asked the Secretary of State for Social Services if he will amend the conditions of contracts for consultants in the National Health Service to minimise the number of occasions and situations where they may be employed on part-time and maximum part-time contracts.

No, Sir. Any change in the conditions governing consultant contracts would be a matter for negotiation between my Department and the representatives of the medical and dental professions.

Is the Under-Secretary not aware that in every case in which a part-time or maximum part-time consultant is appointed, National Health Service queues increase? Is he further aware that this means that more National Health Service patients are tempted to go private, which means that the consultants will come forward and ask for even more private practice? Is he not aware that by continuing with consultant appointments on these terms he is only encouraging the gradual breakdown of the National Health Service? Will he seriously re-examine this problem?

I cannot accept the interpretation that the hon. Gentleman has put upon these realities. The truth is that the consultant on a maximum part-time basis is expected to devote substantially the whole of his time to the National Health Service and to give it priority on all occasions.

Would the Under-Secretary like to make a statement on the Government's policy about consultants who practise within the National Health Service and at the same time have private beds? Is the policy to increase or decrease this practice, or have the Government no policy at all?

:The hon. Lady knows that a maximum part-time consultant can allocate part of his time to the pursuit of private practice. The question how many consultants should be taken on, whole-time or maximum part-time, is one for boards to decide on their own initiative.

asked the Secretary of State for Social Services how many consultants in the National Health Service are now employed on a full-time basis.

The provisional figure for 30th September, 1971, is 3,576 in England and Wales.

:Will the Minister take urgent steps to increase the number? Waiting lists are getting longer and patients who go to consultants in a private capacity often get quicker access to National Health Service beds than those who go in a health service capacity.

:I do not believe that the opportunity for maximum part-time service has a bearing upon the length of waiting lists or their increase or decrease, except perhaps exceedingly marginally. [Interruption.] The hon. Member will be glad to know, since I take it that this is his point of view, that the number of whole-time consultants is increasing more rapidly than the total numbers.

Did my hon. Friend the Under-Secretary say that the latest figures he had were up to last September?

:The latest figures I quoted were for 30th September, 1971. I have more fully verified figures for the period ended 30th September, 1970, than for the period ended 30th September, 1971.

:Is it not almost criminally wrong that women who are almost demented with the fear of cancer of the womb should be crowded into a gynaecological clinic awaiting the arrival of the consultant who, at the time he should be at the clinic, is engaged in private practice in his own home on the other side of town? Does not the Undersecretary think it high time that he insisted that consultants should be at clinics on time?

If consultants are on maximum part-time they are expected to devote substantially the whole of their time to National Health Service patients and to give them priority on all occasions.

asked the Secretary of State for Social Services what estimate he has made of the income distributional effects in retirement which would be produced for his strategy for pensions proposals.

None, Sir, because of the many uncertain factors involved.

Is the hon. Gentleman aware that his Government's pension proposals will still leave roughly three million people in poverty? Is he further aware that a quarter of the men and four-fifths of the women will still be unable, under the State reserve scheme, even after a full working-life contribution, to earn a pension above the State poverty line? Will he not therefore withdraw these proposals before he forces poverty on 6 per cent. of the population 20 years into the next century?

I do not accept the hon. Gentleman's figures at all. These proposals will substantially improve the retirement arrangements for everyone.

Would my hon. Friend not agree that under these proposals every person will eventually be entitled to two pension incomes as of right? Is that not likely to result in a considerable reduction in the number of people forced to go on to supplementary benefits?

I am obliged to my hon. Friend. I am sure that he is right. The two-pension policy is of major significance for improving provision for retirement.

:Is the hon. Gentleman serious in suggesting that his Department has made no estimate of the effects of the pension proposals for the rest of this century and the beginning of the next? If he denies the figures quoted by my hon. Friend, will he say what is his Department's estimate of the number of people who will still be dependent on means-tested benefits by the end of the century?

I could not answer the question because there are so many uncertain factors involved—for example, how successful this Government will continue to be in improving the rate of pension through annual reviews and how rapidly occupational pension schemes will be extended. These are two of the factors of which no accurate calculation can be made at this point.

asked the Secretary of State for Social Services what consultations he proposes to have with organisations representing pensioners before pensions are increased in the autumn.

