Deficiency Act as a mentally defective person, what action he proposes to take with regard to Miss Betteridge;

(3) if he is aware that an incorrect diagnosis was made in the case of Miss Mary Betteridge, interpreting a psychological illness as a mental defect, and that the facilities at the mental institution in which she is detained do not provide the special treatment for a psychological illness; and what action is to be taken to give Miss Betteridge the treatment she requires.

I would refer the hon. Member to the letters sent to him by my predecessor on 26th September, 1956, and 19th October, 1956. I am informed that this patient has now been granted leave of absence on licence from the hospital.

Does the Minister appreciate that the testimony by the young woman's former employer, the family doctor and this authority from Bromley Hospital is directly opposite to that of the certifying officer? Has the Minister seen the girl's school-leaving certificate, which says,

"Mary is clean and is a member of the Health Brigade. During the past term she has been a School Prefect. She has attended school regularly and been very punctual. She is well-mannered and courteous."

Does this add up to being a mental defective? Will the Minister state why so many young people, because of expediency, are sent into mental homes without treatment and often used as cheap labour?

I have studied many of the documents in this case, and I am aware that there are two different opinions, but I am not satisfied that a wrong decision was taken. This patient is now on licence, and it would be wise to see how she gets on.

In view of the unsatisfactory nature of the reply, I beg to give notice that I shall raise this matter on the Adjournment.

asked the Minister of Health whether he will institute a survey of the problem of dental caries in children in London aged five years, similar to, and in the same area as, the surveys carried out in past years by Sir Edward and Lady Mellanby.

I understand that Lady Mellanby is at present making a further survey.

A very good answer. Thank you.

Can the right hon. Gentleman tell me in writing—because I quite understand that he would not have the answer with him—whether the inquiry is limited to one age-group—

On a point of order. Is it in order for those who have renounced their British nationality and adopted Norwegian to ask Questions in the House of Commons?

That is not a point of order.

Further to that point of order. May I ask you, Mr. Speaker, whether somebody who has said she is ashamed of being British ought to be in this House?

These are all matters of opinion.

rose—

May I have a reply to my supplementary question? [HON. MEMBERS: "No."] Will the Minister let me know in writing whether this new inquiry is being limited only to this age-group, or whether it will be wider, and particularly among adolescents?

Lady Mellanby told us that she was making a further inquiry. I gather that it is limited to the previous scope, but I will look at the point.

asked the Minister of Health whether he will move to appoint a Select Committee to consider what immediate and practical steps can be taken to reduce cigarette smoking.

No, Sir. I do not consider that a Select Committee would be an appropriate body for this purpose.

Now that a definite connection has been established between cigarette smoking and lung cancer, can the hundreds of millions of pounds made by the Government out of cigarette smoking be regarded as moral earnings? Are not the Government under a solemn obligation to warn the public of the risk and to take much more positive action than they have shown signs of doing, even if it means upsetting the Chancellor of the Exchequer and the tobacco magnates?

The hon. Member gave notice that he was going to raise this matter on the Adjournment, but he has not yet done so. If he did, it would give an opportunity for dealing with some of the rather unfair allegations he has made.

Short of appointing a Royal Commission, does not the right hon. Gentleman feel that the evidence is sufficiently strong for something definite to be done by his Department? Ought not young people and children in the schools at any rate to be warned of the dangers of cigarette smoking?

I do intend to look further into this matter and to take the advice of those concerned. I do not believe at the moment that a Select Committee would be the right vehicle. My right hon. Friend the Minister of Education has, of course, recently issued further advice to the schools.

asked the Minister of Health how many local authorities have a statutory committee for the welfare of the blind; and how many of these have a registered blind person serving on the committee.

All county and county borough councils have committees for the discharge of their functions under Part III of the National Assistance Act, 1948, including functions relating to the welfare of the blind. Information in regard to the second part of the Question is not available.

