asked the Minister of Health if he will state the progress being made by Cathlene Murray, at present a patient in Dovenby Hall Hospital, Cumberland; and whether he can yet state the probable approximate date of her release from detention as a mental defective.

I have written to my hon. Friend giving a full account of this case.

I thank my right hon. Friend for his letter. Is he aware that this letter, which forecasts the reasonably early release of this girl, after twenty years' detention as a mental defective, is extremely welcome? Does he agree that if this young lady's case had had the sympathy and understanding twenty years ago that it has had in recent months hers would have been a very different story? Will he bear individual cases such as this in mind in framing fresh legislation, which we expect in the near future?

I am obliged to my hon. Friend for what he said about my action. I do not think I can usefully go back into the past, but, in regard to the future, I am always very happy to discuss these matters with my hon. Friend.

asked the Minister of Health how many X-ray examinations were performed at the North Staffordshire Royal Infirmary in 1950 and in 1956; and how many members of the staff were employed as radiographers in these two years.

The numbers of examinations were 29,305 in 1950 and 41,370 in 1956. In both years there were nine qualified diagnostic radiographers.

In view of the very significant increase in the amount of work done by some members of the staff, would not the right hon. and learned Gentleman agree that, for example, the payment of about £600 a year made to a superintendent radiographer after ten years' experience in this hospital is very low indeed? Will he look again at the whole of the salary scales, realising that the increase last year was very tiny and does not do justice to these servants?

There is certainly an increase in the number of examinations, but I do not think the hon. Gentleman is right in describing the salary in crease last year as very tiny. In fact, it was about 10 per cent., which is a considerable proportion.

asked the Minister of Health how many schemes of hospital reconstruction costing £20,000 or more were sanctioned by his Department in 1956; and what was the average time between sanction and commencement of building.

Two hundred and eleven such schemes were included in hospital boards' approved estimates for 1956–57. I regret that the information asked for in the second part of the Question is not available.

Is the right hon. and learned Gentleman not aware that there is a good deal of dissatisfaction in the hospital world because of the long delay between the approval of a scheme and the ability to start actual work on it? Will he give consideration to whether something cannot be done in his Department to speed up matters accordingly?

Anything that can be done in my Department to speed matters will most certainly be done. I think the hon. Gentleman will find that the time which is taken between authorisation and the actual physical work of building is occupied by such matters as getting out the plans, detailed working drawings, bills of quantity, tendering, and so on, each of which in the case of some of these large schemes is inevitably a fairly elaborate procedure.

asked the Minister of Health how long discussions have been going on with the Joint Consultants Committee on the future of senior registrars who have completed their normal term of service; and when he expects to announce a decision.

The present series of discussions which has raised issues of considerable complexity has extended over the past two years but developed from earlier discussions on junior hospital medical staffing. A decision will be reached as soon as possible.

Will the right hon. and learned Gentleman say whether it is his Department or the consultants who are responsible for this interminable delay which is causing acute anxiety and distress to the senior registrars? Does he not appreciate that he is himself in breach of faith to these men at the moment, and will he come to a decision very quickly?

I do not accept any allegations of breach of faith. I am certainly getting on with this as fast as possible. My proposals went to the Committee in November, and they are to be discussed again at the next meeting with the Joint Committee which is on the 30th of this month.

asked the Minister of Health for what reason a meeting of the Professional and Technical Staffs Council A of the Whitley Councils for the Health Services (Great Britain), summoned for 10th December for the purpose of the first joint discussion of a claim tabled by the Staff Side in September for an improvement in the salary scales of radiographers, was cancelled at short notice without explanation.

asked the Minister of Health why a meeting, due to take place on 10th December, of the Professional and Technical Staffs Council A of the Whitley Councils for the Health Services, Great Britain, was cancelled at short notice.

I understand that the Management Side wanted more time to consider the claim and its implications.

Does not the right hon. and learned Gentleman agree that for a claim of this character to lie on the table for more than three months is likely to undermine still further the confidence of the staff in the efficacy of the Whitley Council system? Will he not take some steps to ensure that that confidence has some chance of being restored to the staff? It is three months, and still no indication has come from the Management Side of its attitude to a claim of this importance.

As the hon. Gentleman will appreciate, the Management Side has to consider this claim in the context of the difficult economic situation of the time. [HON. MEMBERS: "Ah."] It is perhaps natural that it should want time to consider a claim and its implications.

Does not the last part of that reply show that the people in the National Health Service who are concerned were right in thinking that the cancellation of the meeting was due to the previous attitude of the Government on the 3 per cent. award that was given to other workers? Surely, in a service which is so important to the health of the nation and in which there is a shortage of radiographers, it is time the Government were taking this matter much more seriously?

