asked the Minister of Health what amount in dollars and other foreign currencies was spent in the United Kingdom on imported drugs and medicines during the 12 months to date.

The value of pharmaceuticals imported in the year up to October, 1966, was £12·9 million of which £2·8 million was from North America.

What proportion of the total prescriptions made up during that year does that figure represent?

The percentage is small. If the hon. Member wants an accurate mathematical figure, he will have to put a Question down on the Order Paper.

asked the Minister of Health whether he will state the amount earned in foreign exchange by the exports of the British pharmaceutical industry during the past 12 months.

The value of "Medicinal and Pharmaceutical Products" exported from the United Kingdom for the year up to October, 1966, was £65·15 million, of which £37·17 million was to non-sterling areas, but the net foreign exchange earnings would, of course, be much less after allowing for imports of raw materials and remission overseas of royalties and dividends, the figures for which are not ascertainable.

Is the right hon. Gentleman aware that direct exports this year are running at the rate of over £73 million a year, which is 6½ times the level of imports, and that even this does not show the industry's true contribution to the balance of payments, because it does not include the earnings of British subsidiary companies operating overseas?

I had in mind that, according to the industry itself, in 1963 it had contributed £35 million to the balance of payments. This was, incidentally, almost entirely earned by British-owned firms. The net export earnings of British subsidiaries of overseas firms slightly exceeded their net remittances abroad.

I hope the Minister is not going to be grudging about this remarkable industry. Is it not a fact that exports in the last 12 months are 9 per cent. up on the year before? Would he not admit that this industry makes a valuable contribution not merely to the conquest of disease but also to the balance of payments?

I have not contradicted this. I just wanted to get the figures right. I gave the figures in my original Answer, and for the year up to October the gross figure was £65·15 million.

asked the Minister of Health whether, in disposing of land for which his Department has no further use, he will give the previous owners first refusal if they had been unwilling sellers to his Department in the first place even though they did not insist on compulsory purchase.

No, Sir. Other Government Departments have first refusal of surplus hospital land.

Does not the Minister feel under a definite moral obligation, particularly if land is not needed for the public benefit, to offer the land back to the owners, who agreed to sell purely to help the hospital service and who would now be offered the land back automatically had it been compulsorily purchased in the first place?

No, Sir. Surplus hospital land for which there is no other Government use is then offered, save in one set of exceptional circumstances, to local authorities.

May I give notice that, owing to the unsatisfactory nature of that reply, I shall raise the matter on the Adjournment at the earliest possible opportunity.

asked the Minister of Health what representations he has received concerning the Report of the Committee on Hospital Supplies Organisation under the chairmanship of Mr. Hunt.

I have invited comments on the Report from interested bodies, but have so far heard from only a few.

In view of the real concern felt within the suppliers' organisation of the Health Service about certain of this Committee's proposals, is the Minister aware that there is a real need for further consultation with the people doing the job on the spot before reaching a final decision?

It is early to say what the reactions to the Report will be, but I have asked for comments by the end of the year and I shall, of course, study them very carefully when I receive them.

Does the Minister insinuate that he will publish the Report in full, or has he passed it to certain organisations? Is he aware that a large number of organisations are holding up their manufacturing programmes until a decision is reached about the recommendations of the Report?

Copies of the Report have been made available not only to hospital authorities but to a wide range of interested professional and staff organisations and trade associations. They have also been given to the professional Press.

asked the Minister of Health whether he is satisfied that it is sufficient for cervical cancer tests to be carried out once every five years; and if he will make a statement.

I am advised that on present information the interval is reasonable, but I shall be willing to reconsider it in the light of experience and research.

My right hon. Friend's willingness to reconsider it will be welcome, because it is the view of some doctors that a short period of, say, two years would be preferable, especially in view of the fact that one of the two forms of cancer concerned tends to develop rather more quickly than the others.

Research is going on into this. All I can say is that at the moment the five-year interval is based on what we consider the probable natural history of the pre-invasive condition.

We very much welcome the Minister's willingness to look at this aspect of the matter. Is he aware that recent experience of screening suggests that some positive results are being detected now among women below the age of 35? Would he consider the possibility of reducing the age at which screening begins?

