asked the Minister of Health if he will state the number of deaths which have been caused by leukaemia in each of the last five years; and to what causes the increase in the incidence of this disease since the end of the Second World War are attributed.

For the years 1960 to 1964 respectively 2,694, 2,645, 2,707, 2,830 and—provisionally—2,867. The incidence of the disease has been increasing since before the Second World War. The reasons are not fully known but improved diagnosis and the rising number of old people—who are particularly prone to the disease—are contributory factors.

Does any information exist to disprove the contention that the increased incidence of this disease is connected with the increased incidence of radiation throughout the world as a result of nuclear weapon testing? If that is so, will my right hon. Friend give as much publicity as possible to any information on this in order to make everybody aware of the price in human suffering and death of possessing nuclear weapons?

It is known that heavy doses of radiation can cause leukaemia, but there is no evidence to show that the very slight increase in radiation received in this country from nuclear fall-out has been a contributory factor. Indeed, there is some evidence to show that it is not.

In view of the figures and of what the right hon. Gentleman said about the increasing incidence, may I ask whether he can assure us that the amount spent and the range of research in the last few years have similarly expanded?

I think that there is no shortage of resources for research of this kind. Research is going on under the auspices not only of the Medical Research Council but also of voluntary organisations like the British Empire Cancer Campaign, the Imperial Cancer Research Fund and the Leukaemia Research Fund.

asked the Minister of Health if he is satisfied that the regulations which prohibit the conveyance of foodstuffs alongside dangerous chemicals are sufficient to prevent any danger to public health; and if he will make a statement.

My right hon. Friend is satisfied that the Food Hygiene (General) Regulations, 1960, require sufficient precautions to be taken to prevent contamination of the food.

Is my hon. Friend aware of the case in my constituency earlier this year in which a large number of people were affected as a result of flour being contaminated by dangerous chemicals during transit? In view of that case, may I ask my hon. Friend to have another look at the situation, since I understand that no adequate Act or regulations exist to govern the transfer of dangerous chemicals of this sort which are not prescribed poisons?

We are responsible for the regulations governing the carrying of food and are satisfied that they are adequate for most cases. I think that my hon. Friend will agree that there is always danger of an isolated occurrence similar to that which took place at Epping and that, no matter what regulations might be framed, they could not eliminate entirely the possibility of such occurrences.

Will the Parliamentary Secretary show a little more urgency about this matter and get down to it instead of just waffling?

I do not know about waffling. We believe that the regulations are adequate and, indeed, if one bears in mind the total amount of food transshipped all over the country as compared with the number of occurrences of this sort, one can only assume that they are adequate. As for waffling, perhaps I can have notice of that question.

asked the Minister of Health what evidence he has about the rate of cervical cancer in Jewish women compared with other women; and what are the reasons for the disparity.

National statistics do not distinguish between religions. Various studies have shown that Jewish women have a markedly lower incidence rate than others but the reasons are not yet established.

Will the right hon. Gentleman seek further into this matter and see what Professor Ross of Newcastle has to say about it? If he is correct in his assumptions, and they are no more than assumptions, is it not important that the information available from them should be made known to the public?

There is no conclusive evidence available at the moment but there are indications that male circumcision may be a factor in the lower incidence rate among Jewish women, and there is also the fact that the death rate from cancer of the uterine cervix in Israel in 1961 was only 1 per 100,000 compared with 10½ per 100,000 in England and Wales.

Will the right hon. Gentleman publicise this? The disease is so lethal that anything we can do to reduce its incidence and save life should be urgently pursued.

No doubt the Question and Answer will get publicity, but I want to be certain that this is the cause before making any definite statement on the subject.

asked the Minister of Health how many complaints against medical practitioners and dentists, respectively, were received in the year 1963; and in what percentage of cases it was determined that there were valid grounds for complaint.

I would refer the hon. Member to Table 28 of my Department's Annual Report for 1963.

Would my right hon. Friend give some thought to the present method of making complaints against the general practitioner? Would not he think it is fair that the person who makes a complaint should be invited to meet the local executive committee as well as the doctor?

I think that this is very frequently done. But in any case the disciplinary machinery in the general practitioner service is one of the matters which I shall be discussing with representatives of the profession.

Would my right hon. Friend take the opportunity of the present discussions with the general practitioners to look at this question? Is he aware that there is a quite disproportionate anxiety among general practitioners about this procedure and that it would be most useful if, during the present negotiations, he could reach a settlement more satisfactory to them?

This is what I shall endeavour to do.

asked the Minister of Health what study has been made by his Department of a compound, whose chief ingredient is a plentiful mineral zirconium, developed by dental research laboratories in the United States of America, which could eliminate dental decay within a decade; and if he will consider the use of this new compound in future, instead of adding fluoride to the water supply.

