asked the Secretary of State for Social Services what is the estimated number of employees now covered by private occupational retirement pension schemes; what percentage this represents of the total number of employees; how this compares with the position 10 years ago; and what proposals he has to maintain and encourage the private provision of retirement pensions.

It is estimated that just over 12 million employees were members of occupational pension schemes at the end of 1967; this represents about 50 per cent. of all employees. Comparable figures which are available for 1956 are, just over 8 million employees and about 35 per cent., respectively. On the last part of the Question, I must ask the hon. Gentleman to await the publication of the Government's proposals later this winter.

Will not the right hon. Gentleman take this opportunity to express his extreme satisfaction at the remarkable success story in the growth of private provision of retirement pensions and give us the assurance that private schemes will not be unfairly disadvantaged under any proposals which he might have?

Yes, I can certainly record my pleasure at the steady expansion of the schemes. Although I must ask the hon. Member to await the actual details of our scheme, I should like to wager that the scheme which we have designed has been expressly tailored to fit in as a partnership with the private schemes and not as something to replace them.

The right hon. Gentleman will be aware that he has a reputation for being hostile to these schemes. Would he go a little further and say specifically that it is the Government's policy to encourage these schemes?

I do not know what is "further" and what is not. What I said is that our scheme is designed to work in partnership with the private schemes. That means to encourage their growth and to provide, not a substitute, but a service which they cannot themselves provide. As for my reputation, the hon. Member may remember that I was, I think, one of the chief authors of national superannuation in 1957, in which the whole concept of contracting out was first invented.

asked the Secretary of State for Social Services whether he is considering methods by which the proposed area health boards will be able to raise funds independent of the central Government.

No, Sir.

Does not the right hon. Gentleman realise that he has to find a method of getting more money into the Health Service and health generally other than by taxation? Secondly, has he any comment on the dissatisfaction which is felt at the reduced rôle which, apparently, is to be played by voluntary bodies and voluntary organisations under the Green Paper, particularly in connection with finance?

I have just this comment to make. The Green Paper, published by my predecessor, was a Green Paper to which I am in no wise committed, as I have to repeat for the third time. As for the financing of the Health Service in general, I would have thought it true to say that there are other methods already at the disposal of the Health Service than taxation, and we can, of course, consider whether they should be improved. As for the rôle of the voluntary organisation, I would like to support the hon. Gentleman in re-emphasising the importance of its being in no wise reduced by the existence of the Health Service.

Is the right hon. Gentleman aware that voluntary assistance to the hospitals of the Health Service has been very much hampered and impeded by the wholesale dismissal of hospital house committees? Is he aware that the Caterham and District Hospital House Committee, which had amenity funds to help the Health Service, has been summarily disbanded, in my view quite improperly? If I write with details to the right hon. Gentleman, will he look into it as a matter of urgency?

Yes, I am perfectly prepared to look into it; and if the hon. and learned Member puts down a Question I will answer it.

While I agree that it is wrong for the area boards to raise money in this way, will my right hon. Friend consider further the possibility of local community activities which would help in our endeavours?

I did not say that it was either right or wrong. I said that we were not committed to the Green Paper or to the organisation therein proposed.

asked the Secretary of State for Social Services what estimate he has made of the increase required in the present basic state retirement pension of £7 6s. in order to bring it up to its value in real terms at Christmas 1965.

The present pension of £7 6s. is in fact worth more in real terms than the rate in payment for a married couple at Christmas 1965.

asked the Secretary of Sate for Social Services what proposals he has to restore the value of the basic state retirement pension for husband and dependent wife to the value in real terms at the time of the increases made in 1965.

A further increase in National Insurance benefits, as my hon. Friend knows, is not envisaged before the autumn of next year.

In welcoming that reply with great interest, may I ask my right hon. Friend whether he would not agree that we have a duty to keep parity of value all the time? Would he not agree that the matter of a proper index weighting system for an old people's expenditure pattern is long overdue? Can my right hon. Friend say whether we are likely to get this in the near future?

I agree thoroughly with the first proposition put forward by my hon. Friend. With regard to the second proposition, it is a matter which has been investigated many times and I am always prepared to go into it further. The Government have certainly undertaken to maintain the real values.

Is it not disturbing that, since March, 1965, prices have gone up by 15 per cent. and contributions by 20 per cent., but the pension has gone up by only 12½ per cent.? What steps are the Government taking to remedy this situation?

Nevertheless it is a fact that the real value is higher than it was at Christmas, 1965, as stated in my Answer, and the noble Lord will take into account that supplementary benefits have recently been increased.

asked the Secretary of State for Social Services what was the percentage increase in real terms of the purchasing power of the retirement pension between October 1960 and October 1964, and between October 1964 and October 1968.

About 19 per cent. and 14 per cent., respectively, for the standard rate of retirement pension.

Does not this show that during the time of Conservative rule pensioners were looked after much better than during the time of the Labour Government's rule? Would the Minister also say how much of the first increase in pension under the Labour Government led to this?

