asked the Secretary of State for Social Services whether the meals supplied to hospital nurses are at standard charges and of standard quality and quantity throughout the country; and whether hot drinks of tea, coffee or milk are subject to additional charges.

I have asked hospital authorities to ensure that meals are provided at the standard charges and I rely on them to achieve the highest possible standards of quality and quantity. Some hospitals also provide alternative meals at charges determined locally. Beverages are subject to additional charges if not paid for as part of a basic meal, but the Whitley Council has now agreed that the cost of beverages supplied to resident nurses outside mealtimes should be regarded as covered by their existing annual lodging charge.

The right hon. Gentleman has, I think, acknowledged that there is a good deal of evidence that the charges and the quality and quantity of meals are not uniform throughout the country and meals are sometimes inadequate. Does he not think that the pay-as-you-eat scheme, not in principle but in practice, is often working out in a thoroughly unsatisfactory way having regard to the demanding nature of the nurses' work?

I am glad that the hon. Gentleman agrees that this is something for which the nurses themselves have been asking, although it has worked out irregularly because of the variations in practice of the different areas. This is, I think, being averaged out, but there is still a good deal of dissatisfaction even in spite of that.

Bearing in mind that a little progress has been made, will the right hon. Gentleman tell me when the next Whitley Council, which he says is to meet, will in fact meet? Further, I ask him again whether he will give adequate instructions to the management side of the Whitley Council so that it may really deal with the question of nurses' pay, student nurses' pay and all the matters which are essential to the nursing profession?

I am grateful to the hon. Lady for agreeing that some little advance has been made—

Very little.

—some little advance on the beverages side. On the other other side, as she knows, the position is that the staff side rejected the offer and made a claim for an increase of £1 a week for younger students, pupils and nursing auxiliaries, or, alternatively, the issue of a free meal voucher for a main meal each day. That is now being considered. My Ministry is considering it very seriously indeed, but the hon. Lady will appreciate that the idea of my simply ordering all the authorities concerned to follow a certain line would not be in accord with the Whitley Council tradition.

This is a most unsatisfactory "beverage report". Will my right hon. Friend take immediate action to give social justice to the nurses and avoid growing militancy?

I am very anxious to get this settled, and I agree with my hon. Friend that more should be done. This is why I said that we were very seriously considering the staff side's demands.

When is the Council to meet?

Are we not in danger of some confusion here about whether what is really wrong is that the charges for nurses' food are too high or the pay for nurses generally, and student nurses in particular, is too low? If the right hon. Gentleman is in such great difficulty, could he not, perhaps, ask his right hon. Friend the Secretary of of State for Education and Science to put up the price of school meals and give him something to help him out?

That is a suggestion which I am prepared to consider—coming, as it does, from that quarter.

asked the Secretary of State for Social Services what consideration he has given to the Goodmayes Hospital site in deciding where the proposed new District General Hospital to serve the Ilford area should be built.

asked the Secretary of State for Social Services whether he had now considered the question of the allocation of a new district general hospital to the Ilford area; and if he will consider the Goodmayes Hospital site for this purpose.

Development on the Goodmayes site is one of several possibilities under consideration.

Is the right hon. Gentleman aware that the lines of communication with, and the sense of participation by, the general practitioners who are so vitally concerned in this area are totally inadequate? Would he arrange for the hon. Member for Ilford, South (Mr. Arnold Shaw) and myself to discuss with him this problem of the site?

I should be delighted to do that. I was at Ilford the other day and I had a long discussion with members of the hospital management committee and the regional hospital board. If the general practitioners wish to make representations through their Members, I shall be delighted to hear them.

May I ask my right hon. Friend to take the hon. Gentleman's request into consideration? Is he aware of the deep concern in Ilford about the future of the hospital services there?

I was made aware of it during the afternoon that I spent there. I realise that there are major decisions to be taken, and I should like local community interests to be fully appreciated when they are taken.

asked the Secretary of State for Social Services what percentage of beds in National Health Service hospitals was occupied by geriatric cases and mental health cases, respectively, in 1960, 1964 and 1968.

With permission, I will circulate figures in the OFFICIAL REPORT.

I am not particularly grateful for the Answers which I am getting from the Secretary of State this afternoon. Will he confirm that a large proportion of beds in National Health Service hospitals are occupied by geriatric and mental patients, and say what his Department is doing to provide accommodation for such patients in other than ordinary hospitals, so that ordinary hospital beds may be occupied by people needing urgent treatment?

I do not think that the figures bear out what the hon. Gentleman says. Between 1960 and 1968 there has been a decrease in mental illness beds of nearly 20 per cent. and a slight increase in geriatric beds of 1·6 per cent. This is very proper, since we need more geriatric beds and, because of the rapid turnover of mental patients, fewer mental illness beds, so the percentage is related to the need in that period.

asked the Secretary of State for Social Services what is the waiting list for the fitting of bone conduction hearing aids in the area of the South Teesside Hospital Management Committee and the average length of time that patients have to wait before being supplied with these appliances.

Twenty-nine patients for initial fitting and 48 for replacement aids. Three to four months.