The Government do take all these matters seriously. The considerations which the hon. Lady mentions are no doubt important, but they have to be seen in the context of the general economic situation, which is also important at all times, but particularly at this time.

Is the right hon. and learned Gentleman not aware that this is a very special category of workers, that there is a grave shortage of them, and that it is well known that their work involves a risk to health? In view of those facts, how can the Minister justify the delay? Would he not give an undertaking that the matter shall be considered forthwith?

The matter has not yet reached the stage of Ministerial consideration under the statutory regulations, because it is still under consideration by the Management Side of the Whitley Council.

Does not the Minister realise that if he gives an appearance of using this machinery as a means of sheltering himself he will destroy faith in collective bargaining? Does he not realise that the right way to handle this matter, if he wants to veto it, is not to delay meetings of the Whitley Council but to allow the Council to meet and to reach its conclusion on the facts presented to it, and then for the Government to step in and take whatever misguided action they think appropriate?

The hon. Gentleman refers to what I wish to do. I want to make it quite clear that I have not yet made any decision as to the exercise of my statutory duty in the hypothetical event of a recommendation being made.

asked the Minister of Health what progress has been made towards a settlement of the claim, tabled in March, 1957, by the Staff Side of the Professional and Technical Staffs Council A of the Whitley Councils for the Health Services (Great Britain) for an improvement in the payment to radiographers for emergency work.

The Whitley Council met to discuss the claim in April. I understand that supporting evidence then requested by the Management Side was produced by the Staff Side at the end of September and is under consideration.

Is this not another example of the lethargy with which Whitley Councils are allowed to proceed? Is the right hon. and learned Gentleman aware that, according to my information, the claim was lodged in March, there was the meeting in April to which the Minister refers, when the Management Side, without specifying what information it required, intimated that it could not decide the issue until it had further information, and that it was not until September, after repeated efforts, that the Staff Side succeeded in eliciting from the Management Side what information it required?

No, Sir. I understand that the Staff Side took the view that it required guidance as to what sort of supporting evidence was required by the Management Side. My understanding also is that it did not seek for such guidance until five months after the initial meeting of the Council. In regard to speeding up the proceedings, the Staff Side did not, in fact, ask for this claim to be placed on the agenda of a meeting of the Council which had been arranged for 10th December.

Is the Minister aware that many of us have had great difficulty and trouble in the past in convincing workers of the fairness and efficacy of arbitration? Is he further aware that if we get many more evidences of this kind the workers' faith in arbitration as impartial machinery will be very seriously jeopardised?

The hon. Gentleman cannot quite have comprehended my reply to the supplementary question of his hon. Friend the Member for Waltham-stow, West (Mr. Redhead). It took the Staff Side five months to ask for the guidance that it thought it needed or to supply the information required.

Does not the right hon. and learned Gentleman realise that, in the experience of those with knowledge of every side of industrial matters, what causes and aggravates disputes is for a long time to elapse before a decision is made? Will he take steps to speed up the process?

If the right hon. Gentleman had listened to my last reply but one he would realise that he ought to address his injunction to the members of the Staff Side.

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 how the present salary scales of radiographers in the National Health Service compare with those in operation at the date of the inception of the Service; and what percentage variation there has been in respect of each grade.

As the answer contains a number of figures, I will with permission, circulate it in the OFFICIAL REPORT.

While thanking the right hon. and learned Gentleman for the figures that he promises, may I ask him whether the percentage increases that the figures reveal show that the staffs concerned had an increase in the period in question of the order of 30 per cent. to 35 per cent., compared with a rising cost of living in the same period of more than 50 per cent.; and that in every case the percentage increase is markedly less than has been conceded in any other field of the public service? Does not the inadequacy of the salaries supply an additional reason for expedition in dealing with the claim?

The rise in the Index of Retail Prices in the period in question was 49 per cent. If the hon. Gentleman will be good enough to study the figures which he will see in the OFFICIAL REPORT, he will observe eight percentages specified therein, the lowest of which is 27. There are then some in the 30s. two in the 40s. and one in the 50s.

Do not these figures clearly show, as is well known surely to both sides of the House, that the salaries of public servants always lag behind general rises in wages and usually behind rises in the cost-of-living index? On that basis, how can we refuse, if there is to be common justice, to accept and admit this claim?

The first part of the hon. Gentleman's supplementary question seems to be another way of saying that people in the public services are the greatest sufferers from inflation. That is why it is in the interests of all concerned, and not least of these people, that inflationary pressures should be prevented. Even the most superficial study of the policies of right hon. Gentlemen opposite shows that a return to power of the Labour Government would mean continuance and aggravation of inflation.