It all depends on the period one picks. If we had picked the first four years of Conservative rule from 1951 the answer would have been 10½ per cent. compared with 14 per cent. during the first four years of Labour rule after 1964. I am giving the increase in real value. The Government have increased the real value in very difficult times.

In view of the fact that it is already expected that the cost of living next year will rise by over 7 per cent., does the Prime Minister's statement last January, that there will be no increase in the pension till next autumn, still hold good?

While I do not accept what the hon. Member has said about the increase in the cost of living, I would point out that we have said many times that any increase would be taken into account in any review, and that is the nature of the undertaking about the review in the autumn of next year.

asked the Secretary of State for Social Services what is the value of the basic retirement pension in real terms, as compared to its value in October, 1964; and what proposals he has to increase pensions within the next six months.

The basic retirement pension is worth, in real terms, 14 per cent. more than the pension in payment in October, 1964. My right hon. Friend has no proposals for any increase within the next six months.

Is my hon. Friend aware that the Government have little to apologise for in their record in this matter in the last four years? Nevertheless, since the Prime Minister himself said that the lower-paid and lower income groups would be protected from the effects of devaluation and consequent measures, will my hon. Friend give an undertaking that there will be a substantial increase in the old-age pension very soon?

In answer to a previous Question I said that an increase was not envisaged before the autumn of next year. I can assure my hon. Friend—especially in the light of what he said at the beginning of his supplementary question, which I very much appreciate—that all the factors that he has mentioned will be taken fully into account.

Is the hon. Gentleman really aware of the hardships which old people face in the coming months? If he cannot give an increase during the next six months, will he give an assurance that old people will get an increase before the next General Election?

The hon. Member will be aware that two substantial increases have been given, which have raised the pension 14 per cent. in real value above the value of October, 1964. He may also be aware that the Government have recently approved an increase in supplementary benefits. I do not pretend that the situation is entirely satisfactory but I hope that the hon. Member will take this into account and remember that the Government will take into consideration all factors in making their next review.

asked the Secretary of State for Social Services what fresh proposals he has for issuing four-wheeled vehicles to disabled drivers.

My right hon. Friend is unable at present to extend further the classes of patients eligible for cars.

Would the Minister consider issuing a priority list of those who will be issued with four-wheelers from the moment resources become available? In the meantime, would he bear in mind the burden on disabled drivers and consider seriously increasing the allowance for petrol, as petrol has risen 9d. in nine months while disabled drivers have received no help towards that at all?

I think that that second question is a rather different issue, but if the hon. Gentleman will put down a Question on it I will seriously consider it. As to the first point, the hon. Gentleman will understand how very anxious we are to restrain public expenditure, and I know he will do his part to help us in this matter.

Has the hon. Gentleman considered the point put forward by the joint committee on the mobility of the disabled, namely, that in the long term public expenditure would be saved by using Ministerial resources to adapt mass production cars for the disabled rather than on producing vehicles especially for them?

Yes, that matter is being considered very closely by my Department. It is not a new suggestion, but what we have to protect is the interests of as many disabled people as possible who demand and require personal mobility.

asked the Secretary of State for Social Services what has been the total cost in the last convenient period of 12 months of maintaining his Department's three-wheeled disabled drivers' vehicles.

About £1½ million.

If the Minister pressed for the production of the new prototype P5 and also issued a few more four-wheeled vehicles, would not the great cost of maintenance come down?

The average annual maintenance grant paid to recipients of cars is £80 compared with a not strictly comparable figure of £76 for three-wheeled vehicles. I myself think that the production of the P5, which, I think, is the vehicle the hon. Gentleman has in mind, is going on very satisfactorily. It is largely a technical problem at the moment.

asked the Secretary of State for Social Services what administrative savings have now been made in staff due to the amalgamation of Departments that has taken place in the social services; and how the staff of his combined Department compares with the position in December, 1964.

asked the Secretary of State for Social Services to what extent he expects to be able to make staff reductions in the two former Ministries of Health and Pensions and National Insurance as a result of their amalgamation in his new Department.

The main purpose of the mergers of social service Departments that have taken place during the past two years was not so much to save staff as to secure better co-ordination of social security policy. Since 1964 the services have been expanded and improved by measures including earnings-related supplements to flat rate contributory benefits and the new scheme of supplementary benefits which has attracted nearly half a million additional beneficiaries.

Is the Secretary of State aware that what many people on retirement pension want is real help and not paper staff work?

Yes, I think I am aware of this, and that is why the hon. Member will, I hope, study the end of my Answer, when he will see that I said the new scheme of supplementary benefits has attracted 500,000 additional beneficiaries. That is not paper—that is half a million people who were entitled to supplementary benefit under the Tories and did not get it, but got it, for the first time, under our entitlement scheme.

Was not one of the objectives of amalgamating the two Departments together that there should also be an effect in reducing the numbers of civil servants, whose number has steadily risen ever since this Government took office? Does not the right hon. Gentleman accept that that should be one of the objects? If so, when, and to what exent, does he expect to achieve it?

Of course it is one of the objects, but I have pointed out that I am not expecting a net saving on the merging of the two Departments for the reason I have given; because in social security there has been an enormous expansion of the work, and the very proper public demand that we should see there is no abuse of the work. These things put together mean that in social security we might, if anything, have an increase of staff.