Although this is a welcome improvement on the position earlier this year, many people are still having to wait an undesirable length of time. Will my hon. Friend continue to make every effort to ensure that the waiting period is further reduced?

I will, indeed. In the last two months there has been a considerable improvement, partly because a new supplier has been found for a component which has caused particular difficulty. Pressure is being exerted on contractors to improve delivery, and we shall follow this very carefully.

asked the Secretary of State for Social Services what steps he is taking to improve the procedure for the delivery of centrally supplied vehicles ordered by hospital management committees through his Department in conjunction with the Ministry of Defence.

The procedure is being discussed with the Ministry of Defence.

I welcome my hon. Friend's reply. Will he look seriously into the complaints which I have sent to him about the length of time, sometimes more than 12 months, which hospital authorities have had to wait for vehicles, and the quality of workmanship of the vehicles when they are delivered?

For most vehicles there are no delays, and there are few difficulties in meeting orders of hospital authorities for standard cars and commercial vehicles. The delay has been for specialised coaches and commercial vehicles. We are looking into the points which my hon. Friend has made, and I will give him as full an answer as I can.

asked the Secretary of State for Social Services (1) whether he will re-examine the rôle of the general practitioner in the hospital service;

The rôle of the general practitioner in the hospital service has been expanding, especially in maternity work, and is now receiving consideration by a number of committees of the Central Health Services Council and of the Standing Advisory Committees. I will further study the position in the light of their reports.

Would not it be more efficient, humane and economical for the elderly sick to be cared for in small general practitioner hospitals, instead of in large, consultant-run hospitals far from the patients' homes, which results from the policy of closing small hospitals?

It would be fair to say that the policy of regionalisation, with the big district hospital, is one which we inherited from our predecessors. I am looking at it with a critical eye because of various problems, but I have no doubt whatsoever that in terms of modern scientific advance and medical efficiency we must recognise that there are a large number of operations and treatments which must take place in that kind of hospital. The problem of geriatrics is a special one. I favour the idea of moving them out of the hospital service altogether, but that requires the local authority to have not only the will but the cash to do so.

Does the Secretary of State recognise that it is often false economy to close small hospitals, which can be used admirably by the general practitioner to care for elderly patients?

I repeat, the closure of small hospitals did not start with this Government. I and my Minister of State personally, as did our predecessors, supervise each closure and look carefully at it, with a very sympathetic eye from this point of view.

asked the Secretary of State for Social Services (1) why no capital expenditure was planned for 1968–69 and is planned for 1969–70 for extensions or improvement projects to Exmouth Hospital;

The South Western Regional Hospital Board did not accord the same priority to capital expenditure at these hospitals as to schemes included in its programme for 1968–69 and 1969–70.

Does the hon. Gentleman realise that among doctors and many of the smaller hospitals in Devon, which are providing a massive service for the local population, there is the feeling that all expenditure is going into improvements in Reading—I am sorry, I should have said Exeter—and that if the small hospitals were to be closed down the extra numbers on the waiting lists of people wanting beds would be so great that it would be impossible to meet the demands?

Obviously we cannot spend money on everything all at once, I am glad the hon. Gentleman has now remembered which constituency he represents. Capital expenditure is now being concentrated in Exeter, which is the district general hospital for the area, in which substantial sums have been spent—£160,000 in 1968–69, and £925,000 is expected to be spent this year on the new Wonford Hospital in Exeter, providing 446 beds. In addition £348,000 was spent in 1968–69, and £775,000 in 1969–70 on other schemes in the Exeter area.

asked the Secretary of State for Social Services whether he will now establish a commissioner to investigate complaints by both staff and patients in the National Health Service.

I have nothing to add to my reply to the hon. Member for Hampstead (Mr. Whitaker) on 16th April.—[Vol. 781, c. 272.]

Will the right hon. Gentleman press ahead as fast as possible and ensure that when a commissioner is set up he will be entirely independent of Ministers?

I made it clear earlier that I am not pressing ahead as fast as possible with this because I first want to establish the hospital advisory service under its director and see how far that meets one side of the problem, which is the need for somewhere to which members of the staff of the services can go with their complaints without fear of victimisation. I want to get that established. Both these proposals require very careful examination in view of the professional interest of doctors and nurses that their freedom should not be violated. I promise to consult them on both aspects.

Would my right hon. Friend agree that there is need for a health ombudsman quite distinct from an inspectorate? Could he give a date for an announcement on this subject, in view of the fact that Scotland has had such a successful system operating in the mental health scheme for many years?

We had this system, of course, in our mental health service for a good many years, but we got rid of it some time ago. We want to put in its place something better. I cannot give my hon. Friend a date because I want to get the hospital advisory service going and then to see how the commissioner fits in. I myself am convinced that there is a substantial case for a public health commissioner, but such an office should not be confused in its functions with the hospital advisory service and its inspectorate.

asked the Secretary of State for Social Services what parts of the National Health Service will be cut as a result of the reallocation of resources within the National Health Service to mental hospitals.

In my recent discussions with chairmen of regional hospital Boards, I asked chairmen to report by July on the reconsideration of the distribution of revenue funds to which I referred in my reply to the hon. Member on 12th May.—[Vol. 783, c. 972–4.]