We have discussed this before at Question Time. The lower age limit is to some extent tied to our resources and the stage of development of the service. Women below that age who want to have a test are not refused and the full service will be extended as soon as possible.

Is the Minister certain that there are sufficient facilities to deal with all cases which are detected by this test?

No doubt the hon. Member means hospital facilities—and the answer is, Yes. Sir.

asked the Minister of Health what progress is being made in the provision of facilities for cervical smear tests.

By June of this year tests were being performed at a rate of nearly 1¼ million a year. This was double the figure for June 1965.

I thank my hon. Friend for that most encouraging reply. Will he ensure that further public health education measures are taken to encourage more of the women who are especially at risk to visit these clinics? Would he also take steps to ensure that, wherever possible, clinics are held in the evening so that women with large families can more easily visit them?

I will certainly consider the last point my hon. Friend has made. Publicity has to be carefully managed locally to keep it more or less in line with the development of facilities. I have been in communication with local health authorities which are responsible for publicity on this point.

asked the Minister of Health if he will take steps to bring the drug industry into public ownership to avoid the competitiveness in this field.

I cannot usefully comment on this proposal in advance of the report of the Sainsbury Committee.

Would not my right hon. Friend agree that duplication of research and wasted expenditure on advertising detracts from the efficiency of this industry? Is he aware that on this side of the House there is a strong suspicion that in certain sections of the industry private profit takes priority over human health?

The matters to which my hon. Friend has referred are certainly within the terms of reference of the Sainsbury Committee.

In considering these matters, will the right hon. Gentleman always bear in mind that his hon. Friend is really advocating a State monopoly on the lines of the system that operates in Russia, where notoriously no new drugs are being produced and where the industry is about the worst in the world?

I assure the hon. Gentleman that I shall, as always, bear all the relevant considerations in mind; but I think that we had better await the report of the Committee.

May I remind the right hon. Gentleman, concerning his hon. Friend's suggestion, that the Department's statistics show that competition between drug firms has had the effect in recent years of sharply reducing prices?

That may be true in one or two cases. Competition where there are patents to the extent that there are in the pharmaceutical industry is, of course, limited.

asked the Minister of Health what steps he has taken towards setting up a pilot scheme for the treatment of drug addiction.

I would refer my hon. Friend to my reply to the hon. Member for Cheadle (Dr. Winstanley) on 24th November.—[Vol. 736, c. 354.] A further meeting of the conference of experts will take place next week.

Is my right hon. Friend aware of the considerable concern on both sides of the House about the lack of progress since the publication of the Brain Report? What is being done about the register of addicts, about over-prescribing by doctors and about treatment centres? Is he aware that several doctors have ceased to treat addicts and that this is of grave concern to us all'?

I am aware of the concern in the House generally about this problem. I assure my hon. Friend that we are not by any means inactive in this matter, and that, in any case two of the things she asks for would require legislation and I am not yet in a position to make a statement about that.

asked the Minister of Health if he will initiate an inquiry into the overall needs of disabled people and the steps necessary further to co-ordinate the services at present provided by various authorities.

asked the Minister of Health what steps he is taking to ascertain the needs of the disabled and chronic sick and the steps necessary to improve and co-ordinate the services provided for them by all the authorities concerned.

A number of studies of the needs of the disabled or of the services provided for them are in progress or projected, and I see no need for any general inquiry.

Would the right hon. Gentleman not agree that the Answer to the last Question indicates a lack of necessary knowledge? Does not the fact that at least seven Ministries are concerned with various aspects of the disabled, as well as local authorities, indicate that there is a great need for us to have a fuller understanding of the problem and for more adequate action to be taken to cure it?

I agree that one of the difficulties about the terms "disablement" and "chronic sick" is that they have no precise meaning. I have sponsored a research project to find an acceptable measure of "disablement" for use in a subsequent prevalence study. A study into the state of the services provided and demanded will, if practicable, be associated with this.

Is the right hon. Gentleman aware that the disabled generally and the chronic sick in particular, who get no constant attendance allowance when at home, are wholly dependent on local authority services, which vary widely in both scope and quality from one part of the country to another? Would it not be helpful, in the framing of policy, for the Minister to co-ordinate what is being done and inaugurate fresh inquiries so that something effective may be done for our fellow citizens?

