asked the Secretary of State for Social Services what recent representations he has received asking him to raise the age of exemption for the payment of prescription charges from 15 years of age to 16 years, on the raising of the school leaving age

Eighteen letters since the beginning of the year. Replies have explained that no relationship is intended between the age limit for automatic exemption from prescription charges and the age of ending full-time education.

Does not the Minister accept that it is a little illogical for the State to accept full responsibility for the education of a child and not to accept full responsibility for the health of a child?

The hon. Gentleman's own Administration drew the line at the age of 15 for the logical reason that up to that age a wide variety of childhood ailments was prevalent. Above that age we think it is reasonable to move to the general system of exemption which exists for other sections of the population.

Is my hon. Friend aware how much hardship this causes to parents who keep their children on at school? Will he seriously consider changing his mind on this question?

I hope that my hon. Friend and her constituents are aware of the wide range of exemptions available where hardship arises. As many as 50 per cent, of all prescriptions are prescribed free.

How does the hon. Gentleman justify charging a child of 15 when it is sick and not charging a child of 14 when it is sick, neither of whom will be wage-earners when the school leaving age is raised? Is not this illogical as well as mean and unjust?

On the point of meanness and injustice, I hope that the hon. Lady appreciates that the present arrangements date from the re-introduction of prescription charges by her own Administration. Children of 15 do not themselves pay prescription charges. They are dependants, and the normal exemption arrangements apply for the parents where hardship arises.

asked the Secretary of State for Social Services if, to help his formation of policy on payment of supplementary benefit to dependants of strikers, he will examine the practice in other countries, and publish his findings.

Information about arrangements in some European countries and the United States is being considered as part of the current policy review.

Is my right hon. Friend aware of the widespread concern at the extent to which the State intervenes on the side of strikers, and does he appreciate how important it is that employers in this country should not be at a disadvantage compared with employers in other Common Market countries?

I am aware of the concern. The Government are re-examining the position.

Is it not clear that the Government are likely to make another great mistake if they move in the direction suggested by the hon. Member for Norfolk, North (Mr. Ralph Howell)? They have already made a great mistake by introducing the Industrial Relations Act. Is it not clear that there is no widespread concern over this matter except among some of the backwoods Conservative back-benchers?

No, the hon. Gentleman is wrong. There is widespread public concern and it is shared by supporters of both main parties in the House. The hon. Gentleman is very out of touch if he denies that fact.

Will the right hon. Gentleman explain to his hon. Friend the Member for Norfolk, North (Mr. Ralph Howell) that the Supplementary Benefits Commission does not intervene on the side of employee against employer, and that the traditional posture of Government, the National Assistance Board and also the Supplementary Benefits Commission is one of neutrality in which the strikers themselves receive no assistance in the form of supplementary benefit? Will he also instruct his hon. Friend that the proportion of strikers who claim supplementary benefit is only a tiny fraction of the total number of people who go on strike in any one year?

My hon. Friend was making no comments against the Supplementary Benefits Commission, whose functions and efforts to relieve hardship are respected by Members in all parts of the House.

asked the Secretary of State for Social Services if he will make a statement on his plans for granting supplementary benefit to the dependants of men on strike in the form of loans.

I have no such plans.

Will the right hon. Gentleman agree to reveal the extent of the pressures being put on him by the cavemen behind him to implement this kind of proposal, and will he resist those pressures, despite the fact that the Industrial Relations Act is now working as we forecast in that there are more working days lost now than at any time in the last 40 years?

I recognise a great many Neanderthal characters opposite. But the Government are surveying all the alternatives in this difficult field.

rose—

The original caveman.

I deprecate my right hon. Friend calling hon. Members opposite, in a masterpiece of under-statement, Neanderthal men, but will he realise that every increase in welfare supplementation is a direct inducement to continued strikes by the idle, the in disciplined, and the unworthy?

I think that my hon. Friend is over-simplifying a relatively complex matter.

Is the Secretary of State aware that we on this side have noted his unwillingness to agree to the evil and inaccurate propositions put forward by the hon. Member for Worcestershire, South (Sir G. Nabarro)? Would he also bear in mind that we regard it as invidious that money paid in supplementary benefits to help ex-strikers and their dependants should be reclaimed as a result of payment in the form of loans, so that their personal circumstances are open to every clerk in every wages office in a company in which there has been a strike?