In view of the urgent need for more money for mental hospitals and for nurses' pay and the like, does not the Minister think that it is absolute folly to raise £½ million more in health charges and then to hand it over to the education services?

It would be folly if it was done. But any Minister who attempted to do this would be forbidden to do it by his Permanent Secretary. Therefore, I would advise the hon. Gentleman not to believe in something it is said I did.

Would my right hon. Friend bear in mind that he gives the impression of somebody whose left hand does not know what his other left hand is doing? Are we to take it as a precedent that the National Health Service now has so much money that it can afford to give it to another Government Department?

That would be a wrong conclusion to draw from my answer to Question No. 33.

asked the Secretary of State for Social Services in view of the fact that there are a number of old people in mental hospitals who have no need of this type of attention, what action he is taking together with the local authorities to provide more hostels in order to help to relieve the overcrowding in this type of hospital.

I accept that there are old people at present in mental hospitals who might leave if accommodation elsewhere was available, together with the necessary support from day hospitals and other services. But no precise estimate of their number is possible. Loan sanctions totalling £14 million were given to local authorities in the financial year 1968–69 for building welfare homes for old people including the elderly mentally infirm, and I hope the total will be more this year and will continue to grow.

I thank the right hon. Gentleman for that Answer. Will he make a further survey so that we know the exact number? I am sure that he will agree that it would be a tragedy for any old people to remain in this undesirable environment taking up beds needed for people who really should have this type of treatment?

It is not a question of keeping an exact number. The particular clinical diagnosis whether an old person needs to be in hospital is a matter for the individual doctor. We know that there is a large number who never should have been put there. But that does not mean that we can take them out tomorrow, because they may have been institutionalised. Therefore, it is extremely difficult to give a precise number.

The Minister mentioned financial help for these hospitals. Does he recollect that he was going to do something for the South Ockenden Hospital? Will he say how much of the £3½ million that he has promised will go to the mental hospitals will go to this particular hospital?

It is too early to say, because the team that I sent in to give me a Report on the South Ockenden Hospital has not yet reported. But I will answer my hon. Friend directly I hear from the team.

asked the Secretary of State for Social Services whether he will make a statement on the experiments carried out in hospitals to fertilise human ova in test-tubes.

I would refer the hon. Member to my reply to my hon. Friend the Member for Bebington (Mr. Brooks) on 13th May.—[Vol. 783, c. 209.]

In view of public anxiety aroused by these experiments, legitimate though they may be, will the Secretary of State consider appointing a commission to report on their moral and social implications?

I will be a little more precipitate. I have a meeting arranged on Wednesday, 21st May, in the Ministry.

asked the Secretary of State for Social Services when he expects to receive the report of his advisory committee on transplant surgery; and whether he will publish it.

I expect advice from my standing advisory group soon.

But as heart transplant surgery has now restarted in this country, throwing up important ethical, moral and legal considerations, would the Secretary of State bear in mind that the public will in due course be looking to Parliament to provide necessary legislation to protect, not only the recipients of transplant operations, but also potential donors?

Yes, I am very much aware of this problem. My advisory group has a difficult job on its hands in trying to estimate public opinion, which on this subject is ambivalent and uncertain. In those circumstances, I do not think that it is wise to legislate until one is quite sure that one has the matter right and one knows the state of public opinion. It is better to leave it until things are clarified. But I would hope to get legislation if we are confident that the public will accept a view on the key issue.

asked the Secretary of State for Social Services whether he is now in a position to announce the names of the persons whom he has invited to serve as members of the Medicines Commission.

I cannot yet add to the reply my right hon. Friend gave to my hon. Friends the Members for Hampstead (Mr. Whitaker) and for Willesden, West (Mr. Pavitt) on 22nd April and 12th May.—[Vol. 782, c. 69–70. Vol. 783, c. 962–3.]

Will the hon. Gentleman bear in mind that delay in announcing the names of the members of the Commission is causing delay also in the issue of regulations, so that firms cannot make their own arrangements for such matters as tablet markings, containers, packs and so on? Will he at least assure the House that he is making advance arrangements for accommodation of the staff of the Commission's secretariat, since already even in the excellent Dunlop Committee's work, owing to under-staffing, there are considerable delays?

Order. Long supplementary questions and long answers mean fewer questions and fewer answers.

A good deal of consultation has to be done because a whole range of interests must be represented on the Medicines Commission. I can give the hon. Gentleman an assurance that it is our expectation to announce the names before the end of the summer.

Is it not also a fact that the Health Service would be richer by over £1 million a year if non-proprietary medicines were prescribed instead of their brand equivalents? Will the Commission be able to deal with that matter, or, if not, will the Minister?

With respect, that is a different question. If my hon. Friend will put a Question down, I shall do my best to answer it.

Is it the work of the Dunlop Committee being taken over by the Medicines Commission or is it the additional work imposed by the Act which is causing the delay?

There is consultation about the additional work caused by the Act. There is consultation about the membership of the Commission and how it should best be composed. This is the reason why we have not yet been able to announce the names. We want to get the Commission exactly right; it is a very important body.

asked the Secretary of State for Social Services if he will seek to apply selectively the proposed increase in retirement benefits announced in the Budget.

