asked the Minister of Health, as representing the Minister for Science, what progress has so far been achieved in research into the cause and treatment of multiple sclerosis; on what lines such research is to be carried out in the future; whether he is satisfied that the funds available provide adequately for the needs and opportunities for further research; and if he will make a statement.

My hon. Friend the Member for Croydon, South (Mr. R. Thompson) gave a very full report of research on multiple sclerosis in a debate on 15th May. He explained that the problem is intractable and that it is this fact rather than lack of funds which hampers progress. Research continues, however, and I can assure my hon. Friend that any promising line of research will receive adequate financial support.

While I thank my right hon. and learned Friend for that reply, may I ask him whether the House should gather that, since the debate to which he refers, there have been no promising lines of research uncovered?

Yes, Sir; that is so.

Does the right hon. and learned Gentleman really mean that this problem is intractable? Is he aware that there are 50,000 cases in the country, including nearly twenty in my constituency? Could he report on how far the research into the Russian drug has yielded results?

This is, unfortunately, an intractable problem, not only in this country but the world over. Russian workers claim to have isolated from cases of multiple sclerosis a virus closely related to the rabies virus, but they do not claim that treatment with their vaccine prepared from this newly isolated virus has been an unqualified success, and no adequately controlled trials of its therapeutic value have been reported.

asked the Minister of Health, as representing the Minister for Science, whether he is aware of the growing damage to human efficiency, the bad effects upon health, and the incursions into leisure caused by unregulated noise, and that, with each scientific advance, the impact of noise upon the human constitution is growing; and whether he will establish a committee, analogous to the Beaver Committee which led to the clean air legislation of 1956, to inquire into all sources of noise, including jet aircraft, exhausts of sports-cars and motor-cycles, steam hammers pile-driving, pneumatic drills, and un-insulated industrial machine-shops, and to make legislative recommendations.

asked the Minister of Health, as representing the Minister for Science, what action he proposes to take to deal with the growing menace to health of mind and body caused by noise of all kinds; and what research under his control is being conducted into it.

The Government have decided to set up a committee to examine the nature, sources and effects of the problem of noise and to advise what further measures can be taken to mitigate it. The membership will be announced later.

While I congratulate my right hon. and learned Friend upon this objective and valuable action, may I ask whether, having regard to the complexity and scope of this problem of unregulated noise in modern society, he will ensure that the membership of the committee is established as widely as possible so that expert opinions from every section of the problem may be available to the committee?

I am grateful to my hon. Friend for drawing attention to that aspect of the matter. This is, indeed, a very wide subject, and we shall make the membership of the committee as comprehensive as possible, subject always not to making it too unwieldy. I have it in mind that it will be possible, for example, for sub-committees to be set up to examine special and technical aspects of the problem.

While the subject is indeed complex, will my right hon. and learned Friend make sure that the committee is so selected that its report will be received reasonably quickly and that it will recommend action, because there have been Government committees on noise since the 'twenties and it would be very sad indeed if this turned out to be one of the committees which have sat for many years and resulted in nothing?

I am sure that my noble Friend will have fully in mind the desirability of the committee reporting as soon as is practical, having regard to the complexity of the problem and the fact that its recommendations should be followed by appropriate action.

Will the right hon. and learned Gentleman be good enough to circulate all local authorities asking them to collate, between now and when the committee sits, all the information, complaints and grievances in their possession in regard to noises other than those adumbrated in the Question?

The catalogue of noise in my hon. Friend's Question is very wide, but if there are any sorts of noise which have escaped his particularisation, we can certainly have them in mind.

While the whole House will welcome the announcement by the Minister, the right hon. and learned Gentleman will be aware that there have been other committees whose recommendations have proved abortive. Will he ask this committee to submit an interim report—instead of sitting for a number of years without issuing a report —making recommendations so that the whole country will realise that action is being taken and may take the recommendations as a warning?

I am sure the right hon. Lady will have it in mind that it is contrary to practice to ask a committee, at the time of its constitution, to make an interim report. What not infrequently happens in these matters is that when the committee gets to work with the task which is laid upon it, it sees, in its wisdom, that an interim report on certain aspects of the matter could be of great value. I certainly would not exclude the possibility of that happening in this case.

asked the Minister of Health, as representing the Minister for Science, what investigations he has made into the possibility of certain toxic sprays used in agriculture causing cancer; and with what result.

In the investigations on the toxic effects of chemical sprays used in agriculture which are being sponsored by the manufacturers of the products and the Medical Research Council and other organisations, consideration is always given to the possibility that these substances may cause cancer. A few substances have been condemned in the United States, but the great majority proposed for use show no evidence of such properties.

Is the Minister aware that scientific research abroad has shown that certain of these weed killers can cause thyroid cancer in rats? In view of that information, will he take steps to urge his right hon. Friend the Minister of Agriculture to appoint a commission to inquire into this and other aspects of toxic sprays.

I am sure that my right hon. Friend will take note of what my hon. Friend has suggested, but I would like to make it clear that no toxic sprays have been condemned in this country as carcinogenic, and those identified as such in the United States have not found their way on to the British market.

asked the Minister of Health, as representing the Minister for Science, what investigations he has made into the possibility of D.D.T. and some of its solvents used in agriculture, causing leukemia, aplastic anaemia, jaundice and other blood disorders; and with what result.

