asked the Secretary of State for Social Services how many extra people would now be in possession of invalid tricycles if previous policies had been maintained.

No precise estimate can be made. The hon. Gentleman may, however, like to to know that under our new policy over 48,000 severely disabled people are now receiving outdoor mobility help for the first time ever.

Is the Minister satisfied that many people who have become disabled since last July, when trikes were no longer given out to disabled people, are severely restricted and need assistance?

I shall be delighted to look into any particular case that the hon. Gentleman may wish to refer to me. Other hon. Members have taken advantage of a previous offer. The Question assumes that there was no element of choice in the previous scheme, whereas in fact more and more people were choosing a private car allowance instead of a trike under the old scheme. Between January and June 1976, when there was a choice between the trike and the mobility allowance, about 96 per cent. of disabled people chose the mobility allowance.

I appreciate the help that is being given, but is my hon. Friend aware that there are many people who have been able to spend a lifetime at work because from the word "go" they have had the ability to get to work and back? Is there not a disincentive under the present system to people starting work while disabled because of their inability to get to work and back? Could not this be taken into consideration?

I fully appreciate the point that my hon. Friend is making. Our phasing-out programme is very gradual. We are particularly mindful of the claims of people who will need extra help to get to and from work. We have been in close contact with the Royal Association for Disability and Rehabilitation about a scheme which may provide for the leasing of vehicles. All that my hon. Friend has said today will be taken fully into account.

Can the Minister tell us what progress is being made towards developing a new and more suitable vehicle than the tricycle and whether there is any hope that those at present with tricycles can look forward to receiving a replacement vehicle either by leasing or by some other means?

There are a number of prototypes and I have seen several of them recently. The GKN Sankey prototype is fairly well known. We have given a strong commitment to people in the existing scheme. My right hon. Friend the Secretary of State has given what he calls a "cast-iron assurance" to disabled drivers in the old vehicle scheme. The hon. Gentleman can be well assured that we are fully mindful of the problems of people who will still need specialised vehicles when we can no longer replace their tricycles.

Regarding employment, is it not a fact that my right hon. Friend the Secretary of State for Employment has said that no person would be denied the opportunity of seeking and retaining employment and that he would deal with the matter? Is it not true that an evaluation of the GKN prototype vehicle is being carried out and that there are now discount schemes with the major motor manufacturers?

On the final point, I recently gave a reply to my hon. Friend the Member for Stoke-on-Trent, South (Mr. Ashley), listing all the available concessions. My hon. Friend is correct in the point that he makes about the GKN Sankey prototype. In regard to the Employment Service Agency scheme, we are in close contact with my right hon. and hon. Friends at the Department of Employment. The very worst inheritance that I had when I became a Minister was the arrangement under category 3 of the old scheme whereby if a disabled person lost his job he also lost his vehicle. I take pride in the fact that this Government have ended that system.

We accept that a lot has been done. Does the Minister accept, however, that there is still great concern about those leaving school or who have become newly disabled and cannot go to work? Will he institute a special inquiry among the schools for the handicapped and the training centres for the newly disabled to make sure that no one is prevented from working by the lack of a vehicle?

I share the concern of those who have anxieties about further improving the mobility of the disabled. Getting out of hardware is not an easy task. There were many criticisms of the invalid tricycle. We must not be put in a position where we cannot do right for fear of doing wrong. I am mindful of the point made by the hon. Member for Wallasey (Mrs. Chalker). I assure her that we shall do everything possible further to improve the mobility of disabled people, not least disabled young people.

asked the Secretary of State for Social Services what further consulations he has had with pharmacists about their new contract.

asked the Secretary of State for Social Services what further consultation he has had with pharmacists about their new contract.

I am meeting representatives of the Pharmaceutical Services Negotiating Committee again on 25th July to continue our discussions about NHS remuneration.

Will the Secretary of State explain why he is proposing to make retrospective cuts of £11 million in the revenue receivable by chemists from the NHS? Is not this another example of the Government penalising efficiency and a matter which will ultimately redound against the interests of all consumers?

There is no question of retrospective cuts. The stock-holding inquiry held in 1975, the validity of which was not challenged by the Pharmaceutical Services Negotiating Committee, showed that pharmacists' working capital had fallen from its previously assumed level. The PSNC agreed that the new figure, whether it be higher or lower, should operate from the date of the inquiry.