Has not the Minister a great responsibility in these matters? Is he not aware that these radiographers are exposed to a risk to health? Could he not therefore concern himself particularly with these negotiations and try to speed them up in order that these workers should receive justice?

I am not sure to which set of negotiations the right hon. Lady is now referring, because we have had two Questions on different aspects of radiographers' claims. I think I dealt with both those matters in reply to the earlier Questions.

Do I gather from the last but one reply of the Minister that only 1 per cent. of the radiographers have had their salaries maintained according to the cost of living?

No. Certainly not. That would be a very wrong deduction to make. The column which is, or will

asked the Minister of Health if he is aware of the shortage of psychiatrists in all branches of our mental health services; and whether this special consideration was before the Willink Committee in its deliberations on the future requirements of medical manpower.

The answer to both parts of the Question is, "Yes, Sir".

Can the right hon. and learned Gentleman say why there was no mention whatever of psychiatry in the Willink Report? Is he not aware that our mental hospitals are grossly understaffed and that patients who can benefit from treatment are being denied treatment because there are not the doctors available? Does he not also appreciate that the implementation of the Royal Commission's recommendations must involve a very great expansion of our psychiatric service? How can this take place if the medical intake is to be reduced by 20 per cent. overall?

I am not sure how far it is for me to interpret what was in the minds of Sir Henry Willink and his Committee. I understand their conclusion was that it was not necessary for their purpose to include in the Report a separate estimate far each specialty. The hon. Gentleman may like to know that in the evidence given by my Department and the Department of Health for Scotland to the Willink Committee we specially drew attention to the need for more psychiatrists.

Will the right hon. and learned Gentleman think again on this particular point and, possibly, send out some further advice to the universities to follow the copies of the Report which he sent to them a short time ago?

I have not, in fact, sent out advice to the universities on this point. I have drawn their attention to the Report of the Committee, as it was appropriate for me to do, but I shall certainly bear in mind what the hon. Gentleman has said.

asked the Minister of Health what advice and assistance he has afforded the Sunderland Executive Council on the recruitment of clerical and administrative staff.

None, Sir. I was not asked for any.

The Minister has had a communication from the council in which it has been made quite clear that we have had very real difficulties in recruiting staff in the last year or so and now we find it impossible. Has not his recent mischievous example earned him the reputation of being the meanest Minister of Health since Neville Chamberlain?

The hon. Member is clearly embroidering on the letter in such a reckless way as to raise doubts whether he has even seen the letter to which his Question refers.

The Minister knows quite well that I have seen the letter because I have been in correspondence about it, and he knows there was a previous Question last week about it. In view of the inability of the right hon. and learned Gentleman to understand Questions put to him and to know what is happening in his Department, I beg leave to raise the matter at the earliest opportunity on the Adjournment.

asked the Minister of Health what further reports he has received of hospital work being affected as a result of the overtime ban now in operation by administrative and clerical employees in the hospital service.

asked the Minister of Health if he is aware of the decision of the Confederation of Health Service Employees to support the overtime ban by clerical and administrative workers in the National Health Service; and whether he will make a statement.

I am aware of the decision referred to in the latter. I continue to receive regular reports and have no evidence of any detriment to patients or interruption of services.

How long is this to go on? Is the Minister really happy about it, as he does not seem to care one way or the other what happens? A vast part of his staff is engaged in an overtime ban which may have a serious effect; they are getting no help from his Ministry but instead a lot of smug replies. What is the Minister going to do about it?

It is not for me to do anything about the ban. I have said from the start of the outbreak of this ban that it would be entirely inconsistent with the duty of Ministers if they allowed themselves to be coerced in the exercise of their statutory duty by such direct means as this.

Is the Minister aware that there are very real dangers of these bans extending and that, in time, they may affect every hospital in the country, especially mental hospitals, which are already in difficulties? Will he not show his willingness to take some action to remove the difficulties he himself imposed originally?

No, Sir. As I said in answer to the hon. Member for Bermondsey (Mr. Mellish), I am receiving regular reports and keeping this matter under careful review. The overtime ban at mental hospitals to which the hon. Member has referred did not arise out of the question of the decision on the Administrative and Clerical Whitley Council claim but was, in fact, going on some time prior to that.

The right hon. and learned Gentleman must be aware that he was a coward when he singled out this staff, because its members are unable to hit back in an effective way against very unfair treatment. Many other sections of the community might have withdrawn their labour, but these workers cannot do that; they are trying to get him to understand their problem.