Experimental studies undertaken under the auspices of the Medical Research Council and by other workers have provided no evidence that blood disorders can be produced by D.D.T. I understand that manufacturers of this substance avoid the use of solvents which may have undesirable effects on the blood.

Again, I point out that research abroad has established that there is a connection between certain toxic sprays and these diseases. Again, I ask my right hon. and learned Friend to ask his right hon. Friend the Minister of Agriculture to press for an immediate inquiry into this aspect of toxic sprays.

My answer to the latter part of my hon. Friend's supplementary question is the same as my answer to the first part of his supplementary question on the last Question. On the connection between this and blood diseases, it is a fact that occasional reports in medical literature have attributed blood diseases to D.D.T. but the cause of the illness has invariably been poorly substantiated in those cases.

asked the Minister of Health, as representing the Minister for Science, when the Report of the Veale Committee, examining the training requirements of health officers on radiation hazards, is expected to be published.

My noble Friend is advised by the Atomic Energy Authority that the Veale Committee hopes to submit their Final Report in February, and that it will be published as soon as possible thereafter.

Can the Minister indicate when such a training course for medical officers is likely to be in operation? I ask this question because many of them are very apprehensive about their lack of training and that of their staffs. At the moment, they are seeking training in Civil Defence courses and in other ways, which cannot possibly be so satisfactory as properly organised courses on peace-time hazards from radiation which the Veale Committee is investigating.

We will just have to see what the Veale Committee recommends in its final Report about the organisation of training courses. However, as the hon. Lady is no doubt aware, as a result of the Veale Committee's first interim report, special postgraduate courses have been set up at Birmingham University and elsewhere and, as a result of the second interim report, a summer school was held very successfully at Oxford; so we are seeing a good deal of activity in this important subject.

asked the Minister of Health, as representing the Minister for Science, in view of increased mortality from leukemia during the past thirty years, to what extent he has related the figures in recent years to the number of nuclear atomic bomb tests.

The extent to which the increased incidence of leukemia over the past thirty years may be related to increased exposure of the population to radiation from all sources is, of course, being closely studied by the Medical Research Council. All the expert bodies that have reported on the hazards to man of nuclear radiation have agreed that in the light of the available evidence it is impossible to state whether fall-out from nuclear weapon tests has had any effect on the mortality from leukemia.

Has the Minister any figures to show that the increase in leukemia has been greater since these atomic tests have been taking place, in which case would not that give some indication of what is happening?

The increase in mortality from leukemia dates not just from the last seven years of the nuclear tests but over the last thirty years, during which period the exposure of the population to radiation has increased owing to the greater use of radiology in medical practice and, to a smaller extent, because of the various forms of radiation in industry. The further increase in radiation exposure due to fall-out from test explosions which has taken place over the last seven years has been very much smaller. With such minute differences, no conclusions could be drawn from any comparison.

asked the Minister of Health, as representing the Lord President of the Council what was the nature of the last comprehensive inquiry into or review of medical education; and when it took place.

Since the Committee on Medical Schools under the chairmanship of Sir William Goodenough reported in 1944, the General Medical Council in 1947, and again in 1957 after comprehensive review, published revised recommendations on the medical curriculum.

Does the Minister not think that the time has come for a careful and perhaps more dispassionate examination of the subject to discover the extent to which medical education is in line with current concepts of medicine and with the requirements of the National Health Service? Will he give this matter some thought?

This is primarily a matter for my right hon. Friend the Lord President of the Council. I take the hon. Member's point, but he may be assured that there is constant thinking about these matters, independently of setting up specific inquiries such as the Goodenough inquiry.

asked the Minister of Health what consideration he has given to the Memorandum on Accident Services, 1959, published by the British Orthopædic Association, a copy of which has been sent to him; if he is aware that the accident services of Great Britain are inadequate in organisation, staffing, accommodation and training of medical personnel: and if he will make a statement.

I have sought the advice of the Standing Medical Advisory Committee, who have set up a sub-committee to consider the provision of traumatic and accident services.

Will the Minister undertake to ensure that the British Orthopædic Association is well represented in this inquiry, as it is the professional association of the specialists who treat more than 90 per cent. of the accidents?

I will bring the hon. Member's observations to the notice of the Standing Medical Advisory Committee.

asked the Minister of Health if he is aware of the case of Mr. D. Lindsay of Wallsend who, when on a trip to Germany in 1959, suffered a sudden serious illness and was taken to a British Army hospital in Hanover for 14 days, and who was charged £44 for treatment plus about £30 for transport by air; and if he will arrange that, for any British people who get medical treatment in a British military hospital while on a temporary visit to Germany in future, no charge shall be made to the individual, but that such treatment shall be paid for by his Department.

I know of this case, but I am afraid there are no funds at my disposal from which Mr. Lindsay's expenses could be met.

Is it not true that men are paying 1s. 10½d. a week or £5 a year for medical treatment under the National Health Service? Can the Minister say how much the National Health Service is saving by the policy which the Government are adopting in respect of people who go into military hospitals in Germany and elsewhere?