The hon. Member should not speak as if his own Government did not face these problems when they were in office—

We did not do that.

Indeed, right hon. Members opposite brought forward to the House proposals which they later dropped under pressure from their own back benches which showed how seriously they took the problem which we are now facing.

asked the Secretary of State for Social Services if he will establish a new section in his Department for health protection which will consolidate under one administrative head the work at present being undertaken on food and drugs, communicable diseases, epidemiology and nutrition.

No, Sir. I do not think it would be advantageous to group together all the different subjects mentioned by the hon. Member, and it would certainly not be practicable for one division to cover all aspects of health protection.

If the Department cannot accept that grouping, will the hon. Gentleman have another look at what is going on in Canada which has established a health protection committee? Will the hon. Gentleman undertake to make a continuing survey of these matters because although, we in the House always talk about preventing illness, it must be appreciated that there is little that either side has ever been able to do about it?

I shall study the hon. Gentleman's supplementary question and, if the need arises, I shall write to him further.

asked the Secretary of State for Social Services whether, in calculating the amount of a war disablement pension excluded for purposes of supplementary benefit payments, he will increase the figure from £2 per week to a level which takes into account the rise in the cost of living since 1966.

We have undertaken to review the disregard levels at an appropriate time and we shall take into account the rise in the cost of living since 1966.

Does my hon. Friend agree that, if such a review were made now, it would decide that the figure should be increased from £2 to about £2·75? Can he give some idea when a review is likely to take place?

My right hon. Friend thought it right during the first two years to concentrate the available resources on improving the level of benefit, particularly in respect of the very severely disabled and also war widows. He has given an undertaking that the rates will be reviewed. We accept that their value has been eroded.

Why not review them a little higher? Last Friday the Govern- ment revealed that the Prime Minister's pension would amount to £7,500. What is the difference? Why make fish of one and fowl of the other?

The hon. Gentleman knows that we now have an annual review of national insurance pensions for the first time ever and that the improvement in the benefit in two years has been well over £1,000 million a year.

asked the Secretary of State for Social Services what representations he has received, urging him to consider increasing the amount of capital disregarded for the purposes of assessing income for supplementary benefits from £325 to £500.

A few suggestions have been made that the £325 figure should be raised, but I am not aware of any suggestion of a figure of £500.

I am grateful to hear that the Government are considering raising the figure, although I think that £500 of capital should be the minimum disregarded figure—it is not a great deal and surely the Government wish to encourage people to save. The £500 figure would make a difference of 40p per week of income in respect of some one on supplementary benefit. It was as long ago as 1960 that it was last adjusted—

Order. This is Question time.

Yes, Sir, these rates will be reviewed, but I must point out on the aspect of thrift that an owner-occupied house is completely disregarded and that under the present arrangements people with no other disregarded resources may have up to £800 of capital disregarded.

Following the supplementary question put by my hon. Friend the Member for Bolsover (Mr. Skinner), may I ask why poorer people are subject to restrictions when more highly paid persons who are awarded higher pensions than the rest have no such restrictions? Surely all people, whether the Prime Minister or anybody else, should be treated in the same way.

I do not think the hon. Gentleman is comparing like with like. He is comparing occupational pensions, for which there is one rule, irrespective of the person and the level of income, with the National Insurance Scheme, which is another matter.

asked the Secretary of State for Social Services when he proposes to announce his decision about the provision, under the National Health Service, of an ear-level hearing aid for all deaf people who would benefit from one.

I have nothing to add to my right hon. Friend's reply to my hon. Friend the Member for Keighley (Miss Joan Hall) on 8th May.—[Vol. 836, c. 280.]

I pay tribute to the Secretary of State for Social Services for taking a greater interest in the problems of the deaf than did any of his predecessors in any Government. Is the hon. Gentleman aware that ear-level hearing aids can be manufactured for £8, compared with the figure of up to £80 by commercial manufacturers? Will he investigate the possibility of the Department manufacturing these aids, or through an agent, and will he resist the suggestion that a commercial firm should operate through the Department?

