asked the Minister of Health whether he will now make a statement on the escape of Richard Upcher from Broadmoor Hospital on 21st February.

I would refer the hon. Member to what my hon. Friend said in the Adjournment debate on Broadmoor Hospital on 1st April.

Is the right hon. Gentleman aware how appreciative I am of the personal consideration that he has given and the trouble that he has taken in regard to this case and Broadmoor generally? Does he recall that there have been criticisms that the six sirens are apparently not yet in operation? Can he say when he expects that that will be put right?

I am grateful to the hon. Gentleman for his observation at the beginning of his supplementary question. It is true that none of the six additional sirens is yet operational, but four of them will be very shortly. As to the initial testing of the sirens, regular testing will be carried out when they are established. Questions about the actual execution of the work are for my right hon. Friend the Minister of Public Building and Works.

asked the Minister of Health if he has yet been able to meet representatives of the National Associa- tion of Registration Officers to discuss ways of raising the status and salaries of the service; and what are his proposals.

asked the Minister of Health if he will now make a statement on the status and salary conditions of registration officers, following the representation made to his predecessor in March, 1964.

I have myself had a useful talk with representatives of the officers and the hon. Member for Leeds, North-West (Sir D. Kaberry) and am considering what can best be done to meet their difficulties.

While thanking my right hon. Friend for that reply, may I ask him whether he can say when he will be able to make a further statement in view of the length of time it has taken for the matter to come to his notice and be further considered?

I cannot give my hon. Friend a definite reply. The difficulty is that neither I nor the Registrar-General has any locus in the established negotiating machinery. Any special action would require the co-operation of the parties to the machinery.

Is there any liaison between the right hon. Gentleman and the Secretary of State for Scotland in the matter of the conditions and salary of registration officers?

Yes, indeed, Sir.

asked the Minister of Health if he will ensure that every section of the community is given fair and adequate representation on the Birmingham regional hospital boards and hospital management committees in the Birmingham area.

So far as my appointments to the regional hospital board are concerned I would refer my hon. Friend to the reply given to my hon. Friend the Member for Oldham, West (Mr. Hale) on 16th November. The regional hospital board is responsible for appointments to hospital management committees but I have no doubt that its object is the same.

While thanking my right hon. Friend for the reply, may I ask him whether he realises that in Birmingham and the West Midlands there has been considerable disquiet about the partisan manner in which the previous Government made appointments to the board? While I am not asking him to adopt a partisan approach, may I ask whether he will ensure that in future the appointments to the committees will cover a broad cross-section?

I am aware that a certain amount of criticism has been voiced in the area. I am sure that my hon. Friend will know that political parties are not consulted about appointments to boards or committees, but I consult the Trades Union Congress about the appointments to boards, and the regional hospital boards in their turn consult local trades councils before making appointments to hospital management committees

Is it not the right hon. Gentleman's general view that party political considerations should not affect his choice?

Yes, Sir. My general view is the same as that of my predecessor, that appointment to membership of a regional hospital board is made primarily for the individual contribution which members can make to the efficient running of the hospital service.

Does my right hon. Friend realise that, while we on this side would agree that party considerations should not come into the matter, the cause of the complaints in the past has been that they appear to have done so?

asked the Minister of Health in what way provision of toilets, operating rooms and other accommodation at Barnstaple Hospital falls short of the standards laid down by his Department.

It is old fashioned and insufficient. The South Western Regional Hospital Board hopes to start work on a new operating theatre and out-patient clinics later this year.

Does not this show the very real need to do something more at once, and will the hon. Gentleman bear in mind that I am still receiving letters complaining about the delays in getting operations in the hospital? Will he also take account of the extraordinary fact that a crematorium is being built in North Devon before a new general hospital?

I do not think that that is by a regional hospital board. I answered the Question as it was tabled. We appreciate that it is a very old hospital. I believe that its date is 1825. The hospital board itself is responsible for planning to meet the needs in the area which it covers. It would be to some degree presumptuous if my right hon. Friend interfered with regional hospital boards in this way. We appreciate that this is an old-fashioned hospital. The board is getting on with the job of the new operating theatre and clinics this year, and we hope that this will bring about an improvement.

While I am in no way blaming the present Administration for the state which they have inherited, may I ask the hon. Gentleman whether he would not agree that when one has a hospital with nearly 1,000 people on the waiting list, with no day room, no utility rooms and no central sterilisation rooms, with wards already over-choked with beds, and with only 12 lavatories for all the patients and staff to share, to build one new operating theatre is merely a patch-up and a very bad patch-up at that? Does he not feel that the need for a new hospital is of the greatest urgency?

