asked the Secretary of State for Social Services if he will make an official visit to hospitals in the London borough of Hackney.

The hon. Member for Hackney, South and Shoreditch (Mr. Brown) has already been to see me and I have told him that I shall include the City and Hackney health district in my official programme of visits in the near future.

I thank the Minister. Is he aware that there is appalling deprivation in that part of London? Is he also aware that the regional health authority has indicated that Hackney must make further cuts when that is quite impossible? Is it not completely irresponsible for the RHA to take that view?

No, it is not irresponsible. We are aware of the great needs in this part of London. Is not the hon. Member pointing out the disastrous situation that was left by the previous Government, whose policies led to increasing difficulties for the inner city areas and created great hardships for this part of London?

I thank the Minister for his meeting with me and his agreement to come to Hackney. Is it not a fact that, as a result of the Chancellor's increased VAT, an extra £3,500,000 has been added to the bill of the regional health authority?

Once again the hon. Member is drawing attention to the appalling situation left by the previous Government.

On a point of order, Mr. Speaker. In view of the appalling and disgraceful nature of that reply, I give notice that I shall seek to raise this matter on the Adjournment.

asked the Secretary of State for Social Services if he will consider giving a special bonus of £16 to single pensioners and £25 to married pensioners to take account of the shortfall in their pensions due to the inaccurate forecast of the level of inflation made in calculating the last pension increase.

No, Sir. The increased pension rates which we shall introduce from November take account of the shortfall in the rates introduced by the previous Administration last November. There is no statutory requirement to do even this and, in view of the urgent need to reduce public expenditure, we cannot do more.

Will the hon. Lady agree that the changes to be made in pensions will only allow prospectively for the miscalculation, and not for the miscalculation in the current year? Is she aware that in the current year pensioners are losing out by the amount that I quoted in my question? Will she take the opportunity of the Bill dealing with the Christmas bonus to introduce a summer bonus as well to make good that shortfall?

I am afraid that we cannot do that. As the hon. Member knows, if he looks back at the statement of my right hon. Friend, we have corrected the 1·9 per cent. shortfall that the pensioners suffered. That will have to suffice in the present economic situation.

Will my hon. Friend comment on the fact that the Government propose to increase pensions by 19·5 per cent., whereas the previous Administration's proposal amounted to only 12·8 per cent.?

It has been necessary to make up not only the 17·5 per cent. uprating in line with the forecasts for price increases, many of which were held back in the previous four months, but to make good the 1·9 per cent. shortfall that resulted from the November 1978 up-rating.

rose—

I never thought that I would see the hon. Member on the Front Bench.

Order. The hon. Member for Macclesfield (Mr. Winterton) may find himself there one day, with a bit of luck.

He did, Mr. Speaker, but he did not last very long.

I congratulate the hon. Member for Birmingham, Perry Barr (Mr. Rooker) on his elevation to the Opposition Front Bench. The hon. Gentleman takes far too pessimistic a view. Of course, we shall consider the effect of this year's uprating when we have the actual price movements to November. But I cannot make any forward predictions. It would be foolish for anybody in this House to do so.

asked the Secretary of State for Social Services when the Royal Commission on the National Health Service is expected to report.

I understand that the Royal Commission expects to report next month.

Will my right hon. Friend await the report of the Royal Commission before turning his attention to the future of Motability? Does he recognise the importance of the role of this organisation to the disabled, and is he aware that it may not now be able to fulfil its avowed function?

I am aware of that concern. I am happy to be able to announce that my right hon. and learned Friend the Chancellor of the Exchequer will be laying an order as soon as possible which will relieve Motability of the effect of the Value Added Tax (Cars) Order 1977. While the regular leasing charges paid by Motability clients will still bear VAT, the organisation will now be able to recover all the input tax paid on cars. This concession, along with the £2 increase in mobility allowance, will allow Motability to operate on better terms than those which obtained before the Budget.

While he is waiting for the Royal Commission report, will the right hon. Gentleman examine the representations which are currently being made by health visitors, midwives and other community nurses? Is it not clear to the right hon. Gentleman that the car and mileage allowances for such nurses are completely out of line with current rates of inflation? Will he urgently examine the position?