Inquiries have shown that work on this and similar compounds in America is only in a preliminary stage. I know of no scientific evidence to suggest that they are an alternative to fluoridation.

While realising the need to prevent dental decay, may I ask my right hon. Friend to recognise that there are widespread objections to the addition of fluoride to the public water supply? Will he or his Department consider this and other possible alternatives to meet this growing problem?

This report on the development of the compound referred to by my hon. Friend the Member for Birmingham, Yardley (Mr. Joan L. Evans), appeared only in an article in a popular magazine. So far as I know, there have been no reports whatever in scientific journals. I am completely convinced of the desirability, on health grounds, of fluoridation, and also of its safety. I hope shortly to be giving further guidance to local authorities on this matter.

Does the Minister realise that a great deal of opposition to fluoridation is being stirred up by an organisation of cranks known as the National Pure Water Association? Does he realise that there are some hon. Members on both sides of this House who are so gullible as to be taken in by the unscientific propaganda of this organisation, and will he takes steps to educate hon. Members on the complete safety of fluoridation?

I shall certainly do my best. The hon. Gentleman probably knows that the campaign for fluoridation has been somewhat handicapped for the last two years, because of an action against Watford Corporation brought, I believe, on behalf of the association to which he referred. This action has now been terminated and we can go ahead.

asked the Minister of Health whether he is satisfied that the standards of health and welfare service administered by the Great Yarmouth local authority are comparable to those administered by the local authorities responsible for other county boroughs; and if he will make a statement.

There are so many differences in the problems which confront different local authorities, and so many different aspects of the health and welfare services, that I do not consider it profitable to attempt general comparisons of this sort.

I was just preparing myself to thank the Minister for giving me a kind answer. After that, of course, it is impossible. Would he at least say, in the most general terms, that as far as his Department is concerned, and as far as his Department knows, these services run by the local authority are reasonably satisfactory?

As far as we know, they are reasonably satisfactory.

Can the hon. Gentleman tell us what are his plans, and by what methods he hopes to raise the standards of the less good authorities up to the standards of the best?

The only way we can do that, and it is the way we are doing it, is by asking them to revise their programme. When the replies come in we shall ascertain, as far as we possibly can, whether they are going to be comparable or not.

asked the Minister of Health how many old people have been rehoused since 1950, and how many are being cared for in hostels under the Great Yarmouth local authority; and what are the comparable figures for the Norfolk County Council area of administration.

The numbers of old people rehoused are not recorded, but between 1st January, 1950, and 31st March, 1965, 676 one-bedroom flats and bungalows suitable for old people were built by Great Yarmouth County Borough Council, and 2,715 by borough and district councils in the county of Norfolk. On 31st December, 1964, 174 elderly people were in residential accommodation in the care of Great Yarmouth County Borough Council, and 845 in the care of Norfolk County Council.

I am grateful to the Minister for that reply, which, a hope he will agree with me, shows that Yarmouth is doing pretty well in view of the differentials in the population figures.

Yes. If one takes the percentage related to the figures I have given, it is quite clear that the percentage for Great Yarmouth of elderly persons in special warden service, housing and residential homes is higher than it is in Norfolk.

asked the Minister of Health on how many occasions and what amount of public money has been expended on purchasing drugs produced by Messrs Biorex, DDDSA Pharmaceuticals, or Inter-Continental Pharmaceuticals Limited.

In the last two years, two central contracts were placed with one of these firms and 39 contracts were placed with one or other of them by hospital authorities. The total value of all these contracts was approximately £300,000. Information is not available about sales of the firms' products to the pharmaceutical service.

Is the Minister aware that these companies, these mushroom companies, have grown up as a result of the breaching of the Patent Act, Sections 41 and 46, and that one of these companies sold a life-saving drug for children which was 30 per cent. below strength? Will he not be deflected in his efforts by the business interests of two of his hon. Friends, the Member for Stoke-on-Trent, Central (Sir B. Stross) and for Leek (Mr. Harold Davies)?

Order. I do not understand what that is meant to mean. That part of the question had better be withdrawn.

With respect, Mr. Speaker, the hon. Gentlemen mentioned were directors of one of these companies and I wanted to make that point clear.

The implication, prima facie, underlying the hon. Gentleman's words is that they were exercising themselves as directors improperly to influence the Minister in his duties. The hon. Gentleman must make it quite plain that he is making no such allegation whatsoever.

I make no such allegation.

In view of the hon. Member's supplementary question, I hope that the House can assume, since he has declared no interest, that he himself has not had an association or has no association with the pharmaceutical industry? Perhaps I can tell him, in order to put it on the record, that my hon. Friend the Member for Stoke-on-Trent, Central (Sir B. Stross) resigned his directorship of Messrs. Biorex on becoming a Minister. My other hon. Friend referred to resigned his directorship in April, 1959.