Nevertheless. may I ask the Secretary of State if he would look at the figures again to see if he can stop the very rapid increase over the last 15 months or so of some 12 per cent. at the combined Ministries and help the rationalisation of their forecast and stop the increase in numbers?

I have looked at these figures very carefully. I do not think it is true of the combined Ministry. I would emphasise that in social security there has been an increase of staff because of the three major changes—earnings-related supplement to flat-rate unemployment and sickness benefit, on the one side; and the transformation of our national assistance into supplementary benefit on the other; and thirdly the investigation required. All this could not possibly have been done without an increase in staff.

asked the Secretary of State for Social Services what advice his Department issue to mothers of still-born children regarding prescription charges.

A note on the exemption certificate asks that it should be returned in the event of miscarriage or the death of the child.

Is my hon. Friend aware that many pharmacists are finding difficulty in understanding precisely what this means and that there is great confusion in this matter? Would he try to do something about this with a view to trying to make clear the rights which mothers of still-born children have in this matter?

The fact that my hon. Friend has asked this Question may help to clarify the matter. The advice is certainly regarded as applicable in the case of the stillborn child and I think the majority of pharmacists know this to be so.

Does not this show that there are still many rough edges on the prescription charges scheme with the exemption, and can the hon. Gentleman give an assurance that he will look at this in order to try to smooth them away?

I think initially we recognised that there were one or two areas which needed to be improved. We have already improved them. Of course if any further changes are required we will seriously look at them. However, I am satisfied that the system is working satisfactorily.

Would not the most helpful action be to abolish prescription charges as rapidly as possible?

I think my hon. Friend knows that if we were to do this we would from some other source have to find £25 million of very valuable revenue.

asked the Secretary of State for Social Services if general practitioners in rural areas who dispense medicines for their own patients will receive additional remuneration for the collection and other arrangements involved in prescription charges.

No, Sir.

Is my hon. Friend aware that this is causing considerable difficulty for rural practitioners, who feel that they are being paid half a crown for their services—about one-tenth of what a plumber gets? If my hon. Friend cannot provide extra pay for them will he consider some kind of propaganda campaign, so that patients will be aware of the situation?

No undertaking was given, nor was the matter raised when the scheme was initiated. The rural doctor has much less of a job to do than the chemist. He is not required to secure a written declaration of entitlement to exemption. He does not have to give a receipt and collect the refund. He knows his patients in a way that the chemist does not. Therefore, the problems for him are very much less onerous than they are for the chemist.

Does the hon. Gentleman accept that this matter is causing considerable concern among rural practitioners, who find that their costs are rising? There is also the fact that it is becoming increasingly difficult for patients to get to their places of business. This is a matter of importance. I hope that the hon. Gentleman will reconsider his answer.

I will bear in mind the points that have been raised by hon. Gentlemen, but it is my present conclusion that there is no need for a change.

asked the Secretary of State for Social Services how he intends to check the veracity of persons who claim to be exempt from prescription charges because they hold a season exemption certificate; and what is his estimate of the cost of this check.

Comprehensive records maintained by executive councils and social security offices, including records of the issue or prepayment certificates, enable them to determine whether or not patients are entitled to exemption and systematic sample checking is already in progress. I would expect the total additional cost to be of the order of £50,000 a year, only a small part of which would relate to declarations concerning prepayment certificates.

Does that £50,000 include any legal prosecutions that may arise?

It does not include them, and one naturally hopes that they will not arise. My present impression is that there is likely to be very little misappropriation or failure to carry out the regulations. I hope that it will not be necessary for any prosecutions to be instituted.

Would it not be a tremendous saving if Income Tax were used as the means test to end all means tests, and all these investigations of people's circumstances were dropped?

The hon. Member is doing his best, but that is another question.

asked the Secretary of State for Social Services if he will take steps to designate all patients who need hospital treatment as chronic sick and exempt them from prescription charges.

No, Sir. No charges are made to in-patients, but we do not think there are grounds for any general differentiation between hospital out-patients and the patients of general practitioners.

Does the Minister not appreciate that prescription charges are completely against the principle of a health service free for all in time of need, in which we believe? Does he realise that hon. Members on this side of the House believe that people who need hospital treatment are being penalised—especially those on low wages? Cannot something be done about this?

Those who have very small incomes are exempted. I told the House in answer to earlier questions, that approximately 50 per cent. of the general public is exempted. I am certain that the proposal put forward by my hon. Friend would lead to a great deal of difficulty.

asked the Secretary of State for Social Services what estimate he has made of the cost of additional staff in hospitals needed for the collection of prescription charges and of the cost of the additional clerical and bookkeeping work involved; and if this sum will be taken into consideration when he assesses the benefit to the Exchequer accruing from these charges.

About £75,000; this has already been taken into consideration.

Is the Minister aware that early this afternoon he gave a figure of savings amounting to £25 million through the imposition of prescription charges? Does not he now agree that with the additional cost involved it is not worth the candle to do this kind of thing to people who are in need? Will he seriously consider abolishing the whole scheme?