Many of the chronic sick, particularly the young chronic sick, are dependent on hospital services as well as local authority services. My Standing Medical Advisory Committee has advised me to undertake a survey of the services they receive in hospital. That will be done, and, in addition, my Department is conducting a planning study of the home help service, which is relevant to this problem, and a sub-committee is being set up to review the services for epileptics. This shows that a great deal is being done in this matter.

Would my right hon. Friend indicate that the representations which have been made to him and which may be made in future by the Disablement Income Group will be afforded full and authoritative examination?

I should, perhaps, refer my hon. Friend to the reply which my right hon. Friend the Prime Minister gave to my hon. Friend the Member for Plymouth, Sutton (Dr. David Owen) on 17th November.

Would the Minister not agree that he has himself outlined the difficulty here in that there are so many different organizations—hospitals, home helps, local authorities and seven Ministries—involved in providing these services? Would he, therefore, not agree that there is a real and urgent need for integration under somebody like a disabled persons' officer?

No, Sir. I do not think that that would be the solution to this problem. The two areas to which I referred are both under my Departmental responsibility, and I do not believe that there is any serious lack of co-ordination there.

asked the Minister of Health whether, in the light of his review of the problem, he will now agree to provide suitably converted cars for disabled drivers instead of the single-seater vehicles at present provided.

asked the Minister of Health when he expects to receive and act upon the promised report on invalid vehicles.

asked the Minister of Health when a report will be made on the feasibility of providing suitably adapted small cars for the use of disabled persons and their families.

asked the Minister of Health whether he has completed his review of the regulations governing the circumstances in which his Department bears the cost of converting vehicles to hand-controls for war-disabled pensioners; and whether he will make a statement.

asked the Minister of Health whether the current review of vehicles for the disabled will include financial help for people who have their own cars adapted or who buy cars which are already suitably adapted.

asked the Minister of Health when he proposes to provide disabled drivers with two-seater vehicles or an alternative cash allowance, equal to the cost of maintaining single-seater tricycles, to offset the cost of maintaining their own cars.

My right hon. Friend is studying the results of the review and hopes to make a statement to the House early in the New Year.

I thank my hon. Friend for that indication that further thought is being given to this matter. Is he aware that the House was given to understand in the summer that the results of this review would be made available during the earlier part of the winter? Is it not a matter on which neither procrastination nor parsimony should be allowed to stand in the way of the happiness of the disabled?

I must correct my hon. Friend on one point, which is that I have constantly said in the House that I hoped to have this review available before the end of the year.

Is my hon. Friend aware that the provision of suitably adapted small cars would enable disabled people to live more normal family lives?

Without wishing to be presumptuous, I do not believe that anyone is more aware than I am of the problems and benefits that might accrue from this review. All the problems concerning this issue will be taken into account in the review.

Is the hon. Gentleman not aware that I entirely agree with the hon. Member for Bebington (Mr. Brooks) and that a promise was made to me last summer, four months ago, that a review would shortly be forthcoming, that this was said eight months after I had first raised this matter, and that for 12 months previously my predecessor had been raising it? Since this is a straightforward matter of fairness to disabled ex-Service men, does he not agree that it is time that his Department got a move on?

The last thing I want to do is to get involved in a political discussion on this subject. I have repeatedly said time and again from this Box this year that I hoped to get the review through by the end of the year.

Referring to Question No. 49, can the hon. Gentleman give an assurance that the anomalies which appear to exist in the case of those who buy vehicles which have automatic transmission and appear to get a smaller grant will be dealt with in the review?

I can assure the hon. Gentleman that my right hon. Friend will take into account all these matters. But apart from this review, if the hon. Gentleman has a particular case and will let me have the details, I shall be glad to look at them for him.

Can the hon. Gentleman assure us that the problems of alternative grants as well as second seats in these vehicles are being included in this inquiry? He will surely be aware that we are all conscious of the problem and difficulties, but we do not accept that these difficulties can any longer stand in the way of the provision of these things?