We are aware of the hon. Gentleman's figures. We do not rule out the possibility in any future provision of buying aids already developed by commercial interests, but we would want to supply them as an integrated part of the full medical service for the deaf available in the National Health Service.

Does my hon. Friend agree that much anxiety and concern are being expressed in both the medical profession and in societies for the care of the deaf at the lack of choice at present for National Health Service patients, whether in terms of a body-worn set or a post-aural set?

Yes, I am aware of the disquiet to which my hon. Friend refers, and we are also fully aware of the preference expressed by many people for a head-worn aid.

Will the hon. Gentleman look again at his previous answer which stated that the provision was three times greater than Medresco, since in fact the figure is only two times greater than Medresco? Will he take account of the psychological factor, which is part of the resistance to effective use, and also the fact that Medresco is being exported privately? Does he not consider that a profit could be made for the Department in exporting post-aural aids?

I appreciate the hon. Gentleman's point, but we do not under-estimate the therapeutic as well as the cosmetic value of head-worn aids. Indeed, the existence of head-worn aids may encourage some people who may turn down other aids to come into aid use entirely.

asked the Secretary of State for Social Services how much has been spent on research by Medresco on hearing aids in 1970 and 1971.

My Department's expenditure on Medresco hearing aid research was £2,250 and £2,650 in 1970 and 1971, respectively.

Is not that a very small sum of money to spend on the development of hearing aids for National Health Service patients? Is not the only way to overcome the "rackets" of the private hearing aid world to develop a comparable National Health Service instrument?

My hon. Friend asked a Question about the development of the Medresco hearing aid. He will know that the specification and the development of this hearing aid date back to 1946. It has been developed very substantially now. Further sums are being expended on development outside the immediate Medresco range.

Will the hon. Gentleman look further into this? Is it not the case that successive Governments have taken this quesion with insufficient seriousness and that it is necessary to devote much more public money to research to deal with a disability which is not taken sufficiently seriously in any part of society?

I have listened with sympathy to the hon. Gentleman's point. I hope that he heard his hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley), who paid a tribute to my right hon. Friend when he said that an unprecedented degree of thought and concern was being devoted to this aspect of disability.

Is my hon. Friend satisfied that this is the best instrument for improving the hearing of deaf people?

It is not necessarily the best for every kind of condition, but it covers a very wide range of conditions, although we certainly believe that there is scope for improvement.

Will the Under-secretary at least press his right hon. Friend the Chancellor of the Exchequer to exempt hearing aids from the provisions of value added tax?

That is a further and very much more far-reaching question, which is beyond the ambit of my responsibility.

asked the Secretary of State for Social Services if he will make a statement on the rôle and scope of community hospitals as a part of the future hospital service; and if he will announce plans for the development of this concept.

I am consulting the representative bodies of the medical and nursing professions and of the hospital service about the concept of community hospitals. I will make a statement on the role and scope of these hospitals when the consultations are complete.

Is my right hon. Friend aware that his own words of encouragement in recent months in favour of community hospitals have been warmly welcomed by many people who have thought it right to support their own local or cottage hospital? It is appreciated that there are areas of doubt, such as children's wards and casualty facilities, and would he not agree that guidelines might be helpful to regional hospital boards?

Certain guidelines will be necessary and I shall be issuing them. I am grateful for my hon. Friend's kind comments. I hope that the qualifications in my various speeches have been noted. There cannot be a charter for the sur- vival of all cottage hospitals. We cannot afford to provide an intensive service in new district general hospitals and to keep all cottage hospitals, but the community hospital is a new concept to complement district general hospitals and will enable a new function to be found for some of the local hospitals—but only some.

Will the right hon. Gentleman implement the report on rehabilitation published by his Department today which implies the establishment of a comprehensive scheme of rehabilitation within the community for the mentally handicapped, physically handicapped and other handicapped people? Would not this go a long way towards helping community care?

It is a different, overlapping and very important question. Rehabilitation presents us with some very difficult and urgent problems.

asked the Secretary of State for Social Services if he will seek to increase the number of reciprocal arrangements that ensure that a retirement pensioner who, having earned his pension in Great Britain, resides in the Commonwealth, does not thereby suffer a financial penalty by loss of subsequent increases.