My right hon. Friend has already announced our proposals for increasing pensions.—[Vol. 833, c. 1501–18.]

Is the hon. Gentleman aware that all old-age pensioners' associations have expressed disappointment, and some of them anger, at the pension provision for them in the last Budget? Does he agree that when pensioners receive their increase in October its value will have been eroded? Will he consider giving the pension then the same purchasing power as the increased pension would have had when the announcement was made?

The pension will not have been eroded by the time it comes into operation in October. There will be a real improvement in its value, on the best estimate we can make of what will happen to prices. Above all, pensioners now have the assurance that their pensions will be increased each year and that they will not have to wait two or three years as in the past.

Will my hon. Friend not attach undue weight to the crocodile tears shed by Labour Members about the decline in pension values when they have contributed so much to that decline by supporting inflationary wage settlements in sectors with which they are concerned?

I agree with what my hon. Friend says. Labour hon. Members' criticisms would be more convincing if they had been able to do half as much as this Government have done for pensioners in the past two years.

It is no argument to talk about what previous Governments have or have not done. [Interruption.] I can say that, because I was one of those who argued throughout the six years of the Labour Government that we were not doing enough to help the pensioners. The pensioners are not interested in these party arguments. Is it not clear to the Minister that what is being done is not enough to assist the pensioners? They feel very humiliated. They have to rely on bus passes and things like that instead of getting a decent pension to meet all their costs.

I agree that what matters is what is being done for pensioners now, but when we are criticised we are entitled to point out the record and the facts.

asked the Secretary of State for Social Services what representations he has received from organisations concerned with retirement pensioners as a result of the Budget proposals on pensions.

Six letters expressing some disappointment at our proposals.

Does not the hon. Gentleman accept that one of the things that disillusioned pensioners was the fact that so much was given to people with higher incomes, those above £5,000 a year, whereas a miserable pittance of 75p was given to the single pensioner? That has to keep pensioners going until the autumn of 1973. If the pension is not eroded by the autumn of this year, it certainly will be by the time of the next increase, and we have still not tackled the problem of how pensioners are to survive once we go into Europe, if we do.

There is a firm commitment by the Government that any increase in prices which may occur because of entry into Europe will be taken into account in the reviews of pensions. The hon. Gentleman is not comparing like with like. Tax reductions leave a little more of people's own money in their own pockets, whereas pension increases must be paid for by the contributions of the working population.

asked the Secretary of State for Social Services whether he will now institute a Government inquiry into the events surrounding the death of a patient in South Ockenden Mental Hospital.

:The death mentioned in recent Press reports occurred early in 1969, and has already been very fully investigated by the police. However, following the death of a patient earlier this year, on whom an inquest is expected to be held shortly, some specific complaints about nursing standards were made by a former member of the staff. The hospital management committee has now set up an inquiry into these complaints and I will inform the right hon. Lady of the outcome.

:Is the right hon. Gentleman prepared to leave the matter there? Is he not aware that the killer of Robert Robertson has still not been found, that there were several unsatisfactory features about the trial of David Burles, who was most unfairly treated before being found not guilty, that earlier there had been a case of severe injury through beating without a charge having been brought and that there has been this curious coincidence of a subsequent death at the hospital?

The first two cases to which the right hon. Lady refers and on which she lays great emphasis occurred respectively four and three years ago. The second case, the death, was subject to a police inquiry and, on the repeated application of A.E.G.I.S. renewed police inquiries were reopened last year and have just been concluded.

Although this hospital is in my constituency, no notice was given to me about this Question, which was extremely discourteous. It might also explain why the name of the place as it appears in the Question on the Order Paper is wrongly spelt.

I am particularly grateful to the hon. Gentleman for those remarks. I am sure that my predecessor was right to take into account in reaching his decision the need not to over-investigate any particular hospital—a hospital in which it was found that, despite the over-crowding and lack of staff, there were a number of excellent features and that the staff were vigorous and conscientious in dealing with the problems which they faced.

:Will the right hon. Gentleman consider with his hon. Friend the Under-Secretary, who knows all about it, the case of a constituent of mine, John Meter, a 16-year-old autistic boy who should not be in this hospital at all? While sharing fully what my hon. Friend the Member for Thurrock (Mr. Delargy) says about the dedication of the staff, may I remind the right hon. Gentleman that there are far too few of them to deal with this sort of case?

