HC Deb 23 November 1939 vol 353 cc1376-81
25. Sir Percy Harris

asked the Minister of Health what salaries and allowances were paid by the Ministry of Health to house physicians and surgeons appointed to hospitals organised for war-time service on the outbreak of war; how this compared with rates of pay in voluntary hospitals; and whether there has been any alteration of these salaries and allowances since the beginning of the war?

Mr. Elliot

The basis of employment in the Emergency Medical Service of house officers was at the outset £350 per annum, normally on a three months' contract, plus board and lodgings or an allowance in lieu. This flat rate was somewhat in excess of the rates paid by voluntary hospitals, though these vary widely according to the type of hospital. This arrangement has now been reviewed and it has been agreed with the advisory committee, with which I have recently been in consultation, that no further individual enrolments of house officers in the Emergency Medical Service should be made, but that hospitals should receive a payment equivalent to £200 per annum for each of their house officers who are required for whole-time work under the emergency hospital scheme. The precise allocation of this payment however will be a matter for the hospital authorities.

Sir P. Harris

Can the right hon. Gentleman give an assurance that he is doing nothing to undermine the great London voluntary hospitals?

Mr. Elliot

Certainly, We are working in the closest possible consultation with the voluntary hospitals.

26. Mr. de Rothschild

asked the Minister of Health what authority was constituted to initiate and work out the present scheme of war-time hospital organisation; and whether the hospitals were asked to give their own views as to how each could best contribute to the building up of such an organisation?

Mr. Elliot

The war-time hospital problem was examined in the first place by a committee of distinguished medical men and of others representing the hospitals, under the chairmanship of Sir Charles Wilson. Making full use of this committee's advice, the present scheme has been worked out by my Department under the authority of Section 50 of the Civil Defence Act, 1939. My Department has, of course, had frequent consultations, both formal and informal, with the hospital authorities. Indeed, the views of the hospital authorities as to how each could best contribute to the building up of the war-time organisation have throughout been most fully taken into account.

Mr. de Rothschild

Is the right hon. Gentleman aware that there is a feeling among the directors and managers that they ought to have been taken into consultation?

Mr. Elliot

It is best to make representations to me. I have always done my best to meet any such cases. In fact I have specially arranged to meet those responsible for the administration of the hospitals.

27. Mr. de Rothschild

asked the Minister of Health what were the qualifications required of group officers appointed to take charge of the hospital sectors into which London and the home counties have been divided for the purpose of wartime organisation; and what are the responsibilities of these officers?

Mr. Elliot

The group officers were appointed as representing the voluntary hospitals in the London sectors, on account not only of their professional distinction but also of their administrative experience at the teaching hospitals, in which were concentrated much of the personnel and equipment required for the working of the sectors. Their professional qualifications appear in the list circulated with my reply to my hon. and learned Friend the Member for Ashford (Mr. Spens) on 26th October. Their duties are, in general, to supervise the working of the emergency medical arrangements in their sectors and are explained in more detail in a memorandum, a copy of which I will send to the hon. Member.

Mr. de Rothschild

Was the Central Emergency Committee set up by the voluntary hospitals consulted about the appointment?

Mr. Elliot

After due consultation those officers were appointed by the hospitals themselves.

Sir Ernest Graham-Little

Is my right hon. Friend aware that the selection was not made either by the medical committees or the governing bodies of the hospitals; and will he take what measures he can to modify the selection thus made?

28. Mr. de Rothschild

asked the Minister of Health how many council and municipal hospitals in the area covered by London and the Home Counties have received additional staff and equipment in connection with the war-time organisation scheme; what percentage this represents of the total number of these hospitals; how many voluntary hospitals in the same area have been similarly prepared; what percentage this represents of the total number; and how many voluntary hospitals in this area have suffered a diminution of staff and equipment since the beginning of the war?