This is not a matter on which I expect the Royal Commission to say a great deal, but my right hon. Friend the Minister of State has been examining the matter. The tax treatment of car allowances is being applied in exactly the same way as it applies to other taxpayers.

Before the Royal Commission reports, will my right hon. Friend give weighty consideration to the opposition within the country to the establishment of mixed wards within the National Health Service? Is he aware that there is an increasing number of people, particularly those patients who seek to enter hospital for urgent treatment, strongly opposed to the trend which is developing within the NHS of establishing mixed wards? I accept that there is need for this practice in intensive care units, but will he ensure that this trend does not develop any further?

I am well aware of the widespread concern expressed about the growth of mixed wards. My Department is currently studying the subject to see how best to resolve the problem.

Is the right hon. Gentleman aware that we shall closely examine the proposed statement by the Chancellor of the Exchequer on the subject of Motability? No doubt we shall return to the matter when we consider the Finance Bill.

I accept that there will be great interest in the Royal Commission's report. It has received an enormous volume of evidence and has been studying the subject for over two and a half years. I hope that the report will be presented before the House rises. If that happens, I expect to make a statement to the House on how we should handle the matter. I can confidently promise the right hon. Member for Salford, West (Mr. Orme) that there will be a full debate on its recommendations.

asked the Secretary of State for Social Services if he has any plans to meet the Society of Radiographers.

The president and council of the Society and College of Radiographers kindly invited my right hon. Friend to attend the inauguration of their president for 1979–80. Unfortunately, he will not be able to attend the inauguration personally, but I am very pleased to attend on his behalf.

Delighted as I am that my hon. Friend is to attend this important function, may I ask whether he is aware that as a result of represent- tations made by the society, nurses in the cottage hospitals in my area are unable to take simple X-rays? Since much of this exercise is water under the bridge, so to speak, will the Minister do his very best to ensure that—if we have to pay more for the Society of Radiographers to conduct X-rays—a regular service will be provided and that, even more important, X-ray services will remain in cottage hospitals throughout the country?

I have some sympathy for the cause which my hon. Friend has championed in past months. However, I am advised that both for the protection of patients and to obtain the best use from diagnostic X-ray equipment it is preferable to use staff trained in radiography.

asked the Secretary of State for Social Services how many hospital beds in the Essex area are at present unused owing to lack of funds.

Regrettably, 10 mental illness beds at Princess Alexandra hospital, Harlow, were temporarily closed last year. These beds are due to reopen on 1 July.

Is the Minister aware that the number of unused beds in the district is much greater than his answer indicates? Is it not a disgrace that wards and beds lie unused while waiting lists for operations lengthen and while facilities for geriatric, psycho-geriatric, mentally handicapped and young chronically sick patients are most inadequate, particularly in the Harlow area? Will he take steps to ensure that adequate money is made available and that there are no further cuts?

I greatly sympathise with the hon. Gentleman's feelings, although not with the way in which he expressed them. We are deeply concerned about the standard of care of patients, since those standards have been falling steadily in the past four or five years. We now have an appalling situation in which beds are empty but waiting lists are steadily lengthening.

How many hospital beds are unused in the metropolitan Essex area as a result of area health authorities closing wards in small cottage hospitals in advance of statutory consultations? Is he aware that the children's ward in the Victoria hospital, Romford, has been closed for more than a year, presumably to pre-empt a decision on the future existence of that hospital?

Hospitals cannot be closed in advance of statutory consultations, except on a temporary basis. But we are clear that many people wish to keep their local hospitals. If there are no major medical reasons against this, why should these hospitals not be retained? Therefore, unlike the previous Government, we shall, wherever possible, keep open the small hospitals.

Is it not likely that the cuts referred to by my hon. Friend the Member for Harlow (Mr. Newens) are likely to happen all over the country, not only as a result of sticking to the rigid cash limits established by the Labour Government, but because of the VAT increase? With the level of inflation as high as it is, does this not amount to about a 3 per cent. cut in real terms for health authorities? Will not this produce disastrous results? What does the Minister intend to do about the position?

I do not agree with the right hon. Gentleman's analysis of the financial position, although it is an appalling one and one which we have inherited from the previous Government. Is he not referring to examples of what he and I would like to see but which we now cannot afford nationally because of the financial chaos left by the previous Government?

asked the Secretary of State for Social Services what immediate proposals he has to improve the standard of life for one-parent families.