Would the Minister not agree that it is most desirable that, so far as possible, actual registered blind persons should be recruited to these welfare committees for the blind? Would the right hon. Gentleman give some encouragement to local authorities in that connection?

I agree with that, and I hope that this Question may come to the notice of those concerned. I do not think I could go so far as to issue a directive on the subject.

asked the Minister of Health if he is prepared to extend the use of Bacillus Calnette-Guerin for young people up to the age of 21 years.

I will consider the question of some extension of the present arrangements when local health authorities have had longer experience in vaccinating 13-year-old children and in the light of further reports from the Medical Research Council on its trials of the vaccine.

Can my right hon. Friend assure me 'that there will be no difficulty in doing that—if it is thought advisable—due to any shortage of the serum?

I do not think so. If any health authority now feels that it can tackle this matter I would give consideration to the proposal.

As it is a most vulnerable period between the ages of 21 and 25, would the right hon. Gentleman consider extending the limit to age 25?

I will look at that. At the moment we have been concentrating on the 13-year-olds, but we must consider extending the limit upwards.

asked the Minister of Health if he will make a statement on the negotiations with the representatives of the medical profession concerning salary increases for doctors in the National Health Service.

asked the Minister of Health if he is aware of the discontent among members of the medical profession over his refusal to continue negotiations on the question of increased salaries; and if he will make a statement.

asked the Minister of Health what negotiations are pending to increase the salaries of doctors.

My right hon. Friend the Secretary of State for Scotland and I have agreed to meet representatives of the profession towards the middle of February. For the present, I have no statement to make.

Will the Minister give an assurance that he will deal with this matter on its merits and not treat the doctors in the same shabby and dirty way as the Government treated the question of Members' salaries?

I do not think it would help my negotiations and the meeting in February to make any further comment at this stage.

As the honour of the Government is at stake, will the Minister at least agree to have an independent arbitration to settle a firm basis for any future adjustments of doctors' salaries? Surely that would be the best way of doing it?

While not sharing the views of the hon. Member for Brixton (Mr. Lipton), may I ask if my right hon. Friend is aware of the enormous importance today of the State honouring its obligations to important sections of the community and seeing that justice, as pledged and promised in the past, is fully discharged? Will my right hon. Friend argue with the Chancellor of the Exchequer that the possible inflationary consequences of doing this thing can be taken care of by other means?

I have to answer other Questions on the legal obligations in this matter. I will take note of what my noble Friend has said.

Will the right hon. Gentleman say whether or not he proposes to examine the claim and the basis on which the claim is founded?

I should not like to add to my original Answer.

asked the Minister of Health if he is now prepared to accept the contractual obligation implied in the Spens Report as the basis of all future salary negotiations with the medical profession.

I am advised that no legal contractual obligation exists.

Does the Minister not realise that now he has properly decided to meet the doctors in negotiations over their claim for higher remuneration, it will be necessary for him to face up to what are called the implications, alleged or otherwise, of the Spens Reports?

Would it not be wise of him to take this matter into consideration in the negotiations?

I have just said in my original reply that no legal contractual obligation exists. That opinion was conveyed to the doctors at an earlier meeting, and when they meet me in February they will be well aware of the position.

Is the Minister not aware that this is one of the points which has caused every scalpel in Scotland at least to be drawn during the week-end and that there will be no satisfactory issue unless the matter is dealt with? The doctors do not accept the explanation he has given.

I have already said that I will meet the doctors, and I shall look forward to that meeting; but I shall not be meeting them on the basis that a legal contractual obligation exists.

asked the Minister of Health the number of persons known to be suffering from tuberculosis in the county borough of Sunderland on the latest available date.

One thousand, nine hundred and one on the 31st December, 1956.

Is not the right hon. Gentleman very disturbed by this figure? Is it not very disturbing that this figure is both much larger than it was pre-war and has been increasing over recent years? To what does the right hon. Gentleman attribute this increase?