If I had wanted to go into the background of this I should have said very much what the hon. Member for Devon, North (Mr. Thorpe) has said. We appreciate that until we get a new hospital in the area the facilities will be inadequate. Improvements have been made. We hope that with the new hospital we can solve the problems. We are very mindful of the difficulties.

asked the Minister of Health if he will give instructions to the Manchester Regional Hospital Board that they should discuss with the National Coal Board North-West Divisional Marketing Department the relevant details of new boiler plant equipment which is to be installed in any of the hospitals under the control of the Board, when they are requested to do so by the Marketing Department.

I have asked all hospital boards to consult the National Coal Board in the early stages of planning before deciding what forms of heating should be installed in hospitals.

asked the Minister of Health what steps he has taken to improve the provision of hospital beds for turbulent mentally-defective children.

I have recently asked hospital authorities to review their building programme and I have drawn their attention to the need to give the psychiatric services not only a due share of the resources available but an early share. The review will cover the needs of these children for hospital accommodation.

While appreciating that reply, may I ask whether the Minister does not agree that it is anomalous that a turbulent adult immediately has a bed found for him but a turbulent child is normally placed on a virtually stationary waiting list?

I would not put the problem in quite such stark terms as that. It is true that there are about 2,200 mentally subnormal children awaiting admission to hospital at the moment, but at the end of last year there were about 8,000 beds occupied by such children. Additional beds are in the course of being provided and further provision is being planned.

Does not the Minister recollect his undertaking that he would ask groups of regional hospital boards to work together in order to improve inpatient accommodation for subnormal children? Has any progress been made in this grouping of regional hospital boards?

I do not recall giving an assurance that groups of regional hospital boards could work together. I said that regional boards and local health authorities were being asked to work together for this purpose.

Does not my right hon. Friend agree that every regional board has waiting lists of children seeking admission to such institutions?

I think that that is probably true.

asked the Minister of Health what steps he is taking to provide additional accommodation in hospitals for geriatric cases and in nursing homes for elderly and infirm persons, in view of the anticipated progressive increase in the percentage of elderly persons in the community during the next decade.

asked the Minister of Health what steps he plans to take to provide extra accommodation in hospitals for geriatric cases, in view of the expected increase in the percentage of old persons in the national population during the next 10 years.

I have asked regional hospital boards in reviewing their programmes to give due priority to the expansion of hospital geriatric services. I propose shortly to ask local authorities to review their health and welfare plans, including the adequacy of residential accommodation to be provided for the elderly.

In the Minister aware that there is a serious lack of suitable accommodation in hospitals for special attention to and comfort of the elderly? The housing programme is geared to special housing for elderly people, but many more will require care and treatment in hospitals or nursing homes specialising in their needs. I wonder whether special arrangements are made for dealing with advanced programmes for the geriatrics in general.

It is partly because of this general problem that I asked hospital boards to give special consideration to the needs of geriatric services. I do not think that there is an overall shortage to the extent suggested by the hon. Member in his supplementary question. We have told hospital authorities that where the complementary services in the community are of a high standard and well developed, adequate provision would normally be about 10 hospital beds for every 1,000 persons aged over 65.

This is not only a grave but a growing problem. Would the Minister consult the Chancellor of the Duchy of Lancaster in the current review which I understand he is undertaking to see whether the whole needs of the elderly and the ageing in the future can be included in that review?

The broadest aspect of this question will be included in that review, but it is just because of the considerations which the right hon. Gentleman has put forward that I have asked for particular attention to be given in the review and for joint planning to be done in respect of the elderly between local authorities and hospital authorities.

Will the Minister bear in mind the importance of seeing that the accommodation which is made available is near the old people's homes?

I am not quite sure what sort of accommodation the right hon. Gentleman means.

Hospital beds.

Hospital beds, I am afraid, will have to be provided in the hospitals which exist.

asked the Minister of Health what is the average waiting time for admission to the various departments of Walkergate Hospital, Newcastle-upon-Tyne, based on the average for the last two years.

Three months for ophthalmology; 10 weeks for ear, nose and throat surgery; three weeks for dermatology; less than one week for all other departments. Urgent cases are admitted without delay.

Is my hon. Friend aware that, according to the British Medical Association, in the Newcastle-upon-Tyne Regional Hospital Board area, based on the Walkergate Hospital, there is an immediate and urgent shortage of at least 10 per cent. in the number of beds? Will he agree that he and his right hon. Friends inherited from the previous Government a grave shortage of hospital services in the Tyneside area? May the House assume that the years of callous neglect are now over?

Well—[Laughter.]—I am delighted to accept the sentiments expressed by my hon. Friend in the first part of his supplementary question and in the second part with which he concluded his remarks.

Is the hon. Gentleman aware that a very great deal has been done in Newcastle in the past 13 years in the development of its various hospitals? Would he confirm that which he suggested in his Answer, namely, that, following some disturbing reports in Newcastle-upon-Tyne in recent days, emergency cases are received within the regional hospital board area without any delay?