No, sir. To apply the increase selectively to retirement pensioners would undermine the contributory principle on which entitlement to those benefits is based.

Is it not clear that indiscriminate and across-the-board increases necessitate an increase in the National Insurance contribution, the magnitude of which is only just becoming apparent? Would the hon. Gentleman reconsider his position?

The amount involved in increasing pensions was made clear by my right hon. Friend the Chancellor of the Exchequer in his Budget speech. [HON. MEMBERS: "No."] Yes, indeed. I repeat what I said, that the amount required to increase the benefits was made clear by my right hon. Friend. To remove the right to a pension paid for by contributions over the years would be a betrayal, and I should be surprised if even the Conservative Party suggested that there should be means testing of the 7 million retirement pensioners before they got their rights.

Has my hon. Friend been able to discover whether the Conservative Party agrees or disagrees that there is an urgent need to increase retirement benefits? Comparing promise with performance, and allowing for the proposed increase, how will the value of the retirement pension compare with its value in October, 1964?

When the new pension rates are introduced in November, they will be 20 per cent., in real terms, above the 1964 level. It was impossible to discover from the debate on Thursday whether the Conservative Party wished there to be an increase, and if so how much, or how it would pay for it.

Can the hon. Gentleman now tell us how the £430 million will be found?

There is a later Question on the Order Paper about that matter to which my right hon. Friend will reply.

asked the Secretary of State for Social Services what consultations he has held on the problems of protecting pension rights in occupational pension schemes on changes of employment with organisations representing the beneficiaries of such schemes; and what consultations he intends to hold.

Informal discussions have been held with the T.U.C. and the National Association of Pension Funds. These bodies are among those who have been invited to comment on a consultative document and we expect to hold further talks when their replies have been received.

Has it been brought home to the Minister that people changing jobs are losing their pension rights at a rate well in excess of £100 million a year—in other words, at the rate of a great train robbery every nine days? Does not the hon. Gentleman appreciate the urgency of this matter, even if only to promote greater mobility of labour?

I am glad to hear that. It is precisely because so many people can neither transfer their pension rights nor have them preserved that we are bringing in this legislation. It is to remedy the faults of the past.

Is my hon. Friend aware that the fault is that of the employers and that I can quote many industries in which old workers are frightened of changing their jobs because the employers will not make their pensions transferable?

It is absolutely true that the failure of employers either to make the rights of pensioners transferable or to preserve them causes a considerable hold-up in the movement of people from one job to another.

asked the Secretary of State for Social Services if he will now withdraw the consultative document on proposed legislation on preservation of occupational pension rights issued on 31st March, and circulate in place of it a comparable document setting out the possible arrangements for legislation to protect pension rights by ensuring that transferability is granted in all practicable cases.

No, Sir. We are satisfied that the consultative document sets out the most realistic basis for the proposed legislation.

Does the Minister realise that, according to official figures, preservation goes only a quarter of the way towards solving the problem and that full transferability is the only satisfactory way of dealing with it? Will he prove to the House his perseverance and his administrative capacity by changing the target and going for full transferability?

The Government are, of course, in favour of the transfer of pension rights on change of employment where this can be arranged. The difficulty is to put this into legislation. The hon. Gentleman underestimates the difficulties of compulsory transferability, and also underestimates the advantage of preservation, which does not now exist for many millions of workers.

asked the Secretary of State for Social Services if he has received an invitation to meet representatives of the Psychiatric Committee of the Royal College of Nursing consequent upon the Committee's special meeting on 3rd April; and whether he has accepted it.

; Yes, Sir. I met a deputation from the Royal College of Nursing, including representatives of its Psychiatric Committee, on 15th May.

Was the right hon. Gentleman able to give the members of the psychiatric side any reassurance that they would get a fairer cut in the sharing of available resources so that we shall not have so many Elys in future?

I was able to tell them what we have achieved. I told them that the regional hospital board has been requested to consider how much it can shift expenditure in that direction this year. But I also emphasised the number of things which they could do at little or no cost to help morale which, from the staff point of view, would be equally important.

asked the Secretary of State for Social Services what further proposals he has for vehicles for disabled drivers.

I have nothing to add to my hon. Friend's reply to a series of Questions about vehicles for the disabled on 27th January, 1969.—[Vol. 776, c. 929–32.]

Can the hon. Gentleman say how many of the 1,600 cars for people eligible for four-wheel cars have been issued? Is it about 250? If so, why is the number so small, considering that the offer was made in February, 1967?

I cannot give the exact number of cars issued. If the hon. Gentleman puts down a Question, I will give it to him. It is true that there has been a slightly smaller number of applications under the new category than we expected when we introduced the expansion scheme.

asked the Secretary of State for Social Services (1) how he plans to finance the increase in retirement pensions this autumn;

asked the Secretary of State for Social Services how he proposes to finance the autumn increase in pensions.

asked the Secretary of State for Social Services what is the size of the existing imbalance between income and expenditure of the main National Insurance Fund.

asked the Secretary of State for Social Services whether he proposes to bring in graduated contributions to pay for the cost of the autumn pensions' increase.

asked the Secretary of State for Social Services (1) when he expects to announce the contributions increases necessary to finance the increase in pensions this autumn;

I would refer the hon. Members to what I and my hon. Friend the Minister of State said in the debate on 15th May.