I refer the hon. Member to the statements on the Budget and the uprating of social security benefits on 12 and 13 June.

Since the hon. Lady in opposition showed concern for one-parent families, and in the light of the budgetary measures involving VAT increases, rises in the price of coal, and so on, may I ask what she intends to do now, when the measures already announced by the Government will affect one-parent families?

I am grateful to the hon. Gentleman for pointing out these matters, but he will be aware that large areas of consumer spending—about half the total—are not chargeable to VAT. I refer to food, children's clothes, heating, lighting, public transport, house prices and rents—all of which are zero-rated. The poorer households tend to spend proportionately more of their income, as I am sure the hon. Gentleman knows, on such zero-rated goods.

Will the Minister consider ways to remove the disadvantages of widowers with young children as compared with widows in a similar position?

Widowers often face difficulties, particularly where there is no day care available for their children. The hon. Gentleman may well be referring specifically to that. We intend to look at all possible ways of providing day care so that widowers may be helped, as well as widows and other single parents, and thus continue in work wherever possible.

Does my hon. Friend believe that the parent in charge of a child has ready access through the courts to remedy the situation if the other parent falls down on his or her obligations so that, in that way, allowances are kept up to date with inflation? If that is not the case, will the Government come forward with suitable recommendations to help the parent in charge of the family to gain such redress?

I am aware that many maintenance payments are not being paid and that that creates a continuing difficulty. We shall examine the matter as soon as we have had more time to consider other current matters.

The hon. Lady, with her well-known interest in this matter, must be aware that her answers so far are not satisfactory. Does she agree that, with the prospect of a 17½ per cent. to 20 per cent. inflation rate over the coming months, something must be done to assist single-parent families? What do she and her colleagues propose to do to assist those families beyond the uprating which has been announced by the Chancellor of the Exchequer?

As I said in answer to a previous question, we have taken account of, and concentrated the available resources on, those most in need. The FIS uprating and the child benefit increase have been designed specifically to help the lone parent first. The right hon. Gentleman is being unduly pessimistic about the uprating and the forecast for the increase in prices to November. If the assistance should fall short we shall look at the matter again.

asked the Secretary of State for Social Services if he is satisfied with the arrangement for the payment of retirement pensions in Giro cheque form following the delay in issuing pension books.

I very much regret the delay in the issue of some pension order books which resulted from a combination of factors. In addition to a change of computers at the Department's Newcastle central office, a nine-week overtime ban from 23 February to 30 April and delays in the postal service have had an adverse effect. We arranged to pay the affected pensioners by giro cheque in accordance with our normal procedures and these arrangements appear to have been satisfactory. I visited the Newcastle central office last week, and I know at first hand the efforts being made by management to recover normal working service.

I am grateful to the hon. Lady for that helpful reply. Does she accept that any delay of this nature in payments of pensions is critical to many of those involved? Furthermore, if delays occur in the issuing of pension books, with fresh increases later in the year that will increase the burden on those who are already in difficult circumstances. Will she instigate a complete inquiry into all the procedures concerned, in addition to the pension books?

First, I assure my hon. Friend that I am conducting an inquiry into the matters that were under way even before we took office. We are concerned that the industrial action which has recommenced will put pensioners and other beneficiaries in grave difficulties. The long history of industrial problems at Newcastle and Washington will take time and patience to resolve. We shall do everything—including giving fresh information to local offices where necessary—to ensure that pensioners who do not receive their payment books will know that they have to go to their local office. We shall make arrangements for payments to be made through the local offices if the industrial action continues.

Will the Minister make the same arrangements for the payment of child benefits? Is she aware that some of my constituents are having to wait three months for those payments and, as many are on low incomes, the payments are an essential part of their incomes?

I regret to have to tell the hon. Gentleman that not only is there an overtime ban at the Washington child benefit centre but, in addition, a work to rule has been commenced. We deplore the action and we shall do all that we can to bring matters back to normal. In the meantime, we are examining urgently measures to help the parents who will not only be inconvenienced severely but put under great financial pressure. I advise hon. Members that any constituents writing to them should be told to go to their local office if they are in financial difficulty.

asked the Secretary of State for Social Services what is his policy on flexible retirement dates; and if he considers that these should apply to both men and women.