I am not too sure precisely what the hon. Gentleman means by alternative grants, but I can assure him that what has been discussed in question and answer in this House and all other related matters will be considered in this review.

I am aware of the very large sum of money involved and also of the concern which is always shown by the hon. Gentleman about this matter, but I think that the provision of a substantial amount of money on motor cars for the disabled——

Order. The hon. Member must know he must ask a question.

I beg your pardon, Mr. Speaker.

I think I understand the hon. Member's question, although it was not posed in the form of a question. He referred to the substantial amount of money involved, and I would ask the House to recognise that the question of the additional amount of money which can be allocated will have to be considered in the light of all the other priorities with which my Department is concerned.

asked the Minister of Health what proportion respectively and excluding consultants, of the physicians and surgeons working in the Hospital Service are citizens of the United Kingdom; and whether he will publish in the OFFICIAL REPORT figures showing separately for each regional hospital board the numbers and country of birth of doctors, excluding consultants, both resident and non-resident working in the Hospital Service.

asked the Minister of Health how many doctors now working in British hospitals were born outside the United Kingdom.

I am circulating in the OFFICIAL REPORT such figures as are readily available.

To what extent is the National Health Service relying on doctors other than those born in this country—that is, doctors largely from the Commonwealth?

Taking all the grades from senior registrar downwards, the total number is 4,854 doctors. The percentages vary considerably according to the grade.

In view of this very large number, what steps has the Minister taken to discover what proportion of the doctors who are immigrants intend to return to their countries of origin in the comparatively near future?

Doctors have been coming here for post-graduate training for very many years. I do not think that the pattern has changed materially between those who stay and those who—and these form by far the larger majorit—return home again when their training is over.

asked the Minister of Health what steps he proposes to take to implement the recommendations contained in the Cohen Report on Health Education which relate to dental health education.

On 1st December, a joint circular from the Health and Education Departments was sent to all local health and education authorities in England and Wales with suggestions for strengthening their dental services, including their arrangements for dental health education. My right hon. Friend will consider with the new health Education Council, when it is set up, what further steps should be taken.

Could my hon. Friend say when this consideration is likely to take place, and will he bear in mind that it is anomalous that in a matter of national concern dental health education should be borne simply by the profession at the present moment?

My right hon. Friend has actually recently informed local authorities and dental and other interests of his proposal for the setting up of this body and has asked for nominations.

asked the Minister of Health what plans there are to develop further the geriatric services.

I have asked hospital boards to make an early provision in their programmes for the expansion of their geriatric services.

Would my right hon. Friend go further and try to encourage a much greater degree of co-ordination between hospital services, general practitioner services and local authority services with the intention of maintaining many more old folk in their own homes rather than in institutions and hospitals?

Yes, I have on several occasions urged on all authorities in the Service the desirability of co-ordinated planning of joint operations for these services. I agree with what my hon. Friend has said.

In view of the need to pursue this line of co-ordination, would my right hon. Friend seek to have in various areas an experiment in a changed structure of co-ordination between the three wings of the Service to deal with old people?

In so far as this is possible under the present statutory structure, I think that my hon. Friend will find that this is already taking place in certain areas.

Will the Minister take steps to ensure that local authorities have more money to spend on domiciliary services, because these are of vital importance in keping old people happy?

The hon. Lady knows that the provision of local services is a matter for local authorities. They must decide their priorities as between the various headings of expenditure which they incur.

Is the Minister aware how disappointed we are in North-East Essex that he has not been able to help us with day hospitals?

If the hon. Gentleman has a Question about his constituency or area, I should be obliged if he would table it.

Order. I called the hon. Member for Harwich (Mr. Ridsdale) for the next Question, but he got a supplementary through on this one.

asked the Minister of Health if he will recognise play groups for young children as a social service for which grants are made available, particularly in areas of high blocks of flats.

This matter will be considered when my right hon. Friend the Secretary of State for Education and Science considers the report of the Central Advisory Councils for Education on primary education, including the educational needs of children under five.

I am grateful for that Answer, for what are mothers to do if they have nowhere to put their children to play? How can mothers living on the tenth floor run down in time to keep their toddlers from running in front of traffic?

My Department is concerned, in dealing with the question of children under five, with children who need care on health and welfare grounds.