The National Health Service element in the National Insurance contribution to which the hon. Gentleman referred is only a relatively small proportion of the finances of the National Health Service as a whole. What I have to do, and what I am permitted to do, under the National Health Service Act is to provide a health service in England and Wales. I fear that I have no power to pay for the cost of treatment obtained overseas. What we always seek to do is to make such reciprocal arrangements as we can with other countries, but there we are limited by the facilities that they have available.

Does the Minister recall a case that was raised by the former hon. Member for Holborn and St. Pancras, South, Mrs. Jeger, about a year ago, involving a medical hospital in Singapore, when a very much larger sum of money was involved? Does the Minister recall that the then Secretary of State for War undertook to have a discussion with him to see whether some arrangement could be reached whereby these expenses could be refunded to the patient?

The hon. Gentleman has followed the history of the matter up to a certain point, but not up to the conclusion. He will recall, or should recall, that my right hon. Friend the then Minister of Defence made a statement in regard to this matter in April last and explained the extension of military hospital facilities to dependants and connections who had not previously been within the ambit of that privilege. This provision of free treatment at these hospitals, I am afraid, does not go wide enough to take in the case of Mr. Lindsay.

asked the Minister of Health if he will require publication of the names of doctors fined by executive councils of the National Health Service for neglect of duty.

While all practices and procedures are kept under review, I do not at present think it would reflect the balance of the public interest to propose that the existing arrangements under which doctors enter into contracts with Executive Councils should be amended in this way.

Would not the Minister agree that it must be a bad case before the doctor is fined in this way? Why does he still maintain that on balance it is in the public interest that a doctor who fails in his duty to his patients—for example, in refusing to visit a dying patient—should have his name shielded in this way by a secret tribunal?

They need not necessarily be serious cases which come within the ambit of this procedure whereby doctors have part of their remuneration withheld from them. There are some which are technical and relatively trivial offences where the harm done to a man's professional reputation would be out of proportion to the gravity of the offence with which he is charged.

asked the Minister of Health if he is aware of the widespread concern at the proposal of the London County Council to take over the Home Nursing Service on 1st September, 1960: whether he has given his approval to this scheme under Section 20 of the National Health Service Act; and if he will make a statement.

asked the Minister of Health if he is aware of the value of the services rendered by the District Nurses Association and the public esteem in which this voluntary organisation is held; and if he will take this into account in considering proposals to take over the administration of these services submitted for his approval under the National Health Service Act, 1946, by the London County Council.

asked the Minister of Health if he will ensure that, when the London County Council, in accordance with plans approved by him, takes over the district nursing associations on 1st September, 1960, the pensions and other rights of the nurses are safeguarded under powers conferred on him by the National Health Service Act.

asked the Minister of Health if his attention has been drawn to the fact that 23 superintendents of district nurses' homes in London have been asked by the London County Council to apply for posts which would be available in the new scheme; whether he has given his approval to the scheme under Section 20 of the National Health Service Act, 1946; and if he will make a statement.

asked the Minister of Health if he is aware of the anxiety and concern which exists in view of the London County Council's decision to take over the District Nursing Service on 1st September, 1960; whether he has given his approval to this scheme under Section 20 of the National Health Service Act. 1946: and if he will make a statement.

asked the Minister of Health if, when considering the proposals of the London County Council to take over the District Nursing Service in 1960, he will give first consideration to the comfort of the old people who benefit from the service at present, and the wishes and rights of its nurses.

I have received from the London County Council proposals for altering, as from 1st September next, the present arrangements for providing home nursing and, in certain areas, domiciliary midwifery services. These proposals require my approval before they can be brought into operation, and under the statutory procedure interested organisations have until 22nd December to make recommendations to me for their modification. I have already received a number of such recommendations and shall take these, together with all other relevant circumstances, into account in reaching a decision.

Is my right hon. and learned Friend aware that his statement will give great satisfaction to many people who are under the impression that the decision of the London County Council could not be revoked and that he was merely a "stooge" in this matter? When he makes his decision, as he is required to do by Statute, will he further bear in mind the extremely valuable services of a personal nature which are rendered and which are quite unsuitable for central control?

There should be no room for any misunderstanding in this matter. There can be no decision save that made by the Minister under the duty imposed on him by Section 20 of the National Health Service Act. The London County Council has submitted proposals, but it is for me to make a decision having regard to all the relevant factors and the public interest as a whole.

When my right hon. and learned Friend is considering his decision, will he bear in mind that the close personal relationships of trust and confidence which at present exist in the service between the elderly sick and the disabled and the devoted band of nurses who look after them are priceless assets which cannot easily be replaced by a more impersonal and centralised service?

I am sure that we all have very much in mind the quality of the service and the devotion of the people rendering this service, as my hon. and gallant Friend has been good enough to say. Regarding the further matters, he will, I know, understand that it is better for me who am seized with this duty not to make any observations which might seem to anticipate my final decision.

Will my right hon. and learned Friend realise that in this matter he is regarded as the bulwark between freedom and a virulent bureaucracy and, under those circumstances, will he repulse with vigour the marauding raids of the "buccaneers" of County Hall?

I shall seek to discharge the duty imposed on me under Section 20 of the National Health Service Act and try conscientiously to arrive at a decision which seems to reflect the public interest in regard to all the relevant circumstances.

Is my right hon. Friend aware of the great services which have been rendered, and will he make it quite clear that, since there has been no question of a lack of efficiency, there can be no case on the grounds of efficiency for a take-over by the L.C.C.?