My right hon. Friend knows of my special interest in the Pharmaceutical Society. I am grateful, as are most responsible chemists, for the special interest that he takes in problems facing pharmacists. Is he aware that the new President of the Pharmaceutical Society, Mrs. Estelle Leigh, is a Liverpool pharmacist? Will it be possible for my right hon. Friend to arrange to meet her and her colleagues during the Summer Recess to discuss not only negotiation, which is not the real duty of the society, but outstanding problems in this regard?

I have already met Mrs. Leigh, for whom I have great respect. I assure my hon. Friend that if she and her colleagues from the Pharmaceutical Society want to have a discussion with me on any relevant issues I shall be delighted to see them.

Does the Secretary of State appreciate the problems in villages caused by chemists shops shutting down? Will he pay special regard to this problem, which is causing great anxiety to the elderly who have to travel many miles to the nearest chemist's shop?

I am always concerned when this happens. There is a steady reduction year by year in the number of pharmacies, but most of them are not in villages. Some closures in urban areas are due to changes in population patterns as a result of slum clearance and so on.

In view of the difficulties encountered by the pharmaceutical profession—there has been reference to the numbers of pharmacies closing year by year—and since this situation has nothing to do with the intrinsic nature of the National Health Service, will my right hon. Friend try to encourage local authorities to institute pharmacies within health centres?

There are pharmacies within a number of health centres. It is far better that that should be the case than that there should in a sense be competition to get a pharmacy very close to a health centre. I am not prepared to give a direction on this matter by any means, but I should always approve of a recommendation that there should be a pharmacy within a health centre, particularly a big one providing services for a larger population.

Is the Secretary of State aware that there is widespread anxiety about the likely effect of the announcement that he has made about the pharmacists' contract, as evidenced by the fact that there is an all-party motion on the Order Paper signed by 212 hon. Members from both sides of the House? Does he agree that there is something inherently undesirable about a contract which appears to penalise efficiency in that the more efficiently the pharmacists use their capital, the more income they appear to lose? Is the examination taking account of the need to try to build in some kind of incentive payments for pharmacists that will help to keep pharmacies within the community instead of accelerating their closure?

I do not agree with the right hon. Gentleman's diagnosis. I am prepared to look at any new proposals, though none has yet come forward, on a totally new restructuring of the system of remuneration. The only announcement that I made today was that I was going to meet the negotiating committee on 25th July. I do not want to anticipate anything that happens then. I am considering carefully the representations that have been made to me by the pharmaceutical companies.

asked the Secretary of State for Social Services what plans there are to reduce Health Service facilities for those living in the Bromley Health Authority Area.

There are no firm plans to reduce facilities. The Bromley Area Health Authority is examining the feasibility of rationalising maternity and children's services in order to free resources, mainly to improve community and psychiatric services.

I appreciate that there is a surplus of maternity beds in the area. Will the Minister bear in mind that the suggestion that the Beckenham Maternity Hospital might be closed would bear particularly hard on the residents of Penge and Anerley who have less private transport than most residents in the area and that public transport facilities for getting to other hospitals are grossly inadequate?

If the community health council makes those points, I am sure that the Bromley Area Health Authority will listen to them. If there is still a dispute about the future of the hospital, ultimately the decision will come before my right hon. Friend or myself and at that stage I should be prepared to see the community health council. At this stage I should not want to comment on the merits of the scheme.

We appreciate the problems that the Minister is creating in the Bromley area. Will he tell us what advice he has given to the Bromley Area Health Authority for dealing with cases such as that of Mrs. Ward?

I should like notice of Mrs. Ward's case. I am not creating any problems in the Bromley area. I have had no contact with the Bromley Area Health Authority. I do not see how I can be accused of creating problems in that area.

asked the Secretary of State for Social Services when he expects the Supplementary Benefits Commission to have completed its review of the supplementary benefits system.

I cannot yet say when the team of officials which my right hon. Friend established to carry out this review in close consultation with the Commission will complete its work. But we hope to receive early next year its first recommendations for discussion of possible options for the future, which we have undertaken to publish.

Why must we wait until 1979 for the full implementation of the child benefit scheme? Why does not the Minister take the opportunity to complete the change next April?

That question has nothing to do with the Question on the Order Paper.

Does the Minister recall those confident days when the Labour Party used to condemn any extension of means-tested benefits? How will he end means-tested benefits? What does he have to say about the fact that there are 1 million more people on means-tested benefit today than there were four years ago?

