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QUESTION TIME
37
population
as
possible ; in providing houses for newly
married couples; and in establishing a system of family allowances wherebv the amount would increase with each successivechild. But for our troops stationed overseas the responsibility belonged primarily to the War Office. Why was the incidence of venereal disease in the Far East six times as high, and in Germany and Austria today almost five times as high as in the Middle East ? Dr. Segal felt that it should be the aim of the War Office to encourage the recruit to retain as far as possible’ his civilian outlook during .the brief term of his military service. -Mr. JOHN FREEMAN, under-secretary of State for War, agreed that this difficulty would only be overcome by creating conditions in the Services overseas which would prevent the temptation which led to this scourge. Although he did not underestimate the seriousness of the problem, there was ground for the belief that the peak had now been passed. For the first quarter of 1946 the Rhine Army figures were 30’4 per 1000; for the second quarter 41.8 ; for the third quarter 44-6; for the fourth quarter 41-8; and for the first quarter of this year 30. The build-up in the middle of last year, and the reduction at the end of last year and the’ beginning of this year were reflected substantially in the commands. It was worth pointing out also that while these were terrible figures they were lower than those for a similar period after the first world war, and it must be remembered that men were far more ready to report this disease than they were in the past. He could not give a clear answer to Dr. Segal’s question why the incidence of the disease in the Middle East should be lower than in the Far East and north-western Europe, but the conditions under which men lived in the Services in the Middle East were not conducive to venereal disease. In Germany and Austria they were conducive to the disease, and in both areas the incidence of the disease among the civilian population was high. In the Far East it had been difficult to control the sources of infection, and only recently had they started to make progress on that side of the problem. He could assure the House that the War Office fully recognised the importance of trying to give the Serviceman the opportunity of making civilian contacts, and there were more civilians doing welfare work overseas than during the war. While it was possible to take medical measures to limit- the seriousness of this problem where it had started, clearly the way to eliminate it was by a moral, educational, and welfare approach.
QUESTION TIME
-
Interim Report on Negotiations Dr. S. SEGAL asked the Minister of Health whether any interim report would be issued to the House on the progress of negotiations with the negotiating committee of the medical profession ; and when the interim report could be expected. - Mr. A. BEVAN replied : I anticipate that these negotiations will remain confidential until the outcome is known. Dr. SEGAL : Can the Minister give an assurance to the House that, if at some future date an interim report is received it will be just circulated to hon. Members of the House rather than issued for private circulation among the 55,000 medically qualified members of the profession ?-Mr. BEVAN : These are negotiations with the profession about the conditions on which they propose to serve in a national service. They do not directly concern hon. Members of the House, except in their medical capacities. For instance, if there were negotiations going on between the Government and members of the Civil Service on conditions of employment the decision would not be first announced to the House of Commons. This is essentially a matter for the medical profession in the first instance, and afterwards for the House, if it wishes.
Administrative Machinery Mr. S. HASTINGS asked the Minister whether, in selecting representatives of the medical profession for the local executive councils under the new Health Act. he was asking for nominations from the medical committees in the various areas : and whether he was aware that in not a few of these areas medical committees were elected in 1938 and there had been no election since.—Mr. BEVAN replied : Appointments of medical members to executive councils are made bv the local medical committees and not by the Minister. I am
that in most areas there have not been elections for committees since 1939, and therefore my recognition of local medical committees for the new service has been
aware
panel
provisional. Dr. SEGAL asked the Minister how, and by whom, the chairman of a local health service executive council was selected; which local bodies were consulted ; and what qualifications were required in assessing suitability for this post.-Mr. BEVAN replied : Chairmen of executive councils are appointed under the National Health Service Act by the Minister of Health. I am making careful inquiries in each case, but there have been no formal consultations. No particular qualifications can be specified : my object is to get good chairmen. Dr. SEGAL : Is the Minister aware that in at least one area public opinion has been outraged by the appointment of a chairman who has had a pecuniary interest in hospital contracts in the past ? Is it already too late to reconsider this appointment ?-Mr. BEVAN : I do not know the instance which the hon. Member has in mind, but in these appointments I am not concerned with party or political considerations, but to get the right kind of chairman for the bodies who have to do this work. If there is any instance of nepotism, or near nepotism, I would like the hon. Member to bring it to my notice.
Local Health Committees In answer to a question, Mr. BEVAN stated that all local health authorities except Norfolk and Cardigan county councils had constituted health committees, and Norfolk county council had appointed a health services reorganisation committee which was engaged on the preparation of
proposals.