I will certainly have in mind what my hon. Friend has been good enough to say.

Should not the right hon. Gentleman tell the House what are the facts; that the London County Council has been providing 93 per cent. of the cost of this service, and that, far from this being revolutionary, 70 per cent. of the local authorities in a similar position have already taken over the District Nursing Service? Is not the House aware that, in these days of comprehensive domiciliary service, this action is in the interests both of the nurses and the patients?

Oh no, it is our money anyway.

Under Section 25—

Silly old man.

Oh.

The right hon. Lady should address her observations to me.

I beg your pardon, Mr. Speaker. Under no circumstances would I address that observation to you.

I hope I may assume that such an observation could not possibly be addressed to me either.

I thank my right hon. and learned Friend for that satisfactory reply. Is he aware that at the present moment the London County Council, through its clerk, is recruiting staff for the new scheme which is supposed not to take effect until 1st September, 1960, and then only with his consent? Is he aware that the District Nursing Association members have today received a letter calling them to County Hall for interviews for posts under this scheme on 18th December—

And very prudent, too.

—and will my right hon. and learned Friend express a view about whether there is any need for apprehension in view of these forthcoming arrangements?

I do not think so. The County Council, I understand, has held discussions with the District Nursing Associations and has invited applications from superintendents of district nurses' homes for posts that would become available were these proposals approved. But I understand that it has stated expressly that these discussions commit nobody. The proposed new posts cannot become effective in advance of my decision, as I have explained, and I understand that the London County Council did not intend otherwise.

asked the Minister of Health if he will take steps to amend the National Health Service Act to enable a consultant to do preventive as well as clinical medicine.

I am not sure what a mendment the hon. Member has in mind, but consultants can be employed by local health authorities as part of their arrangements for the prevention of illness. Preventive health in work places covered by the Factories Acts is primarily a matter for my right hon. Friend the Minister of Labour.

Is the Minister aware that unless the Act is amended pioneering efforts in the field of occupational help will be put in jeopardy? In the meantime, will he consider extending the provisions of Section 16 to enable consultants who are co-operating in health units attached to regional or local hospitals in connection with local industry to continue their excellent work?

Section 16 deals with research and gives me certain powers in that regard. There is a difficulty which arises, for example in the case of the Central Middlesex Hospital which I explained last week, where at the moment power does not exist.

asked the Minister of Health when he will have completed his review of the possibility of replacing the present single-seater invalid tricycles by larger and more suitable vehicles; and whether he will then make a statement.

I cannot yet say when my right hon. and learned Friend's review will be completed, but as soon as it is he will make a statement.

We shall, of course, await the Minister's review with patience and great interest, but may I ask my hon. Friend to impress on the Minister that there seems to be a paramount factor in this problem? It is that at present, in the crowded and dangerous condition of our roads, the last people who ought to be made to travel alone are the paralysed, the gravely disabled and those who have lost the power of their limbs? Will the Minister put that matter at the very head of his consideration in making his review?

Yes, but I must make clear to my hon. and gallant Friend that the promise made about cars—which evidently is in his mind—related to war pensioners. I should add that the review means that we are considering commercial vehicles and some of the things like the Isetta, the Bond and the Scootacar, which ex-Service men's organisations undertook to consider for trials and on which they have not yet reported.

Is the Parliamentary Secretary aware that, while the Invalid Tricycles Association appreciates tremendously the benefits the Minister has conferred on its members, not only the happiness but also the health and safety of the crippled, to whom mechanical transport is the only means of conveyance, are involved in the inquiry? Will the most earnest consideration be given to the claims of those cripples?

Yes, all these things will be taken into consideration in the review which is taking place at present.

Will the Minister realise that it will give great satisfaction to the war-disabled who now have single-seater tricycles to have them replaced by some form of small car, but it will be very disappointing if civilian disabled with exactly the same disability are left with these unsuitable vehicles?

I take the point, and I do not wish to sound unsympathetic, but I have said before in this House and must repeat that there is no power in the National Health Service Act to enable my right hon. and learned Friend to provide two-seater vehicles.

asked the Minister of Health whether, following the successful introduction of the "no smoking" rule into the shops of a leading chain store company, he will consult representatives of the retail food trades with a view to possible legislation prohibiting smoking in food shops.

No, Sir. While appreciating the desirability of people refraining from smoking in food shops, my right hon. and learned Friend does not think it appropriate to make it a penal offence for customers so to do. Smoking by employees of food businesses in any room where there is open food is prohibited by Regulation 9 of the Food Hygiene Regulations, 1955.

Is the Minister aware that customers and those serving behind the counter would welcome a ban of this description? Will not the Minister look at this matter again? After all, she has had a very good example set by a well-known multiple store.

The multiple store which has introduced such a ban is concerned probably as much, if not more, about the fire risk as about the risk in connection with food handling. This is a matter for co-operation and good will between the shopkeeper and those who trade in his shop.

Is the Minister not aware that shopkeepers are notoriously shy about using their initiative in any restrictive matter but that many of them would welcome such a ban as this if it were demanded by the law? Will the Minister look at the matter again?