I am afraid that I do not for a moment accept my hon. Friend's conclusions.

Why not?

Because when the estimate of the £25 million saving was made the figure I have given and other figures were taken into consideration. The amount of money involved is very important in terms of the expansion of the hospital services.

Is the Minister aware that this £25 million saving is not a real one but is only a saving in terms of the transfer payments involved, whereas the waste of manpower involved in clerical operations such as he has mentioned represents the true cost to the nation, since the people concerned could be employed on more useful duties?

The hon. Member has referred to clerical workers. Only about 100 clerical staff are concerned. In the majority of cases the work is done by other persons doing tasks additional to those that they were already doing.

asked the Secretary of State for Social Services what instructions have been given to the special investigation officers of the Department of Social Security to ensure that they do not assume untenable rights of entry to and search of private houses.

It is made clear to all officers dealing with claimants to supplementary benefit that they have no right of entry into houses.

I am grateful for that reply. Would not the Secretary of State agree that many people who are visited by these officers are very hazy about their rights, and that it is, therefore, essential that the officers when calling should make it completely clear to the householder that they, the officers, have no right either of entry or of search?

I think I know the case to which the hon. Gentleman refers, and I have personally looked into it. I am convinced that the officer in question was a perfectly normal officer and did what he should. Mind you, when people are vague about their rights they will ask somebody inside from the front door because they do not want to be seen talking to him at the door.

asked the Secretary of State for Social Services whether he will reconsider his recent policy of deciding on a re-imbursable price for prescription drugs based on the price of imported products presented in simple forms, in view of its discouraging effect on the main British-based pharmaceutical companies.

I take it that the hon. Member has in mind those few drugs which are prescribed by generic name and which are marketed only under brand names and at more than one price. My right hon. Friend sees no reason to alter the long-standing practice of fixing the reimbursable price of these drugs on the assumption that chemists will have bought the lowest priced brand generally available. He has, however, decided to make a change in the form in which the reimbursable price is notified to avoid mentioning any brand by name.

Now that the imperative need for the saving of imports has been made all the more dramatic by the Government's recent actions, would not the Minister of State agree that the dispensers' reimbursement fee should in future be based upon the much reduced prices of the old established and reputable British-made brands rather than on doubtful and untried imported brands?

The hon. Gentleman would be wrong in assuming that the cheapest brand is always the imported brand. He must also recognise that, while we must watch the balance of payments, we must also watch the cost, and our anxiety is to see not only that the appropriate and suitable drug is available but that we get value for money.

Will the Minister of State give two undertakings to the House; first, that any use of cheaper imports, or cheaper home manufacture for that matter, does not result in a narrower range of preparations being available, that is to say, only in the more simple form of capsules and tablets; secondly, to watch for any fall off in safety or efficacy, as happened some years ago in the case of a tetracycline syrup for children?

I will watch both these matters, but the changes to which I referred in my answer will have neither of these implications.

asked the Secretary of State for Social Services when the White Paper on future development of social insurance will be published.

As I have already said, later this winter.

Will the White Paper be limited to the National Insurance system and the social security system, or will it deal also with the Health Service?

We had better await the White Paper. It is likely to be a formidable document. It certainly will have some relation to the Health Service.

Was it not the Government's intention that a Green Paper should first be published so that there should be adequate discussions on this at all levels in the community, including trade union branches?

It will be a White Paper which will stimulate discussion. It will make perfectly clear that, before we finalise the arrangements for the Bill which we hope to present in the next Session, we are willing and eager to hear representations from all sides.

Will the right hon. Gentleman say whether it is true that this publication is being held up by the Chancellor of the Exchequer?

Yes, I can deny that.

Is the right hon. Gentleman aware that already the Health Service is under discussion in the Green Paper, in the Todd Report on Medical Education and in the Seebohm Report? Is not this the last straw that will break this camel's back?

When he sees the White Paper the right hon. Gentleman will find that it will be concerned only with the issue of the Health Service contribution.

asked the Secretary of State for Social Services what action the Government expect to follow the completion of the field work in January of the study of the disabled being carried out by the Government Social Survey.

This will largely depend on the results of the survey.

Will the Government ensure that appropriate bodies are given the task of pursuing the next stages of this investigation, once the information about the disabled is available, in order to ensure that the impetus is maintained?

I will certainly consider that suggestion. The survey will be a formidable affair, and tabulation and analysis will take some months. I will consider any proposals for the constructive use of the figures and statistics when we have obtained them.

asked the Secretary of State for Social Services if he will now make a further statement on the practice of Scientology.

After careful consideration, I have decided that the right course is to leave things as they are, at any rate for the present. The specific measures announced by my predecessor were directed at limiting the number of foreign nationals studying and practising scientology here; I consider that these are justified on the basis of existing information. No further measures are contemplated.

Is the Minister aware that that is about as unsatisfactory an answer as could be made by the Government? The Government have sufficient information, one supposes, to justify the actions which they have already taken. Should not this information be made public, so that at least the Press and other people can make free comment upon what the Ministry already knows?