But the right hon. Gentleman did not answer the question then. Is he seriously saying that when the Government decided to increase pensions and announced their decision in the Budget no decision about how they would be paid for had been taken and that still no decision has been taken? Is not this the act of a spendthrift?

I do not think that that was the impression created by my speech last Thursday. On the contrary, I told the House, and it was printed fully in the Press next day, that we still had one major difficulty, which was the problem of the benefit which should be paid on the so-called graded element of the scheme and that I was still discussing this.

Does the right hon. Gentleman seriously deny that it is an unprecedented and astonishing situation that five weeks after the Chancellor of the Exchequer told the country that pensions would be increased the workers still do not know by how much contributions will go up?

The Chancellor of the Exchequer made his statement a few weeks ago and the increase will be made in November. If the hon. Gentleman says that it is an absolute scandal that people should not be told now rather than in three weeks what they will be paying in November, he somewhat aggravates the problem.

Would not the Minister agree, with hindsight, that it has been very unwise to let the Fund run into such a heavy deficit so that increased pensions have to be linked to increased contributions? Is not this the result of the inflationary policies of the Government?

I would put it differently. The Fund has run into deficit owing to three factors: the great increase in the number of old people who are receiving pensions; the very considerable increase in sickness benefit payments; and the considerable increase in unemployment benefit payments. These are the three major factors which have caused the present situation. If the hon. and gallant Gentleman thinks that in those cases it would have been simpler not to pay, I do not agree.

Does the right hon. Gentleman realise that to have to wait for another three weeks before the level of extra contributions is known is having a paralysing effect on all employers, who have to make estimates and put forward predictions of what their activities will cost in future? Will he, therefore, urgently consider making a statement, since otherwise the pensions plan merely becomes "Crossman's chaos"?

I gave the employers last Thursday a very accurate account of the total costs which would fall on the Fund and I gave them an assurance that they would not pay any extra part of it and that it would be shared equally between employers and employees. They should easily be able to assess their total burden.

Surely these Questions must have been tabled three weeks before the debate. Are not right hon. and hon. Members simply using them to try to score party points?

One would be surprised if hon. Members opposite did not behave according to their characteristics and those of an Opposition.

The right hon. Gentleman is reported to have said last Wednesday that the Bill was to be published this week. What is the cause of the delay? What has happened since last week to make him change his mind?

If the hon. Gentleman will study the speech I made on Thursday afternoon, he will see the reason I gave and I will now repeat it. The difficulty we have which is not yet resolved is in the problem of whether graded benefit should be remitted to receive the uprating every two years according to the flat-rate pension. We want to give further consideration to this and it was in the light of this that I decided to postpone publication of the Bill until after next week.

The right hon. Gentleman owes the country the plain and simple duty to sort out the now unbelievable muddle which exists about how the extra £430 million needed for the National Insurance Fund is to be raised. Why did the right hon. Gentleman announce on Wednesday that he was going to introduce a Bill this week and on Thursday decide to withdraw it? Has his swindle been over-ruled by the Cabinet?

I do not often do so but I re-read my speech in the OFFICIAL REPORT and I am satisfied—and I am sure the hon. Gentleman will agree if he reads it carefully—that there should be no uncertainty or confusion about the way in which this money will be raised. I am clear that the total amount involved, the method of how we are to divide it, for the first time, between the flat rate and the graded element, together with the element of doubt to which I referred and which has caused postponement, were all clear to everyone outside the House.

asked the Secretary of State for Social Services what increases he proposes to make in the autumn in the rates of war pensions and industrial injury benefits; and, in respect of the latter, what increases in contributions are under consideration.

I must asked the right hon. Gentleman to await the publication of the Bill which will also be the occasion for the announcement of the increases proposed in war pensions.

Does the hon. Gentleman recall hearing the Secretary of State a few moments ago telling my hon. Friend the Member for Horncastle (Mr. Tapsell) that the pensioners were entitled to hear very soon what they were going to get in the autumn? Does the hon. Gentleman not recall that he himself said the same thing on Thursday night? if that is right for retirement pensioners, is it not right for war pensioners and industrial injury pensioners? Or do the Government think of them as inferior?

The latter categories have known for a number of weeks that there is to be an increase. The increases in the main rates of the war pensions and the industrial injuries schemes will be, as in the past, broadly proportionate to the main National Insurance increase. One of the main reasons why my right hon. Friend the Chancellor of the Exchequer announced a pensions increase in his Budget Statement was in order that the pensioners should know that they were to have an increase in the autumn, and if hon. and right hon. Members opposite do not appreciate that notice, the pensioners do.

The Secretary of State has just said in answer to a previous Question that everyone outside knows how much extra they are going to pay. Will the hon. Gentleman be specific and say how many people will pay 5s. a week or more on the stamp?