My hon. Friend the Under-Secretary has, of course, told me about this case and about the hon. Gentleman's concern for this patient, who is, I understand, the subject not of any ill-treatment but of lack of staff, something from which the whole of the service is suffering. Despite the Government's increased injection of resources, the fact remains that it will be some years before we are able to provide enough facilities and staff to treat properly all the patients in public care.

asked the Secretary of State for Social Services whether he is satisfied that the terms of the Abortion Act, 1967, legalising abortion only if a continued pregnancy would endanger a woman's life or harm her physical or mental condition or that of her existing children to a greater extent than if there were an abortion, are being generally carried out; and if he will make a statement.

The Government look for an answer to this Question from the Lane Committee on the Working of the Abortion Act whose report we expect in the first part of next year.

Will my right hon. Friend bear in mind, while awaiting the Lane Report, the deep public concern that exists within the lay and medical services over this matter, and will he pay particular regard to the views expressed by the working party of the Royal College of Obstetricians and Gynaecologists about the urgent need for a review?

Yes, and I am always ready to consider evidence and to invite people to put evidence before the Lane Committee. However, I can do no more than be very careful about approvals given to approved private places.

May we be assured that, pending the publication of the Lane Report, to which we look forward with considerable interest, the right hon. Gentleman will extend his control over private clinics and will in particular pursue those which, having been put out of business in Langham Street, are apparently continuing their business elsewhere?

:I am keeping an extremely watchful eye on any private clinics about which allegations are made, but I have no reason to fear that my observations are inadequate at the moment.

Irrespective of whether the terms of the Act should be restricted or extended, may I ask the right hon. Gentleman whether he is aware that many women in some parts of the country, particularly in the Liverpool area, even when they come within the terms of the Act, are unable to get bed facilities in their areas and have to travel to London? Will he find out why facilities are not available in these areas?

I must await the Lane Committee and its judgment on the scale of facilities available. I hope that the hon. Gentleman will see that the points which he makes are put to the Lane Committee.

asked the Secretary of State for Social Services whether he will amend the National Health Service (Charges for Drugs and Appliances) Regulations so as to grant a one-year exemption from prescription charges to any woman whose child is either stillborn or dies within the first year of birth.

No, Sir. Much as I sympathise with these mothers, the existing arrangements already ensure that exemption is available for anyone who cannot afford to pay the charge for any prescriptions she may need.

Will the hon. Gentleman look at this matter more sympathetically? Is he aware that considerable distress can be caused to a woman who, having lost a child, must hand back her exemption certificate, although she may be in need of prescriptions which she might not have needed had the unhappy incident of losing the child not occurred? Is he aware that the dental regulations take no account of the possible death of the child but allow exemption for a full year after delivery, whether or not the child survives?

Mothers who undergo this tragic experience are not very likely to need considerable medicament following the still-birth or loss of a child. As I told the hon. Gentleman, there are wide-ranging exemptions for those for whom any financial hardship arises from the loss of prescription rights through the stillbirth or loss of a child.

asked the Secretary of State for Social Services whether, following recent discussions with the General Dental Services Committee, he will now take steps to initiate a 24-hour, 365 days a year, emergency dental practitioner service.

I recently met representatives of the British Dental Association and agreed with them to set up a joint working party to consider how best within available resources to secure the long-term development and improvement of the dental services available under the National Health Service. The emergency services will be amongst the matters considered by the working party.

All hon. Members will be very glad to hear that statement. I am sure that the dental profession is very anxious indeed that there should be the fastest possible move towards the provision of this service, which will do a great deal to save much hardship and suffering throughout the country.

asked the Secretary of State for Social Services how many letters and deputations he has received from retirement pensioners and their associations.

About 3,300 letters and three deputations in the last six months.

Now that the Budget euphoria has died down, is the Undersecretary aware that it will do little or nothing to help the old-age pensioner to exist? [An Hon. Member: "Nonsense."] When he next replies to these letters, perhaps he could explain to a few of these people how a miserly 75 percent.—75p—increase—[Interruption.]—I nearly slipped up then—will enable them to buy a cheap mink coat for the winter?