I considered the possibility or desirability of two courses of action. One was a public inquiry and the other a White Paper. I have not excluded the possibility of a public inquiry, but I would like to reflect further on these matters. I think it would be an abuse of our tradition to publish a White Paper until after the inquiry had taken place.

Is my hon. Friend aware that in reply to a question on the last occasion he quite rightly described Scientology as a fraud? Is it not right, if it is a fraud, that the Press and others should be able to say so outside the House, and could he not set up an inquiry to make this possible?

I agree with my hon. Friend. There are strong reasons for an inquiry along those lines. I think that the Press is free to print the truth about Scientology, and I have no doubt that, in this sense, my hon. Friend's action last July has resulted in a great deal of the truth being published with favourable effects on the behaviour of the Scientologists, who have withdrawn one or two of their more contentious claims, but I should rather leave things as they are at the moment.

Is the right hon. Gentleman aware that there are a number of citizens, some of them councillors, in East Grinstead who can be inhibited from making what I regard as perfectly fair and proper comment in pursuit of their public duties because of the inaction of the Government, or, if not because of that, at least because, under prevailing conditions, they feel, as a result of libel writs issued on them, that they must pursue a policy of silence, and the right hon. Gentleman's statement has hardly been helpful to them.

I would not agree wholly with the hon. Gentleman, because it is my impression that a great deal of valuable investigation has taken place by the Press and a great deal of interesting information has been published, despite threats of libel action, which have not materialised. I think that the Press is to be congratulated on the thorough investigation it is doing on this activity.

I regret that I find the right hon. Gentleman's answer unsatisfactory. Does not he feel that it would be better to have an impartial objective inquiry rather than taking Executive action based on evidence of which some of us are aware, but of which the public are not aware?

As I said on the last occasion when I answered Questions on this matter, I think that this is a very evenly balanced issue. There are arguments in favour of a public inquiry, but, for the moment, I should like to let the matter run because, on the whole, we are getting a lot of information published, and I think that what I described last time as fraudulent practices are, to some extent, being curbed.

Can the right hon. Gentleman say in how many cases proceedings have been taken against Scientologists for offences against our laws? If the right hon. Gentleman's complaint against Scientologists and the action taken by his predecessor was taken solely on the ground that they were socially undesirable activities, is not that a dangerous precedent to set in the sense that it might be applied to many other religions?

I think that the action taken was justified on the basis of the information that we had. The action did not take the form of prosecution, but merely forbidding foreign nationals to study and practise Scientology here. That seemed a legitimate course of action, but I do not propose to take any further measures.

asked the Secretary of State for Social Services what success has been achieved from the policy of making more rigorous checks on the bona fides of young people applying for social security benefits.

I understand that my hon. Friend is referring to the new steps relating to young unemployed persons announced by my right hon. Friend the Paymaster-General as Minister of Social Security, on 25th July, following consultation with the Supplementary Benefits Commission. Between 14th October and 19th November, 8,950 young, single, unskilled men were given short term allowances under these arrangements when they first claimed; and 605 men and women under age 45 had their allowances curtailed on review after receiving them for three months. In the same period 113 appeals were heard against cessation of an allowance, of which 10 were revised by the Appeal Tribunals.

Is my hon. Friend aware that the measures to which he has referred for tightening the procedures by which young people get supplementary benefits will be welcomed in the country as a whole? Can my hon. Friend say whether there is any evidence that many young people are deliberately choosing, or applying, for supplementary benefits instead of applying for work?

I am grateful to my hon. Friend for what he said at the beginning of his supplementary question.

Although many alleged cases of abuse are based on hearsay, and do not stand up to detailed examination, it is, nevertheless, demoralising for a wide section of the working population, and particularly the elderly, who genuinely believe that many young people, particularly in seaside areas, are abusing the Social Security scheme. Will the Minister do all in his power to let local Social Security offices show what they are doing to check abuses?

I shall be grateful for any suggestions as to how we might better the present system. I agree with the hon. Gentleman that we want to stamp out any abuse which occurs. I shall be grateful for any evidence of such matters. I assure the hon. Gentleman that any cases will be thoroughly investigated.

asked the Secretary of State for Social Services how many widows of former field marshals are included in the 115,900 war widows who receive pensions.

One, Sir.

In that case, was it not unworthy of the Chancellor of the Exchequer to use as an argument against exempting war widows' pensions from taxation that the widows of field-marshals would have to be included? Will the hon. Gentleman ask the Chancellor of the Exchequer to reconsider the whole matter?

As the hon. Gentleman knows, questions on Income Tax should be directed to my right hon. Friend the Chancellor of the Exchequer.

Can the hon. Gentleman give an assurance that the priorities which were allocated to war widows under the previous set-up will be continued, and can he say which Minister has specific responsibility for these matters?

If the hon. Gentleman puts down a Question about that. I shall answer it.

asked the Secretary of State for Social Services how many war pensions are paid to widows of soldiers who were killed while driving army lorries in Great Britain during the Firs' and Second World Wars.

I regret that this information is not available.