I made it quite clear in the debate we had on 6th November, and in my subsequent statement to the House at a later date, that there was no question of singling out this particular staff. A timetable was clearly imposed by the date of the recommendation and the statutory duty imposed by the Regulations upon my right hon. Friend and myself.

Are we now nearer to a settlement of this matter? Can the Minister tell the House what the position is? I understand that he met the deputation, and the Prime Minister met it. Can he give an indication of when these discussions will come to a conclusion and when at long last he can report to the House that he has conceded this claim to these people?

When the Secretary of State for Scotland and myself found it necessary in the exercise of our statutory duty to withhold approval for the time being, we gave an undertaking to review the matter at an appropriate time. In our judgment, that time has not yet arrived. My right hon Friend and I saw the deputation from the Administrative and Clerical Whitley Council. We have also seen a deputation from the Staff Side of the General Whitley Council for the National Health Service, and the Prime Minister is due to see a deputation from the same gentlemen.

When?

In view of the fact that I asked the right hon. and learned Gentleman the day before he met the deputations whether he would receive them with an open mind and he said that he would receive them with a receptive mind—that was a fortnight ago—surely at this stage he is able to tell the House before the House adjourns for Christmas what is to be the Government's attitude towards these matters?

I have said what is the position at the present time. This deputation of the Staff Side of the General Whitley Council is due to meet my right hon. Friend the Prime Minister at some time soon after his return.

asked the Minister of Health how many administrative and clerical workers were employed in the hospital service for the year 1950; and how many were employed in 1956.

At the end of 1951, the earliest date for which fully comparable figures are available, the total was 29,011 in England and Wales. At the end of 1956 it was 30,705.

Since that date the service has grown enormously, as the Minister knows, and we ought to have a considerably greater number of staff than we have at the moment. Our recruiting figures are appalling, and the salaries we are paying—

Order. The hon. Member is making a speech. Can he put it in the form of a question?

Can the Minister say what he is doing to improve the staffing position?

The numbers of people engaged in these occupations have gone up a little, but the work has also gone up and it is right that we should try to get higher productivity in this context, as we should all over the industrial field.

asked the Minister of Health when a decision will be made by him on the award made by the Whitley Council to therapists and other specialist staffs in the hospital service.

asked the Minister of Health if he has yet agreed to the award made to physiotherapists and occupational therapists.

My right hon. Friend the Secretary of State for Scotland and I have today approved the Whitley agreements relating to psysiotherapists, occupational therapists, remedial gymnasts and speech therapists.

Having said some hard things about the Minister, may I say how very glad we are that at last he has shown some common sense, at least in relation to one award? Will he backdate it to 1st October, which was when it was first agreed?

These awards are effective from 1st October, except, I think, in the case of the speech therapists, where the date is from 1st November. I think those are the right dates.

Does not the Minister realise that the fact that he is now assenting to an arbitration court award, where the two sides were in disagreement, accentuates and highlights his refusal to put into effect the previous agreement between the two sides? Does he not realise that as long as he goes on being as vague as he is at the moment about the date for implementing this award he will get no peace from this side of the House?

I do not think that the hon. Member is right; I think these are all agreed recommendations in respect of which I have given my answer today. As for my having peace from the other side of the House, I always welcome peace, but I could not buy it at the price of doing other than that which I thought was my duty in this matter. [Interruption.]

rose—

Before the hon. Member for Yarmouth (Mr. Fell) says a word, I withdraw what I said.

asked the Minister of Health whether he will give an assurance that employees at the Chelmsley, Marston Green and Coleshill Hall Mental Hospitals will receive their wages promptly in future, and that patients at both hospitals will not be affected by the Minister's disagreement with hospital clerical and administrative workers.

I am informed that the responsible hospital management committee has given instructions for priority to be given in future to the payment of wages and that last week they were in fact paid on Friday. I have no evidence that the patients are being or will be affected.

Is the right hon. and learned Gentleman aware that 1,100 patients are in these two hospitals and that if this situation continues trouble is expected in the future? Is he further aware that in January the nurses are to suffer from a ban on overtime and that the local management committee thinks that this may well affect the patients in the long run?

My information is that there is no evidence that the overtime ban is affecting patients at this hospital. If the hon. Member has apprehensions in this regard, perhaps he will be good enough to particularise them and to write to me about them.

As I was present with my hon. Friend at this hospital, may I ask the Minister to consider how serious it is that this hospital cannot continue without overtime, and especially that wages could not be paid without the clerks having to work overtime to calculate and pay out? Quite apart from the dispute, it is a serious matter.

The wages for last week were punctually paid. It is the intention of this hospital management committee to pay two weeks' wages on Thursday next in order to cover the Christmas holiday period.

asked the Minister of Health what steps he is taking to ensure that all mothers are made aware of the desirability of their taking orange juice during pregnancy and of providing it for their young children.