Urgent cases are admitted without delay within the area. Let me make it perfectly clear—I think that the laughter of hon. Members opposite slightly changed my reply to the supplementary question of my hon. Friend the Member for Newcastle-upon-Tyne, East (Mr. Rhodes)—that anything that I may have said did not in any way cast a reflection on the regional hospital board. There have been some difficulties. A consultant in ophthalmology died, I think, in July of last year, but there has been a new appointment and we are hoping that there will be an easing of the position. As I say, there are difficulties. But there are difficulties in many regions. I hope that the House will bear with us for a bit, anyway.

Does the hon. Gentleman mean to say that if anyone laughs at him he changes his Parliamentary reply?

asked the Minister of Health why the redevelopment plans for Bromley Hospital have been deferred; when he now anticipates this work will commence; and whether he will make a statement.

This decision was made by the South East Metropolitan Regional Hospital Board in re-assessing the priorities of its building programme. I am not yet able to say when the work will start.

Is the hon. Gentleman aware that he cannot shrug off his responsiblities in that way? I recently visited Bromley Hospital and found a deep sense of frustration and despair at this delay among the surgeons and senior staff whom I saw there? Would not the hon. Gentleman agree that this cut is typical of the many cuts now being imposed in various parts of the country? Is not this a blatant betrayal of the Labour Party's election promises?

This really is nonsense, because my right hon. Friend has provided an extra £5 million for the hospital building programme. The responsibility for deciding priorities must rest with the regional hospital board. It is planned to spend about £100,000 on improvements in the Bromley area. We invest responsibility with the board, and we do not propose to depart from that policy.

My hon. Friend the Member for Bromley (Mr. Hunt) is absolutely correct. Does not the hon. Gentleman realise that the postponement since October, 1964, of 20 hospital building projects, each costing over £100,000, which were due to be started in 1965–66 has caused a very widespread sense of frustration? Can the hon. Gentleman say when the review of the hospital building programme, which is apparently delaying the building programme, is likely to be published?

There is a later Question on the latter part of the hon. Gentleman's supplementary question, but I can assure him that there would have been far greater cutting if we had not provided an extra £5 million.

Mr. Jennings.

In view of the unsatisfactory nature of the reply, I beg to give notice—

Order. I called the hon. Member for Burton (Mr. Jennings) before I was given notice.

Does the Ministry ever veto a decision of the regional hospital boards? Does the Ministry ever reverse a decision of cancellation or postponement of hospital building, as in the ease of Burton-on-Trent, for example?

We provide the money, of course. [Interruption.] If the hon. Gentleman is going to get stupid about it, the taxpayer provides the money. Of course, the Government—

On a point of order. When the Parliamentary Secretary refers to an hon. Gentleman getting stupid, I hope that he makes clear which hon. Gentleman he means.

I do not think that we will spend time on it. Let us get the Question answered.

I want to make it perfectly clear that I was not referring to the hon. Member for Burton (Mr. Jennings). The Government must have some responsibility. The regional hospital boards determine the priorities within the regional hospital board areas.

The hon. Gentleman has not answered the question. Does the Ministry ever veto a decision?

asked the Minister of Health if he will earmark for preventive medicine a percentage of the block grant made to regional hospital boards.

I think it is preferable for the responsible hospital authorities to settle their own priorities We do, of course, continue to give guidance.

Will my right hon. Friend look at this suggestion again in view of the fact that some areas are falling behind in the provision of cervical cancer screening services and other preventive procedures? Would not this be a helpful way of bringing these areas into line with more progressive hospital boards?

We are doing our best to encourage the development of this service, but I think that it would be a departure, and a very serious departure, from our normal practice if we were to give earmarked grants to hospital authorities for particular purposes. In general, I think that the campaign to develop cervical screening facilities and provide a routine service is making very good progress. If my hon. Friend has any particular region in mind where progress is not good, no doubt she will put down a Question to me.

Will my right hon. Friend give attention to the possibility of giving a lead to all three sectors of the Health Service in relation to the prevention of cervical cancer by exfoliative cytology? Is he aware that there are at present a number of initiatives being taken both by local health authorities and hospitals which certainly do not always coincide?

I am very anxious that we should have proper co-ordination here, but, undoubtedly, the first thing to do in order to get the service established is to see that we have the trained technicians and pathologists in cytology, and we are pressing ahead with that.

Is my right hon. Friend aware that, even if he has the technicians, much of their time will be wasted unless there is a streamlining of the processing of the slides which are used in these test centres? Might not this be a useful focal point for some research by his Department?

A great deal of research is going on into various ways by which a more efficient analysis of slides can be undertaken, but we are not yet satisfied that any of the short cuts, so to speak, are sufficiently reliable to deter us from going ahead with the training of technicians.

asked the Minister of Health what plans he has for further day hospitals, similar to that at Cambridge, for dealing with geriatric cases.