May I put a similar supplementary question to that which I put on the last Question, and ask the hon. Gentleman to request the Chancellor of the Exchequer to reconsider the whole of this problem?

The hon. Gentleman must accept my previous reply. The Chancellor of the Exchequer will, of course, see what the hon. Gentleman has said, but questions relating to Income Tax are not for me.

asked the Secretary of State for Social Services whether the proposed graduated national insurance pensions will be adjustable to take account of changes in the cost of living.

I would ask the hon. Gentleman to await the White Paper on the Government's proposals.

is the hon. Gentleman aware that there is widespread apprehension that the Government's graduated scheme will be a backstairs take-over of the private insurance companies? Will the hon. Gentleman give us some assurance about that?

I think that my right hon. Friend dealt with that earlier today. The widespread apprehensions will be ended very shortly.

When may we expect the White Paper? We have been waiting quite a long time for it.

Answer.

asked the Secretary of State for Social Services what studies he has made to ascertain the proportion of marginal spending power which may be withdrawn from individuals through the incidence of income tax, National Insurance contributions or through the loss of entitlement to special supplements or other benefits without any measurably depressing effect on the incentive to increase earnings.

The points at which these widely disparate items might begin to have an adverse effect on incentives to earn more must obviously vary considerably not only from item to item, but also from individual to individual according to income, family circumstances and disposition. I doubt whether an attempt to subject them to precise measurement would assist greatly in solving the problem.

Will not the application of selectivity in the social services always be limited by the effect on incentives? Is not this a matter which deserves widespread investigation?

Yes, Sir. My only point was that I doubt whether the kind of investigation which the hon. Gentleman wanted would tell us a great deal about it, because I agree with the hon. Gentleman in his conclusion. I think that the application of selectivity reduces incentives, and, therefore, should be avoided wherever it is humanly possible.

asked the Secretary of State for Social Services what recent estimate he has made of the number of men in full-time employment whose family income is less than that obtainable through unemployment benefit and social security provision; and what action he is taking to reduce this number.

Our main object in increasing Family Allowances this year was to help such families. No reliable estimate of the effect of these increases or of how many such families there are now, is available.

asked the Secretary of State for Social Services what study he has made of the computerisation of the individual family into a positive-negative income tax system; and what plans he has within the ambit of the current major social security review for introducing social security benefits based on negative taxation.

On the first part of the Question, I would refer my hon. Friend to the answer given by the Chief Secretary to the Treasury to the hon. Member for Chigwell (Mr. Biggs-Davison) on 7th March, 1968. On the second part of the Question, the Government's proposals for the future of national insurance will be announced in the forthcoming White Paper.—[Vol. 760, c. 134.]

But would not my right hon. Friend agree that, irrespective of the steps the Government are taking to close gaps in the social security system, immense gaps will remain unless there is some system of a negative Income Tax basis with a work incentive? Will my right hon. Friend give priority to helping lower-paid workers by introducing some scheme with that sort of basis?

I do not think that helping lower-paid workers is necessarily only to be achieved by introducing negative Income Tax, of whose practicability I am profoundly sceptical, if for no other reason than that there are a great many workers who do not pay Income Tax.

Would not the right hon. Gentleman agree that P.A.Y.E. and the social security system run so closely together that they should be combined, and would not he agree that, if they were combined, there would be substantial administrative savings?

I hope that the hon. Gentleman observed the skill of the Chancellor of the Exchequer on the last occasion in his notorious claw-back in getting the first successful combination between Social Security and Income Tax personal allowances.

Is my right hon. Friend aware of the negative Income Tax experiment that is being run by the Office of Economic Opportunity in the States? It so, will he look at it very carefully, because negative Income Tax can be a radical means of supplementing low wages? It is not necessary for the workers concerned to be paying Income Tax.

It may not be necessary, but one of the claimed advantages of the scheme is that one has a single form to fill in whether one is receiving from or giving to the State. The point I made was that millions would have to fill in forms who had never filled in an Income Tax form in their lives. I suggest that there really are very great practical difficulties in the scheme being tested in the States, and I cannot give my hon. Friend any confidence that in the near future we shall be able to rely on it as a kind of cornucopia.

asked the Secretary of State for Social Services why he will not introduce legislation this Session to restrict cigarette advertising and sales promotion; and what further steps he is taking to increase the effectiveness of deterrent propaganda against smoking among young people.

I am now considering a number of proposals designed to discourage cigarette smoking, especially among young people. The preparation of adequate measures is by no means easy and it is unlikely that the Parliamentary timetable will allow legislation this Session. The Health Education Council is undertaking several measures of publicity, and also research into the effectiveness of the smoking and health campaign and of the different techniques that can be used.

I appreciate that there are some difficulties in this matter, but is it not the case that my right hon. Friend accepts the report of the Chief Medical Officer of the Ministry of Health that over 50,000 people die yearly as a result of cigarette smoking? Would he not, therefore, agree that it must follow that in course of next year another 50,000 people will be lured to their deaths by the cigarette manufacturers, and is there not some urgency in the matter?