Certain caterers and food stores already have notices asking customers not to smoke at cafeterias and food counters. The Kensington Borough Council has encouraged food shops in the borough to display similar notices. We have told some other local authorities, who have written about smoking in food shops, what Kensington has done. I am sure that the right way to approach this question is through cooperation and not through legislation.

asked the Minister of Health whether he has noted the decline in the total consumption of cod-liver oil; to what extent this is due to the recommendation of the Joint Sub-Committee that the vitamin content be lowered and only drop doses given; and what steps he is taking to ensure that as many children as possible receive this welfare food.

Yes, but it is not possible to say precisely how much of the decline is due to the reduced doses recommended. It is our constant endeavour to secure, by persuasion and appropriate publicity, that children who need cod-liver oil are given it.

Is the hon. Lady not aware that her right hon. and learned Friend and the advisers in the Department are all agreed that this is a very valuable substance for children to take in their early years in order to prevent certain diseases? While it is true that the Minister and the hon. Lady take steps to advertise the value of cod-liver oil by means of leaflets and posters, is it not very disturbing that there is a continuous fall in the consumption of cod-liver oil?

Yes, but vitamin D is obtainable from the diet in other ways, apart from cod-liver oil. Now that we have an infinite variety of foodstuffs to purchase and the money to buy them, there is no deficiency of this vitamin, although we are anxious to encourage mothers to continue to give it to their children.

Has my hon. Friend seen the recent expression of medical opinion that we stuff far too many of these things down our children's throats? What steps are being taken by her Department to make sure that medical opinions so expressed are rightly assessed?

The appropriate steps are taken. This is left to the individual mother, though we do our best to encourage her when we know the value of certain vitamins; and the value has certainly been established in this case.

asked the Minister of Health (1) whether he is aware that, in the Newcastle region, the financial allocation for implementing a 44-hour week for nurses only permits its introduction in some hospitals; and why he has authorised expenditure sufficient only for a selective rather than a universal scheme;

I regret that the detailed estimates requested by my hon. Friend are not available. In many hospitals it has been possible to reduce hours without extra cost by re-arranging duties and other similar measures, and an additional £1½ million was made available to regional hospital boards during the current year to enable further progress to be made at hospitals where extra money was most needed for this purpose. In the Newcastle Region an 88-hour fortnight has already been introduced in full or substantially in 16 of the 19 general hospital groups and in all of the 11 mental hospital groups.

A hospital in my constituency, at which the number of nurses was below the number permitted, was told that its recruitment was frozen and that no additional staff could be recruited. In view of the letter I received, which said that only £62,000 had been allocated for the region, is my hon. Friend satisfied that the nurses in our region will have a fair deal?

The hospital about which my hon. Friend wrote to me was short of 13 nurses, but they have, in fact, been recruited. The allocation of this money is entirely a matter for the regional hospital board. The addition for each region was dependent on a formula which took into account the ratio of beds to nurses. The Newcastle Region had a better staffing ratio than the average, which is why it received £62,000. This is the right proportion, and I am satisfied that the region has had its share.

While the hon. Lady may be satisfied about the Newcastle Region, has she had any representations from other mental hospitals where it has been very difficult to implement the 88-hour fortnight and where nurses are subject to the greatest tension?

Not to my knowledge, but if the right hon. Lady puts down a Question on that much wider subject, I will try to get the information.

asked the Minister of Health, in respect of the new capital programme announced for the hospital service, if he will state, per 1,000 of the population, the value to each region of the allocation.

If, as I assume is the case, my hon. Friend is referring to the major centrally-financed projects which I particularised in answer to my hon. Friend the Member for Hertford (Lord Balniel) on 16th November, it is too soon to give the desired evaluation, as precise cost and date of commencement must depend on detailed planning. In addition to these centrally-financed major projects, there are the normal allocations to regional hospital boards for their own work; and my aim is to deal fairly with all regions, taking into account both types of project.

Would I be right in assuming from that somewhat unsatisfactory reply that in its new capital allocation the Newcastle Regional Hospital Board will be catching up on the deficiencies which we have had to carry because of the pressure over very many years? Can I have a specific assurance on that point?

Whatever my hon. Friend might feel about the reply, the fact is that the Newcastle Region is ahead of the average in the amount of capital expenditure on hospitals devoted to it, because up to the end of the last financial year in England and Wales, 8·2 per cent. of our capital expenditure on hospitals went to that region against the proportion of population of only 6·6 per cent. We are also taking into account all the deficiencies in existing resources in the major projects to which I have referred. Two new hospitals, at Hensingham and North Tees-side, have been provided for in this programme, with no fewer than ten other major projects.

On a point of order. Since I have not had time thoroughly to examine the answers given by my right hon. and learned Friend and my hon. Friend, if they should prove to be unsatisfactory, I beg to give notice that, when the House resumes after the Christmas Recess, I will pursue the matter on the Adjournment.

Provisional notice given.

asked the Minister of Health if, in view of the desire of regional hospital boards to plan their building programmes in such a way as to eliminate avoidable delay, he will make an early statement concerning the centrally-financed projects which will be commenced during the next three financial years.

Hospital boards have already been asked to plan all the major schemes that are likely to be started in the next three years.

Does my right hon. and learned Friend appreciate that this uncertainty as to what they can spend and when they can spend it is a source of great difficulty to regional hospitals boards? Will he do his best to produce a long-term plan to enable them to know where they stand? So far as I understand from his Answer, the difficulty is that they have been asked to say what schemes are likely to be started, but the initiative, surely, should come from him?