We seek to increase the number of these arrangements where possible and, in fact, negotiations for a reciprocal agreement with Jamaica, under which each country's pensions and future increases will be paid in the other, are well advanced.

Is my hon. Friend aware that if an eminent civil servant on retirement accepts a lucrative directorship, his pension with cost of living increases is paid in full, but that if a similar civil servant—I have in mind the former head of a Department—elects to go overseas to devote his remaining years to service to an under-developed country in some unpaid capacity, his Civil Service pension is reduced? Is this not so unethical that it cannot possibly be defended?

My hon. Friend is talking more about Civil Service pensions, which are not for me, than about National Insurance pensions.

Does the hon. Gentleman appreciate that these discriminations between ourselves and our overseas partners in the old Commonwealth are not restricted only to the benefits referred to in the Question but apply also to health service benefits? Is the hon. Gentleman aware that I was astonished the other day to discover that two of my constituents who are British subjects and who enjoy all the facilities and benefits of the health service, could not, on going to Canada, be guaranteed the same facilities? Bearing in mind that Canada is one of our closest partners for whom we have the greatest respect, could not there be a political move towards some kind of reciprocal arrangement with Canada? After all, Canadian subjects coming to this country have the service of our hospitals. British subjects going to Canada, on the other hand, cannot get the same service there without paying heavy fees.

We are anxious to encourage reciprocal arrangements in the social services generally, and considerable progress is being made. But it takes time to work out details with any country.

In view of a recent announcement by a Government Department or agency that it intends to employ retired people in developing countries, will my hon. Friend look again at the question raised by my hon. Friend the Member for Dorset, South (Mr. Evelyn King)?

I explained just now that it was not really a matter for me. However, I will see to it that my right hon. Friend primarily responsible has his attention drawn to it.

asked the Secretary of State for Social Services what plans he has for improving the working conditions of junior hospital doctors.

As indicated by my hon. Friend in the Adjournment debate on 21st January, 1972, there have been significant improvements over the years, and I hope that the process will continue.—[Vol. 829, c. 926–38.]

Has the right hon. Gentleman seen the report entitled "More in Sorrow" published by the Sheffield Junior Hospital Doctors Association? Its complaints of overwork, too little free time, and exploitation are matched by the burning anger that many young doctors feel about the way in which they are compelled to dance attendance on the private patients of consultants. Will the right hon. Gentleman do something about this scandal within the National Health Service?

I am a fairly good reader. I have read every word of that report. I note that the doctors who themselves prepared it stress that a lot of their grievances—I am sure in some cases legitimate ones—should be dealt with by effective approaches to the hospital authorities concerned. It is for them to take their grievances to the authorities. I shall ensure that the regional hospital boards and the hospital authorities concerned study the report "More in Sorrow"

asked the Secretary of State for Social Services whether he will set up an inquiry to investigate the incidence of chronic bronchitis and emphysema in industry, with a view to having it classified as a prescribed industrial disease.

No, Sir. Chronic bronchitis and emphysema are extremely common among the general population and there is no evidence to suggest that they could satisfy the conditions for prescription as industrial diseases laid down in Section 56 of the National Insurance (Industrial Injuries) Act, 1965.

If that is the case, perhaps the hon. Gentleman can explain why it is that a few years ago chronic bronchitis and emphysema in association with pneumoconiosis was accepted as an industrial disease? If one pursues that kind of logic, someone somewhere in the Department is accepting that chronic bronchitis and emphysema should be a prescribed industrial disease and that there are thousands of miners and ex-miners whose lungs have been destroyed totally as a result of this form of industrial accident. Has the hon. Gentleman any comment on the first point especially?

A connection has been established in the case of pneumoconiosis, and it is for that reason that this exception has been made with regard to the mining community. A great deal of research has been done into bronchitis and emphysema. It is "the English disease", and we have to be careful that we do not prescribe something which does not fall within the terms of the Industrial Injuries Act. None the less, I assure the hon. Gentleman that much research continues into this problem and other industrial diseases. As soon as we get firm evidence that any additional disease can legitimately be brought within the Act, we are prepared to act upon it.