Fifty-six geriatric day hospitals or units are now in existence. The provision in existing programmes for additional hospitals and units will be reviewed in the course of the current review of the hospital building programme.

Is the hon. Gentleman aware that we regard the Government as being very slow in giving encouragement to this idea? Is it not an economical way of using our scarce capital resources in the best fashion, by encouraging people to stay in their own homes as long as possible, relieving the burden on the general hospital service for acute cases?

I agree that we have been slothful, possibly, in the last six months. I wonder what the hon. Gentleman thinks his colleagues were.

asked the Minister of Health what was the result of his Department's recent study of the cost of food in acute hospitals; and when he expects to receive the result of a similar study covering psychiatric hospitals.

The conclusions of the study of the cost of food in acute hospitals were conveyed to hospital authorities in letters of 14th November, 1963 and 31st December, 1964, of which I am sending copies to the hon. Member. The result of a similar study covering hospitals for mental illness will be available later this year.

Is the right hon. Gentleman satisfied that patients in psychiatric hospitals are receiving enough to eat?

I have no reason to believe the contrary, although I expect that the results of this study will show some disparity in the cost of food between acute and psychiatric hospitals because of the greater number of elderly patients in the latter whose requirements of food will be less. In addition the protein content of their meals will not necessarily be the same. There is likely to be a difference.

Does the right hon. Gentleman agree that the discrepancy between the cost of food in acute hospitals and in psychiatric hospitals is very wide? Although there are certain reasons, such as special diets which the right hon. Gentleman just mentioned, is he aware that there are many people who feel that this is perhaps not quite an adequate answer and, when he receives the report of the study, will he give it urgent attention?

Yes; the disparity is wide, but as to whether it is too wide or not, we must await the results of the study.

asked the Minister of Health how many more nurses, male and female, are now needed in the acute hospitals and in psychiatric hospitals, respectively; and what steps he is taking to obtain them.

Each employing authority determines its staffing needs, and information is not collected centrally about the additional number of staff required to meet those needs. Pay increases are under negotiation in the Nurses and Midwives Whitley Council, and I am discussing with regional hospital boards ways of improving methods of recruitment.

Can the right hon. Gentleman say what the discrepancy is? How many nurses are we short of in these two kinds of hospital? Would it not be a good thing to encourage male nurses in psychiatric hospitals at least not to retire too soon by changing the earnings rule? Now, if they retire and take part-time employment outside the Government service, their pension is not affected, but if they take other part-time employment inside the Government service it is. Would it not help to alter the earnings rule so as to encourage them to stay on after 55?

On the second part of the hon. Gentleman's supplementary question, which does not strictly arise out of this Question, the earnings rule is not peculiar to the hospital service. Perhaps the hon. Gentleman will be good enough to put a Question down if he wishes to ask about that. On the first part, the latest figures I have available, for September, 1964, show that the total number of hospital nursing and midwifery staff in all grades is the highest so far recorded.

asked the Minister of Health what is his policy on the provision of new maternity units other than those incorporated into new or existing hospitals.

Except in special circumstances, all new maternity beds will be provided at new or redeveloped general hospitals.

Will my right hon. Friend confirm that it is his policy, unlike that of the previous Government, to provide enough places so that not only women who need to have their babies in hospital but those who want to do so can do so? Will he accept that there will, therefore, have to be more maternity units in other places separately created?

It will be necessary to increase the maternity provision in the country, and a large number of schemes are in progress or planned. I remind my hon. Friend that the Cranbrook Committee recommended that general practitioner maternity beds should be within or close to consultant maternity hospitals or general hospitals with maternity departments.

asked the Minister of Health when he expects to complete his review of hospital building; and if he will make a statement.

I have asked hospital boards to send me their preliminary proposals by 1st November, 1965. I outlined the objectives of the review in the statement I made on 8th February.

Could my right hon. Friend indicate when he thinks the review is likely to be published?

I can express a hope, and that is that we may be able to publish the results of the review during the first half of 1966.

Is the right hon. Gentleman aware of the very considerable disquiet felt in all parts of this House about projects which are being postponed, and will he give a firm undertaking now that, as was promised last October, the resources available are going to be greater than they were for the hospital programme which the previous Government had in mind?

Of course, any postponement is bound to cause disappointment in some area. I really must make it clear to the right hon. Gentleman and to the House that postponements during the current year are on a substantially smaller scale than took place in any of the previous annual reviews of the regional hospital plan. I repeat what my hon. Friend said in answer to an earlier supplementary question—that if I had not provided an extra £5 million over and above what the previous Government had intended to allocate for the current financial year the number of postponements would have been substantially greater.

Can the right hon. Gentleman say whether there is to be a similar review of local authorities' health and welfare plans?