The hon. Gentleman knows perfectly well that the Bill will be published and that it will contain both the details of the amount that will be contributed and the details of the amount of benefits. He must just be patient.

asked the Secretary of State for Social Services what increase he proposes to make in the rates of supplementary benefits at the time when National Insurance benefits are raised in the autumn.

asked the Secretary of State for Social Services by how much he proposes that supplementary benefit levels will be raised this autumn; and what estimate he has made of the cost.

I must refer the hon. Gentleman to the replies which I gave my hon. Friends the Members for Abertillery (Mr. Geoffrey Williams) and Darlington (Mr. Ted Fletcher) on 28th April.—[Vol. 782, c. 158–9.]

Does not the hon. Gentleman appreciate that the 2 million poorer pensioners will not know how much net they are to get in the autumn until they know what the increase is going to be in supplementary benefits, because they do not know how much of the increased pension will be clawed back?

Those on supplementary benefits know that there will be an increase in the autumn because it has been announced. They also know that there was an increase last autumn and that this further increase will cover the changes in prices during the 12 months.

Will the hon. Gentleman explain how it is that, while the Secretary of State justified the timing of the Chancellor's announcement purely on the ground that the poorer sections of the community had to be given advance reassurance that their benefits would go up, he is taking the line that it is not necessary for the poorest of them to be given details?

Obviously, when the Bill is published it will give details both of contributions and of benefits. Perhaps the hon. Gentleman will look carefully through the records of the Conservative Government. If he does, he will find that there were long delays, sometimes as much as 3½ years, between pension increases when they were in office. He will also find that their Bills to give effect to their announcements of increases were introduced after a longer interval than this Bill is being introduced after the Budget announcement. The interval in this case between the announcement and the introduction of the Bill will be shorter than what was achieved by the Opposition.

Will my hon. Friend consult the Chancellor of the Exchequer to see whether we can have an annual review of the old-age pensions as such in order to avoid the invidious position whereby supplementary benefits apparently lose out every time we have this second year review?

Under the new scheme to be introduced on the target date of April, 1972, instead of having to have legislation from time to time in order to raise the rates, any increases made will be brought in automatically by a review every two years, and in these reviews the level of supplementary benefits will be considered as well as the National Insurance rates.

Why is it desirable to tell pensioners the exact amount of extra benefits they will be getting this time but to refuse figures for the very poorest sections of the community?

The hon. Gentleman should consult his hon. Friends behind him. They have been complaining that we have not given all the details of the benefits as well as the details of the contributions.

On a point of order, Mr. Speaker. Arising out of the unsatisfactory nature of the reply and also of the reply to Question No. 10, I beg to give notice that I shall seek to raise the matter on the Adjournment at the earliest opportunity.

asked the Secretary of State for Social Services what was the average net remuneration before tax of National Health Service dentists in the latest year for which figures are available in the age brackets 25 to 35 years, 35 to 45 years, 45 to 55 years and 55 to 65 years, respectively.

I will, with permission, circulate the figures in the OFFICIAL REPORT.

Would not the right hon. Gentleman agree that, with the possible exception of the oldest profession in the world, there is no other profession the remuneration of which steadily declines as the professor gets older? Will he have urgent discussions with the British Dental Association and other representatives of the dental profession to amend this state of affairs?

Order. The hon. Gentleman must put down a Question on the first part of his supplementary question.

The hon. Gentleman would be advised to study the figures to be published in HANSARD before he jumps to any dangerous conclusions.

asked the Secretary of State for Social Services if he will institute a study of the future of family allowances, with particular reference to negative income tax as an earnings-related alternative to the present system; and if he will publish the results as a Green Paper.

The Government have future policy on family support under continuous study. I have no statement to make at this stage.

In view of the fact that the unpopularity of the system of family allowances makes increases difficult, and because of the difficulties which the Chancellor has run into this year in extending the claw-back principle, will my right hon. Friend undertake to look much more seriously at negative income tax than has been done so far, not as a cornucopia, as he once called it, but simply as a more efficient method of paying a family allowance to those families who really need one?

There are two ways of looking at it. One, as he says, is as a cornucopia which simply substitutes negative income tax for all rates and taxes and social services, which is administratively impracticable. The second and much narrower way is to make it a substitute for family allowances. The second method has almost as many administrative difficulties as the first.

Will the right hon. Gentleman look a little more sympathetically at his hon. Friend's proposition? Is he aware that we have never been given the evidence against this system, and that it would be of value for all the facts to be given to the House?

I am sympathetic to this idea. A great deal of research has recently been done into it, some of which was summarised in the White Paper which does refer to negative income tax. I am perfectly prepared to consider the possibility of publishing this information, because it is in the public interest that people should understand this problem.

asked the Secretary of State for Social Services if he will now consider taking steps to involve education authorities in responsibilities for play groups.

A circular issued last October drew the attention of local health authorities to the desirability of seeking assistance from officers of the local education authority in supervising play groups.

May I remind my right hon. Friend that the Pre-school Play Group Association is using this week to highlight the fact that there are 116,000 children under the age of 5 in groups under its care, and that the co-operation of his Department and the Department of Education and Science is needed to provide financial assistance and training courses if the Association is to meet the needs of those children who are deprived of nursery school education?