It is high compared with other parts of the country, but there has not been a large increase in recent years. I should attribute it to intensive case finding and the fact that people suffering from this disease are living longer.

asked the Minister of Health if he will now give permission for the city of Stoke-on-Trent to undertake a chiropody service to aged people.

I regret that I cannot do so at present.

Is the right hon. Gentleman aware that in Stoke-on-Trent, like other large areas, the problem of dealing with aged sick and people who cannot get out is very serious and puts a heavy strain on other services provided by the local authority? Is the right hon. Gentleman aware that it is estimated that about 25 per cent. to 70 per cent. of old people suffer from the need for chiropody, and if this could be provided other services could be relieved?

I have considerable sympathy with what the hon. Lady has said. I do not underestimate the need, but sufficient resources are not available to reconsider the matter.

May I ask the right hon. Gentleman to reconsider it for this reason? If he establishes chiropody services, particularly in some of the industrial areas, that inevitably will relieve pressure on the hospitals. Is he aware that there are other Questions on the Order Paper asking for services for aged people and that this service would immediately help to solve the other problems?

I do appreciate that the welfare and domiciliary services may well relieve problems in the hospitals, but at the moment I have not available the considerable resources needed to start nationally a service of this nature.

asked the Minister of Health how many local authorities are giving chiropody service to old people.

Four under the National Health Service and many at homes for the aged and infirm established under the National Assistance Act, 1948.

Is it not a fact that any local authority can establish a service of this type, but not directly—it has to be done by giving a grant to a voluntary agency? If that is the case, why is it not possible to allow the local authority to do it directly?

I speak subject to correction, but I think local authorities can establish such a service under the National Assistance Act in old people's homes; but any service provided generally would be grant-aided, and I am not in a position to meet such requests at the moment.

If the local authority could establish such a service in old people's homes, does not the right hon. Gentleman realise that very few old people could be dealt with? Is he aware that old folk who are tied to their homes and cannot get out need home helps, sick visitors and other assistance for their relief, whereas if they could be made mobile it would relieve the whole of the services dealing with the aged? Does it not seem foolish that, as in the case of Stoke-on-Trent, we were told by the former Minister that we can make a grant—which we do—to the meals on wheels service to provide a chiropodist service? Does that not seem a round-about way of doing the job?

I hope my original Answer shows that I appreciated much of what the hon. Lady said, but I cannot make any further announcement at the moment.

asked the Minister of Health what arrangements he has made to overcome the hardship caused to diabetics and to others suffering from chronic illness by the existing prescription charges.

It is open to the doctor to prescribe in quantities sufficient to last a reasonable time according to his assessment of medical need. Anyone who, on paying the ensuing charges, shows that he will suffer financial hardship in accordance with the National Assistance Board's standards can obtain a refund.

The right hon. Gentleman has given a formal Answer, but is he aware that we are hoping, now that we are glad to see a new face at the Ministry, that he is taking a different view of the matter? Does he realise that very great hardship is imposed in many cases where application cannot be made to the Assistance Board, and that there is great anxiety whether individual cases will get the amount of treatment they ought to have?

I am aware of the arguments about the chronic sick. My predecessor took certain measures to relieve their problems. At the moment, I am not convinced that there are individual cases of hardship which need further action.

Will my right hon. Friend say what he considers to be a reasonable period? Would he be a little more explicit and say three or four months, which is generally thought to be a reasonable period?

I had in mind a period of three months.

asked the Minister of Health what reply he has sent to the Norfolk Executive Council in reply to their resolution expressing disapproval of the increase in charges on doctors' prescription forms from 1s. a form to 1s. an item.

I am informing the Executive Council that the Government decided that the revised charges were necessary because of the present financial and economic situation, but that every effort is being and will be made to avoid hardship, and the working of the new arrangements will be closely watched with this in view.