Yes, there is, and I hope to send a circular to local health authorities in the very near future.

asked the Minister of Health if he will now give the location and possible completion date for the new Salford Royal Hospital.

I am unable to add to the Answer given to my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ellis Smith) on 15th March.

asked the Minister of Health if he is satisfied that the local hospital management committee will be able fully to staff the Eccles and Patricroft Hospital with qualified midwives if and when it becomes a maternity hospital; and if he will make a statement.

I do not underestimate the difficulties, but have no reason to suppose that they would be insuperable.

While thanking my right hon. Friend for that Answer, may I say that I am rather perturbed at the delay over Salford Royal Hospital? In view of the fact that there is a difficulty of staffing the Eccles and Patricroft Hospital, may I ask my right hon. Friend to reconsider the closing of this hospital in the light of the importance of continuing its existence for general purposes? It is most vital to the area.

I must tell my hon. Friend that this decision has been reached by the regional board after a very careful consideration of all the circumstances, and the board is satisfied that this change is in the best interests of the hospital service in the area. However, if my hon. Friend likes to write to me about any misgivings he may have I shall certainly be very glad to consider them.

asked the Minister of Health if he will report on the subcommittee set up three years ago in the National Health Service to report on an incentive bonus scheme for skilled building craftsmen.

I would refer my hon. Friend to the reply I gave to the hon. Member for Down, North (Mr. Currie) on 18th May.

Is my right hon. Friend aware of the serious concern now being expressed amongst these Health Service workers, and that there is in fact a strike scheduled for 14th June amongst workers who have not taken part in that type of industrial dispute for a number of years? In view of the urgency of the situation, would he not reconsider the question of giving early consideration to their justifiable claims?

I must remind my hon. Friend that this matter has not been neglected. We are going ahead with the experimental scheme, and I am told that the experimental approach is approved by the staff side of the Whitley Council. Consideration of this matter is being carried out by a joint subcommittee of the Builders' Committee of the Ancillary Staffs Council, which it was agreed to set up in July, 1963, and which first met in October, 1963, which is a good deal less than the three years ago mentioned in this Question.

Will the Minister consider making some temporary authorisation of an increase for these workers pending the outcome of the report?

That is a matter for the appropriate Whitley Council.

Is my right hon. Friend aware that for workers on such meagre incomes to threaten industrial action is in itself a comment on the seriousness which they attach to the situation? Will he agree to bring pressure to bear on the parties concerned to speed up these negotiations as much as possible?

I can only say that I am anxious to see this experimental scheme under way, and I shall do what I can to expedite it.

My right hon. Friend says that there has not been any neglect. Is he aware that for nearly two years under the previous Government, and for six months under this Government, these men have had to work below the district rate paid to other workers doing similar jobs?

I said that the problem was not currently being neglected, or at least that is what I intended to say.

Is my right hon. Friend aware that the delay in implementing an incentive scheme is causing considerable difficulty for hospital boards in competition for labour, and that there is a tremendous shortage of this category of worker, which is creating difficulties in the general hospital service?

Yes, Sir, but perhaps I should point out to my hon. Friends that incentive bonus schemes such as are applied in industry, and even in some local authorities, are not easily introduced into the very different conditions of work in hospitals, partly because of the nature of the work, and partly because of the relatively small size of the labour force involved. But the matter is occupying our urgent attention.

Owing to the unsatisfactory nature of my right hon. Friend's reply, I beg to give notice that I shall raise this matter on the Adjournment at the earliest opportunity.

asked the Minister of Health what action he proposes to take to speed up the movement of ambulances to accidents when they are called.

My right hon. Friend is not aware of any general difficulties but if the hon. Member has any particular case in mind I shall be glad to look into it.

Is the hon. Gentleman aware that about three weeks after I tabled this Question I was involved in a motor car accident and have nothing but praise for the ambulance service which attended to me and others involved in the accident? However, what I intended to ask the hon. Gentleman when I tabled the Question was: does he not think that there is some need for co-ordination, because certain areas do not seem to operate an all-night ambulance service while others do and there are differences between parts of the country in regard to the type of support given at night, particularly in regard to road accidents?

All local health authorities are charged with the responsibility of providing as a priority adequate emergency ambulance services. There are bound to be variations between one area and another. Local health authorities are human. If any hon. Members would give me particulars of cases where there is extreme difficulty, we shall be only too glad to do something about them.

asked the Minister of Health what consultations he has had with the British Medical Association, regarding the use of personal medical cards with emergency information in case of accidents; and whether he will make a statement.

My Department, in consultation with the British Medical Association, has arranged for the trial use of personal medical record cards in 20 practices.

Dose the hon. Gentleman accept that medical cards are a help and could save life in the event of an accident? Will he do all he can to encourage the general public to carry such forms?