Will my hon. Friend consider that in the planning of high blocks of flats of high density provision should be made for play-group facilities?

There may be much in what my hon. Friend says, but planning, of course, is a matter for the Ministry of Housing and Local Government.

asked the Minister of Health what is his estimate of the amounts spent on medical research in the years 1955, 1960, and 1965, respectively; and what steps he is taking to increase this research.

The approximate amounts spent by my Department on medical research in England and Wales were as follows:

While I welcome the increased amount spent on research, may I ask my right hon. Friend whether he does not agree that it is now high time to break away completely from the miserly attitude of our Tory predecessors? Would he further agree that some of the millions of pounds wasted on armaments could be transferred to meet this human need?

I can only repeat that, so far as my Department is concerned, I hope to continue increasing the provision.

Has the right hon. Gentleman noticed the growth in the number of professionally-sponsored organisations which are set up purely to raise money for research into such matters as congenital heart disease and leukemia? Would the right hon. Gentleman agree that this growth represents a failure on the part of official sources to provide enough money for research?

No, I would not agree with that. I think this is probably more a question for my right hon. Friend the Secretary of State for Education and Science.

asked the Minister of Health if he will now make a statement on the distress and inconvenience caused to patients by the work-to-rule by limb fitters at Roehampton.

asked the Minister of Health if he will now intervene to end the work to rule by limb fitters at Roehampton.

An agreement has been reached between the employers and the union, and the limb fitters have today resumed normal working.

Is the right hon. Gentleman aware that the country will be delighted that this shameful business is finished? Is he also aware that there is great concern about the appointments system at Roehampton Hospital, which was partly involved with the working-to-rule by the fitters? Will the right hon. Gentleman arrange for an immediate inquiry to take place into the appointments system at Roehampton Hospital?

We are constantly seeking ways of improving the appointments system, but I think that the important and immediate thing for me to do is to get rid as quickly as possible of the waiting list that has developed as a result of the go-slow.

While being grateful to the Minister for his original reply and for his reply to the supplementary question, may I ask whether he will consider again looking carefully into the facilities at Roehampton Hospital which, I understand, have caused some of the complaints among both patients and those who work there—facilities which were once adequate but are no longer so owing to the increase in work?

If the hon. Gentleman has any specific criticism or complaint to make on behalf of those who go to Roehampton Hospital for treatment, I shall be very glad indeed to look into it.

asked the Minister of Health what steps he is taking to co-ordinate the diagnosis, treatment and social welfare provisions available for invalid children.

In March of this year a joint circular was sent by the Department of Education and Science and my Department to all local health, welfare and education authorities calling for a review of arrangements for co-ordinating services for handicapped children and young people, and emphasising the importance of early and complete diagnosis and continuing care and support. Reports from these authorities are now being considered.

While thinking my hon. Friend for that reply, may I ask him to bear in mind when he reviews the matter that a great deal of suffering could be avoided if the results of early diagnosis were made available to education authorities so that they could place children in suitable schools, and to the youth employment service to enable it to place them in suitable employment?

I appreciate my hon. Friend's point. My right hon. Friend will be considering the reports and, no doubt, will bear in mind what my hon. Friend has said.

asked the Minister of Health, in view of the concern expressed by many local authorities regarding the unregistered child minder, whether he will take steps to ensure that the present-day nursery building programmes of local authorities are fully implemented without delay and extended to meet the growing demand.

Local authorities' ten-year plans envisage an increase of 68 in the number of day nurseries between 1965–66 and 1975–76. Thirty-two day nurseries are included among the capital building projects for which my right hon. Friend hopes to recommend loan sanction this year and in 1967–68. He will review the programmes again early next year.

I thank my hon. Friend for that reply, but is he not aware that because the demand for these places exceeds the supply there is a growing mushrooming of rather unsatisfactory child-minding services now? Would he therefore give an assurance to the House that there is no plan to cut this nursery building programme in the foreseeable future?

We consulted local health authorities in 1965 and asked them to review the arrangements in force in their areas under the Nurseries and Child Minders Regulation Act. A small num- ber of local authorities raised the question of unsatisfactory and illegal minding. I would not like the House to get this out of all proportion. We shall keep watching the position.

asked the Minister of Health how many local authorities have set up weekend or evening infant welfare clinics.