In addition to advice given by their general practitioners and at the ante-natal clinics, expectant mothers receive a leaflet on maternity care which stresses the importance of taking orange juice and other welfare foods during pregnancy and of giving them to their young children. I am sending the right hon. Gentleman a copy.

asked the Minister of Health whether his attention has been called to a report indicating that the percentage of London children of five years of age with caries-free teeth has decreased considerably since 1947; what reports on this subject he has received from other parts of England and Wales; and if he will cause an inquiry to be made as to the reason for this deterioration and how it can be prevented.

asked the Minister of Health what percentage of London schoolchildren aged five years are free from dental caries; and how this figure compares with previous investigations conducted in a similar manner on this age group.

According to a recent report by Lady Mellanby and others, 15·5 per cent. of London schoolchildren aged five years were free from dental caries in 1955, compared with 28·1 per cent. in 1947. A report from Staffordshire which was included in the Chief Medical Officer's Annual Report for 1955 also showed a decrease. Research into the reasons and into methods of prevention is proceeding; but my right hon. and learned Friend is advised that the deterioration is due largely to faulty dietetic habits and that the main hope of prevention lies in dental health education reinforced where necessary by the fluoridation of water.

Yes, but does not the hon. Gentleman agree that there are not enough dentists to give proper education and also to undertake the stopping of these teeth and their preservation for as long as possible? Will not he consider the desirability of making it easier for more suitable young men and women to become qualified as dentists by giving more places in the schools and more scholarships to enable them to take the courses?

Yes, Sir. In accordance with the recommendation contained in the McNair Report, a committee has been set up to examine the methods necessary to secure better public awareness of dental matters and to co-ordinate publicity in this sphere. Other recommendations of the McNair Committee are being followed up.

I agree completely that the reason for this deterioration must lie in faulty dietetic habits and that the question of dental repair and the use of dentists is secondary rather than primary in bringing about a solution of this problem, but has the Parliamentary Secretary noted that this process is apparent not only in Staffordshire and London but also in Scandinavian countries? What does the hon. Gentleman propose to do to see that we have the type of health education which will allow mothers to know how they should feed their children—for example, whether they should give them as many sweets as they do, or avoid the white bread which is now provided?

The hon. Member is correct in saying that this state of affairs does not exist only in this country. Research into the cause of deterioration and the means of prevention is at present in progress at a number of universities.

In view of the fact that some doubt has been expressed as to the effect of fluoridation in the United States, can the Parliamentary Secretary say from what data he draws the conclusions he has just expressed?

Not without notice.

asked the Minister of Health if he will take steps to have included in the syllabus of medical and dental students some elementary knowledge of the economics of the National Health Service and of the costs of treatment for which they will eventually be responsible.

I am considering a recommendation made in the Report of the Select Committee on Estimates on the Running Costs of Hospitals that I should urge upon all medical and dental schools and teaching hospitals the inclusion of these subjects in the curricula.

Is the right hon. and learned Gentleman aware that this is very satisfactory news because, for all practical purposes, the doctors in the National Health Service have blank cheques to an almost unlimited extent on public funds? It would be very useful to have some increase in their awareness of their financial responsibilities.

Can the Minister at least follow up the point about the advisability of dealing with the problem of prescribing through the curriculum, because this is a matter which so far has been missed out?

The actual curriculum is the responsibility of the universities concerned. As the hon. Gentleman may know, the question of the cost of prescribing is under consideration by the Committee at present sitting under the chairmanship of Sir Henry Hinchliffe.

asked the Minister of Health why he has refused the application of Mr. John Smith of 40, Greystone Road, Carlisle, for inclusion in the list of medical auxiliaries kept by the Minister under Section 3 (4) of the National Health Service (Medical Auxiliaries) Regulations, 1954; whether he is aware that Mr. John Smith has practised as a chiropodist in Carlisle for 22 years; and if he will now reconsider his decision in the light of the numerous professional and other testimonials submitted to him concerning Mr. Smith's ability as a practitioner.

I will look at this case again in the light of the additional information sent to my hon. Friend the Parliamentary Secretary, and will write to my hon. Friend as soon as I have been able to do so.

I thank my right hon. and learned Friend for his decision in view of the fact that this case is one of great personal hardship.

asked the Minister of Health if he will encourage the taking, and posting up in public of periodical bacterial counts of samples of sea or river water at locations where there is suspected pollution, together with indications of how such counts compare with the worst degrees of uncleanliness allowed in swimming baths.