I recognise the case for greater flexibility in relation to retirement ages for both men and women. However, we need to give further consideration to the problems involved before we put forward proposals.

Has any progress been made to establish how many men wish to retire before 65 if they have the opportunity to do so? For that matter, is it known how many women would be prepared and anxious to go on working later than 60? Does my right hon. Friend agree that until there is better assessment of how many are in each category it is difficult to estimate the total cost that would be involved? Will he confirm that the long term aim of the Government is for sufficient flexibility in retirement so that men and women may retire at any time between 60 and 65?

I give my hon. Friend that assurance. It is our long-term aim not only to see greater flexibility in retirement but progressively to ensure that there should be a move towards the same rules applying to both men and women. There is no strong feeling in the country against that proposition of which we are aware.

Does the Minister recognise that many men whose employment involves heavy manual labour are frequently obliged to give up work for health reasons long before the normal age of retirement? Is it not vital that these men should be rescued from the scrapheap and given an opportunity to retire early and carry on a reasonably decent form of life which, frequently, is not too rosy in its prospects anyway?

I am not sure whether the hon. Gentleman is referring to the sort of scheme for partial retirement that, for example, is operated in Sweden. I have always seen the attractions of such a scheme. However, it is a proposition that will have to await the improved state of the economy before it can be contemplated.

asked the Secretary of State for Social Services what recent representations he has had from pensioners' associations and others with regard to abolishing the television licence fee for pensioners; and if he will make a statement.

No representations have been received from pensioners' associations and only three have been received from members of the public. These have been referred to my right hon. Friend the Secretary of State for the Home Department who has responsibility for setting the level of the licence fee.

The Government would receive more representations if the pensioners could afford the stamps. I see that the Minister for Social Security is missing again—absent, as usual.

Order. The hon. Member must come to his question.

Is the Minister aware that, while the Government have made serious attempts to make it easier for top-salaried people—Cabinet Ministers, Members of Parliament and so on—to be able to pay for their television licences, old-age pensioners are finding that television viewing is becoming dear? The price of electricity, a cup of tea, and cigarettes has risen—as well as VAT. When the Prime Minister returns from waddling round the world's capitals perhaps she will make a move—if she wants to impress the pensioners and their associations—to implement the Labour Party proposal to abolish the television licence.

I regret to have to tell the House that my right hon. Friend the Minister for Social Security is ill. That is why he is not with us today.

Is my hon. Friend aware that pensioners are upset that some are able to take advantage of a 5p licence while others, who are no better off financially, have to pay the full amount? Is she prepared to consider the introduction of a uniform licence fee for all pensioners, perhaps at half the full rate?

The question of the licence fee is not for my Department, but I am aware of the anomalies that occur in some local authority homes and we shall consider that problem.

asked the Secretary of State for Social Services what is his policy on means tests for social benefits.

Our first priority is to get the economy right. As living standards improve, so there should be less need for dependence on means-tested benefits.

That is an optimistic reply. Are the Government still hankering after the tax credit scheme, or have they accepted that it would be too costly and would still leave millions on supplementary benefit anyway? If so, what alternative proposals have the Government to reverse the extension of the means-test State which their regressive policies in the Budget have made inevitable?

It is a bit rich for members of the previous Government to talk about the means-test State. Under Socialism there was a massive increase in means testing. The numbers on means-tested supplementary benefit went up by 1 million, the number of unemployed on means-tested supplementary benefit almost trebled, the number of children receiving the means-tested benefit of free school meals increased from 750,000 to well over a million and the number of families on means-tested housing benefits increased by 1 million. Had the Labour Party remained in power, that appalling record would have been crowned by a half-baked, half hearted means-tested benefit scheme for sixth formers. It does not lie in the mouths of Ministers in the previous Government to criticise means testing.

Does my right hon. Friend agree that there can be no justification for paying public money unless the need for it has been established? Does he also agree that, although the phrase "means test" is emotive, the public will not easily forgive the payment of its money to any extended palm without a clear indication that the filling of that palm is necessary?

It has been the policy of successive Governments to seek to maintain and, where possible, to increase the real value of the contributory benefits under the national insurance scheme to which beneficiaries are entitled as of right without means testing. However, the chairman of the Supplementary Benefits Commission has repeatedly drawn attention to the fact that it is a feature of the pattern of the post-war period that those who have had to rely on means-tested supplementary benefits, instead of being the small residue which was envisaged when the scheme was introduced, have reached very large num- bers. That is something to which the Government will be giving attention.