We are doing our best in this direction. Hospital boards have been told that the total capital allocations for the next financial year are £25½ million and, for the year following, £31 million. We have large projects to the ultimate value of nearly £40 million which we expect to start in the next two years, and we also have schemes, which the boards have been asked to plan and on which work has not yet started, to the value of nearly £80 million. So I think the boards will find that there is plenty of work for them to be getting on with in the next few years.

Is the Minister aware that although the money might be available there are not enough people in the architectural and planning departments of regional boards for them to be able to get anywhere near the estimates of spending which he has just given? What steps is he taking to see that the departments concerned which have to do the planning and architectural work are built up with the necessary personnel to get on with the jobs it is necessary to do?

I have this matter in mind. There is considerable pressure on the architectural skill of the country, but we are doing what we can to help. In particular, we have expanded our own design unit at the Ministry so that we can furnish the greatest help by way of designs, suggestions and so on.

asked the Minister of Health (1) whether he is aware that many hospitals are understaffed in their pharmacies, and that recruitment of experienced staff is becoming continually more difficult; whether he will give an estimate of the present shortage for the service as a whole; and what action he is taking to find the staff needed;

Though no precise information is available, I am aware that there is a shortage of pharmacists generally and that this affects some hospitals. Advice was recently given to hospital authorities on the organisation of hospital pharmaceutical services, with a view to making the best use of available trained manpower. A salary claim for hospital pharmacists is now being considered by the Pharmaceutical Whitley Council.

Is the Minister aware that a great teaching hospital, the Middlesex, had to go on to this procedure about a week ago due to lack of staff and that it is estimated that about £13,000 a year would be involved as an extra charge on the Health Service as a result? Is he further aware that, whilst appreciating that the question of payments to pharmacists is now being discussed, this seems to be the root of the problem and that the hospital service cannot easily compete with the payments made outside to people of similar qualifications? In view of this, will he not accept from us all that the right thing to do is to see that the hospital service gets the best possible staff, because that will be the most economic way of giving service to the public?

I appreciate the point made by the hon. Gentleman, but I am sure he will understand that it would not be appropriate for me to comment on the salary question while the claim is under negotiation. There has been a slow but gradual improvement over the years in the number of pharmacists, and there has been a more substantial increase in the number of assistants in dispensing.

The numbers have increased but, by and large, they tend to be in the lower ranks and the female staff tend not to stay for as long as men who assume greater responsibility. Is not the serious problem that experienced staff are becoming more difficult to obtain each year?

I tried to improve the distribution of the pharmaceutical staff, and in this I had the advantage of the Report of the Sub-Committee of the Standing Pharmaceutical Advisory Committee, issued last year, under the chairmanship of my hon. Friend the Member for Putney (Sir H. Linstead).

Would my right hon. and learned Friend not agree that part of the difficulty has probably arisen through a virtual deadlock in the negotiations of the Whitley Council? Will he not make inquiries to see whether that deadlock can be broken?

So far as I know, the negotiations in the Whitley Council are proceeding appropriately. I will certainly have regard to what my hon. Friend has suggested, but I do not think there is any reason to apprehend what he has in mind.

Will the Minister explain why this shortage has been allowed to go on? We have had a shortage of pharmacists, a shortage of radiologists and of practising midwives. When the position becomes acute, the Minister has to adopt methods of this kind and issue EC 10 forms, which will be a most costly answer. Finally, he has to say that we will give these people more, and the Whitley machine begins to turn. Why is it that, in all these cases, the Ministry does not anticipate these shortages?

We have a considerably expanding service and, over all, there are many demands for skilled manpower. All these things provoke, in some context, a shortage of available manpower, but we do our best within the context of the material available, our responsibility for public money and so on to ensure that the service is staffed as it should be.

asked the Minister of Health what is the present shortage of trained nurses employed for service to mentally deficient children and adults, respectively; how this compares with five and ten years ago; and whether the question of adequate salaries for this kind of service has been reconsidered within the last two years.

I regret that precise information of the kind asked for in the first part of the Question is not available; but for mental deficiency hospitals in England and Wales the latest figures for March, 1959, of trained nurses employed are 3,214 whole-time and 431 part-time compared with 3,120 and 413 five years ago and 2,613 and 250 ten years ago. The Nurses and Midwives Whitley Council has reviewed the salaries of all National Health Service nursing staff during the past year and has agreed substantial increases for all grades from 1st March, 1959.

Does the right hon. and learned Gentleman appreciate that trained nurses employed in this service to mentally defective children by public authorities give quite as devoted service as do those employed by private organisations, but that there are not enough of them? As this kind of service entails particularly arduous work and great care and affection, is the Minister satisfied that even the increase he has announced will be sufficient to bring in the extra recruits which are required?

I hope so, although it is relatively early days yet to say. I fully endorse what the hon. Gentleman has been good enough to say about the devotion and the value of the work done by these nurses. I am glad to say that, over the last ten years, the number of whole-time trained nurses in mental deficiency hospitals has increased by 23 per cent. and the total whole-time nursing staff by over 44 per cent. There has also been a welcome increase in the number of beds over that period, but the ratio of staff to beds has improved.

asked the Minister of Health how many mentally deficient children are now on the waiting list for admission into suitable hospitals or institutions; and what progress has been made towards ensuring that no child who should be in such an institution, or receiving special care and oversight, has to await admission for long periods as at present, thus involving severe strain to the family.