We believe—that is the operative term—that medical cards can be of immense value in certain circumstances. We have trials in operation at present, some in Birmingham and some in Norwich, and we are mixing them as between urban and rural districts. We hope to receive the reports in the summer, and then the medical practitioners will tell us whether the cards have real value or not.

asked the Minister of Health what further consideration has has given to the suggestion that steps be taken to publicise the dangers of foot deformities through the wearing of pointed shoes by young people; and what has been the outcome of his consultation on this matter with the Secretary of State for Education and Science.

I have nothing at present to add to my reply to my hon. Friend on 5th April.

Has the hon. Gentleman any information about the wearing of pointed shoes in the Middle Ages? Is the danger not rather a matter of wearing shoes which are too small than of a particular shape?

I should not like to get involved in a discussion about what people wore in the Middle Ages. But if the hon. Gentleman means the middle age in normal life, my advice—I have to be guided by my advice—is that most of the deformities take place through the wrong type of shoes being worn before the age of 16. There is a working party studying the problem. After it has reported we may be able to give the House much more information about the matter.

Does my hon. Friend realise in relation to what he has said that it is recognised that it is due not only to ill-fitting shoes but to badly-designed shoes? Will he in his consultation with the Secretary of State for Education and Science consider the possibility of giving chiropodists access to schools and school clinics so that younger childen can be informed about the dangers that they are laying up for themselves through wearing ill-fitting shoes?

The suggestion that we should give chiropodists access to the schools is a matter for my right hon. Friend the Secretary of State for Education and Science. My hon. Friend may be pleased to learn that the working party will include representatives from the Consumer Council, the trade research organisation and the British Medical Association. I feel sure that all aspects of the problem will be considered.

Will the hon. Member say whether this is a working party or a walking party? Would it be a good idea to include some Members of Parliament in it in view of the number of Divisions which we are having on the Finance Bill?

asked the Minister of Health whether he will give publicity to the facilities which now exist for regular routine medical examinations and their desirability in the interest of good health; and whether he will extend the facilities for mass-radiography for the early diagnosis of lung diseases, by setting up clinics for regular periodic medical examinations.

Local publicity is already given to existing facilities. I am advised that regular medical examinations are of value chiefly for selected groups of people or for specific purposes; apart from screening for cervical cancer my right hon. Friend has no plans for a general extension of such services at the present time.

Is the Minister aware that there are many patients, both of medical practitioners and of hospitals, who are suffering from chronic diseases and who could have had an alleviation or an avoidance of the disease had it been detected in its early stages? I wondered whether a scheme could be set up for more regular check-ups, perhaps on a yearly basis. Surely that would eventually reduce the number of cases as well as the expensive and long treatment.

The hon. Member ought to be very careful here. There may be a case to be made for routine examinations for specific diseases, but our medical advice is that it would possibly even be dangerous to institute a routine examination of a general kind on a systematic basis, because we should have a considerable number of people bothering about minor symptoms and thinking that they had the disease.

Is the hon. Member aware that in diabetes and certain forms of cancer there is a fear of the unknown and that early action might prevent much future suffering?

There is some doubt whether this is so. If I may use diabetes as an illustration, medical opinion is that it might be inadvisable to institute routine screening for diabetes at present until some of the causes of the disease are known.

Does the argument which the Minister is putting forward also apply to psychological screening for cancer which the Government believed absolutely right and were trying to carry forward?

It may well be that the arguments which one applies to a general issue would apply to a specific issue. The right hon. Gentleman ought to know that we are completely guided by medical opinion in this respect. If he were in the same position as we are, he would have to do the same; he would have to be guided by medical opinion—as we are being guided by it.

Is it not a fact that medical opinion on the other side of the Atlantic is very much in favour of a general check-up at stated periods? Will not the Minister also take that into consideration.

I do not know why the hon. and learned Gentleman is so self-righteous. We are taking into account not only medical opinion on this side of the Atlantic but medical opinion on the other side of the Atlantic, too.

asked the Minister of Health, in view of the need to end the present uncertainty in the dental profession and among members of the public generally about the abolition of dental charges, if he will state whether he intends to introduce legislation on the subject next Session.

I cannot say when I shall be able to introduce legislation, and I hope no patient will relay seeking dental treatment which he needs.

Is my right hon. Friend aware that many patients are putting off treatment which they ought to have now and that many dentists, and particularly dental mechanics, find that they are not as busy as they ought to be because of this? Would he bear in mind that many old-age pensioners who do not apply for National Assistance, or may not qualify for it, find the £5 charge a very heavy charge to bear? Would he consider bringing in legislation to meet this particular circumstance?

The latter complaint comes a little ill from the Conservative side of the House. My information does not confirm what the hon. Member says. The latest figures show that the number of courses of treatment given by dentists continues to rise.