There is enormous urgency in the matter, and I accept the figures of Sir George Godber. But the sole issue is not how or whether one taxes cigarette advertising: there are other ways of handling the problem, and I believe that our own positive propaganda, especially to young people, must take top priority.

Will the right hon. Gentleman not ignore the fact that at present the tax from tobacco is almost equal to the cost of the whole National Health Service?

I certainly do not ignore it, and I suspect that my right hon. Friend the Chancellor of the Exchequer does not, either.

asked the Secretary of State for Social Services whether he will cause an inquiry to be made into the disease suffered by shipyard workers and known as welder's lung.

I assume that my right hon. Friend has in mind welder's side rosis or iron-oxide lung. This is a benign condition which causes neither symptoms nor disability. Toxic fumes or dust which may arise in the welding process may occasionally cause disablement. Such cases are already covered either by the accident provisions of the Industrial Injuries Act or in the existing schedule of prescribed diseases.

I am obliged to my hon. Friend for his reply and for the pains he has taken over this inquiry. Is he aware that we have recently been very disturbed in the shipyards at the incidence of this disease? That being so, will he see that closer attention is paid to it, so that the cause can be diagnosed more carefully? This disease has caused very serious disturbance on both sides of the shipbuilding industry.

I am well aware of that, and I am also aware of the individual case in my right hon. Friend's constituency. If he will allow me to, I will write to him about the case, and deal with the various aspects.

asked the Secretary of State for Social Services what action he is taking pursuant to the report of the British Medical Association on Aids for the Disabled, a copy of which is in his possession.

We are at present considering the report.

As many of the recommendations can be carried out administratively, will my hon. Friend expedite this consideration and as soon as possible publish a reply saying what steps he feels able to take?

I am giving urgent consideration to a number of the proposals. Some of them are quite complicated, requiring much more than administrative decision. But it is a very valuable report, and it has been treated very seriously. I will let my right hon. Friend know the outcome.

asked the Secretary of State for Social Services what estimate he has made of the amount of carbon monoxide discharged into the atmosphere each year; at what rate he estimates that it will increase; and what accumulative effect he estimates that it will have on health.

None, Sir. I understand that such an estimate would have little practical value. The total amount discharged is likely to increase broadly in accordance with any increase in the output from petrol-driven vehicles. No cumulative effects on health are expected.

Is the right hon. Gentleman aware that an increasing number of people are becoming alarmed about air pollution? Can he give a categorical assurance to the House and to the country that the build-up of carbon monoxide, due to the increasing number of vehicles on the road, is not likely to provide a hazard to health?

Yes. I have just given it.

asked the Secretary of State for Social Services if he will make a statement on his recent official tour of certain areas in Scotland.

I visited three of our Department's local offices and a reception re-establishment centre. I was much encouraged by the way in which the staff are tackling the heavy load of work which they are bearing, often under difficult conditions. I was also very interested to visit Livingston new town. I have no other statement to make.

Is my right hon. Friend aware that his visit to Scotland created a great deal of interest? As a result of that interest, is he not going to put forward any suggested alterations?

No. I was extremely interested to see the offices and the excellence of their work. I am relieved to hear that the excitement that my visit created was of a favourable nature.

asked the Secretary of State for Social Services how many local health authorities are now giving a fully comprehensive family planning service, including facilities for unmarried girls; how many are giving a partial service; and how many are providing no service at all.

Of the 169 authorities which have so far reported to my Department all but one report provision of a service, and about 80 per cent. report some expansion as a result of the 1967 Act. Sixty-five authorities specifically mention provision of some service for the unmarried.

Those are disappointing figures a year after the passage of the Family Planning Act. Why has the whole comprehensive service not been more widely provided? Is it due to lack of interest or to lack of cash?

There was an expansion of the service even before the 1967 Act was passed. The expansion of the service has been substantially accelerated as a result of the passing of the Act. It is true that there are some authorities which have made it clear that they have not expanded their services as far as they would wish, for financial reasons. There are a number of authorities which have made clear what their future plans are but have not carried them out in the present financial year.

Is the hon. Gentleman aware that the Secretary of State for Scotland has apparently told local authorities in a circular that, as an economy measure, they should not proceed with family planning clinics? Is not this one of the strangest economy measures of all?

That is a question which must be addressed to my right hon. Friend the Secretary of State for Scotland. No such circular has been issued from my Ministry.

asked the Secretary of State for Social Services if he will seek to arrange for the National Insurance contributions of mature students in teacher training colleges to be credited to them for the duration of the course of study.

No, Sir. These students are not obliged to pay contributions for periods of full-time study, but in fairness to the general body of contributors to the National Insurance Scheme there must be strict limits to the circumstances in. which contributions can be credited.

But is it not wrong that, although these mature students need not pay contributions, they forgo their pension rights and other benefits meantime? Is there any reason why mature students should be treated worse in this respect than young students, whose family responsibililies are usually much less and who can the more readily afford the contributions involved?

No, Sir. If the mature student was paying the non-employed rate of contribution there are special arrangements enabling him to have certain cover if he had a substantial period of employment before the course. He would benefit by this concession, which is for the mature students.