In view of the fact that those who are responsible for the administration of the Health Service seem to feel that this new imposition is against the well-being of the service to the people, will not the Minister see whether he can find other ways and means of economy in prescriptions, if that is necessary, particularly in the prescribing of drugs?

I have already said that I will watch the situation and review any individual case of hardship, but at the moment I am not convinced that there is any need to adopt a new approach.

asked the Minister of Health if he is aware that doctors are now being urged by many of their patients to strike off prescription items because the latter cannot pay the extra charge of 1s. per item, with the result that chemists in industrial areas have reported a slump of up to 60 per cent. in prescriptions since 1st December; and if he will therefore amend the new system so as to mitigate this hardship.

The information at present before me does not confirm the statements made, and I see no reason to alter the basis on which prescription charges are now payable.

Would the right hon. Gentleman be frank with the House? Since he has received thousands of protests about the increased prescription charges, will he tell us whether he is determined to resist dealing with this awful scandal amongst the sick and poor of this country, whatever the consequences?

I have already said that, from the advice which I have received, both officially and in a private capacity, I do not believe there are thousands of cases of real hardship; but I am prepared to examine any individual case which may be brought to me.

In view of the very satisfactory assurances which the Minister has given, may I ask my right hon. Friend this question: if anybody who is outside the scope of the National Assistance Board can produce proof of hardship, has my right hon. Friend powers so to alter the Regulations that that particular case of hardship can be dealt with? Is my right hon. Friend aware that if he can satisfy us on that point, there will be many very pleased people in this country and in the House?

I should love to please my hon. Friend, but this is a rather hypothetical question. I ought to see the case itself.

asked the Minister of Health if he is aware that many chronic sick, cancer patients, diabetics, those suffering from ulcers, and others with long-standing complaints are not receiving the treatment they need and which was intended by the National Health Act, 1948; that chemists are reporting a reduction of 50 per cent. in the prescriptions since the new charges were made on 1st December; how many doctors' and chemists' professional organisations have reported these facts to him; and what steps are being taken to assist these people.

I have no evidence from professional organisations or elsewhere that patients are not receiving the treatment they need, or that there has been such a reduction in prescriptions dispensed. Where medicines are regularly needed, it is within a doctor's discretion to prescribe reasonable quantities. The National Assistance Board will refund the charges, on application, to persons who cannot pay them without hardship, on the Board's standards.

From the Questions which have been put to him this afternoon, and the number of people who have drawn the attention of their Members to these cases, is not the Minister satisfied that there is hardship among these people; that they are failing to go to the doctors because they have not the money to pay for the prescriptions, and will he take steps to see that the medical need of the patients, and not their pockets, is the criterion?

I do not think I can add anything to my original replies, when I said that at present I have little evidence to indicate cases of hardship.

Will my right hon. Friend give an assurance that he will pay particular attention to the position of diabetics and those in similar categories who, although not on the National Assistance scale, may find it difficult regularly to pay the charges for numbers of drugs; and can he say whether he has had any report about these classes so far?

The next Question on the Order Paper relates to diabetics.

Does not the Minister realise also the great danger of prescribing too large quantities of drugs?

Yes, I am aware of that.

asked the Minister of Health if he is aware that diabetic patients have now to pay in some cases five times as much for a prescription as formerly; that some of these are old-age pensioners or people with a small fixed income, unable to meet the extra charges and who consequently reduce the number of their visits to the doctor below those essential for effective treatment; and if he will now take steps to abolish such charges.

I am aware that in some cases items prescribed for a diabetic may involve charges of several shillings, but it is open to the doctor to prescribe quantities sufficient to last for a considerable period. Persons who cannot pay the charges without hardship in accordance with the standards laid down by the National Assistance Board can obtain refund from the Board. I have no evidence that patients are being deprived of effective treatment. I see no reason to abolish the charges, the need for which has been explained to the House.