I am grateful to my hon. Friend for bringing the attention of the House to this matter, which is a considerable social problem.

asked the Secretary of State for Social Services whether the total number of prescriptions issued by doctors since the imposition of charges has risen or fallen.

My information relates to the number of prescriptions dispensed by chemists. This was lower from July, 1968, to January, 1969, inclusive than in the corresponding period 12 months earlier.

Does my right hon. Friend agree that the fall indicates that patients are, regrettably, being prevented by charges from receiving treatment or, alternatively, does he attribute it to the fact that, before charges were imposed, doctors were prescribing needlessly?

I should have thought that both possibilities were there. Our statistics are insufficient for us to draw a conclusion from them.

Is the Secretary of State aware of the widespread anxiety about his refusal to ratify the agreement reached by the former Minister of Health on the dispensing of medicines in country areas? Does the agree that there is a danger that doctors' prescriptions may be influenced by the drugs which they happen to have in stock?

This is very wide of the Question, but I will reply briefly. It was not a question of my refusing to ratify an agreement but, unfortunately, refusing to ratify a draft agreement which had been repudiated by one side.

asked the Secretary of State for Social Services whether he will make a further statement on the working of the Abortion Act.

I have nothing to add at present to what I said on 28th April in reply to my hon. Friend, the Member for Wolverhampton, North-East (Mrs. Renée Short) and to subsequent supplementary questions.—[Vol. 782, c. 948–51.]

Is it not the truth of the matter that, owing to the right hon. Gentleman's predecessor ignoring the advice offered by the British Medical Association and the Royal College, a minority of doctors are operating a legalised racket in the private sector? Will the right hon. Gentleman seek to amend the Act to prevent these harpies making fortunes by battening on human weakness?

The hon. Gentleman asked me about the truth of the matter. I doubt whether the truth can often have such a strong propagandist tone to it.

Is my right hon. Friend aware that the hon. Member for Chelmsford (Mr. St. John-Stevas) made a widely publicised statement that thousands of foreign women were flocking to London to use the facilities of the National Health Service made available by the abortion law? Will he confirm that the number of such operations carried out on foreign women coming to this country for that purpose is trivial?

It would be a great exaggeration to say what he said, or indeed what was said in America by an hon. Lady who is Member for one of the Birmingham constituencies, who described London as the abortion capital of the world. This seems to me to do the country no good. I think that I am right in saying that the percentage is considerably under 10 per cent. in regard to foreign women. One has to remember that we cannot forbid foreigners coming to our country and making use of medical services here.

Could the Minister say whether there is any evidence that the private sector is interpreting the provisions of the Act differently from doctors working in the National Health Service? If there is any such evidence, could he consider making an investigation and, eventually, a statement?

I must be careful about this. The control which the Secretary of State is permitted to have is not control of the doctor, but control of the premises and the equipment. It is not for us to go beyond our job of looking at the premises and the equipment. To go much further than that would invade clinical freedom in a way that the House would not appreciate.

asked the Secretary of State for Social Services if he will list in the OFFICIAL REPORT items of dental treatment which a patient may require but which may not be provided under his regulations by a dental practitioner under the National Health Service.

asked the Secretary of State for Social Services if he will carry out a review of the list of treatment which cannot be provided by a dental practitioner under the National Health Service.

When a dentist has accepted a patient for treatment under the general dental services, he is required to provide or arrange for the provision of all treatment necessary to secure dental fitness that the patient is willing to undergo.

Is my right hon. Friend aware that a large number of patients are persuaded to pay for private treatment when the same treatment, and equally good cosmetic results, can be attained through the National Health Service? Will he take steps to advise patients of their rights in this respect?

Yes, there are grievances here. Patients should put their complaints against dentists to the executive council concerned. If they are aggrieved with the decision of the Dental Estimates Board then they can appeal to me, and I hope that they know that.

Is the Minister aware that when people are asked to pay extra for dental treatment of one sort or another, or even for spectacles, they would not mind doing this, if the increase is reasonable, provided that they get back the money in decreased taxes, rather than that the Government should waste it in some other direction?

I will hear that in mind and would advise my hon. Friends to approach their dentists in that spirit.

asked the Secretary of State for Social Services whether his discussions about the reorganisation of the National Health Service are yet complete; and if he will now make a statement.

Not yet, Sir.

Can my right hon. Friend say whether his consultations will be completed before the introduction of the Report of the Royal Commission on the reform of local government?

No, I would not expect them to be completed before. I hope that they will have got so far that I shall be able to urge on my colleagues that very soon after the Report of the Royal Commission there will be a statement on the future of the Health Service

Can the Minister say whether he intends to pay a little more attention in the second version of the Green Paper than he did in the first to the position of the voluntary services, particularly those helping in hospitals, mental hospitals and long-stav care hospitals?

I was not responsible for drafting the first version, but the hon. Gentleman will find that the whole structure of the second tier and its close link with the community and the voluntary services will be emphasised in the new version.

asked the Secretary of State for Social Services why, when there is an increase of rent or other changed circumstance which justifies an increase in supplementary benefit, such increased benefit cannot be paid until the pensioner's current order book is exhausted, and then cannot be back-dated; and if he will remedy this anomaly.