While not accepting that is necessary to abolish these charges, may I ask the Minister why the Government think it wrong to have prescription charges and right to have dental charges?

I do not think that that conclusion can be drawn from the Government's actions so far.

asked the Minister of Health (1) what action he is considering as a result of the report on cheap drugs written by Mr. F. G. Stock, the City Analyst of Birmingham, a copy of which has been sent to him; and

asked the Minister of Health, in view of public concern about the danger from sub-standard imported drugs, as revealed by the recent report of the City of Birmingham Analytical Laboratories, a copy of which has been sent to him, what action he proposes to take to establish an adequate system of control.

asked the Minister of Health if, while awaiting the findings of the inquiry into the drug industry, he will introduce regulations governing the manufacture, testing and sale of drugs.

asked the Minister of Health if, in view of the reports of the City Analyst of Birmingham and the subsequent report in the medical press of increased toxic reactions with foreign-manufactured antibiotics, he will now take steps to supervise the activities of small mushroom firms attempting to take advantage of Sections 41 and 46 of the Patents Act, 1949, and lacking the facilities or pharmaceutical experience of established companies.

In the course of the current review of medicines legislation I am considering what measures are necessary to secure that checks on the safety, quality and efficacy of drugs used in this country meet present-day requirements.

Is my right hon. Friend aware that that reply will give a great deal of satisfaction? Will he bear two other points in mind? First, will he not agree that Mr. Stock, the Birmingham City Analyst, of whom we are all proud in Birmingham, in his analysis of tetracycline paediatric drops performed a national service? Will he accept that although many people see the need for importing cheap foreign drugs, they are extremely concerned that the tests on such drugs should be thorough and exacting?

We are grateful for the discovery which Mr. Stock made. Certificates of analysis in respect of drugs imported by my Department under Section 46(1) are supplied by the overseas manufacturer for each batch of drugs imported for hospital use. We are aware that the present legislation is not sufficient on this matter because, except for a limited range of substances such as sera-vaccines and injectible antibiotics, the law as it stands provides no direct means of requiring manufacturers to incorporate adequate quality controls in the process of production.

Can my right hon. Friend give any indication whether it will be possible to bring forward his comprehensive legislation to an early date in view of the great need for adequate quality in both home and imported drugs? In the meantime, is there any means by which he could insist on the quality control procedures of manufacturers and importers being published and being made available?

I think that in the interim we probably must rely on the powers which the food and drugs authorities already have, limited though they are. I am anxious that there should be no avoidable delay in introducing this legislation, but my hon. Friend knows that it is not for me to decide the time of the introduction of the Bill.

Would not my right hon. Friend agree that there is indiscriminate distribution of inadequately tested drugs by unscrupulous firms which are acting from a profit motive? Would not it be possible, while this is going on, to institute a Government testing and licensing agency straight away, because the public is in some danger from these drugs?

I assure my hon. Friend that the quantity of what are called cheap drugs imported from foreign sources by importers for profit is a very small proportion of the total consumption of drugs in this country. I am not satisfied that a central testing unit is necessarily the most effective provision, but, even so, I do not think that we could implement this or the other suggestion of my hon. Friend without legislation.

Would the right hon. Gentleman mention to his right hon. Friends that legislation on this subject is likely to be more acceptable to the Opposition than some of the other proposals that they have in mind?

Will the right hon. Gentleman take note that, important as this question of drug testing is, it is only one aspect of the necessary reforms in medicines legislation? Would he also take note that I am sure that hon. Members on both sides feel that there is a degree of urgency about the need for reform? Could he urge his colleagues to bring forward comprehensive legislation on this matter as soon as possible?

I have already assured the House that I want to bring it forward as soon as I can. We have not quite finished the necessary consultations, but certainly the Measure will be ready for presentation before very long. The hon. Gentleman need have no doubt that it will be a thoroughly comprehensive Bill when it is introduced.

asked the Minister of Health whether he will introduce the necessary amending legislation to relieve students who reach the age of 21 from paying dental charges when they are receiving full-time education or when they are dependent on grants.

No, Sir.

Whereas the difference between earning and non-earning might be a valid distinction in this respect, can the hon. Gentleman explain the validity of the distinction between 20 years and 21 years?

A question is bound to be raised wherever one puts the line. If one took 22 or 23, the same question could be asked: what is the difference between 22 and 23?

One.

I was attempting to deal with the question seriously, because the hon. Gentleman asked me what was the difference between 20 and 21. We appreciate that there are bound to be anomalies in this sort of matter where-ever one fixes the age.

The distinction I am inviting the hon. Gentleman to draw is as between a person who is earning and one who is not earning, in which case whether the age be 21, 22 or 23 is entirely irrelevant.