I regret that this information is not available centrally.

Is my hon. Friend aware that some of these clinics have been set up and in one, for example, in the Notting Hill Gate area the number of attendances has more than doubled since it was set up four years ago? Would my hon. Friend not agree that this demonstrates that there is a demand for these services and that possibly many young children would probably not receive the services of a welfare clinic unless it takes place in the evening or at the weekend?

I agree that, in addition to the clinic mentioned by my hon. Friend, there have been one or two other experiments along these lines in London. But I am not sure that evening clinics of this kind are as satisfactory as may appear on the surface. I would not like to think that we were pursuing a policy which meant that youngsters would be kept up very late in the evening.

asked the Minister of Health what steps he is taking to increase the number of qualified doctors in this country by 1970.

I would refer the hon. Member to my reply to the hon. Member for Essex, South-East (Mr. Braine) on 24th October.—[Vol. 734, c. 622–3.]

How does the Minister expect to increase the supply of doctors when the morale of clinical teachers has been shattered by the mishandling of their salary claim? Can the Minister give an assurance that the just claim of the clinical teachers will be met by the end of July?

I am sure that the hon. Member knows that that is a question for my right hon. Friend the Secretary of State for Education and Science.

Yes, but I think that the House would like to know whether the right hon. Gentleman, whose heart is in the right place on this issue, I am sure, is making the strongest possible representations because, as my hon. Friend said, unless young clinical teachers are encouraged to remain in the medical schools the medical schools will not be able to turn out the number of doctors we need by 1970. It is as simple as that.

I am sure that the hon. Gentleman, who has been a Minister, knows that discussions and representations between Ministers are not made public in the House.

asked the Minister of Health if he will issue a circular to medical practitioners drawing their attention to the dental side effects of some of the tetracycline group of antibiotics.

I understand that an article in this month's issue of Prescriber's Journal will draw attention to the risk of staining of children's teeth by tetracyclines. These effects have been well reported in medical, dental and other scientific journals and warnings are included in the British National Formulary and, where appropriate, by the drug firms in their literature. My right hon. Friend does not think that a circular to doctors is necessary.

The Parliamentary Secretary mentioned an article. Can he tell us the date when it will appear?

I understand that it is to appear in this month's Prescribers' Journal, which the hon. Gentleman will recognise is an independent journal and is sent to every doctor.

asked the Minister of Health how much he estimates will be paid during 1967 by National Health Service patients in respect of the four new charges to be introduced on 1st January, 1967.

These are charges for services outside the National Health Service. I cannot estimate what will be paid, but the total is unlikely to be large.

In spite of that reply, can the right hon. Gentleman say whether this means that he has now removed his previous policy with regard to abolishing all charges within the National Health Service, and can he further say whether he agrees with Professor Abel-Smith in his suggestion that there should be charges in other aspects of the Health Service as well?

No, Sir. This bears no relationship to policy on charges within the National Health Service.

asked the Minister of Health what advice he has received from the Medical Research Council on the treatment of sensory-neural deafness by fluorides; and if such treatment is available within the National Health Service.

None, Sir. I understand that this treatment is not being investigated by the Medical Research Council, and I am not aware that it is being used in the National Health Service.

As this has shown some startling results in the United States of America, particularly at Johns Hopkins University, will my right hon. Friend use his influence with the Secretary of State for Education and Science to get the Medical Research Council to embark on research on this and make the results available to people in this country?

I shall certainly call to my right hon. Friend's attention what my hon. Friend has just said.

asked the Minister of Health what further steps he will now take to limit cigarette advertisements and to discourage cigarette smoking, in view of the proven hazards to health of this addiction.

asked the Minister of Health if he will seek power to take action against the rapid growth of cigarette sales promotion by means of gift coupons and against Press advertising of cigarettes.

asked the Minister of Health if he will make a statement with regard to his recent discussions with the tobacco manufacturing companies about restraint in advertising by such manufacturers.

asked the Minister of Health whether he will make a statement on his negotiations with the tobacco manufacturers to control and restrict the sums spent on cigarette advertising and other forms of promotion.