I am sure that the hon. Gentleman wants to be fair—[Laughter.]—I will amend that. I hope that the hon. Gentleman wants to be fair. There was a substantial increase last September. The annual review comes into operation for the first time this year and will provide another substantial increase, which will more than cater for the increase in prices.

Has my hon. Friend seen the recent report of the Institute of Fiscal Studies, which shows that people with the lowest incomes are 28 per cent. better off under the present Government than they were under the previous Government, and is he aware that those figures were produced before the Budget and not after it?

I am grateful to my hon. Friend for reminding the House of those impressive figures.

Would the hon. Gentleman agree that, under the present system of paying pensions, and even when pensioners receive their further increase six months in the future, the position is by no means satisfactory? I should have thought that that was accepted on both sides of the House. In the financial circumstances in which the Government find themselves this year, does not the hon. Gentleman consider that the Chancellor should, even now, give further help to pensioners by increasing the Exchequer supplement so that there could be a very substantial increase at a time when the Government could give it if they wanted to?

We all want to continue to improve the pensioner's financial position, and we shall continue to do so. But the fact of the matter is that since last September, and taking into account the new review that comes into operation in October, about an additional £1,000 million will be made available to pensioners and other beneficiaries, and they now have the absolute assurance that each autumn there will be an improvement in the rate of pension at least to take account of the rise in prices.

To ask the Secretary of State for Social Services whether he is now in a position to make his announcement on further action with regard to cigarette smoking and heath

On a point of order, Mr. Speaker. There is a grave misprint in the Question. The last three words should be "smoking and health", not "smoking and heath"—because the Prime Minister is a non-smoker.

Further to that point of order, Mr. Speaker. My right hon. Friend the Prime Minister sets an admirable example on the subject of smoking.

Would my right hon. Friend hurry up in this matter? Does he recall that last year, when he preferred his voluntary arrangements to my legislative intentions and he frustrated the Cigarettes (Health Hazards) Bill, he estimated that cigarette smoking would fall dramatically, instead of which it fell by 10 per cent. for a very short period and has now resumed its former force? Will he take early steps to try to deal with this dramatic and difficult situation?

I do not think that I ever committed myself to any expectation that there would be a dramatic and early fall in cigarette smoking. I wish that I thought the problem was that easy to solve. But certainly the Government are engaged in examining the evidence as to what should next be done, and I shall not indulge in any unnecessary delay.

asked the Secretary of State for Social Services what is the latest estimate of the rate of take-up for the family income supplement.

At the end of March, about 75 per cent. of those entitled to £2 or more were in receipt of the benefit, 50 per cent. of those entitled to between £1 and £2 and 30 per cent, of those entitled to under £1. So the overall rate of take-up was about half. Detailed figures for April are not yet available, but I estimate that the overall rate of take-up remains the same.

:Is the Minister aware that it is now almost a year since the Government introduced what many of us regard as a degrading method of alleviating family poverty? Do not these figures make it clear that it has been an absolute failure and that the Government would have done far better to increase family allowances and to make them payable for the first child?

If we had followed that course, the families who are now benefit-ting, those with one child, would probably not yet be receiving any improved benefits. I am sure that the hon. Gentleman wants to be fair. How can he regard this as a failure when 75 per cent. of those entitled to more than £2 are receiving not only that benefit but a whole range of other benefits automatic- ally, on the passport system? This whole family income supplement was presented as an immediate first aid and is now possibly likely, subject to the opinion of the House and decision of the Government, to be overtaken by the tax credit scheme which my right hon. Friend the Chancellor proposed in his Budget.

Would my right hon. Friend suggest to the Opposition that all these Questions are due to jealousy and because they had not got the guts to do what the present Government have done, for which we are all very grateful?

I am grateful to my hon. Friend. It would be slightly more convincing if the Opposition had shown any capacity to match their deeds to their words.

Would the right hon. Gentleman disregard what was said by the hon. Lady the Member for Tyne-mouth (Dame Irene Ward)?

He will not.

It is not a case of jealousy but one of disillusionment, particularly in Scotland, where we have heavy unemployment. Many of the people there are not accepting or not applying for family income supplement because they feel that they have been misinformed. Will the right hon. Gentleman now keep his election pledge and give an increased family allowance, as his party, prior to the General Election, said they would do?