Land for Health Centres
Mr. HASTINGS asked the Minister to what extent major local authorities were, at the present time, able to acquire land to enable them to build health centres when conditions were more favourable ; - and whether he would take steps to increase these powers where they were insufficient.-Mr. BEVAN replied : There are ample powers in section 58 of the National Health Service Act, but I am advised that these cannot be exercised yet. Provincial authorities can proceed under the Public Health Act, 1936. The powers conferred by the corresponding London Act are narrower, but I fear that I cannot promise legislation to increase them. Mr. HASTINGS : Does the Minister realise how important it is that sites that are required for health centres should not be lost for all time, because sufficient powers are not available ? - Mr. BEVAN : I doubt whether sites are being lost. At all events, it is no use at the moment acquiring them too far ahead of time, because the health centres could not be built at the present time for lack of building materials and labour owing to the prior claims of housing. Next year the position may be different.
Hospital Equipment and Supplies Mr. H. DAVIES asked the Minister to what extent it was proposed to obtain equipment and supplies for hospitals under the National Health Service by centralised purchase, in place of the present system of purchase by individual hospitals ; and whether a similar policy would be applied to installation and maintenance services.-Mr. BEVAN replied : Hospital equipment and supplies cover a wide range. For some items, there may be advantage in central purchase. But where present methods of supply and servicing are working satisfactorily it is not proposed, at the outset of the new service, to interfere with them. For the time being central purchase will be limited to major equipment which is in short supply, and various other items which may be found to lend themselves to central purchase on grounds of economy
or
better
efficiency..
Tuberculosis in the Air Force Mr. H. USBORNE asked the Secretary of State for Air how many men had been discharged from the R.A.F. suffering from tuberculosis, between September, 1939, and June, 1945, and June, 1945, and the present time, respectively.—Mr. P. NOEL-BAKER replied : The numbers are as follows : September, 1939-June, 1945 6642; July, 1945-June, 1947 =3147. The increase in the number of discharges per annum during the later period is largely due to the wider application of radiography to the Royal Air Force. An X-ray examination is now provided for new entrants and for members of the Service on release from overseas. =
_
population
as
possible ; in providing houses for newly
married couples; and in establishing a system of family allowances wherebv the amount would increase with each successivechild. But for our troops stationed overseas the responsibility belonged primarily to the War Office. Why was the incidence of venereal disease in the Far East six times as high, and in Germany and Austria today almost five times as high as in the Middle East ? Dr. Segal felt that it should be the aim of the War Office to encourage the recruit to retain as far as possible’ his civilian outlook during .the brief term of his military service. -Mr. JOHN FREEMAN, under-secretary of State for War, agreed that this difficulty would only be overcome by creating conditions in the Services overseas which would prevent the temptation which led to this scourge. Although he did not underestimate the seriousness of the problem, there was ground for the belief that the peak had now been passed. For the first quarter of 1946 the Rhine Army figures were 30’4 per 1000; for the second quarter 41.8 ; for the third quarter 44-6; for the fourth quarter 41-8; and for the first quarter of this year 30. The build-up in the middle of last year, and the reduction at the end of last year and the’ beginning of this year were reflected substantially in the commands. It was worth pointing out also that while these were terrible figures they were lower than those for a similar period after the first world war, and it must be remembered that men were far more ready to report this disease than they were in the past. He could not give a clear answer to Dr. Segal’s question why the incidence of the disease in the Middle East should be lower than in the Far East and north-western Europe, but the conditions under which men lived in the Services in the Middle East were not conducive to venereal disease. In Germany and Austria they were conducive to the disease, and in both areas the incidence of the disease among the civilian population was high. In the Far East it had been difficult to control the sources of infection, and only recently had they started to make progress on that side of the problem. He could assure the House that the War Office fully recognised the importance of trying to give the Serviceman the opportunity of making civilian contacts, and there were more civilians doing welfare work overseas than during the war. While it was possible to take medical measures to limit- the seriousness of this problem where it had started, clearly the way to eliminate it was by a moral, educational, and welfare approach.