Is the hon. Gentleman aware that he has a case before him from my constituency where the Pneumoconiosis Panel said that a man did not have pneumoconiosis? Subsequently the man died. An autopsy revealed that he had chronic bronchitis, emphysema and pneumoconiosis. Is the hon. Gentleman aware that the Pneumoconiosis Panel still denied that he had it, despite the fact that the pathologist's report clearly revealed it? Will the hon. Gentleman look again at this matter?

I shall look at it gladly, though I am sure that the hon. Gentleman would not expect me to comment on an individual case now. I emphasise that the exception made in the case of pneumoconiosis has gone a long way to deal with the undoubted problem suffered in the mining community as a result of this disease.

asked the Secretary of State for Social Services what studies he has undertaken concerning the provision of alternative care within the community for patients who no longer need mental hospital treatment.

Following earlier studies in this country and abroad, my Department is now supporting two large, and several smaller, development projects. The aim is to establish to what extent and in what manner the mentally ill or handicapped can be looked after in the community rather than in hospital.

I am grateful to my right hon. Friend for that. Will he accept that there are a great many people who on discharge from hospitals need gradual adjustment to modern society and that there are inadequate facilities for the purpose? Will my right hon. Friend consider expanding the number of hostels or half-way houses for the purpose?

There are grossly inadequate facilities for these and many other related purposes. We are just beginning to realise how much we have to provide. The ten-year plans that I shall be asking local authorities to produce, so that they may be published, in the near future will, I hope, reveal how much local authorities are proposing to expand the present services.

Will the right hon. Gentleman recognise the great urgency of this matter, as there are thousands of patients in mental hospitals who have no medical need for long-stay institutional treatment? When will the right hon. Gentleman produce the plan for psycho-geriatric patients which has been awaited for some time, since they comprise 44 per cent, of the total number of patients in mental hospitals?

The hon. Lady knows that during all the years since the Mental Health Act, 1959, there have been tens of thousands of patients in mental illness and mentally handicapped hospitals who were not detained under the Act but who were there only because there were no other facilities. The hon. Lady's Government did nothing. For the first time, this Government are trying to expand the services so that those people may come out. Surely we have shown that we take this matter seriously. The circular on psycho-geriatric advice will be coming out later this year. I am consulting authorities about it at the moment.

asked the Secretary of State for Social Services if he will authorise an increase in the allowance payable by regional hospital boards for kidney patients undergoing haemo-dialysis treatment at home in order to meet the cost of heating by electricity as well as the operation of the machine.

I would refer my hon. Friend to my hon. Friend's reply to the hon. Member for Exeter (Mr. John Hannam) on 22nd February.—[Vol. 831, c. 255.]

Does my hon. Friend not agree, first, that heating is necessary both for the maintenance of the kidney machine and for the comfort of the patient and that kidney patients at home are relieving the hospital services of considerable expenditure both in nursing and on technicians? On both of these grounds, is there not a case for meeting all their costs?

I think that my hon. Friend knows that hospital authorities are responsible and that they already meet the cost of electricity used for the kidney machines themselves. Of course, my Department, through the Supplementary Benefits Commission, can help in the cases of people who need extra heating allowances and have limited means.

What is the policy here? Are people to be encouraged to remain at home or are they to be put with other cases in already overcrowded hospitals?

The answer that I have already given, showing that hospitals not only provide home dialysis facilities but also meet the cost of electricity used in them, is an indication of the way in which we want people to be treated at home as far as possible.

asked the Secretary of State for Social Services what instructions have been given by his Department regarding rent increases for tenants living in property owned by regional hospital boards.

Hospital authorities are expected to review rents once a year so as to keep in line with the rents of comparable properties in the neighbourhood either by comparison with rents charged by local authorities for similar properties, or, when this information is not available, by obtaining the advice of the district valuer.

Is not the hon. Gentleman aware that in my constituency there have already been flat-rate increases of over £1 a week for workers who are not highly paid? As they have no right of appeal—they live in what is really a tied cottage system—surely he will reconsider this and give these people the right of appeal, and also take note of the hard- ship that these increases are causing to many of them.