The rule described by my hon. Friend is not of general application. It applies only to changes of circumstances resulting in a variation of 2s. a week or less in the rate of supplementary benefit. Its purpose is to avoid altering order books, with all the associated work and inconvenience, for very small amounts. The rule operates in respect of downward changes as well as upward.

Since that seems to mean that administrative convenience takes precedence over individual welfare, does my hon. Friend realise what hardship is caused to a number of people by the application of this rule? It would not be so difficult administratively. Why, therefore, can the increase not be backdated?

As I said, the rule operates downwards as well as upwards in regard to these changes. It was not brought in with any idea of disregarding real hardship cases for supplementary benefit. When the Supplementary Benefit Commission was brought into being and we established one order book, the rule operated more or less to meet the claimants' requirements and not for any other purpose.

Will my hon. Friend not agree with me that there are few examples at present of rents which go down? Is it not clear, therefore, that this operates very much against the interests of those who are in the greatest need? Would he not look at this again, because the point raised by my hon. Friend the Member for Barking (Mr. Driberg) is a very sensible one?

I realise the concern that there is about this, and it would be understandable if the rule always operated upwards. But, as I said, it also covers downward movements. There have been quite a number of cases, following the introduction of the new Rent Act, where rents were downward. However, I will take note of what my hon. Friend says.

Is the hon. Gentleman aware that rates have gone up very steeply recently and that they hardly ever go down?

Yes, Sir, but the rule to which we are referring is known as "the tolerance rule" by the Department. It does not apply to increases in the scale rates of supplementary benefits.

asked the Secretary of State for Social Services if he will take steps to improve the design of spectacle frames available under the National Health Service.

We have this matter under consideration.

In the course of that consideration, will the hon. Gentleman bear in mind that in most cases the present frames are dreary, unimaginative and outdated, and that many people needlessly pay several pounds extra for private frames because of the total inadequacy of the National Health Service range?

It is true that some are unattractive and not in great demand. Others are particularly attractive and in great demand. The 524 plastic frame which comes in six colours is a good example. But one cannot act as a sort of cosmetic service. Recently one has seen glasses almost as large as bicycle wheels. One could not expect those to come on the National Health Service.

asked the Secretary of State for Social Services whether, in view of the difficulties which have arisen with regard to the operation of the Abortion Act, he will ensure that all local authorities take full advantage of their powers under the National Health Service (Family Planning) Act, 1967.

I am taking every opportunity to encourage local authorities to expand their family planning services, but it must be a matter for each individual authority to determine the speed of its advance in the light of finance and staff available.

Is the right hon. Gentleman aware that he has at last given a more or less satisfactory answer? Will he be so good as to use all his persuasion on the local authorities to achieve better results in terms of their assistance to family planning centres?

Certainly I will. We have reached the point where 170 out of 175 have reported that they have some kind of service, but, of course, the quality varies enormously.

asked the Secretary of State for Social Services what is the estimated cost of the 1969 Test Census.

£55,000, Sir.

Will the hon. Gentleman say, when this trial census has been completed, when it has been examined and when the information required has been obtained, whether it will be destroyed?

Certainly the experience that will be gained will not be destroyed. After all, the main purpose of this Test Census is to formulate a suitable list of questions presented in a way which can be understood and satisfactorily answered by the public. This test will enable us to produce the best possible results for the 1971 census.

asked the Secretary of State for Social Services whether he will publish a White Paper detailing social statistics such as suicide, illegitimacy, children in care, venereal disease, divorce and crime rates in the principal urban areas of England and Wales.

The Central Statistical Office is preparing a new regular publication on social statistics to be published under the title "Social Trends" which will cover the topics mentioned by my hon. Friend. I regret that comprehensive statistics of this nature for individual urban areas are not available.

While thanking my hon. Friend for that encouraging reply, will he not agree that meaningful planning by national, local and regional authorities necessitates the availability of social statistics of this type in detail, as well as the economic statistics at the disposal of the D.E.A.?

Yes, but to do an overall survey would be costly in terms of both money and staff time. However, if my hon. Friend has a particular request to make, I will endeavour to supply him with the information.

asked the Secretary of State for Social Services if he will make a claim for overpayment in respect of the purchase for the National Health Service of broad-spectrum antibiotics in cases where the parent companies of the suppliers fail in their appeal to the Supreme Court in the United States of America against their conviction on price-fixing and other charges.

I am advised that I have no claim against these suppliers arising out of proceedings in the United States.

Is my right hon. Friend aware that this is an area where £3½ million might well be saved? Has he examined the results of the Kefauver Report, the Report of the Public Accounts Committee of 1961 and the Sainsbury Report to see how much more vigorously he can pursue economies in this direction?

I am well aware that this has, quite reasonably, raised a sense of annoyance among those who, as I do, want to see a reduction in the cost of drugs. However, the decision of the American court does not confer any rights under English law. That is our difficulty.

Will the right hon. Gentleman not agree that these attacks on American owned companies are misconceived in that it is greatly in Britain's economic interest to have American research investment based here for export to Europe rather than vice-versa, and that the V.P.R. scheme precludes this practice?