Our attitude to means-tested benefits has not changed. The development of the child benefit scheme is an indication of the phasing out of means-tested benefits.

What response has the Minister felt able to give to Professor Donnison, who has committed himself to believing that the best way of getting rid of many of the problems of means-tested benefits is to phase in a full tax credit scheme?

Professor Donnison, as Chairman of the Supplementary Benefits Commission, rightly has a great deal of freedom to express his and the Commission's views, and obviously the Government will listen to what he has to say.

asked the Secretary of State for Social Services if he will receive a delegation from Stockport Gingerbread Group to discuss the child benefit scheme.

My right hon. Friend has twice received a delegation, which included Gingerbread, at national level, and its views have been taken fully into consideration. As my hon. Friend will know, we have now announced a substantial improvement in the rates of child benefit, including doubling the premium for one-parent families now getting 50p.

May I assure my right hon. Friend that the Stockport group is extremely pleased about the announcement that was made last week? However, there is still some concern because it is so sad that the announcement always comes so early compared with the actual uprating. Can my right hon. Friend tell us how soon the whole thing will be put on a computer so that the uprating can be done more quickly and so that there can be variations according to the age of the child?

On the last point, I am sure that my hon. Friend and the House would want to examine in some detail whether we wish to have different rates, because that could possible be regressive. As for computerisation, we are taking steps in that direction but it will possibly be some time in the 1980s before this is completed.

Will the Minister explain his reply to my hon. Friend the Member for Romford (Mr. Neubert) in which he said that the supplementary benefits review and Professor Donnison's speech had nothing to do with the child benefit scheme, although the right hon. Gentleman has spoken of using the scheme as a means of getting people off mean-tested benefits? Why have the Government decided not to bring in the full child benefit scheme by April of next year?

We have discussed this in the House many times and we now have an agreement for phasing in the child benefit scheme which has been widely accepted. I should have thought that the substantial increase that is proposed for next year—which will cost more than £300 million in public expenditure—was a sign of the Government's good intentions.

asked the Secretary of State for Social Services when he expects to be able to advise parents of vaccine-damaged children how they are to submit claims for compensation; and if he will announce some guidelines at an early date.

As I made clear in my statement to the House on 14th June, the detailed provisions of the scheme of payments for vaccine damage cannot be determined until we have received the report of the Royal Commission on Civil Liability and Compensation for Personal Injury. As soon as the report is received. we shall examine its recommendations in detail so that a scheme of payments can be decided without delay. The provisions of the scheme and arrangements for the submission of claims will then be publicised. In the meantime, advance work is in hand by my Department on possible arrangements.

I thank the right hon. Gentleman for that reply. Would he agree that it would be tragic if, in the case of some parents, hope were to turn to disappointment and even bitterness because they had thought that they would qualify for compensation on behalf of their children and subsequently found that they did not? Will the right hon. Gentleman consider establishing immediately some form of preliminary inquiry, even one as basic as for the purpose of establishing that a child received a vaccination at a given time from a certain doctor and subsequently suffered symp- toms similar to brain damage? Would not that avoid some of the potential misery that might occur?

To start setting up some form of inquiry in advance of an agreed system would lead to precisely what the hon. Gentleman is concerned about—that is, hope turning to bitterness. We must accept that there will be people—and this applies in other situations—who may apply for benefit without the adjudication necessarily being that they are entitled to it. The assumption that every brain-damaged child is brain damaged as a result of vaccination is not accurate. One of the most difficult aspects of the matter is the determination of a method by which it can be seen whether the damage was due to vaccination. It would be unwise to start anything other than preliminary work in advance.

Is my right hon. Friend aware that most hon. Members recognise his anxiety to help in the matter and the genuine difficulties that he faces? However, will he consider recommending to the independent medical assessment board that in cases where there is a margin of doubt the board should be generous and give the benefit of the doubt to the children concerned, as happens in other countries?

Such considerations must be taken into account when the Commission's recommendations have been received and we have established a system. It would be unwise for me to comment now.

Will my right hon. Friend say whether the Commission and its recommendations will deal with the point about whether payment of compensation, or even application for compensation, will undermine the rights of parents to sue manufacturers if at a later stage they decide to do so?

I revealed to the House the broad principles upon which the Royal Commission would be working in connection with vaccine damage. I did not, and should not, reveal to the House any other aspects of the consideration of the Commission. We shall have to await the report of the Commission, when I shall be better able to answer such questions.