We have several times debated the reasons why the Government prefered this method coupled with the sharp raising, on two separate occasions, of the tax threshold, which had been left so calamitously low under the previous Labour Government, to any increase in family allowances.

asked the Secretary of State for Social Services what is the latest figure for successful applications for family income supplement in the Yorkshire and Humberside departmental region.

About 11,000, excluding second claims from families whose first awards have come to an end.

Throughout the Yorkshire and Humberside region the average wage is far lower than in the rest of the country. Is the Under-Secretary not surprised that the figure is only 11,000? What is he doing to see that everyone who qualifies for the family income supplement applies for it? Can he say why the workers on short time at the G.E.C. works at Swinton, near Mexborough, have even been refused an application form for family income supplement, although their wages are below £12 a week?

I will look at the last point, but I cannot give an answer off the cuff. The figures which I gave referred to the period before the uprating of the family income supplement and we have already had a substantial number of new claims since the beginning of this month, so that the figure will go up. But about 30 per cent. of the awards in the region are to one-parent families, and this is a considerable help to them. The average weekly payment in the region at the end of March was £1·62, again a substantial help to those who qualify.

The Secretary of State's acclaimed figure of 75 per cent. take-up applies to only about 30,000 families, which is an extremely small number. Increase in the take-up of family income supplement has virtually stopped and virtually none of those families has been brought up to the State poverty line.

:The take-up figures for those receiving the larger amounts, and therefore those in greatest need, is about 75 per cent., which is a very good figure. We are hoping to improve it all the time. Equally, the up rating of the F.I.S. by £1 which came into operation at the beginning of this month is bringing more people in, but we are having a further publicity campaign to ensure that all those who are eligible for the allowance get it.

asked the Secretary of State for Social Services whether he has yet completed his review of family planning services; what further improvements he proposes to introduce; and whether he will make a statement.

No, Sir. I shall make a statement when my review is complete.

:In further considering this matter, would my right hon. Friend bear in mind that this year important bodies of medical opinion have recommended that there should be a fully comprehensive family planning service within the Health Service Will he say now, if he can, whether he accepts the recommendations of the Todd Committee on medical education?

I assure my right hon. and learned Friend that the Government will be taking into account in their review the veritable avalanche of advice about this subject, descending upon Ministers from all sorts of highly reputable bodies, including the recommendations of the Todd Committee.

Is my right hon. Friend aware that a recent survey shows that even in those areas traditionally thought to be opposed to family planning over 65 per cent. of Conservative voters favour the prescription of the pill under the National Health Service?

I do not wish to be incautious, but I am not conscious of any grave political constraint upon the expansion of Government activity in this matter, provided that it can be addressed to those areas where it is most needed.

Will not the right hon. Gentleman accept that this is a very urgent matter and that, therefore, his review should be treated with high priority so that the House can have an early discussion on this matter, which is of not only national but global importance?

By her last words, the right hon. Lady has prevented me from giving a brief, "Yes, Sir", in reply to a supplementary question. I remind the House that I am not responsible for population policy and that such questions are for my right hon. Friend the Prime Minister—[Laughter.] I am simply responsible for the health and social services aspects of this question.

asked the Secretary of State for Social Services what representations he has received concerning the reduction in grants to drivers of invalid vehicles; and what replies he has sent.

None, Sir. The grants payable to individual drivers of invalid vehicles have not, in general, been reduced.

Is it not the case that there are individuals who will suffer substantial reductions? I have a Dunkirk veteran in my constituency who lost both his legs and his net allowance will be reduced by £35. Where he receives the £5 increase, he loses the hand-controls benefit. When these people reach retirement age they can lose the car altogether. Is this not a cheap, mean and miserable way to treat people who have served their country and sacrificed themselves for it so faithfully in past years?

I should want to look at the individual case which the hon. Member quoted. The figure of £35 may arise as a result of their no longer being an obligation to provide a garage, but I would like to look at the particular case the hon. Member mentioned.

asked the Secretary of State for Social Services what representations he has received from the General Medical Council asking for amendments of the Medical Act, 1956; and if he will make a statement.

The General Medical Council and the other organisations represented on the Brynmor Jones Working Party on the composition of the General Medical Council have indicated their acceptance of the Working Party's report. The Government will seek a convenient early opportunity to introduce the legislation to effect the necessary constitutional changes.