With regard to one of the firms, Biorex, is it not a fact that this firm has spent a lot of money in valuable research and that it has carried out a considerable amount of price cutting on drugs to the benefit of the public as a whole? Is it not unfortunate that the hon. Gentleman the Member for Birmingham, Perry Barr (Dr. Wyndham Davies), who I believe shares the hostility of the Association of British Pharmaceutical Industry to this firm, because it is not a member of that association, is himself retained as one of their advisers, and is the senior medical adviser of Nicholas Laboratories, Ltd., which is one of the main competitors of Biorex?

Disgraceful.

Order. It is of the greatest importance in the interests of the House that there should be complete cesser of this implication that hon. Members on one side of the House or the other are activated by wrong motives. It must be so in the interests of the House. I do not think that it is for the Minister to express a view on the question put to him, which was whether such and such a matter was unfortunate. That asks him to express an opinion on a matter for which he is not responsible.

On a point of order. Would it not have been appropriate for the hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies) to have declared an interest if the statement was correct before asking the supplementary question?

I am not to say what is appropriate or not. But the practice of the House does not require an hon. Member to declare an interest on asking a question. The rule does not apply to that.

On a point of order. I am not retained by the Association of British Pharmaceutical Industry and I am not associated with the pharmaceutical industry, otherwise I should have withdrawn.

Withdraw.

Order. That does not raise a point of order. It is a correction of a point of fact made by an hon. Member who takes responsibility for the fact stated in his question. But all this is far from our business.

On a point of order. The hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies) has given certain information to the House. I note that there is no withdrawal or suggestion that I was in any way inaccurate in one of the suggestions made. With regard to the second—

Order. The hon. Member must be careful not to repeat by implication what I have indicated I regard was an undesirable practice.

On a point of order. In view of the Ruling which you have just given, Mr. Speaker, in regard to the hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies), do you recollect that language of a stupid and silly nature was used by the hon. Member for Orpington (Mr. Lubbock) in respect of a number of perfectly good people who hold contrary views to the remnant of a great party?

One might attract the accusation "stupid" if one thought that that point of order arose on this Question.

You asked the hon. Member for Birmingham, Perry Barr (Dr. Wyndham Davies) to withdraw, Mr. Speaker, and he did. Another allegation which you thought was improper was made by the hon. Member for Devon, North (Mr. Thorpe). Would it not be advisable if he withdrew it?

It is so far back that I have forgotten what it was. I do not propose to pursue the matter further. I want the House to get on.

Perhaps I could answer the first half of the supplementary question of the hon. Member for Devon, North (Mr. Thorpe). According to my information, it is quite correct that Messrs. Biorex have manufacturing capacity and some research facilities in this country, whereas the other two firms mentioned in the Question rely entirely on imports from abroad.

asked the Minister of Health what proposals he now has for securing a more uniform ambulance service in terms of hours of availability, manning and stand by.

None, Sir. I am satisfied that local health authorities make ambulance transport available in accordance with local needs. If the hon. Member has any individual case of difficulty in mind, I shall be glad to look into it.

Does not the Minister agree that there are variations in the ambulance service between one area and another and that there is need for co-ordination so that the public may know that, wherever they are, they can get a service equal to the best that should be available?

Yes, but needs vary. In the more urban areas, ambulance stations are manned for the whole 24 hours on a shift system, but in rural areas stations are manned for varying times in relation to the demand experienced in the area. In many of them, staff are on stand-by duty at their homes at night.

In view of my right hon. Friend's Answer, may I ask him to consider setting up an inquiry into the possibility of establishing a national ambulance service, which is vitally necessary because of the difference in service that certain areas give to patients?

I have told the House that I am considering the arguments for and against that proposal.

Is the Minister aware that there is a great deal of dissatisfaction among the staff of the ambulance service in Greater London? What steps is he taking to ensure that their complaints against the conditions of service are sorted out?

If the hon. Member wants to ask a Question about the particular problems of London, I shall be glad if he will put it on the Order Paper.

asked the Minister of Health whether, before briefing the British delegation to the World Health Organisation Assembly, he sought the opinion of all sections of the medical profession through such bodies as the British Medical Association, the Royal Colleges of Surgeons, the Royal Society, the universities or the Advisory Committee on Medical Research in Scotland, with regard to the desirability of setting up a World Health Centre in Scotland, Great Britain or elsewhere.

The Medical Research Council and the Council for Scientific Policy were consulted on the scientific merits of this proposal and the delegation was instructed in accordance with their advice.

Is the Minister aware that many distinguished medical men were in favour of setting up such a centre in Scotland? Was the Secretary of State for Scotland consulted about this matter?