I do not think that the posting of such information would serve any useful purpose. I am advised that, in view of the difficulty of interpreting such a count, the information would be misleading to the public.

Does not my right hon. and learned Friend agree that the apparatus for taking these tests exists everywhere; that the tests are, in fact, taken and very commonly found to be highly unsatisfactory, and that the only way in which the public can know that work needs to be done—if local authorities choose to suppress the results of these tests—is for such tests to be posted?

Though the mechanism of testing is there, one of the difficulties is that the conclusions can be assessed only by scientific people trained in evaluating the meaning of material of this kind. There are practical difficulties in incorporating such technical conclusions in a satisfactory way on posters exhibited to the general public.

asked the Minister of Health what action, other than routine, has been taken by his Department and local health authorities to ascertain accurately the causes of the three cases of poliomyelitis, medically attributed to sea bathing at one heavily polluted beach, particulars of which have been sent to him.

Further inquiries reveal that the notification of poliomyelitis in two of these cases has been corrected. I am advised that in the third case, as in most cases of poliomyelitis, it is not possible to establish accurately the mechanism of infection.

Unless the most careful examination can be made of any case reported by doctors as having been probably infected by sea bathing, it is not unlikely that evidence will be supplied on which to make a decision whether or not sea bathing is to blame and there will continue to be uncertainty behind which the forces of inertia can shelter?

I should not like to feel that there is any inertia regarding a subject of such great human interest and social importance. As my hon. Friend is already aware, a Committee of the Public Health Laboratory Service is at present making a survey of the degree of bacterial pollution of seawater on various sections of the coast and is trying to find out whether any relationship exists between enteric disease, including poliomyelitis, and recent bathing in heavily polluted seawater.

Can the Minister say when this Committee is likely to report and whether he is convinced that its terms of reference are sufficiently wide? Is the Minister aware that there is great disquiet among people who take young children to the seaside, and also among people who make their living in seaside towns?

I hope there will not be any disproportionate disquiet. So far it has not been revealed that any significant risk attaches to sea bathing in this country. I have no reason to think that the terms of reference of this Committee are unduly restricted, but if with his great experience in this sphere the hon. Gentleman can suggest any improvement, perhaps he will be good enough to communicate it to me.

I thank the Minister.

asked the Minister of Health what is the quantity of cod liver oil which must be taken by an infant or young child in order to supply a daily dose of 50,000 units of vitamin D.

About a bottle-and-a-half of the cod liver oil at present provided through the Welfare Foods Service.

I am not sure whether I heard the Parliamentary Secretary correctly and he said "a bottle-and-a-half." Is he aware that in some newspapers there have been occasional attacks on the use of cod liver oil, and the suggestion made that children may become seriously ill after taking an overdose? Does he not agree that to receive an overdose one would have to consume a vast amount of it over a prolonged period, and that such a risk literally does not exist in this case? Will he make clear that that is the view of his Department?

A dose of one teaspoonful daily, which is recommended for children of six months and over supplies about 800 units of Vitamin D. The new type of oil with a lower vitamin content, which is advised by the Cohen Committee, and which will be supplied next month, will provide 400 units, the reduced daily intake recommended by the Medical Research Council Conference on Hypercalcaemia as adequate and sufficient to protect against rickets.

asked the Minister of Health what arrangements are made, and what expenditure he is prepared to meet, for the transport of gas-air analgesia used by midwives in domiciliary cases.

Arrangements for the transport of analgesia apparatus are the responsibility of the local health authorities, and they bear the cost with the usual Exchequer grant.

In view of the importance of this as a national question, will the Minister look into the way in which it is working out? For instance, is he aware that even in Central' London it has been known for a midwife to arrive on her bicycle to attend a case having been unable to bring the apparatus with her and having had to send an expectant father—in the usual state of collapse—on a two or three mile walk to fetch it?

If the hon. Lady knows of cases of difficulty, I should be obliged if she would provide particulars.

Will the Parliamentary Secretary tell us more about this? In the Report of his Department it states that 91 per cent. of the midwives are taught administration. Can the hon. Gentleman say why 100 per cent. are not taught and whether those who are so taught are properly equipped?

That is a different question. Perhaps the right hon. Lady will put it down.

asked the Minister of Health the total number of day nursery places for the current year, compared with last year; and what is the comparable expenditure.

On 31st December, 1956, the latest date for which figures are available, there were 26,109 approved places available compared with 28,024 a year earlier. No comparative information is yet available about expenditure in the two financial years which included these dates.

Can the Minister state why it is the Government's policy that the number of places in day nurseries is being decreased? Is he aware that while there are fewer facilities for mothers to put their children in day nurseries there is no decrease in the number of mothers going out to work, and does not this raise a serious question of child welfare?