:Is it not a fact that the General Medical Council requires the amendment of the Act in order to secure a striking off from the register of any doctor who does not pay the annual £5 retention fee? Eight thousand doctors have already refused to pay the fee. The B.M.A. is opposed to it. If this is carried through, it will have serious consequences for the medical profession.

Without accepting the allegations in the hon. Lady's supplementary question, I must ask her to await the legislation, the main purpose of which is to alter—to the prescription recommended by the Brynmor Jones working party and accepted by the representative bodies involved in it—the balance of membership of the General Medical Council.

asked the Secretary of State for Social Services when he hopes to complete his discussions on the introduction of a medical identity card, giving details of the carrier's blood group, allergies to penicillin and steroid therapy, history of coronary disorder and diabetes, as a means of increasing the number of organs available for transplant.

Present consideration of such cards has no bearing on the question of the supply of organs for transplantation. This, as the hon. Member knows, is being pursued by other means.

As the provision of medical identity cards probably represents the lowest common denominator of agreement among those who would like to change the law on transplants, could not this be considered fairly quickly? On the Minister's reply, both the donor and recipient would benefit from such a provision.

There is already a good deal of difficulty in reaching agreement professionally about what the medical identity cards at present on trial should contain. Arguments whether information about transplantation should be included in such cards in the future would make it even more difficult to reach agreement in the profession.

asked the Secretary of State for Social Services if he will introduce legislation to prohibit general practitioners operating within the National Health Service from charging for the issuing of prescriptions for contraceptive pills.

I am not yet ready to add to my reply to the hon. Member on 22nd February.—[Vol. 831, c. 245.]

It is ridiculous that when people for financial, moral and other reasons wish to make use of the contraceptive that not only do they have to pay the prescription charge but in many cases doctors actually charge for writing out the prescription. Is this not a ridiculous situation when there is a great deal of discussion about population policy and so on?

This is one of the facts of the position which I am taking into account in the present review.

asked the Secretary of State for Social Services when he intends to hold the conference on the health hazards of lead compounds in engine exhausts.

The subject was considered at a conference on "Lead in the Environment" held in January by the Institute of Petroleum, the Chemical Society and the British Occupational Hygiene Society and we see little point in duplicating these discussions.

:With the ever-increasing number of cars on the roads this is becoming a very serious problem. The lead compounds emitted by engine exhausts are particularly harmful to children. Will the Under-Secretary tell the oil companies that they should reduce the level of lead additives in petrol to assist the situation?

The last part of the question falls within the ambit of the Department of the Environment, but the hon. Member can rest assured that we are keeping a hawk-like eye upon the level of likely pollution in the environment arising from lead discharge.

asked the Secretary of State for Social Services if he will now give consideration to providing further assistance to those families which contain two or more persons suffering disability, particularly when these cases, whilst involving considerable hardship, do not qualify for the constant attendance allowance.

I have recently announced our proposals for the extension of attendance allowance to bring in about 250,000 more disabled people, which should help many of the people whom the hon. Member has in mind.—[Vol. 833, c. 1501–18.]

While the new modified allowance is very welcome and maybe most relevant in such cases, will the right hon. Gentleman consider revising the arrangements to allow a greater and perhaps earlier generosity when applications are received from persons living in a household in which there may be two or more individuals who are disabled? Is he aware that I have written about such a case in my constituency?

I am aware of the constituency case to which the hon. Gentleman refers, and I believe that the two cases concerned in the same household are subject to review by the Attendance Allowance Board.

asked the Secretary of State for Social Services whether he will introduce legislation to apply the earnings rule to the pensions of former Prime Ministers.

No, Sir. The earnings rule for which my right hon. Friend is responsible applies only to national insurance retirement pensions and is the same for former Prime Ministers as for anyone else.

Is not the hon. Gentleman aware that old-age pensioners who work 40 years before they receive a pension and who contribute to their pension feel it rather unfair that they should have the earnings rule applied to them, whereas certain people who have a good salary, for many years in some instances, can go on to a non-contributory pension of £4,000 or £5,000 a year without the earnings rule being applied to them? Old-age pensioners feel that there is one rule for the rich and another for the poor.

The earnings rule has never applied to occupational pensions, which are being received by a very large number of people. It was to meet the point the hon. Gentleman made that the Government last year increased the amount that could be earned under the State scheme by no less than £2 a week.