Certainly, the Secretary of State for Scotland was consulted. I should, however, tell the hon. Member that since the proposal for a World Health research laboratory was opposed at Geneva by a large majority of the Assembly, the question of its location does not arise.

asked the Minister of Health how many prescriptions were issued under the National Health Service in England and Wales for the six months before the abolition of prescription charges and for the six months after, respectively.

asked the Minister of Health what evidence he has received respecting increases in prescriptions following the abolition of prescription charges.

asked the Minister of Health if he will state the number of medical prescriptions issued in February, March, April and May of this year, and the numbers issued in 1964 for the same months.

As the Answer contains a number of figures, I will, with permission, circulate them in the Official Report in tables showing the numbers of prescriptions dispensed by chemists in England and Wales during the three months February to April, 1965—the only months for which figures are available since the abolition of charges—and the numbers dispensed during the corresponding months of 1964 and during the six months before the abolition of charges.

Is the right hon. Gentleman aware that certain figures which he gave earlier this year showed a very marked increase in the number of prescriptions over the period, and is he satisfied that this increase is not due to abuse of the service by certain patients?

If the hon. and learned Gentleman is talking of abuses of the service, I wonder why he says "by certain patients" since it is the doctors who sign prescriptions and not the patients, but I would tell him that the increase has varied very considerably from area to area and from month to month, and it is far too early to draw any final conclusions about it.

Is my right hon. Friend aware that the contacts which I have made both with doctors and other people in my constituency confirm the fact that doctors are not prescribing to any degree greater than they prescribed before, when there were charges, and that for old people in this country, certainly in my constituency, the abolition of charges is as good as an increase of 5s. or 6s. a week in their pensions?

I am sure that this abolition is very much appreciated, particularly by old people, but in reply to my hon. Friend I would say that there is some indication that doctors are tending to prescribe smaller quantities, which reduces the average cost per prescription, but may increase the total number if more repeats of prescriptions are necessary.

Is my right hon. Friend aware that an Answer to me last week dealing specifically with the Scottish figures and items of service rendered by general practitioners over these four months compared with the corresponding months last year showed a very significant rise? Does the same apply to England? If it is the case that there has been a considerable rise, will that fact be kept in the forefront in all the consultations which are now going on with the general practitioners?

Certainly general practitioners lose no opportunity of telling me about their workload, but I would not necessarily accept the contention that the number of prescriptions and the increase in these necessarily means an equivalent increase in the number of items of service which a doctor gives.

Is it not very likely that the drug bill will show a very considerable increase by the end of this year; and, looking back, would it not have been very much wiser if the right hon. Gentleman had found improved methods to relieve the needy rather than subsidise people who are well able to pay?

I have already told the right hon. Gentleman and the House that it is too early to draw any final conclusions about the effects of this action. I would certainly remind him that his Government apparently tried for 13 years to find better ways of relieving the needy and signally failed to do so.

Is my right hon. Friend aware of the fact that Her Majesty's Opposition have always been opposed to a free National Health Service and that that is why they are squealing now?

asked the Minister of Health what estimate he has made of the shortage of doctors in the northern region; what action he proposes to initiate in order to improve the present position; and if he will make a statement.

A precise estimate is impracticable. The numbers of doctors is being increased generally by expanding the intake to medical schools. I am also seeking to facilitate better use of existing medical manpower.

Would my right hon. Friend agree that in view of the new impetus which is being given to economic development in the northern region it is more or less essential that there should be very early establishment of a medical school based on Durham University to resolve the existing problem of the shortage of doctors in the northern region?

I take note of what my hon. Friend says about Durham, but perhaps I should let him know that the ratio of general practitioners to population in the northern region is really not very much greater than what it is in the country as a whole. It requires only 26 additional general practitioners to bring the average list down to the national average.

Is the right hon. Gentleman aware that the Chancellor of the Duchy in November promised he was going to make a statement about this shortage and methods of relieving it. We have now waited for eight months. May we be assured that we are going to get this statement during this Parliament?

I do not know whether the right hon. Gentleman is referring to the number of doctors in particular, but certainly there will be a statement about this before long. I cannot say when. It will, of course, be made not by me but my right hon. Friend the Secretary of State for Education and Science.

Is the Minister aware that the Parliamentary Secretary referred only a little earlier to one new medical school which has been established? Is he aware that the decision in regard to that was taken by the late Government? May I ask the right hon. Gentleman, therefore, to address his mind to the question whether in present circumstances something in the nature of a crash programme is not required?

I can assure the hon. Gentleman that we are very well aware of the need for doctors, but I would point out that the intake into all our medical schools has increased by 25 per cent. over about the last five years.

asked the Minister of Health in view of the centralisation of the traumatic service in the Glantawe Hospital Board area at Morriston Hospital, Swansea, what is the number of senior consultant anaesthetists permanently based there; and if he will make a statement.

There are two consultant anaesthetists based at Morriston Hospital and, in addition, three consultants based in the Glantawe Hospital Management Committee area hold regular weekly sessions there. The Welsh Hospital Board is at present considering the relative priorities of the need for additional consultant anaesthetists in Wales.