QUESTION TIME
-
Interim Report on Negotiations Dr. S. SEGAL asked the Minister of Health whether any interim report would be issued to the House on the progress of negotiations with the negotiating committee of the medical profession ; and when the interim report could be expected. - Mr. A. BEVAN replied : I anticipate that these negotiations will remain confidential until the outcome is known. Dr. SEGAL : Can the Minister give an assurance to the House that, if at some future date an interim report is received it will be just circulated to hon. Members of the House rather than issued for private circulation among the 55,000 medically qualified members of the profession ?-Mr. BEVAN : These are negotiations with the profession about the conditions on which they propose to serve in a national service. They do not directly concern hon. Members of the House, except in their medical capacities. For instance, if there were negotiations going on between the Government and members of the Civil Service on conditions of employment the decision would not be first announced to the House of Commons. This is essentially a matter for the medical profession in the first instance, and afterwards for the House, if it wishes.
Administrative Machinery Mr. S. HASTINGS asked the Minister whether, in selecting representatives of the medical profession for the local executive councils under the new Health Act. he was asking for nominations from the medical committees in the various areas : and whether he was aware that in not a few of these areas medical committees were elected in 1938 and there had been no election since.—Mr. BEVAN replied : Appointments of medical members to executive councils are made bv the local medical committees and not by the Minister. I am
that in most areas there have not been elections for committees since 1939, and therefore my recognition of local medical committees for the new service has been
aware
panel
provisional. Dr. SEGAL asked the Minister how, and by whom, the chairman of a local health service executive council was selected; which local bodies were consulted ; and what qualifications were required in assessing suitability for this post.-Mr. BEVAN replied : Chairmen of executive councils are appointed under the National Health Service Act by the Minister of Health. I am making careful inquiries in each case, but there have been no formal consultations. No particular qualifications can be specified : my object is to get good chairmen. Dr. SEGAL : Is the Minister aware that in at least one area public opinion has been outraged by the appointment of a chairman who has had a pecuniary interest in hospital contracts in the past ? Is it already too late to reconsider this appointment ?-Mr. BEVAN : I do not know the instance which the hon. Member has in mind, but in these appointments I am not concerned with party or political considerations, but to get the right kind of chairman for the bodies who have to do this work. If there is any instance of nepotism, or near nepotism, I would like the hon. Member to bring it to my notice.
Local Health Committees In answer to a question, Mr. BEVAN stated that all local health authorities except Norfolk and Cardigan county councils had constituted health committees, and Norfolk county council had appointed a health services reorganisation committee which was engaged on the preparation of
proposals.
Land for Health Centres
Mr. HASTINGS asked the Minister to what extent major local authorities were, at the present time, able to acquire land to enable them to build health centres when conditions were more favourable ; - and whether he would take steps to increase these powers where they were insufficient.-Mr. BEVAN replied : There are ample powers in section 58 of the National Health Service Act, but I am advised that these cannot be exercised yet. Provincial authorities can proceed under the Public Health Act, 1936. The powers conferred by the corresponding London Act are narrower, but I fear that I cannot promise legislation to increase them. Mr. HASTINGS : Does the Minister realise how important it is that sites that are required for health centres should not be lost for all time, because sufficient powers are not available ? - Mr. BEVAN : I doubt whether sites are being lost. At all events, it is no use at the moment acquiring them too far ahead of time, because the health centres could not be built at the present time for lack of building materials and labour owing to the prior claims of housing. Next year the position may be different.
Hospital Equipment and Supplies Mr. H. DAVIES asked the Minister to what extent it was proposed to obtain equipment and supplies for hospitals under the National Health Service by centralised purchase, in place of the present system of purchase by individual hospitals ; and whether a similar policy would be applied to installation and maintenance services.-Mr. BEVAN replied : Hospital equipment and supplies cover a wide range. For some items, there may be advantage in central purchase. But where present methods of supply and servicing are working satisfactorily it is not proposed, at the outset of the new service, to interfere with them. For the time being central purchase will be limited to major equipment which is in short supply, and various other items which may be found to lend themselves to central purchase on grounds of economy
or
better
efficiency..
Tuberculosis in the Air Force Mr. H. USBORNE asked the Secretary of State for Air how many men had been discharged from the R.A.F. suffering from tuberculosis, between September, 1939, and June, 1945, and June, 1945, and the present time, respectively.—Mr. P. NOEL-BAKER replied : The numbers are as follows : September, 1939-June, 1945 6642; July, 1945-June, 1947 =3147. The increase in the number of discharges per annum during the later period is largely due to the wider application of radiography to the Royal Air Force. An X-ray examination is now provided for new entrants and for members of the Service on release from overseas. =
_