Is the right hon. Gentleman aware that the proposed introduction of free television licences for pensioners was one way in which the previous Government were to move away from means testing? Is he aware that our proposal for a new pension scheme, to float pensioners off means testing, would have been another positive step forward? Does he realise that his Government's proposals, particularly on VAT and increases in the cost of living, will put more people, not fewer, on means testing?

I am astonished that the right hon. Gentleman should refer to his party's proposal for free television licences for pensioners when he, as one of the Ministers involved, must know that there was not one penny piece provided in the Government's Estimates to pay for that proposal.

asked the Secretary of State for Social Services if he is satisfied that community health councils are alone sufficient to meet the need for public participation in Health Service affairs.

Community health councils should be informed, responsible and responsive local forums for discussions of local health services, but I do not see them as the only means of public participation.

Is my right hon. Friend aware that the Bromley area health authority has recently refused to meet the Orpington Nurses and Citizens Association, which is the only local body taking a professional interest in the Orpington hospital, on the ground that the community health council is the only appropriate body for public participation in local Health Service matters?

There should be room for flexibility in the arrangements and we certainly do not regard community health councils as the only channel of communication. At the same time, we have to take a responsible and realistic view of the options facing area health authorities.

Is my right hon. Friend aware that there are a large number of people in communities throughout the country who would like to participate in the well-being of their local hospitals by raising funds for them and offering voluntary services? Will he do everything he can to encourage that healthy trend?

That is indeed the policy of the Government, as indicated by the proposals that we announced shortly after the election for saving the Elizabeth Garrett Anderson hospital.

If all the community health councils in the Lambeth, Lewisham and Southwark area health authority district meet the right hon. Gentleman and tell him that any cuts over and above the arrangements made with the authority by the previous Administration would so damage its service as to make it unworkable, will he guarantee that there will be no such further cuts?

The hon. Gentleman must know that I could not conceivably give such a guarantee. The role of community health councils is to represent local people in the delivery of local health care services. Their representations should be made, therefore, to the local area health authority. The CHCs have a statutory power to object to specific proposals, such as hospital closures, and to require that I should consider closures before they take place.

asked the Secretary of State for Social Services what steps he proposes to take to ensure the early establishment of regional secure psychiatric units for the mentally-disordered.

I refer the hon. Member to my reply to him on 12 June.

Does not the Minister consider it disgraceful that, five years after the units were recommended as a matter of great urgency and after £24 million has been given to regional health authorities, we still have not one single unit in existence? Is he aware that three regional authorities have not spent one penny of the money allocated to them for this purpose and that three others have not submitted plans to his Department? Will he call in the chairmen of every regional authority and insist that progress is made soon?

I am interested that the hon. Gentleman has pointed out the failures of the previous Government. My right hon. Friend and I share his concern about the lack of places in regional secure units. We should like to see more units for the sake of patients, nurses and the communities in which they are placed and we are urgently looking into the provision of units. We shall shortly be meeting the chairmen of regional authorities and this matter will be on the agenda.

I seldom, if ever, agree with the hon. Member for Ormskirk (Mr. Kilroy-Silk), but may I impress upon my hon. Friend the importance of secure units? Is he aware that many people are concerned that violent, mentally disordered patients are being allocated to hospitals without secure accommodation, and that this is creating great worry to the communities in which those hospitals are located? Will he therefore treat the matter with considerable urgency?

Yes, we will. I share my hon. Friend's concern. It is an appalling situation and we shall deal with it as quickly as we can.

asked the Secretary of State for Social Services whether it is still his policy that National Health Service financial resources should be reallocated in favour of deprived regions.

Yes, Sir, with the emphasis on levelling up, not levelling down.

Is the Secretary of State aware of the great amount that that pledge involves? The gap between the North-West and the best endowed authority is still over 20 per cent. and is reflected in the health care of the people of the North-West. In devoting more resources to the region, will the right hon. Gentleman particularly make sure that we do not have the economies of the madhouse, where capital investment, such as represented by the Stepping Hill geriatric unit, is then deprived of the funds adequately to staff it?