Is there any evidence yet of an increased uptake in vaccination generally as a result of all the discussions that have taken place recently and the pleas that have been made to the community not to be put off vaccination?

I cannot give any statistics, but the review of the joint committee was well received by the medical profession which found it helpful and reassuring. That has gone a long way towards re-establishing confidence within the medical profession. I expect that even without further efforts it will lead to an increased take-up. However, no statistics are yet available. I shall follow this up carefully.

asked the Secretary of State for Social Services if he is satisfied with the results of the reorganisation of the National Health Service.

This Government's views on the 1974 reorganisation of the NHS are well known. When the Labour Government came into office three weeks before the date set for reorganisation of the Health Service, one of their first decisions was that it was not practicable in the time available to delay the reorganisation or to attempt to change immediately those features which it opposed.

I am glad to hear that answer, because it is now generally accepted that the reorganisation has hardly been an unqualified success. Has not one of the results of it been that a higher proportion of resources has been spent on administration and consequently, a lower proportion on the patients? Is it not about time that we learned from our mistakes?

Their mistakes.

It is true that if we are to learn we must learn from the mistakes of others and also the mistakes of McKinsey, which gave advice to my predecessor. The Opposition already seem to have learned their lesson and to have recognised that the reorganisation is far from being a success. I agree with much of what my hon. Friend has said about administration and the fact that it has caused us who have responsibility for the NHS to do a great deal of work in slimming the administration without changing the structure. We are now going through a process of reducing management costs to make more funds available for patient care.

Whatever the merits or demerits of the original reorganisation, is there not now real concern, particularly in the Northampton area, about the way that the reorganisation is working in respect of the allocation of funds from the Oxford Region? Is the right hon. Gentleman prepared to meet a deputation of hon. Members representing Northamptonshire constituencies to discuss this unfairness before swingeing and damaging cuts must be made?

Some months ago I received a deputation of hon. Members to discuss the situation in Northamptonshire, just as my colleagues and I have received deputations from people in many parts of the country. When we come to making the allocations for next year, we shall take all these things into consideration. I want to say to the whole House that the policy upon which the Government have embarked—of a redistribution of resources to ensure that traditionally deprived regions will get a higher rate of growth—is a policy that we shall stick to in the interests of social justice.

In view of the fact that the Government will be unable to make basic changes before 1982–83, in these slimming operations will the Government consider making immediate arrangements to get rid of one tier of the NHS—namely, the area health authority tier? Will the Government make the necessary arrangements for the redistribution of funds and people during the next two years so as to bring organisation down to a district level instead of there being an area authority?

That would be a revolutionary change and would anticipate whatever the Royal Commission might decide. Some would say that if one tier were to be removed it should not be that one. I have made it clear to the health authorities that where they believe that it is in the interests of the management of the service, provided that there has been effective consultation with the local authorities and staff, I am willing to look at any changes that would create more single-district areas and change the balance. However, an across-the-board change such as my hon. Friend has suggested would undermine the work of the Commission.

Does the right hon. Gentleman recognise that we would go a long way to endorse the plea which has just been made by his hon. Friend the Member for Brent, South (Mr. Pavitt)—where, perhaps, the slogan ought to be "Prepare to shed thy tiers"? Does not the Secretary of State remember that no fewer than four Secretaries of State in the Labour Government last year signed a report which committed the Government to saying that the reorganised National Health Service

"provides an improved administrative framework within which it is now possible to look at priorities more comprehensively and to plan the allocation"—

Who wrote that?

It is signed by the right hon. Members for Blackburn (Mrs. Castle) and Kilmarnock (Mr. Ross), the Secretary of State for Wales——

Order. We are getting untidy. This is a time for seeking information rather than for making arguments.

Will not the right hon. Gentleman give credit where it is due?

I did not sign the report.

Your predecessor did.

I did not. Nevertheless, there have been aspects of the reorganisation which have produced some improvements in administration, partly because they have brought together the community and the hospital services. That was an important step forward which would have been in any proposals, whether they were made from the Labour or the Tory side. I am glad to hear that the right hon. Gentleman has been reviewing the situation and is shedding "tears", be they crocodile or whatever else. I welcome the fact that he is now crying over the mess the Conservatives made.

If we are to have to make the best of a bad job, at least for the time being, is it not important that the right hon. Gentleman does all he can to try to get management decisions affecting local institutions taken at a more local level rather than have so many people running around in cars telling others in institutions to which they have never been before what to do?