Has not the time cone to eliminate the whole antiquated nonsense of counting contributions and stamp-licking, and to integrate National Insurance contributions into Income Tax?

That is another question. If the hon. Member puts it on the Order Paper I shall try to answer it.

asked the Secretary of State for Social Services what recent discussions he has had with the Birmingham Regional Hospital Board over the future of medical services in Rugby.

The board has assured me that it its intention to maintain St. Cross Hospital with at least its present size for the foreseeable future. The board is at present reviewing its future capital programme, including proposals for expanding this hospital.

May I thank the Depart-men: for its continuing interest in our problems, but would the Minister agree that many of the fears of my constitu- ents would not have arisen if the Board had told them what it was doing? Can he take any steps at all to improve its public relations?

I will certainly bear in mind what my hon. Friend says and discuss the problem with the Board.

asked the Secretary of State for Social Services whether he will increase to an economic level the charge for hospital services after a road accident for which a driver is liable.

My right hon. Friend is considering action to increase the charges payable under the Road Traffic Act, 1960.

But as these charges are only 12s. 6d. at the moment, is not this a rather extraordinary way of tackling the problem? Why should those who are injured but who can well afford to pay even the heavy costs incurred pay only 12s. 6d. when they can afford to pay the full charge?

Increases are at present being negotiated, and consultations are well advanced, and I expect to make a fairly early announcement about this.

asked the Secretary of State for Social Services what plans he has for relieving the present shortage of operating theatre nurses.

I would refer the hon. Member to my reply on the 18th November to the hon. Member for Farnham (Mr. Maurice Macmillan).—[Vol. 773. c. 211.]

Will the hon. Gentleman say when the report is expected, and will he comment on the alarming reports from many parts of the country that staff vacancies are not being filled because there is no money to pay the salaries?

The latter point raised by the hon. Gentleman is at present receiving the urgent attention of my right hon. Friend the Secretary of State. It is important to remember that the total of all nursing staff is now at the highest ever recorded level. We are taking steps to try to relieve nurses with special skills of unnecessary duties. The hon. Gentleman will know that it is not possible to lay down a hard and fast rule about the number needed in operating theatres, for instance, since the design of these theatres is so varied and makes different demands.

asked the Secretary of State for the Social Services whether he is satisfied with the facilities available for ear, nose and throat operations on children in the Birmingham area; and whether he will make a statement.

Cases of medical urgency are admitted at once but the waiting period for other ear, nose and throat patients has lengthened recently. The Board have been asked urgently to consider what steps can be taken to improve the situation.

Will the Minister not recognise that he is condoning a pretty harsh definition of urgency, and that for a boy who is known to be deaf to have to wait nine months for an operation to give him hearing is particularly harsh, bearing in mind the amount of valuable education time he loses for ever?

This is a matter for clinical judgment, but I certainly agree that it is important that those who are likely to suffer as a result of not being admitted at the time when they would wish should be given some priority; it is a question of the degree of priority.

In view of the unsatisfactory nature of the reply, I beg to give notice that I shall seek to raise the matter on the Adjournment.

asked the Secretary of State for the Social Services whether he will extend the provision of cervical cancer smear tests for women under 35 years of age.

Not at present, though we are keeping this matter under review.

Since in reply to questions on 15th November the Minister made it plain that it was neither a ques- tion of cost nor of pressure on the service for the women over 39, will he not now reconsider the matter, bearing in mind that it is the women between 29 and 39 who have had children who are supposed to be at greatest risk?

From the figures we have at present, it looks as though about £1½ million women will be tested during the current year. This will be a considerable increase, and many of them are women of 35 and less. But there is a regrettable reluctance on the part of too many older women to come forward for testing. Lives are at stake here. We must give priority to the over-35s, who are so much more at risk than those under 35.

asked the Secretary of State for Social Services if he will instruct the hospital boards to issue a directive, so that people in the Alton area may know with certainty to which hospital their relatives or children have been taken in emergencies, or after road accidents.

No, Sir. When a patient is admitted after an emergency or accident it is normal practice for the hospital to see that relatives are informed.

Is not the hon. Gentleman aware that there have been instances in this town in my constituency when parents, informed of the destination of their child, have arrived at the hospital and found that the child had been sent to a completely different hospital quite outside the accepted run of the hospitals receiving emergencies?

I should like to look into this case, and perhaps the hon. Lady will send me the details. We have a drill laid on, which has worked reasonably well whereby the police, when they have been concerned in an accident, inform the relatives, and whereby, when casualties have been brought into the hospital direct, the hospital notifies the relatives, if necessary with police help. I should like to examine a case such as the hon. Lady has mentioned.

asked the Secretary of State for Social Services why he will not allow group hospital management committees to provide such accident and emergency facilities within their hospitals as appear necessary to them, in view of their local knowledge and experience.

Because these services need to be planned and organised on a regional basis to make the best use of resources in the interests of patients.

Does that reply mean that hospital committees of group hospitals do not have the right and power to provide facilities in the towns where hospitals already exist, fully equipped, and where casualty and emergency services are already run on a part-time basis?