I would refer my hon. Friends to my reply on 20th June to my hon. Friend the Member for Middleton and Prestwich (Mr. Coe). The review of future levels of advertising and of coupon schemes which I then said we should be undertaking with the manufacturers is at an advanced stage, but I am not yet ready to make a further statement.—[Vol. 730. c. 27–8.]

Can my right hon. Friend say whether he will be ready on Friday, when we shall discuss one aspect of this subject on a Private Member's Motion? Secondly, does he not agree that it is quite illogical, having accepted the argument that advertisements are too dangerous to go on television, to allow them to continue to appear in the Press and other media?

I am not yet in a position to say whether I shall be in a position to say something in the debate on Friday, but I think that perhaps we should await that opportunity, when we can deal with the matter at greater length.

Has not cigarette advertising on television been more than replaced by coupon promotion to the extent of £24 million this year? Particularly in view of the alarming figures of lung cancer which my right hon. Friend gave last week, does he not think that this is deliberately frustrating the attempts to reduce cigarette smoking?

I agree that the number of coupon brands has increased, but I think that there is a significant difference between television advertising of cigarettes and coupon schemes, although I am discussing the question of coupon schemes with the industry.

Will my right hon. Friend undertake that he will——

Order. Mr. Speaker cannot hear the question.

I hope that it was not my fault, Mr. Speaker.

No. I was not referring to the hon. Gentleman.

I was asking my right hon. Friend if he would give an undertaking that he will do all he possibly can to stop the further production of new coupon brand cigarettes, because this is a very serious matter from the point of view of lung cancer being promoted by the smoking of cigarettes.

I certainly deplore any form of sales promotion which brings pressure on people to increase or to maintain the number of cigarettes which they smoke. As I say, I think that we could perhaps deal with this at greater length in the debate on Friday.

Has the Minister seen the report issued today to the effect that cigarette smoking is very much more dangerous if the air is polluted? Is he looking at this side of it as well?

That is another matter, but air pollution and its effects have already been very exhaustively studied in medical research.

Would not my right hon. Friend agree that while tobacco advertising is allowed it renders nugatory the work of his Department in warning the public of the dangers of smoking?

I do not think that it quite does that, but, as my hon. Friend knows, I am concerned to see the amount of advertising of cigarettes limited and, if possible, reduced.

asked the Minister of Health what is the average salary of a full-time hospital chaplain; how many are employed by the National Health Service; and how many have living accommodation provided in or near hospital premises.

The average of the salary scale is £1,327 plus a house or an allowance in lieu; 110 at 30th September, 1965; about 50.

Is my right hon. Friend aware that, in view of the shortage of money for the National Health Service in general and hospitals in particular, it would be a good idea if we were to ask the Church authorities if they would bear the costs of the chaplains' service?

I am not sure that that would be feasible. I rather take the view that if we are providing a service to our patients—and I do not wish to be drawn into a discussion about the merits of one service against another; say, the medical as against the spiritual services—we should pay for it.

asked the Minister of Health how many hospital beds are at present occupied by disabled people who would be capable of living at home if adequate financial resources were available to them to pay for necessary non-medical care and attendance.

I regret that this information is not available.

While appreciating the difficulty of identifying this group of people, would the Parliamentary Secretary not agree that it is very desirable to enable and encourage these people to live at home when possible, not only for their own advantage and for the benefit of their families, but because it would release much-needed hospital beds?

I agree that it is desirable, where possible, for disabled people to live at home.

Would my hon. Friend undertake to make certain that such a survey is put in hand, in view of the fact that the alarming statistics—which show the number of young chronic sick in geriatric hospitals—need positive inquiries?

I appreciate that there is a difficulty of identification here. I assure the House that we are constantly considering the whole issue and that we will continue to look at the whole matter to see how best we can provide a service to these patients.

asked the Minister of Health if he will investigate the possibility of establishing emergency dental services, staffed by local dental practitioners on a rota system, to provide cover during the night and at weekends in those hospitals which do not at present have a dental department.

No, Sir. I have no evidence that the demand for emergency dental treatment at weekends and at night is sufficient to warrant the kind of arrangement suggested by the hon. Member.