Does my hon. Friend consider that the number of three senior consultant anaesthetists is sufficient for all eventualities? Is he aware that, in view of the centralisation of the traumatic service at Morriston Hospital, it means that 700 cases are handled there a year, and does he not think that there should be an increase in the level of consultants to lighten the load on the staff?

The Welsh Hospital Board is reviewing the medical staff and considering the appointment of additional consultants at Glantawe Hospital, but I ought to tell my hon. Friend that Glantawe is not regarded as one of the areas in which there is an extreme shortage of consultants, and in practice it compares favourably with other parts of Wales.

asked the Minister of Health if he will give details of the countries with which the United Kingdom has reciprocal arrangements in health matters; and with which other countries this country is endeavouring to get reciprocal agreements.

The social security reciprocal agreements with Belgium, Denmark, the Federal Republic of Germany, France, Italy, Luxembourg, the Netherlands, Norway, Sweden, Switzerland and Yugoslavia include provisions for medical treatment for British residents on certain conditions; Denmark, Norway, Sweden and Yugoslavia also provide treatment for British short-term visitors. The New Zealand health services are available to all British people and there are arrangements with the Isle of Man and the Channel Islands—excluding Sark—for visitors. There are also limited agreements with Australia, Israel and Malta. No new agreements are at present under negotiation.

In thanking my hon. Friend for that reply, may I ask him whether, in view of the small number of progressive countries supplying reciprocal health services, he will consider special arrangements for holidaymakers, particularly in the United States, where a constituent of mine has just had to pay over £900 for medical treatment while on holiday? This sort of thing causes a great deal of hardship, and I wonder whether some plan can be considered.

There are difficulties when people from this country travel abroad in countries where there are no reciprocal agreements. My Department issues circulars to try to guide people, and, indeed, to advise them that it is necessary in many instances to take out insurance against any contingency. It is very difficult to arrive at reciprocal agreements with many countries because they have not got health services comparable with ours, and it would be very difficult for a Government to provide for British subjects a health service which is better than that which they provide for their own people.

Will the hon. Gentleman bear in mind that at 12 o'clock today the B.B.C. issued an entirely misleading and inaccurate statement on this very subject? Will he ensure that the B.B.C. gives proper publicity to the comprehensive statement which he has just made?

I cannot be responsible for the B.B.C.'s publications, but I hope that it will take note of the statement that was made today and give it the necessary publicity.

In view of the dollar shortage, would not it be extremely valuable if the Minister took account of his hon. Friend's remark and charged American visitors to this country, to help our own doctors to stay in this country?

We give a good Samaritan service to any visitor to this country, and I hope that we shall continue to do so, irrespective of which side is in Government. It would be very difficult to turn down people who needed emergency treatment. We take precautions against any person trying to come to this country for the purpose of abusing the Health Service.

asked the Minister of Health if he will institute an inquiry into the way in which appointments were recently made with regard to the post of consultant dermatologist at the United Liverpool Hospitals; and whether he will empower the inquiry to take written evidence from the prominent doctors in Liverpool who have indicated their willingness to submit such evidence.

No, Sir. I am satisfied that a valid appointment was made and that my intervention would not be justifiable.

Would not my right hon. Friend agree that the fact that in a letter to me he said that the regulations should be considered in itself indicates that this is a serious matter? Is he aware that there are many leading medical people in Liverpool who consider that there has been a conspiracy which has militated against Dr. Readett? Is he further aware that I have at least 12 names of eminent Liverpool medical people who are quite willing to give evidence to such an inquiry?

As my hon. Friend knows, I have gone very carefully into this case. It is a fact that in constituting the Advisory Appointments Committee two nominating bodies nominated the same person, which resulted in a committee of nine instead of ten, but this did not in any way invalidate the advice given to the board, and it is the board that makes the appointment. As to the second part of my hon. Friend's supplementary question, I have had representations on behalf of Dr. Readett from one Liverpool doctor and if there are others who wish to write to me I shall take anything that they say into account.

asked the Minister of Health why a decision was made to close the casualty department at Stanley Hospital before the completion of the new accident unit at Walton Hospital.

Closure as originally planned would have followed the expected date of completion of the new accident unit at Walton. The latter has been delayed, and knowledge of the intended closure of the Stanley made it impossible to maintain staff complements at a level which would have enabled this closure to be correspondingly delayed. I have now agreed to the use of the Stanley by the regional hospital board until 30th June, 1968, to help in the reorganisation and improvement of services which they provide.

Is my right hon. Friend aware that that Answer will give great satisfaction in the area?

Can my right hon. Friend say when the new accident unit at Walton Hospital will be ready?

According to my present information it is not expected to be ready before April, 1966.

asked the Minister of Health whether the date has been fixed for the commencement of building of the new general hospital at Barnstaple.