My right hon. and learned Friend's general policy is to give discretion to local health authorities to close nurseries, as they are best able to determine local needs. I have no reason to believe that nurseries needed as part of the local health service are being closed.

asked the Minister of Health, in view of the usefulness of the British National Formulary, if he will arrange for its more frequent revision and distribution.

A revised Formulary is published by the British Medical Association and the Pharmaceutical Society of Great Britain at intervals of about 2½ years, and I understand that it would not be practicable to do so more frequently.

In view of the very high cost of drugs to the country and the importance of this guide to medical practitioners, would the Minister consider issuing it at least every year?

As the right hon. Lady may know, we have recently had the 1957 edition, and my information is that this periodicity is satisfactory. Having got the new edition, I think we had better wait and see how we get along.

asked the Minister of Health what action he is taking to prevent doctors from prescribing proprietary drugs which are of no greater or of less value than comparable drugs listed in the National Formulary.

I have no power to prevent doctors from prescribing the drugs they consider necessary. But they have been asked to pay regard to comparative price when considering whether to prescribe proprietary preparations which are the equivalent of, or analogous in therapeutic effect to, preparations in the British National Formulary; and not to prescribe proprietary preparations, classified by Joint Committees of the Central and Scottish Health Services Councils as consisting of or containing drugs which, in the Committee's view, are not of proved therapeutic value.

The Minister's answer has made it quite clear that proprietary drugs are being prescribed which have an equivalent in the National Formulary and can be prescribed therefore much more cheaply to the taxpayers. In view of the fact that the price of prescriptions has soared and of the colossal size of our drug bill, will not the Minister reconsider this matter, which has been brought to the attention of successive Ministers of Health over the last few years?

As the House will be aware, it would require legislation to ban the prescribing of any particular preparation by reason of the provision of the National Health Service Act, which simply provides for the supply of proper and sufficient drugs and medicine. On the question of the cost of prescriptions, as I have already told the hon. Gentleman the Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop), the Hinchliffe Committee is considering this at the present time. Meanwhile, there is a voluntary price agreement of which the right hon. Lady may know, and there are, of course, the Prescriber's Notes, which are sent to all National Health Service doctors and should be helpful to them.

asked the Minister of Health if he will make arrangements that all home accidents which require hospital treatment shall be reported to the local medical officer of health.

My right hon. and learned Friend proposes in circulars to be sent to local health and hospital authorities shortly, to encourage the supply of information by hospitals to medical officers of health.

May I thank the right hon. and learned Gentleman for that reply, which is very encouraging indeed, as notification of this kind is very liable to lead to inspection of homes where accidents have taken place and to preventing further accidents in those homes?

While also welcoming that statement, may I ask why the Minister is going only halfway, as it were, and merely encouraging hospitals to do this? Is he aware that several hospitals are already doing this, and is it not a sufficiently serious problem to make it obligatory for accidents involving hospital treatment to be notifiable?

It is not proposed that hospital authorities should notify details of each casualty treated as a result of home injury, information which in any case would require the patient's consent before it could be transmitted.

asked the Minister of Health how many fatal home accidents there were in 1956; and how many of these occurred in the under 5-yearold and the over 65-year-old age groups.

The number of deaths registered in England and Wales in 1956 from accidents in the home and residential institutions was 6,908; 688 of these deaths were in the under 5-yearold and 5,039 in the over 65-year-old age groups.

asked the Minister of Health what has been the increase in fatal home accidents since 1951.

The number of deaths registered in England and Wales from accidents in the home and residential institutions was 5,483 in 1951 and 6,908 in 1956.

Is the Minister aware that this large increase in home accidents is causing great concern throughout the country? Will he take steps to consult other Departments to see what methods—such as publicity campaigns—might be put forward to help people to understand and to prevent many of these accidents happening?

Yes, Sir, it is proposed to send a circular early next year to all local health authorities suggesting ways and means by which, in co-operation with other interested authorities and organisations, they might make their efforts to reduce home accidents more effective.

Is the hon. Gentleman aware that most of these accidents are preventable by sufficient precautions being taken? Is he satisfied that his Department is showing sufficient energy in drawing that directly to the attention of the public?

Yes, Sir. I think the measures we take will be adequate for that purpose. Many of these people are extremely elderly and are especially accident-prone.

I wonder if my hon. Friend has had a look at the question of the difference between protection given to electric fires and to gas fires? I think it true that a tremendous number of gas fires are still in use with no protection at all, whereas, on the whole, considerable protection is given to electric fires. Will my hon. Friend consider that?