We have no plans to imitate the example of our predecessors, who, when faced with the problem of having to cut back on health care, chose to cut back on capital provision rather than offend their political susceptibilities by raising a little more money through prescription charges. I accept that there must be a continuing shift of resources towards the under-provided regions. That is the Government's policy.

Nevertheless, will my right hon. Friend bear in mind that some regions and some parts of regions have particular problems with an elderly population? Will he make sure that this is one of the factors that his Department takes into account when the regional allocations come up for review?

Yes indeed, Sir. Because they could not be quantified, a number of factors were altogether left out of account in the Resource Allocation Working Party formula, and in the more recent studies by RAWP it is recommended that allowance be made for these non-quantifiable factors.

asked the Secretary of State for Social Services if he is satisfied with the number of pay beds in the National Health Service.

We have just issued a consultative letter on our proposals for legislation on independent hospital practice and on the future of pay beds, and a copy was placed in the Library yesterday.

Is the Secretary of State aware that many people regard the proposals that he announced yesterday as passing the buck from the Government down to the areas, and that the hospital unions are utterly opposed to the phasing out of the NHS boards? What criteria does the right hon. Gentleman intend to use to solve the many disputes which are bound to break out at local level about the phasing out of pay beds?

I know, from my discussions with the leaders of the NHS unions, that the overwhelming majority of the members of those unions believe in our democratic process and in the fact of the election, when the Conservative Party was elected on a clear and specific commitment in our manifesto. There has never been any secret about that. I believe that overwhelmingly the unions working in the NHS will recognise that this is a policy which is to be carried forward and that they will co-operate with it.

I welcome my right hon. Friend's paper. Can he give an assurance that he will look for a variety of ways of building bridges between the NHS and the private sector, in order to ensure that more resources are available for health as a whole?

I can certainly give my hon. Friend that assurance. We believe in co-operation and not in confrontation.

Is the right hon. Gentleman aware that the Opposition will oppose his plans for abolishing the NHS boards on the ground that a health service should be provided on the basis of medical priority and not on the power of the purse? Is he also aware that decisions on pay beds should be taken nationally, and that we oppose the idea that the matter should be left to local decision? What the right hon. Gentleman is trying to do is to force on reluctant area health authorities the courage of his convictions.

We recognise that it is the right hon. Gentleman's right to oppose the legislation that we hope to introduce later in the year. As for local determination, we believe that there is likely to be a much better resolution of such problems as may arise if they are handled by the people who are dealing with them locally on the ground rather than that they should be dealt with at head office, as it were, somewhere in London.

asked the Secretary of State for Social Services if he will make Dextrostix available through the National Health Service.

Arrangements already exist for consultants to authorise the free supply of Dextrostix through the hospital and specialist services, if they consider it necessary for diabetic patients' sugar levels to be monitored by blood tests rather than urine tests.

I welcome what my hon. Friend said. May I press upon him the value of the product in terms of the new electronic gadget which is available for measuring the sugar in blood samples in the bodies of diabetics? Will he make this available as widely as possible to the NHS?

Yes, Sir. We are aware of this matter, and I shall bear in mind my hon. Friend's comments.

Is the Minister sure that consultants realise that in treating diabetics they have a similar freedom in the prescription of disposable syringes where a medical need can be shown? Will he bear in mind particluarly the problems of mothers of young children, to whom they have to give injections, and the greater advantage for them of having a disposable syringe?

Yes, Sir. These are important points, and I shall bear them in mind.

asked the Secretary of State for Social Services if he has reached agreement with the British Medical Association on the terms of a new contract for general practitioners; and, in particular, if he will make a statement on the provision of casualty services by general practitioners.

Yes, Sir. The revised arrangements for the remuneration of general practitioners who treat patients on their own responsibility in hospitals cover both in-patient and casualty services.

Is my right hon. Friend aware that no casualty service has operated in Redditch for more than two years as a result of the dispute between the general practitioners and the area health authority over whether they should be classified as clinical assistants or placed in a different category? Does he realise that the matter is crucially dependent on the results of this contract?

I hope to write to health authorities during July to give them the full details of the new agreement and its implementation. It is a little early for me to say whether this will result immediately in an improvement in emergency and casualty facilities in my hon. Friend's constituency, but we certainly hope that it will.