We expect to start the first phase next month.

Will the Minister bear in mind that, although this news is welcome, delay in hospital building has now spread to the Exeter Hospital as well, causing concern in the South-West? Does he not agree that this makes rather a mockery of the Socialist election manifesto which says that the National Health Service

"… has been starved of resources"

"bogged down for lack of funds"?

The Question relates to Barnstaple, not Exeter, but the hon. Member knows perfectly well that £5 million more is being devoted this year to hospital building than his own party planned when it was in Government. The hon. Member also knows that the hospital plan is now under review and perhaps he will reserve his general comments on the matter until that review is published.

Since this is the third occasion on which the hon. Member for Torrington (Mr. Peter Mills) has been kind enough to raise matters of hospital building in my constituency without my prior notice, may I say that I am delighted that the Conservative Party has now realised the urgency of stepping up the hospital building programme in the area? Is not it a fact that the starting date next month is already scheduled and that what we are waiting for now is the second phase which the previous Administration postponed for three years? Can the right hon. Gentleman say when the review of the priorities will be available?

It is the second phase that is being reviewed in the current programme. I shall not be able to give the hon. Member a firm answer on that subject until we have the review completed in the first half of next year.

asked the Minister of Health how many patients are on the waiting list for the Urological Unit at the Newcastle General Hospital; how many were on the waiting lists in July, 1964 and 1963; and what steps are to be taken to improve the situation.

asked the Minister of Health when he received proposals from the Newcastle Regional Hospital Board to improve the urological service; to what extent they take account of a waiting list in excess of 1,000 and an average waiting time of two to three years before admission as in-patients; and what other action has been taken to decrease the number of patients awaiting admission.

I apologise for the length of the reply.

May I thank my right hon. Friend for that helpful reply? Is he aware, however, that kidney sufferers in my constituency are having to wait on an average two to three years before admission as in-patients to this unit? Has not this situation largely arisen through the neglect of the development of hospital services in this region during the last decade?

I know that the board is well aware of the need for improvement in the urological services of the region and its conclusions about the requirements are expected shortly in my Department. It is true that during the last decade this region was perhaps allowed to lag behind the national average, at any rate in some respects.

Is my right hon. Friend aware of the representations which I made to the previous Government on this matter as well as a Question which I put to the Parliamentary Secretary early in the period of office of the present Government? Is he also aware that now the waiting lists are soaring and that if the statement made by the regional secretary is true, there is no immediate possibility of alleviating the present situation? Can my right hon. Friend put some urgency into getting a long-term solution of this very pressing problem?

I have indicated the long-term solution. As for the short term, I hope very much that a number of these patients on the waiting list will be dealt with in general surgical departments. This is something which has happened in the past. It is nothing new.

asked the Minister of Health whether he is aware of the increasing use made of admissions under Section 29 of the Mental Health Act, 1959, as a proportion of compulsory admissions; and if he will take steps to ensure more use of Section 25 with its greater safeguards.

I am aware that Section 29 is widely used; a study is being undertaken in my Department and I shall decide in the light of its findings whether further guidance to hospital authorities is called for.

Is the Minister aware that to say that Section 29 is widely used is not to give a complete picture? Is he aware that it is becoming increasingly more widely used and that this is a Section which was intended for use in emergency only and, in the light of protecting the rights of the citizen, should be used only in those circumstances?

It is a fact that the admission figures for 1964 show 20,494 Section 29 admissions against 9,810 Section 25 admissions, but to keep the matter in perspective I should add that it was estimated at the end of 1964 that over 90 per cent. of patients in psychiatric beds were receiving treatment informally and only 1 per cent. under Sections 25 and 29.

asked the Minister of Health what his estimate was of the shortage of hospital beds in the Tyneside area in October, 1964; and what his plans are for improving the present position.

The main deficiencies are in the provision for geriatrics and obstetrics. These are not measurable solely in terms of beds, since the need is for new buildings and the modernisation of existing hospitals. The hospital plan now under review includes proposals for the future for a new district general hospital at Freeman Road, Newcastle, and the redevelopment as district general hospitals of the Royal Victoria Infirmary, Newcastle, the Newcastle General Hospital, the Queen Elizabeth Hospital Gateshead, and South Shields General Hospital. Major works are now in progress at Prudhoe and Monkton, Northgate and District, Hexham, and Ashington hospitals, and further schemes in the Tyneside area are starting this year.

In view of the fact that the area suffers from quite a severe shortage of beds for geriatric cases, maternity cases and cases which my right hon. Friend did not mention, namely, those of mentally sub-normal children, may I ask him to institute an inquiry into the overall needs of the area with a view to bringing forward the building date of the 1,000-bed hospital in my constituency, to which he has just referred? There is an urgent need to develop hospitals in the area, and I think that the years of complacency must be ended very quickly.