At 31st December, 1958, the latest date for which figures are available, 2,827 children under 16 were awaiting admission to mental deficiency hospitals. During the seven years to the end of 1958, nearly 5,000 additional hospital beds for mental defectives of all ages were provided, and it is estimated that some 4,000 more beds will be added during the next four years.

May I ask whether the right hon. and learned Gentleman will express an opinion regarding the last part of my Question? In any case, does he appreciate that, although there is this encouraging development both regarding recruitment of nurses and otherwise, there is still a large number of pitiful cases which have been waiting a long time for admission to hospital? Can the Minister say something more to indicate that these unfortunate patients will have an opportunity of admission to hospital pretty soon?

As I have explained, we are adding these additional 4,000 beds which will be provided at 12 hospitals as a result of the large scheme which I have announced. As the hon. Gentleman may know, the strain on families is, to some extent, mitigated by the procedure which we follow of admissions to hospitals for short periods in order to give the family a short rest or holiday.

asked the Minister of Health how many time-expired senior registrars are at present employed in the National Health Service.

119 at 1st July, 1959.

Is the Minister aware that these time-expired registrars have a very high degree of responsibility and undertake major operations, yet after all these years in service they have no knowledge of the future of their job? They do not know whether they are going to be shifted at the end of their existing year and, as a result, are left in a state of considerable uncertainty. Will he consider taking action to resolve their difficulties?

We have taken action. Jointly with the Joint Consultants Committee, we set up a working party to study the principle of staff structure in the hospital service with particular reference to this problem. Meanwhile, regional hospital boards and boards of governors have been asked to extend the contracts of senior registrars who have completed the normal tenure of their posts.

Can the right hon. and learned Gentleman say how the figure of 119 compares with that of the previous twelve months; also, what effect the once-for-all arrangements has had on the limited number of permanent

In reply to the first part of that question, the number is five fewer than it was previously; in reply to the second part, we have had twenty-three proposals, of which nineteen have been approved.

asked the Minister of Health if he will state the average waiting time between diagnosis and treatment of people requiring thoracic surgery in the area of the Manchester Regional Hospital Board.

The waiting period varies according to the facilities available and the urgency and type of case. With permission, I will circulate in the OFFICIAL REPORT details of the approximate waiting times for thoracic surgery at the hospitals concerned in the area.

In view of the fact that the benefits of early diagnosis are being completely lost because of this time lag, will not the Minister act quickly to try to expand this service both in respect of professional services and of accommodation? This is a very serious matter in one of the most highly industrialised areas in the country.

There has been some reduction by the Regional Hospital Board in its proposals for thoracic surgery beds. This is due to a very hopeful reduction in the number of tuberculosis cases. The hon. Member will be glad to learn that the board appointed another thoracic surgeon in September.

asked the Minister of Health if he has yet completed the follow-up review of cases of leucotomy which was initiated by his predecessor following the representations on this subject made by the hon. Member for Carlisle on 5th December, 1955.

I regret that the analysis of the results of the follow-up has not yet been completed, but I hope a report will be ready shortly.

Is my right hon. and learned Friend aware that his reply is almost identical with that which he gave me eight or nine months ago when I last asked him the question? Can he now state a date when we can expect the result of this long-awaited inquiry?

My hon. Friend, with his characteristic generosity, has slightly understated the interval of time. This is a complex medical and statistical undertaking. I am sorry that my hon. Friend has had to wait longer than we had hoped, but we expect the work to be completed early next year, and I am sure that it will serve a useful purpose.

asked the Minister of Health if he will make a statement on the circumstances under which Mr. T. J. Drakeley, C.B.E., has ceased to be chairman of the Northern Group Hospital Management Committee; and who is to be his successor.

asked the Minister of Health why Mr. T. J. Drakeley, C.B.E., was not reappointed chairman of the Northern Group Hospital Management Committee, despite the fact that the management committee unanimously requested his reappointment.

I am informed that the North-West Metropolitan Regional Hospital Board proposes to appoint Mrs. Henry Brooke, a member of the board, as chairman of this hospital management committee in April next in succession to Mr. Drakeley. Appointments to hospital management committees are, by statute, a matter for the regional hospital board.

Is the Minister aware that, owing to the vigour, health and personality of Mr. Drakeley, there is unanimous opposition to this change in the appointment? Is he aware that this change has been initiated by Lord Cottesloe, chairman of the regional hospital board, and that, although I have no doubt that he has had the most honourable of intentions, it is an unhappy coincidence that for ten years Lord Cottesloe represented on the London County Council the same constituency as the husband of the chairman-designate?

As the hon. Member should know, these appointments are not a matter for the Minister of Health. [HON. MEMBERS: "Oh."] It certainly shows a remarkable ignorance of the Act of 1946, especially on the part of the hon. Member for Islington, East (Mr. Fletcher), who has some legal qualification. That is deplorable. It is quite clearly a matter for the regional hospital board, not for the Minister of Health. The regional hospital board is composed of various people rendering service to the hospital movement, including not only Lord Cottesloe, a very distinguished chairman, but also the hon. Member for St. Pancras, North (Mr. K. Robinson).