The hon. Gentleman is absolutely right. We have to operate at the moment as best we can within the structure we have. That is the way in which I am approaching this. That means that we need much more effective joint planning as between local authorities and health authorities. This move has received a tremendous stimulus by the £21 million which is available this year for joint spending by social service authorities and health authorities. This is bringing them together in a practical way that is immensely improving the quality of community service.

asked the Secretary of State for Social Services if he will give the latest convenient figures for the shortage of kidneys for transplant.

On 30th June 1977 there were 1,164 patients in the United Kingdom on the waiting list for transplantation. After increasing for many years, the waiting list now shows signs of levelling out.

Does my hon. Friend have any sympathy with the proposals for contracting out of the scheme?

We are not convinced that the proposals for contracting out or opting out would achieve as much as advocates of the scheme suggest. Nor, in spite of some recent evidence, are we satisfied that it would be acceptable to the public at large or welcomed by the profession. Certainly, before there were to be any proposals for a radical change in the law put to Parliament there would need to be widespread consultation with professional and other bodies.

Is my hon. Friend monitoring the effect of the issue to learner drivers of a voluntary ticket enabling them to donate their kidneys? Will he ensure that there is close co-ordination with the Department of Transport to see that this fine scheme does not run into the sands?

The kidney donor scheme is a good one and cards continue to be available in hospitals and doctors' waiting rooms. We are always seeking new ways of improving the distribution of these cards. In addition to being issued with first provisional driving licences, they will shortly be available in all social security offices.

asked the Secretary of State for Social Services what new action he proposes to take concerning the registration of overseas doctors.

The arrangements for the registration of doctors with overseas qualifications were among the matters covered by the Merrison Committee on the regulation of the medical profession.

I am grateful to my right hon. Friend for that information. Does he not agree that older doctors of Asian origin who qualified at the time of British administration overseas have been rather unfairly treated? If that is recognised, will he get a move on and alter the situation?

Most overseas doctors in this country, who have made an extremely important contribution to the National Health Service, would, I am sure, share my view that proper standards must be maintained for doctors wishing to work in this country. We have become excessively dependent upon doctors from overseas, which is fair neither to them nor to the Health Service. I agree that some EEC directives put some of these doctors at a disadvantage. The Overseas Doctors Association has made representations to me and we are considering whether this is an issue which we can pursue formally with our Community colleagues.

asked the Secretary of State for Social Services how many of the recommendations of the Finer Committee have been implemented by his Department since the publication of its report in July 1974.

Nineteeen in full and one in part.

Is my hon. Friend aware that that is not a very good record, considering that there were 230 recommendations? Can he tell the House what the thinking of his Department is at the moment, particularly about long-term financial support for one-parent families? Is he aware that, welcome though the El supplement to child benefit is, it is not a long-term solution to the poverty of one-parent families? What thought is being given to a new scheme, a possible extension of the widowed mother's allowance?

Many of the recommendations in the report related to the details concerning major concepts. In rejecting the idea of a guaranteed maintenance allowance, 54 recommendations—64 to 117—were rejected. All these related to one specific issue. Many of the other recommendations concern local authorities and social services. The speed with which they can be implemented depends on the availability of resources. A number of the remaining recommendations are for other Government Departments and some have been implemented. Help for one-parent families has to be considered in the context of financial help generally for poor people and families. We shall have to wait and see what resources will become available.

Can the hon. Gentleman try to find out whether he can get other Government Departments and his own to implement those proposals which require neither legislation nor extra finance?

In my Department we have implemented the recommendations which do not require legislation. There are one or two more which we are still considering. There were fewer recommendations concerning other Departments, and a number of these recommendations have been implemented. A number of the major ones, concerning family courts and so on, have not been implemented and, I believe, are not likely to be implemented. They would require legislation.

asked the Secretary of State for Social Services what was the total annual National Health Service revenue expenditure on services for the mentally ill for the North-Western Regional Health Authority for the years 1967 to 1977.

Expenditure in 1975–76 was about £25 million, of which about £11 million was incurred in the single-specialty hospitals for the mentally ill. Similar information for 1976–77 is not yet available. Information in this form is not available for earlier years but I would refer my hon. Friend to the answer given by my right hon. Friend the Member for Plymouth, Devonport (Dr. Owen) on 25th May 1976 to my hon. Friend, which, however, relates exclusively to the single-specialty hospitals.