I will look into that.

asked the Minister of Health what steps he is taking to ensure that Sunderland has its required establishment of midwives.

The employment of domiciliary midwives in Sunderland is the responsibility of the county borough council.

Is the hon. Gentleman aware that we have only about two-thirds of our required establishment, that the position is getting worse and is prejudicing us in Sunderland, and that it appears to us it will not improve until better conditions are provided for midwives?

The council is advertising for midwives and offering housing accommodation, but so far. I fear, without much success.

Is the hon. Gentleman aware that we still cannot get the midwives?

The shortage of domiciliary midwives in the country as a whole is about 7 per cent., which is not too serious a figure. There is an acute local shortage in Sunderland, but, as I have said, the council is taking special steps to try to alleviate it.

asked the Minister of Health what report has been made to him on the high incidence of tuberculosis in the docks area of Cardiff; how the figures compare with national average; and what steps are being taken to improve the position.

In 1956 the notification rate was eight times higher than the national average. Energetic measures are already being taken to improve the situation, and I am considering with the Cardiff City Council what more can be done.

Is the Minister aware that in Cardiff we regard this figure as extremely serious? Does he agree that it is probably due to housing conditions in the area? Will he tell us what progress is likely to be made in rehousing a great many of the people living in these conditions?

The question of housing is, of course, not within my sphere of responsibility, but I know that the taking of appropriate housing measures is one of the matters which Cardiff City Council has in mind as well as matters which are more strictly in my responsibility such as clinics for contacts, treatment arrangements, follow-up arrangements and so on. I agree with the hon. Member that this is a very serious figure and a very serious matter, which calls for the best efforts of all concerned.

asked the Minister of Health what, in view of the recommendations of the Guillebaud and Piercy Committees, is his policy on the amalgamation of the health and welfare services; and what advice he is giving to local authorities as to the amalgamation of their health and welfare services as opportunities occur.

I have advised local authorities that there should be close integration of the local health and welfare services. Whether this can best be achieved by combining their administration or in some other way must be left to the discretion of each local authority. having regard to local conditions.

Will not the right hon. Gentleman agree that in most areas the health visitor, part of his own Department, has a more intimate knowledge of the conditions of the people and their need than perhaps anyone else? Is it not highly desirable that the medical officer of health and his staff should be very much more integrated, or that he should be put in charge of the whole welfare department?

The important thing is to get the closest possible co-ordination in the functioning of the domiciliary health and welfare services at the level of the people for whom they are provided. As the hon. Member knows, we had a very full and interesting debate on this question two or three weeks ago, to which he made a very helpful contribution.

asked the hon. Member for Chelmsford, as representing the Church Commissioners, whether he is aware that the Royal Exchange Assurance Company, as head lessees of 52, Warwick Avenue, are in breach of covenant through the management of the property by Messrs. Martin East, the effective owners of the sub-lease, who have given a month's notice to quit to most of the tenants; and whether the Commissioners will urge the head lessees to secure forfeiture of the sub-lease and ensure that sanitary amenities are improved to make evictions unnecessary.

Proceedings have been initiated in the court by the head lessees against the sub-lessees, and the matter is therefore sub judice.

May I thank the hon. Gentleman for the keen interest he has shown in this problem since taking up his new responsibilities, may I thank him for his answer and may I leave it that everything possible will be done to see that these people are not evicted, as is at present threatened?

asked the hon. Member for Chelmsford, as representing the Church Commissioners (1) what progress they have made towards meeting the problem caused by the exploitation of ends of leases of their property by companies, with little nominal capital and no assets, who charge high rents and do no repairs; and whether they will proceed, as a matter of policy, to secure the forfeiture of all leases where there is breach of the original covenant, without subsequent licence from the freeholder, while, at the same time, allowing security of tenure of any part of the dwelling occupied by the leaseholder himself and paying reasonable ex-gratia compensation in suitable cases;

The Commissioners are very aware of the problems arising towards the end of long ground leases; these leases when granted in the last century were drafted in such a way as to make it impossible for the ground landlords to control assignments. The Commissioners can report, however, that breaches of covenant of the nature referred to are now infrequent on their estates.

While thanking the hon. Member again for his very encouraging replies, may I remind him that this problem is one of increasing gravity, that it may need legislation, and that it will be very much better if that legislation can he agreed legislation after consultation between all the authorities concerned to see what maximum use can be made of the existing powers and those which the Commissioners are reviving?

I assure the hon. Member that the Church Commissioners are far from complacent in this very difficult matter. We have taken very careful note of what he and other hon. Members said in the debate on 22nd November. We are more than happy to discuss these problems both with him and with anyone else who may be concerned.