If this Question is not within the responsibility of the Minister of Health, is it not out of order?

Prima facie, being on the Order Paper it is in order.

Is not the Minister aware that considerable pressure has been put on Mr. Drakeley in order to secure his acceptance of this position, presumably on the grounds of his age? Is the Minister aware that Mr. Drakeley's full-time position is that of principal of the Northern Polytechnic, in which position he has the full confidence of the governors of that college, the London County Council and, presumably, Her Majesty's Inspectors of Education? While one can agree that theoretically it is a decision for the regional hospital board, the Minister cannot dodge the fact that he is finally responsible for this matter.

All the regional hospital boards administer their services as agents of the Minister under the terms of the Act. [HON. MEMBERS: "Oh."] Certainly. It is no doubt for that reason that the Question is rightly on the Order Paper. Nevertheless, Part II of the Third Schedule is quite specific as to the methods of appointment. This is an appointment of the board, and is in no way an appointment of mine. I have no doubt that it is a very good appointment. [HON. MEMBERS: "Why"] Because Mrs. Brooke is a lady of great ability who has rendered great service to the hospital movement. In saying that, I in no way derogate from the value of Mr. Drakeley's services in the past. This group is, as I understand it, looking forward to developments over the next six years or so, and it is therefore appropriate that he should be replaced by a younger chairman.

Are we to gather from the attitude of the Opposition that a Minister's wife or other relative should be prohibited from serving the public in any capacity?

I do not think that even the inconsistencies of the Opposition would extend quite to that proposition.

Although it is refreshing to learn that there are "jobs for the girls", is there any precedent for ignoring the unanimous recommendation of a hospital management committee in such a matter?

I should not like to answer the last part of the right hon. Lady's question without checking up on it. On the first part of the question, I am glad that there is this honourable and useful position for Mrs. Brooke. On the general theme of "jobs for the girls", I am only sorry that Blackpool was not as generous.

Is the Minister aware that this disregard of the views of the hospital management committee and this apparent slight to Mr. Drakeley, who has had such a very distinguished record in North London, has created a most unfavourable impression, and particularly the fact that Mr. Drakeley has been superseded in the interests of the Minister's wife? Will the right hon. Gentleman, in the circumstances, make known to the board the views that have been expressed in the House?

Mr. Drakeley has not been superseded in the interests of the Minister's wife. The hon. Gentleman must try to get it into his head that the appointments are made in the interests of the hospital service. Appointments are made by the boards and not by the hospital management committees. I repeat that we are grateful to Mr. Drakeley for his services and to all the people who serve on the committees and boards.

In view of the somewhat disagreeable implications of this matter, would it not be welcomed by Lord Cottesloe and the chairman-designate if the Minister instituted a full inquiry and published the result?

The only imputations are those which the hon. Gentleman is putting forward, in a way which I hope he will regret tomorrow. If he wants an inquiry, perhaps he would be good enough to address himself to his hon. Friend the Member for St. Pancras. North (Mr. K. Robinson), who is a member of the board and helped to make the appointment.

Is my right hon. Friend aware that there are a number of hon. Members and their wives and relatives who serve on various hospital boards and that, if we are to be subjected to this sort of personal innuendo, we will not be prepared to serve? Does my right hon. Friend think that this is a proper way to conduct appointments? In view of the calumnies made by the Opposition, will my right hon. Friend induce the chairman of the regional hospital board concerned to give the voting of the board in favour of asking Mrs. Henry Brooke to be chairman of the management committee?

I think that the whole House will agree that these imputations are wholly out of place in a movement in which all service is given in a voluntary capacity. [Interruption.] The right hon. Member for Belper (Mr. G. Brown) is insisting on making a series of unedifying and sedentary squawks from his place. If he has a supplementary question to put. I will gladly reply to it.

On a point of order. I made it quite clear in my question that I thought that Lord Cottesloe had nothing but the most honourable intentions. Therefore, it is quite improper for the Minister to use that imputation to conceal his views.

The point I was putting, which I now put standing, is that the Minister's pompous remarks come ill from him, since he and the Minister of Pensions and National Insurance—[HON. MEMBERS: "Question."]—I am asking him if he is not aware—[Interruption.] You will not get me down now you have got me up.

The right hon. Gentleman should address his remarks to me.

Sir, I do They will not get me down now that they have got me up. The point I asked the Minister about is this. Is he not aware that the remarks he now addresses to the House come ill from him, since he and his right hon. Friend the Minister of Pensions were the ones who used these things repeatedly against us and friends of ours from 1951 onwards?

If the right hon. Gentleman can identify in a speech by me—[Interruption.] I will gladly give way to the right hon. Gentleman if he will identify any such passage. Also, he puts it from 1951 onwards. 1951 was the time at which, greatly in the interests of the country, the present Administration came into power, so the right hon. Gentleman is clearly quite mistaken in what he said.

On a point of order. Owing to the fact that my Question has not been answered and the unsatisfactory nature of the reply, I give notice that I shall attempt to raise the matter on the Adjournment at the earliest possible moment.

Further to that point of order. Are not these innuendos extremely suitable at the present time? Is it not the only thing for which the Opposition are fit today?

They may or may not be suitable, but they are not points of order.