The hon. Gentleman will know that hospital tenants are eligible for rebates from the authorities. If he would like to send me details of the particular difficulties in his constituency, I will certainly look at them.

asked the Secretary of State for Social Services whether he will now send a copy of the Undersecretary of State's letter of 1st May, 1972, to the hon. Member for Nuneaton about whole-time and part-time consultants' appointments in the National Health Service to all regional hospital boards.

We are satisfied that employing authorities are aware of the Department's guidance concerning whole-time and part-time consultant appointments.

But at the end of that letter the hon. Gentleman said:

"A consultant on a whole-time or maximum part-time contract is expected to devote substantially the whole of his time to the National Health Service and to give it priority on all occasions."

There is no need to do that. Hospital consultants and hospital authorities know very well the terms upon which the contracts are entered into. Indeed, consultants in the overwhelming mass fulfil the terms of their engagements, not only to the letter, but very much more so in the spirit.

Is the hon. Gentleman aware that, in the Birmingham Regional Hospital Board area, 60,000 people are awaiting admission to hospitals, yet in 1971, 10,000 people were allowed to jump the queue? Why does he not have a word with the part-time consultants to try to persuade them to spend a little more time on the 60,000 and a little less on the 10,000?

Waiting lists of any size need not arise in cases in which medical need is urgent.

asked the Secretary of State for Social Services what research is being undertaken by his Department into hearing loss caused by industrial noise.

None directly at present, but research on all aspects of audiology is being undertaken in a large number of universities, polytechnics and other laboratories. The results of a research project promoted under Section 71 of the National Insurance (Industrial Injuries) Act were published in 1970 in a report entitled "Hearing and Noise in Industry".

But my hon. Friend will agree that we are now becoming aware that noise in industry is constituting an injury, that more than 500,000 people are subjected to noise levels continuously of over 90 decibels, and that therefore considerable loss of hearing is being caused. Surely, therefore, insufficient appears to be being done and more should be done to research into this loss of hearing in terms of industrial injury.

We share my hon. Friend's concern about this. It is for this reason that the Industrial Injuries Advisory Council is now considering whether there are degrees of hearing loss due to exposure to noise in the course of employment which would satisfy the conditions for prescription as an industrial disease. Its inquiries are continuing and I cannot say at the moment when they will be complete.

Is the hon. Gentleman aware that noise in industry is having a very serious effect now, not only on the people working in the industries concerned but on folk living nearby? Would he therefore make sure, when these reports are available, that they include the effects on people living near the industries which are causing much of the anguish, not only because of loss of hearing but because of the grave effects on their nerves?

I am grateful for that point and will ensure that it is drawn to the council's attention.

asked the Secretary of States for Social Services what was the total amount spent by the West Riding County Council in applying the provisions of the Chronically Sick and Disabled Persons Act in 1971–72; how much this represents per person in the West Riding; and how this compares with average expenditure per head by other welfare authorities.

This information is not available.

Would the hon. Gentleman agree that the West Riding and a number of other authorities are not spending anywhere near sufficient on providing for the chronically sick and disabled? Would he consider issuing a circular urgently to the more niggardly authorities, to ensure that their stringent attitude is changed to one of much greater generosity?

The hon. Gentleman knows, I think, that my Department's responsibility lies only in respect of the provision of services under Section 2 of the Act. Financial returns on this limited basis are no indication of the extent of an authority's provision for the disabled. It may be, for example, that housing or health provision bears directly on the needs of the disabled but does not necessarily follow the figure of expenditure under the Chronically Sick and Disabled Persons Act.

Could my hon. Friend elaborate on the statement that this information is not available? I should have thought that it clearly is. I believe that what he means is that he has not got it from the local authority. Is there not here something of a point of principle—that, although we may on different sides of the House disagree on policy, we would all agree that we are entitled to information? In many social services there is an increasing tendency for Ministers to decline to give information which clearly is available if they ask the local authorities.

As it happens, the information is not available for 1971–72, but I will pursue my hon. Friend's point further in correspondence with him.