I should be entirely out of order if I answered that supplementary question on the basis of this Question. If the hon. Gentleman wishes to invite me to make observations of that kind, perhaps he will put a Question down.

asked the Minister of Health (1) if he will introduce legislation to implement Recommendation No. 8 of the committee of inquiry into the Aberdeen typhoid outbreak;

My right hon. Friend has this matter under consideration.

May I ask whether the hon. Gentleman is aware of the great urgency in this matter, since the experience of Aberdeen, that a small minority of people refused to be examined, was repeated in Smethwick recently, and should there be an outbreak this would be a weakness in dealing with it by medical officers of health?

As I said, my right hon. Friend has this matter under review. The comments of interested bodies have been sought in relation to the Milne Recommendation No. 8, and we are reexamining the question of the Public Health Acts as well as the Food and Drugs Acts. I think the hon. Member can take it that—without my being associated in any way with his colour prejudices—

Withdraw.

On a point of order. Is it in order for the hon. Gentleman to make a quite gratuitous comment like that in answering a Question on the Order Paper?

I am in this difficulty. I did not, strangely enough, hear what the hon. Member said. Would he be good enough to repeat it?

I said, "without being associated in any way with the hon. Gentleman's colour prejudices".

Shocking.

That is a quite irregular use of an Answer, and that part of the phrase must be instantly withdrawn.

Mr. Speaker, I withdraw it immediately.

asked the Minister of Health what percentage of the sale of dental drills supplied to hospitals and the dental profession is imported from the United States of America and Europe, respectively.

In 1964–65, of the expenditure on dental drill units provided for the hospital service, in England and Wales the proportions imported from the United States of America and Europe were less than 1 per cent., and approximately 35 per cent., respectively. General dental practitioners provide their own equipment, and we do not know how much of it is imported.

Is the Parliamentary Secretary aware that a fair amount of money is being spent on the importation from America of a drill which is available in the same type in this country? Would it not be better to save dollars?

On the percentage figures I think the total expenditure is not particularly great, but if the hon. Gentleman would care to let me have details I should be glad to have a look at them.

asked the Minister of Health what proposals he has for increasing the resources available for hospitals and local health services in the South-West, in view of the large number of old people who live in this region.

I will consider whether any modification in the allocation of resources between hospital boards is necessary when I have the results of the current review in which I have asked boards to ensure that not only a due, but an early share of what is available should be devoted to the geriatric services. The resources allocated to local health services are for each local health authority to determine.

I am obliged to the right hon. Gentleman for that information, but will the Minister bear in mind that the recent report on the economy of the South-West has made it quite clear that the proportion of old people in the population in that region is much greater than such proportion is in any other region, and that that proportion is almost certain to grow?

Yes, but I should tell the hon. Gentleman that the regional board has got many schemes either in hand or planned for additional geriatric accommodation, and I recently announced that a new 60-bed geriatric unit would be started at Manor Park, Bristol, at the end of this year. Perhaps I could add that the capital allocations for this region in the two previous years were £2·4 million, and £3·4 million, and this year we have been able to increase them to £4 million.

Is the right hon. Gentleman aware that there is still a shortage of geriatric beds in Cornwall in particular, and that if his previous answer, when he said he was going to review the kind of beds for old, retired people, means anything, Cornwall should come in for a considerably higher proportion of grant?

I have no doubt that that consideration will be taken into account by the board, and by my Department when it gets the board's revised plans.

How soon?

Will the right hon. Gentleman bear in mind that this is a very real problem? We like to welcome people who come to retire in glorious Devon, but it does create a problem. Could he look into the idea of taking over some of the older houses and converting them into hospital units?

It really is not for me to take those decisions. It is for the regional board, with the allocation provided for it, to do the best it can according to the priorities which it thinks are right.

asked the Paymaster-General if he will publish in HANSARD the reply he sent to the hon. Member for Bournemouth, West (Sir J. Eden) about the regular publications sponsored by the Government Information Service.

I wrote to the hon. Member for Bournemouth, West on 20th May and I am circulating the letter in the OFFICIAL REPORT. I am also sending the hon. Member a copy of the Stationery Office catalogue, "Government Publications", which is issued monthly and annually and which contains particulars of those publications published by the Stationery Office.

I thank my right hon. Friend for that Answer, which shows that he was not attempting to evade the issue, as was suggested last week. Will he give an indication of how much it has cost to provide or collect the information, which could have been easily obtained more cheaply through other channels?

I am much obliged to my hon. Friend for giving notice to my office this morning that he intended to ask that supplementary question. I have tried to get information on the point. It is difficult to make precise calculations, but it may be taken from a sample that the cost amounted to several hundreds of pounds.

In view of this heavy burden, can the right hon. Gentleman assure us that he has enough staff in his Department for the discharge of his multifarious responsibilities?

I shall never have enough staff to answer all the silly questions I am asked.