Is the Minister aware that the present arrangements for dental emergencies in most parts of the country exist only on paper? Will he not agree that there are some dental emergencies—dental haemorrhage, for example—which need very much more effective provision than we have at the moment?

I do recognise that there are serious dental emergencies, but I can assure the hon. Member that where a patient has any difficulty in making contact with his own dentist, or where he has no dentist, telephone exchanges will be supplied with information about other dentists in the area or a local rota scheme.

Can the right hon. Gentleman say whether he has had any recent discussion with the British Dental Association about this, since I believe that the Association always took the view that it was ready to co-operate in such a scheme provided some central premises might be provided?

I am not aware of any recent discussion, but according to my information, in some areas where dentists have formed voluntary rota schemes for emergency treatment they have broken down for lack of patients.

asked the Minister of Health whether he is aware that pay-beds at the General Hospital, Cheltenham, which receives constituents of the hon. Member for South Worcestershire as patients, have increased in charge since 20th July from £5 2s. per day to £5 13s. per day, or £35 14s. per week to £39 11s. per week; and, as this is prima facie contravention of the standstill conditions for prices and incomes, outlined on 20th July, what action he proposes to take in the matter.

asked the Minister of Health why, in spite of the prices and incomes standstill, the charge for a private room at the Aldershot General Hospital has increased from £45 10s. to £57 1s. per week.

I would refer the hon. Members to my reply to the hon. Member for Oswestry (Mr. Biffen) on 14th November.—[Vol. 736, c. 8.]

Can the right hon. Gentleman tell the House why a nationalised service has been allowed to raise its prices for private beds in hospitals by such a wide margin, whereas charges in a private nursing home or hospital have been absolutely frozen? Is there any equity in this matter?

I can assure the hon. Gentleman that my statutory duty under Section 5 of the National Health Service Act, 1946, is to ensure that charges made to private patients cover the full costs of the accommodation and service provided, and the regulations made under the Act require the rates to be revised annually, each October.

Is my right hon. Friend aware that he could save himself a lot of trouble about being asked this sort of question if beds were based on need and not payment?

My hon. Friend will know that pay beds have been subject to review, the results of which I am at the moment considering with a view to equalising the pressure on pay beds and non-pay beds.

Would my right hon. Friend not agree that one of the difficulties we have in the service is that we still provide private beds and that some of us on this side of the House would like to see the service do away with them?

I am not proposing to do away with pay beds, but, as I have said, I am reviewing the whole position and hope to announce the results fairly soon.

Does the right hon. Gentleman not recognise the contradiction in his earlier answer? Is he not aware that when it suits the Government they have caused employers to break their contracts?

I received advice that, in view of the provisions of the Section, I have mentioned, and in the knowledge of what an appropriate charge should be, it was not possible for me, without risk of legal challenge, to make regulations postponing the implementation of the revised charges.

In view of the unsatisfactory Ministerial reply, I beg leave to give notice that I will raise this matter on the Adjournment at the earliest moment.

asked the Minister of Health to what extent the recruiting of Canadian, Australian and New Zealand nurses to the National Health Services has been affected by the application of the Commonwealth Immigrants Act.

I have no means of measuring this, but I am not aware that the application of the Act has materially affected recruitment of nurses from these countries.

If I draw the Minister's attention to an individual case of difficulty, would he kindly consider it with sympathy?

Certainly, but if my guess is right that this is the case of a New Zealand nurse, this may well be a matter for my right hon. Friend the Home Secretary.

asked the Minister of Health if he will state the number of patients awaiting admission to Frenchay Hospital, Bristol, divided into the categories of treatment required.

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

I thank my hon. Friend for that reply. The list is now abnormally large. It has doubled in less than four years. Would he agree that there is a need to increase the number of medical staff and nurses available at the hospital and bring forward the current building programme to meet the hospital's need?

My hon. Friend should be careful about statistics. He knows that Frenchay is a first-class plastic surgery unit. If the plastic surgery is excluded, there has been no increase in the waiting list in the past year. The main reason for the high number of patients awaiting plastic surgery is that a theatre for this specialty was closed in 1965 for major building work and this threw a burden on to the waiting list.