If the hon. Gentleman wants the information, will he consult the Institute of Municipal Treasurers? Is he aware that full comparative information on the implementation of the Act would be warmly welcomed by all the voluntary organisations in this field? Is it not utterly wrong that chronically sick and even severely disabled people should still be treated well or badly according to which side of a local authority boundary they live?

The hon. Gentleman must recognise that the Act, in which he played a substantial part in terms of authorship, along with many right hon. and hon. Members on both sides of the House, deliberately left the disposition of expenditure in the matter of the Act to local authorities.

asked the Secretary of State for Social Services what action he now intends to take to ensure that all local authorities in England and Wales follow up on a house-to-house basis comprehensive surveys into eligibility for assistance under the Chronically Sick and Disabled Persons Act.

asked the Secretary of State for Social Services what replies he has now received from local authorities on their implementation of Section 1 of the Chronically Sick and Disabled Persons Act, 1970; and if he will make a statement.

I cannot yet add to my reply to the hon. Members for Stoke-on-Trent, South (Mr. Ashley) and Portsmouth, West (Mr. Judd) on 16th May, but I expect to be able to do so before the House rises for the Summer Recess.—[Vol. 837, c. 67–8].

Although many local authorities, often in collaboration with voluntary agencies, have arranged a most comprehensive distribution of information about the Act, would the Under-secretary agree that without a house-to-house follow-up of the kind I have suggested there is a serious danger that the most needy cases will fall through the net?

We shall want to judge what has been done in the light of returns from all the authorities concerned. The hon. Gentleman may know that my Department is producing centrally a booklet which will supplement even more widely the efforts which local authorities are making.

Has the Under-Secretary seen the excellent report produced by the social services department of the City of Newcastle-upon-Tyne? Will he arrange for this report to be seen by other authorities and inform the House of the outcome of his inquiries at the earliest possible date?

I shall certainly inform the House as soon as we have the fullest possible number of returns from local authorities. The widespread publicity given to the Newcastle project and the natural desire of local authorities to compare notes and to know what is happening in the field would make it unnecessary formally to draw the attention of local authorities to that particular project.

asked the Secretary of State for Social Services if he will take steps to ensure that persons confined in hospitals for the mentally ill include only those suited to be there.

asked the Secretary of State for Social Services whether he is satisfied that all hospital patients originally committed to institutions under the Mental Deficiency Act, 1913, will now have their cases reviewed; and if he will make a statement.

Less than 7 per cent, of all patients in psychiatric hospitals are compulsorily detained and they have rights of application to mental health review tribunals. There are large numbers of other patients there from the time when these hospitals were expected to provide residential as well as medical and nursing care. Only as residential accommodation in the community is increased will there be alternative homes for many whose real need is for residential care.

I thank the right hon. Gentleman for that reply. Is not the problem of trying to empty these hospitals so that they can do their real job in the treatment of mental illness the responsibility of the Government? This situation will not be resolved by passing the buck to local authorities.

I sympathise with the hon. Lady's attitude, but the fact is that both parties in the House have regarded local authorities as deserving autonomy in the way that they spend large sums of ratepayers' money as well as taxpayers' money. We have every evidence that local authorities are taking seriously this new task on their shoulders. I hope that when the 10-year plans are produced, and in due course published, the country will be satisfied that the progress in making good an immense backlog is as fast as we can expect.

I appreciate the difficulties of rehabilitating these patients in the community, but would the right hon. Gentleman, nevertheless, review all cases of patients who were confined in institutions under the Mental Deficiency Act, 1913?

About 35,000 of the patients now in psychiatric hospitals were originally admitted to them under the Mental Deficiency Acts. Only about 1,000 of these, however, were still detained compulsorily at the end of 1970. All the rest are free to go, if there were anywhere for them to go.

As well as making sure that no persons are confined in mental homes who ought to be outside them, will my right hon. Friend take steps to ensure that some of those who ought to be in mental homes are placed in them, bearing in mind the horrible tragedy of the deaths of three children recently in Liverpool?

Blackpool.

Yes. My hon. Friend has raised a real worry, particularly in connection with the case of the man in Gloucestershire, about which hon. Members will have read in the newspapers. But there are very few barriers to the admission of people who need hospital care in this sort of hospital. I take my hon. Friend's question very seriously.