It is for the regional board to determine the needs and the priorities of the Newcastle region. Whilst I agree with my hon. Friend that there are shortages of geriatric and maternity beds in the Tyneside area, these are more than balanced, numerically, by a theoretical surplus at least, of acute beds.

asked the Minister of Health whether he will initiate legislation to amend Part II of the Third Schedule to the National Health Service Act, 1946, in order to make it obligatory for regional hospital boards to provide an individual, whom it fails to reappoint to a hospital management committee, with an explanation of their action.

No, Sir.

Is my right hon. Friend aware that what is little more than a conspiracy of silence in regard to this matter can give rise to innuendo and gossip which can be quite harmful to the individual concerned? Is he further aware that, referring to the case which gave rise to this Question, Alderman Miss Lily Thomas, of the Manchester City Council, was removed from the North Manchester Hospital Management Committee in the most perfunctory manner? Is my right hon. Friend satisfied with the way that this particular piece of legislation is working in so far as it affects individual members of a hospital management committee?

I am sure that the present practice is right. I made it clear that I do not give reasons for any appointments that I make. Equally, I think that it would be sensible not to give reasons for not reappointing somebody. On the whole, I would think that regional hospital boards were well advised to follow that advice. If they were to do otherwise, they could confine themselves only to a stereotyped and meaningless formula of explanation.

asked the Minister of Health what is the controlling and limiting factor in future plans for hospital building.

The state of the economy and the need to balance all claims on our national resources.

Is the Minister aware that there was issued from his Ministry on 12th May a circular to hospital boards which says:

"Review of the Hospital Plan. The first aim of the review"—

Reading.

I am reading in order that this should be an accurate extract from the—

The hon. Gentleman's difficulty is that verbatim quotation is out of order in a supplementary question.

Thank you for your guidance, Mr. Speaker. What the circular says is that the limiting factor is money. As the limiting factor is money, which seems to be a different answer from the one which the Minister has given, may I ask him whether he is aware that already the abolition of prescription charges has wasted more money than would be needed to build a new district general hospital?

I do not accept the hon. Gentleman's allegations nor the conclusions which he draws from them. There is very little conflict between what he said the circular purported to state and my Answer. I referred to the state of the economy and the need to balance all claims on our national resources. In one word, I dare say that "money" would be a way of expressing the same thing.

Could the Minister explain why we have to wait until early next year for the results of the review? He has already given this afternoon examples of the Hospital Plan being reviewed. Will not regional hospital boards have made up their minds long before the end of the year as to how they will proceed?

I want them to do this job thoroughly and to consult local health authorities in doing it. I have asked them to let me have their proposals by 1st November. I have not given any precise date as to when the new programme will be published or any information given of the results of the review except to say that it will be done, I hope, during the first half of 1966. But I think that the boards need till 1st November to do the very considerable job of review which I have asked them to do.

asked the Minister of Health when he will publish his revised hospital building programme; and to what extent his hospital plans for the South-East take account of the increase in population and the change in its distribution forecast in the South-East Study.

On publication I cannot add to what I told my hon. Friend the Member for Norwich, North (Mr. Wallace) on 31st May; on the second part of the Question, I must ask the hon. Member to await completion of the current review, but, as I stated in reply to a Question by him on 22nd March, I have asked boards to take population changes into account.

Will the right hon. Gentleman bear in mind that these very long-range plans, especially when they are deferred, tend to be irrelevant when finally they are put into effect? Will he have a project made in his Ministry to make certain that when the plan comes into effect, he will site the hospitals where new populations will live and work? Will he particularly bear in mind the Croydon area, where we have an immense influx of population but, at present, no reason to feel that we will cope with it in a few years' time?

We are ensuring that regional boards get the best possible population projections to use in their planning. As for planned population developments in the South-East, I rely upon my right hon. Friend the Minister of Housing and Local Government to keep me fully up to date about that.

Can the Minister give an assurance that the building of hospitals which have already been started or are in an advanced stage will be continued without delay?

I said in announcing the review of the Hospital Plan that I did not want the review to hold up projects which had started or were ready to start. I repeat that assurance.

Would the right hon. Gentleman give an undertaking that areas which are not development districts will not have their hospital plans prejudiced by the need to provide hospitals in new and expanding areas?

As I have said before this afternoon, it will be for the regional boards to determine the priorities within their own areas.

asked the Minister of Health if he is aware that two male spastic patients have been transferred from mental hospital to the residential spastics centre at Wakes Colne, Essex, having spent, respectively, 45 and 30 years in mental hospitals because they were wrongly diagnosed as mentally defective, and that it has only recently been discovered that both of them are of average or higher than average intelligence; and what steps are taken, by periodic re-examination of spastic patients in mental hospitals, to avoid a repetition of such errors.