Mr. Elliot

I am afraid that I am not in a position to give precise figures in reply to the hon. Member's question without obtaining a special return from the group officer in each sector of the London region, and I am reluctant to ask for this at the present time. I can say generally, however, that the hospitals in the London region which have been increased in staff and equipment under the Emergency Hospital Scheme are mainly municipal, because such hospitals have necessarily to be sought in the outer part of the region, where there are comparatively few voluntary hospitals capable of expansion. I believe that all those voluntary hospitals in the outer area that are capable of satisfactory expansion have been expanded. As regards the diminution of staff and equipment, the majority of hospitals inside the County of London, whether voluntary or municipal, have been reduced.

30. Mr. Isaacs

asked the Minister of Health whether he is satisfied that the equipment and organisation of the sector hospitals are adequate for the numbers of patients they are prepared to receive?

Mr. Elliot

I am satisfied that the majority of the sector hospitals are adequately provided for the number of patients which they are intended to receive, but in several of them the equipment and organisation need further improvement. I am making all possible use of the present period of quiescence to this end.

31. Sir E. Graham-Little

asked the Minister of Health whether he has been able to arrange more equitable conditions for members of the honorary medical staffs of the voluntary hospitals who have enrolled for whole-time service and who wish to transfer to part-time service and upon what terms; and whether, in view of the urgent necessity of providing teachers for the medical students now returning to London schools in progressively increasing numbers, he will facilitate the transfer of members of the voluntary staffs to the new and more equitable scheme, notwithstanding any agreements which they may hitherto have accepted?

Mr. Elliot

Yes, Sir, the arrangements which I am announcing to-day in reply to my hon. Friend the Member for Reading (Dr. Howitt) are designed to facilitate the transfer of consultants and specialists from whole-time to part-time service under the Emergency Hospital Scheme. They will be able to take advantage of these arrangements, notwithstanding that they may have accepted the part-time agreement hitherto in operation.

Sir E. Graham-Little

Is my right hon. Friend aware that last year there were over 10,000,000 attendances in the outpatients department of the hospitals and that all this service is now in abeyance, causing very great dislocation in the London area; and would my right hon. Friend not only make a note of that fact but keep in mind the necessity of getting teachers for the medical students?

Mr. Elliot

I will certainly bear that point in mind. I would be unwilling to accept the suggestion that the out-patient services have been in abeyance for London hospitals for 10 weeks, because it is quite at variance with information supplied to me by London hospitals.

Sir E. Graham-Little

Does my right hon. Friend realise the suffering such dislocation causes, and that it is impossible to conduct satisfactorily out-patient departments without the honorary staff, who cannot be properly replaced by junior and inexperienced officers?

Mr. Elliot

The higher the medical skill which can be obtained by the outpatients' departments the better, but to suggest that the service is entirely in abeyance is not only going beyond the facts but discourages people from applying, which is undesirable.

33. Dr. Howitt

asked the Minister of Health whether he is now in a position to state what action he proposes to take with regard to the proposals made to him by the representative committee of the medical profession about conditions of service in the Emergency Medical Service; and whether he anticipates that specialists will now resume their work for the civil population at the general hospitals?

Mr. Elliot

I am glad to be able to announce that I have agreed with the committee in question upon a scheme which will enable specialists at present employed whole-time in the Emergency Medical Service to engage in other work, whether at general hospitals or in private practice. Under the scheme there will be attached to certain hospitals part-time specialists and consultants at a salary of £500 a year, which will cover not only the part-time work required at present but also any additional work appropriate to their grade that may be required by the circumstances. In other words, this salary will cover present conditions and also air attack conditions. My agreement with the committee also secures that the arrangements for providing medical services of all kinds for casualties shall be adapted to the varying types of hospitals, so that there may be the minimum interference with the ordinary medical work of the hospitals.

Dr. Howitt

Would my right hon. Friend make arrangements for an adequate return of nurses and hospital almoners to carry out the work of the hospitals?

Mr. Elliot

I trust that, as the work of the central hospitals extends, it will be possible to secure the return of adequate staff.