In general terms, does my hon. Friend consider that there is a fair allocation for the mental health services in the North-West as compared with other parts of the Health Service in the North-West and as between the North-West as an area and other areas? Will he continue to use his influence in the North-West and other areas to ensure that there is consultation at all levels before any possible changes in the Health Services take place? May we have consultation before final decisions rather than after final decisions have been taken?

Prior consultation before decision-making is built into the system of the reorganised Health Service and I hope that it will work. Mental health and mental illness are two of the highest priorities in future planning of the health services because they have been subject to so much neglect in the past throughout the country and particularly in the North-West. The North-West has had the highest allocation of funds of any region in the Health Service for the current year. Therefore, I would expect slightly larger amounts of money to be available for the mental illness services in the North-West than has been the case.

Now that more mental health patients are leaving hospital for care in the community, what action are the hon. Gentleman and his Department prepared to take to ensure that funds are transferred from the health services into the community so that patients do not fail, as at present, immediately they are left on their own in the community?

It will be some time before we can provide the social service provision for the receipt of the mentally ill outside hospitals that we should like to see. We have set up a scheme of joint financing whereby this year £21 million is available from health funds for the social service departments of local authorities for provision for mental handicap and mental illness, among other categories. In the North-West this allocation is £1·85 million.

Is my hon. Friend aware that insufficient expenditure on this Cinderella of services has led to most deplorable under-staffing in the mental hospitals that serve my area? In addition, the services outside the hospitals are woefully neglected in Preston. Does my hon. Friend agree that it is false economy for money not to be spent on these services?

As I have said, the nation as a whole, through the National Health Service, has neglected the specialties of mental illness over the years. Obviously it will take some considerable time to catch up. There is a new hospital coming on stream at Preston. I hope that it will make a contribution towards alleviating the situation. Bids can be made for joint finance money for the social services.

asked the Secretary of State for Social Services if he will make a statement on the services for mentally sick in the constituency of the hon. Member for Stoke-on-Trent, South and the region generally.

Services for the mentally ill in my hon. Friend's constituency and the West Midlands generally are based largely on old hospitals serving wide catchment areas, with patchy community services. They are typical of the situation in most of the country, and reshaping them to the pattern envisaged in our White Paper "Better Services for the Mentally Ill" is a major priority.

Is my hon. Friend aware that there is a great deal of concern in my region and throughout the country about the neglect of mental illness and the after-care service of which he has spoken? Will he supplement his present efforts by issuing as soon as possible a major consultative document and, if necessary, a White Paper on the Government's future policy?

As a result of consultations on priorities for the Health Service, we are preparing a definitive paper that will set out the definitive priorities for the Health Service for the future. As for my hon. Friend's constituency, it is hoped to provide a new day hospital in Stoke in the next few years. On the social services side, a home for psycho-geriatric patients is planned under joint finance arrangements and there are plans for a new psychiatric after-care hostel in Hanley.

Does my hon. Friend recognise that the all-party Mental Health Committee daily receives letters of anxiety from many people who are concerned about the lack of facilities and the lack of opportunity for local authorities to provide day centres? Will he consider the possibility of improving the whole of the service by means of a new Mental Health Act? Would such a measure be likely to be delayed?

My hon. Friend can be reassured that we have been reviewing the Mental Health Act 1959. My right hon. Friend will shortly be issuing a statement about the results of the review. I can assure my hon. Friend that there is no delay. I appreciate that he must be receiving many letters and expressions of concern about services for the mentally ill. We are trying to make up in a few years for a situation which has been created over the past 30 years or more.

I return to the question put by my hon. Friend the Member for Wallasey (Mrs. Chalker). Is it not the case that, although many mental hospitals now have only one-half or one-third of the number of patients they had 10 or 15 years ago, there does not appear to have been any comparable transfer of resources from the health authorities to the local authorities, which are now faced with the consequences of trying to look after the patients in the community? Does the hon. Gentleman accept that the joint financing arrangements, which are fairly limited, are not an adequate way of dealing with these issues? What we need is a more effective transfer of resources to recognise the number of patients now in the community.

The last thing that I would argue is that joint financing arrangements are the sole answer to the problem of which the right hon. Gentleman is talking. However, I do not accept his figures in respect of mental hospitals. Throughout the country the situation varies from hospital to hospital. It should be said—here I disagree with the right hon. Gentleman—that there has been a substantial development of local authority social service provision throughout the country, especially since the Seebohm Report of the late 1960s. That should be taken into account as well.