The general aim of hospital care is, wherever possible, to enable the patient to return to life in the community, either independently or with help from the local authority or other services; and the possibility of discharge is accordingly considered from time to time. I am glad to assure my hon. Friend that the full history of the two cases which I assume he has in mind does not invalidate this statement.

Is my right hon. Friend aware that one of these two men, now 50 years old, has been locked up ever since he was a child of five and was released only recently as a result of prolonged checking and pressure by the Warden of the Spastics Centre? Is not this kind of thing extremely disturbing? How thorough can the periodic reviews or examinations of patients in mental hospitals be?

I have seen a Press article about the case to which my hon. Friend refers. The impression that the patient was wrongfully detained and was released through the efforts of a voluntary worker in the face of some medical opposition is, I am very glad to assure the House, completely unfounded. The patient was treated for some years in the cerebral palsy unit of Harperburg Hospital. This unit was set up with the specific aim of dealing with such cases as his, and the staff of the unit can justly feel proud of their success in treating him.

Does my right hon. Friend claim, therefore, to inform me, that the statements made by the Warden of the Spastics Centre are quite inaccurate and that these two men were not in a mental institution of any kind?

No. Of course, they were in a hospital for the subnormal. What I said was that the impression conveyed by the article that they were released only by this man's efforts in the face of medical opposition was completely unfounded.

On a point of order. In view of the unsatisfactory nature of the reply, I give notice that I shall endeavour to raise the matter on the Adjournment.

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

Inevitably conditions at the Royal Victoria Hospital, Boscombe, parts of which were built over 80 years ago and the main site of which is restricted, do not comply in all respects with the standards laid down for new hospital buildings. Substantial works of modernisation or improvement have recently been completed or are in progress.

Will the Minister bear in mind the increasing population in the Bournemouth area? Is he aware that old buildings and out-of-date equipment and appliances make for inefficiency and unnecessary delay, thus causing unnecessary suffering?

We certainly appreciate what the hon. Member says. In the long term, it is intended that the Royal Victoria Hospital should be replaced by a district general hospital. Although we have modernised and are modernising the existing hospital as far as possible, the only real solution is a district general hospital, and we will get that as soon as ever we can.

asked the Minister of Health how many Commonwealth nurses and doctors are employed in Bournemouth hospitals.

Fifty-nine nurses—including student and pupil nurses—and 18 doctors employed in the Bournemouth hospitals are from other Commonwealth countries.

In paying tribute to the excellent work of Commonwealth citizens who have reinforced our Health Service, may I ask the Minister what plans he has for attracting a full complement of people from this country to staff what I might describe as our most intimate social service?

I am glad that the hon. Member has paid tribute to the Commonwealth citizens, both doctors and nurses, who are engaged in the Hospital Service. They have made, and are making, a great contribution and I, too, pay tribute to them. Obviously, there is a shortage of doctors, and ways of increasing further the intake into the medical schools are being urgently considered. There is obviously difficulty also in the recruitment of nurses, but we have done what was possible. As the hon. Member knows, there has recently been an increase in pay. In the autumn, we will be conducting a considerable publicity campaign to recruit nurses. Frankly, I do not think that it will be possible to eliminate the shortage of nurses and to obviate the need to use Commonwealth doctors and nurses for a considerable time.

Would not the Minister agree that a crash programme to open up four new medical schools, as suggested in the Labour Party manifesto before the last General Election, would have helped to solve this problem?

The hon. Member is implying that no crash programme was being conducted by the previous Administration. The only way that we shall do this will be to do it gradually. We are considering ways and means of improving the intake of doctors in the medical schools and the recruitment of nurses. I do not see what else we can do.

Will the Minister answer my hon. Friend's question? The Labour Party manifesto mentioned four medical schools. Since the election, we have heard nothing further about them.

At least one new medical school is planned. If the right hon. Gentleman wishes to quote the election statements, he is tempting us to quote other election statements. [HON. MEMBERS: "Answer the question."] We have been in office for less than a year—[HON. MEMBERS: "Too long."] It may be too long for hon. Members opposite, but it is not long enough for us.

asked the Minister of Health what proposals he has received from the South West Metropolitan Regional Hospital Board to amend the catchment area of Springfield Hospital, Tooting.

I am informed that the South West Metropolitan Regional Hospital Board hopes that in the long term Springfield Hospital will serve a local catchment area in the region.

In thanking my hon. Friend for that reply, may I particularly emphasise to him, and ask whether he is aware of, the great distance which the doctors of Springfield Hospital are forced to travel in their attempts to provide the essential domiciliary service in their existing catchment area? Will he do everything possible as a matter of urgency to bring the catchment area of this hospital much closer to its existing site?

The hospital board is trying to solve this problem. Meanwhile, it is trying to make arrangements with other hospital boards, and that is as far as we can go at this stage.