Is the Minister aware that, among the cases which have been brought to my attention, is that of a lady who previously got all she needed on one prescription at the old price and now has to pay 5s. for the same prescription because of the number of items it contains? Is he aware that the National Health Service Act was made for the sick and not the sick for the National Health Service Act? Will he take steps, in future, not to vivisect this Act so that he can find places where he can charge these poor people more than they ought to pay?

With regard to the first part of the hon. Member's Question, the annual charge for stabilised diabetics should be in the neighbourhood of from 17s. to 27s., which is an increase, but not a very large one, over the previous charge.

Will the right hon. Gentleman make clear to the House whether or not it is in his power to consider such cases of hardship which are not covered by the existing standards of the National Assistance Board? We have had several Answers today suggesting, in some cases, that he has such powers and in others that he has not—as in his last Answer. In other cases, he has said that the Question was hypothetical.

What I had in mind was that my predecessor said that certain arrangements, such as prescribing for longer periods and in packs, would receive consideration. This is being done, but I cannot go further than that until I have further evidence.

As the Minister has devoted himself to the question of diabetics, will he reconsider this one case, for this reason? A diabetic has to have two kinds of insulin, needles, spirit and cotton wool. If the right hon. Gentleman grants an exception in this case, he will be helping a section of the public who have a very miserable life, apart altogether from the economic factors.

I think it has been possible to provide one small pack for diabetics, but I cannot hold out much hope of going beyond that.

asked the Minister of Health whether the prescription charge must be repeated for each prescription where the medicine prescribed is for internal medication and will not keep for more than a few days, but prolonged treatment is necessary.

I am not aware what medicine the hon. Member has in mind for use in the circumstances mentioned, but I will look into the matter if he will give me details. In general, a charge is payable for each repeated supply of medicine, except for certain specified preparations ordered for immediate and continuous treatment, which, owing to their pharmaceutical nature, need to be freshly prepared and supplied in separate containers on successive days.

May I thank the Minister for that reply and assure him that I will gladly send him specific examples? May I ask him this? Is he not aware that many medical men when prescribing for inoperable cancer cases use prescriptions such as mixtures of opium and aspirin, and that these keep for only a few days and must be made up afresh? Is it not unfair that such sufferers should be worse off than the class of people to whom he has referred when he said that he hopes that medical men will prescribe for three months?

Some advice has been issued on this point, but I will gladly examine any evidence that the hon. Member may send to me.

asked the Minister of Health whether his negotiations with the pharmaceutical industry regarding the prices of their products supplied through the National Health Service have concluded.

The current negotiations with the pharmaceutical industry concern the prices of proprietary preparations. Discussions have recently been concluded, and in the light of these the industry have revised their proposals, which I am now considering.

In view of that, would the Minister say when he will be in a position to announce the decisions which have been reached about prices?

I am aware that these negotiations have been very protracted, but I have only just started to consider the position and could not advise the hon. Member of any date at this stage.

asked the Minister of Health what advice is given to local authorities as to the necessary precautions to be taken at public baths to minimise the risks of polio and meningitis.

Advice on ventilation, avoidance of overcrowding and treatment of water at swimming baths was given in a Ministry publication in 1951 and in a medical memorandum on poliomyelitis sent to local authorities in 1954.

Is the Minister aware that this Question arises out of a recent incident in Islington when a child contracted polio and meningitis after swimming at the Tibberton swimming baths? Has he any statement to make on that incident?

I am investigating that case, but I can say nothing further today.

asked the Minister of Health if he is aware that the Derbyshire Donor Panel of the National Blood Transfusion Service has had to cut out the collection of donors by omnibus in the Melbourne area due to economies consequent on petrol rationing; and what measures he proposes to ensure that this service is granted sufficient petrol to enable it to carry on its work.

I am informed that this reduction is not due to petrol rationing, but is part of a general re-organisation of transport arrangements.

Is the Minister aware that his information on this matter is contrary to mine? I have a postcard in my hand, sent out by this Service on 18th January, which reads:

"Due to economies enforced by petrol rationing, we shall not be able to send our bus for donors this time. This will probably mean a reduction in the numbers who attend. It will help a deal if you will make a special effort to attend, if it is possible to get in without the help of our bus."

Does this not indicate clearly that petrol shortage is causing difficulty?

I am advised that the re-organisation of transport was planned in any case, and, of course, travelling expenses are fully reimbursed. In actual fact, the number of blood donors has gone up since the new arrangements were made, and I would rather wait to see how things go on.

As the advice which the right hon. Gentleman has received is different from the information which I have given him, will he look into the matter again?

Yes, I will certainly look into that point.

asked the Minister of Health if he will review the working of the Dental Estimates Board.

The Committee on Recruitment to the Dental Profession has recently commented favourably upon the efficiency of the Board. I am of course always ready to investigate individual complaints.

While thanking my right hon. Friend for that reply, may I ask him if he is aware that in the dental profession there is a feeling that this organisation suffers from almost every weakness of over-centralisation; that, by its somewhat autocratic attitude towards the profession, the Board is doing a great deal to alienate from the Health Services the loyalty of the profession? Would he, if necessary, take on the rôle of the new broom in regard to this organisation?

I will do my best to visit the Board at an early opportunity, but it is only fair to say that two independent committees have both come down in its favour.

asked the Minister of Health the cost to the National Health Service of treating foreigners, during the year 1956; whether any sum was recouped from them, such as prescription charges; and whether he will now charge all foreigners the full economic price for any health services they receive in this country.

I regret that the information referred to in the first part of the Question is not available, but the cost must certainly have been relatively very small. As regards the second part, foreigners receiving benefits under the National Health Service pay any applicable charges. In addition, hospital authorities have been asked not to make advance arrangements with foreigners for admission for free treatment. I am considering whether any further action is possible.

Will my right hon. Friend take steps at an early date to get the information which he says is not now available? And will he have some regard to the psychological factor; that large numbers of relatively poor people, being called upon to pay much larger prescription charges, thoroughly resent "plushy" Americans and others coming to this country and getting this service on the backs of the British taxpayer?

It will be comparatively easy to give information about the hospital services, but much more difficult, as my hon. Friend must realise, to give information regarding the general practitioner service. Apart from the matter of principle, it would be a difficult administrative act to make a charge.

Is the right hon. Gentleman aware that if he accepts the suggestion of his hon. Friend he will be excluding all the Hungarian refugees in this country from the National Health Service?

At least will my right hon. Friend consider the express exclusion from the benefits of the National Health Service in this country of those people who, like the right hon. Member for Warrington (Dr. Summerskill), have recently stated that they do not wish to accept British nationality and say that they are ashamed—[Interruption].

Order.

On a point of order, Mr. Speaker. I am thoroughly dissatisfied with the answer and wish to give notice that I shall raise this matter on the Adjournment.

asked the Minister of Health if he is aware of the increase in cancer of the breast in Great Britain; and what action he is taking for additional research into this problem.

I assume my hon. Friend is referring to the paper recently published in the Bulletin of the World Health Organisation. This does not suggest any new line of investigation, but extensive research into this problem is always going on.

While thanking my right hon. Friend for that reply, may I ask if he is in consultation with countries such as Japan, where the figures have fallen? Is he aware of the Hamburg scheme, run in connection with the child welfare clinics, which has proved so beneficial in this type of case?

I cannot follow my hon. Friend into all her supplementary. This report covered a very large number of years, and my information is that in the last five years there has been no rise.

Will my right hon. Friend consider using the good offices of his Department to amalgamate the three cancer research organisations at present operating in this country, and will he also give his blessing to the organisation known as Cancer Anonymous which is studying this problem?

This is a somewhat different and, I suspect, controversial question, and I would not wish to comment on it at this stage.

A very distinguished performance, if I may say so to my right hon. Friend.