HC Deb 08 March 1950 vol 472 cc428-36

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Hannan.]

10.0 p.m.

Mr. George Thomas (Cardiff, West)

I want to raise a subject which is less exciting and perhaps more prosaic than that which we have been discussing, although I believe it is of equal importance in many homes in this country. It concerns the place of school children in the National Health Service, with particular reference to the supply of spectacles and to dental treatment. There is considerable concern both in the ranks of the teaching profession and in many homes at the long time-lag which exists between the child being examined and the actual receipt of the spectacles. So great is this concern that the local associations of the National Union of Teachers in England and Wales have decided to give high priority at their forthcoming national conference to a resolution which states: The conference instructs the Executive to press insistently at the highest levels for priority for school children in the provision of spectacles. Many school teachers have written to me about the delay which is occurring and I want to bring to the Minister's attention some cases from my own constituency in West Cardiff. There is the instance of a lad, Terry, of Sussex Street, Grangetown, Cardiff, who is eight years old. His eyes were examined in April, 1949, and on the 3rd of this month, 1950, no promise could be given as to when the spectacles would be available for this child. On 2nd March he had to be taken once again to the doctor to have his eyes examined.

There are other cases to which I could refer, and I should like to give the example of a girl named Marion, 15 years of age, who is attending the Radnor Road Girls' School, Cardiff. She has worn spectacles from the time she attended the infants' school. The optician has continually been approached about spectacles for this girl who had her eyes examined exactly a year ago. The teacher has written to tell me that she has continually sent her to the optician. In fact, she was there as recently as Friday last when no hope could be given as to when the spectacles would be forthcoming. The eyes of this child have much deteriorated during the past 12 months, and therefore the prescription of a year ago might well now be of no avail when it is forthcoming. I am told that the school nurse went to the school in February and that she then ordered a re-examination. The child went to the clinic and was told to go again before leaving school next May. The teacher says that this child is motherless, that she was an excellent reader and a beautiful writer, but that it is now impossible for her to read or write correctly.

It is in no mood of factious criticism that I raise this question tonight, but because I consider it a matter of considerable urgency. I realise that within the National Health Service, with its gigantic scope, there is bound to be a system of priorities. I understand that there is a dual system of priority—for those who need spectacles for their work, or where there is felt to be a sense of urgency about the need for spectacles. It is in the second category that the children fall. It is when urgency is proved, or is supposed to have been proved, that the spectacles are forthcoming.

I submit to the Minister and the House that when a child has his or her eyes tested there is urgency at once, and that all children ought to have a degree of priority under this scheme, because they use their eyes more than adults do. There is more strain on the youngster with his textbooks at school all day than there is upon the average adult. I earnestly hope that the Minister will be able to tell me tonight that he may have proposals for remedying this position. I can say that the Cardiff City authority has been considering this matter very earnestly—as late, I think, as last week-end—and that they referred the matter to the local Executive Council who, in turn, are referring it to the opticians committee. I wonder whether we cannot make some arrangement with the industry and with the opticians to give a special service—

Notice taken that 40 Members were not present;

House counted, and 40 Members being present—

10.12 p.m.

Mr. Thomas

The action of the hon. Member for Croydon, East (Sir H. Williams) will not go unnoticed by the teachers—

Sir Herbert Williams (Croydon, East)


Mr. Deputy-Speaker (Sir Charles MacAndrew)

The hon. Gentleman must keep his seat if the hon. Gentleman who has the Floor does not give way.

Sir H. Williams

On a point of Order. Surely it is competent for any lion. Member to act in accordance with the Rules of the House, and surely it is quite improper for the hon. Member to criticise any Member for exercising the rights provided in Standing Orders.

Mr. S. O. Davies (Merthyr Tydfil)

Is it competent for an hon. Member to come into the House for the first time at seven minutes past ten at night and explain to the Chair how to conduct business?

Mr. Driberg (Maldon)

It is competent for any hon. Member to call for a count, as the hon. Member, as an old Member of this House, knows well, and he was perfectly within his rights; but may it not be that if hon. Members of this House who, through the previous wisdom of the electorate, have not been with us for the last five years had been here, they would have learned about the developing customs and courtesies which have led to a position in which hon. Members do not call a count, generally speaking, during the last half-hour Adjournment?

Mr. Thomas

I said that my speech would be less exciting than that which had gone before, but I had not anticipated the extent to which some people would go to prevent a speech being made concerning the children of this country. Since I know that another hon. Friend wants to get in, I shall make my remarks as brief as possible.

I want also to refer to the question of dental treatment for our children. There has been a most unfortunate delay. I draw attention to a statement which I have which says that the seriousness of the position regarding outstanding cases for dental treatment was brought to the notice of the Special Service Committee at its meeting on 2nd March, 1950. This is in Cardiff. The school medical officer for the city reported that 2,169 cases were awaiting filling, 3,340 cases were awaiting extractions and of the latter approximately 1,000 were cases of toothache.

It is a very serious thing that these kiddies, some of whom I have seen, are unable to have speedy treatment, and I wonder whether an approach cannot be made to the dental profession to ask them if they could get the local dentists to agree to give certain sessions for school work. I know that he will give attention to this request to get the local dentists to agree to give certain sessions for school work. They might take a rota among themselves. I think that we might require new entrants to serve a minimum period in schools before entering the professional dental service, and we might break down some of the restrictions at present practised by the dental profession.

In this House tonight I met a qualified doctor with German degrees who, since her husband is a practising qualified dentist in this country, could be in the service. She only requires six months' training to obtain the English recognition. Can my hon. Friend not do something in cases such as that in order that we may have the maximum service available for our kiddies in the schools? I express to the Ministry my appreciation of the size of their problem and my deep desire that they regard it as one of considerable urgency.

10.15 p.m.

Mr. Anthony Greenwood (Rossendale)

I think that, with one exception, we are all grateful to my hon. Friend for having raised this matter tonight. I am particularly grateful to him for doing so in that kindly, tolerant and humane manner which makes him respected by all hon. Members of this House. I am glad that he did it in that spirit, because neither he nor I want tonight to criticise the Ministry of Health or the professions responsible for these services.

The truth of the matter is that we are paying now for the previous neglect of these problems. When one remembers that after the first year of working of the National Health Service it was revealed that 800,000 old people were wearing spectacles who had never before had their eyes tested, and that two million wearing spectacles had not had their sight tested for the previous five years, one realises the enormous amount of arrears that had to be made up. The real tragedy is that those arrears are being made up today, in many cases, at the expense of the children, who ought to have priority.

Two days ago I received a letter from a lady in Helmshore, in my constituency, writing about her seven year old son. He has a severe squint and has worn spectacles since the age of three; 14 months ago his eyes were tested, yet the spectacles have still not arrived, and, in the mother's words, The child's schooldays are a nightmare. There is another case of a girl aged nine whose sight was tested in September, 1948; her father came to see me in October, 1949, and her spectacles arrived in November, 14 months after her eyes were tested. There are many other cases of the same kind.

A boy of 11 had his eyesight tested in July, 1949, and his spectacles still had not arrived at the beginning of February of this year. When the father complained to the optician he was told that he could get the spectacles in three weeks if he paid £3 10s. for a set of plastic lenses. When I raised that with the Ministry of Health I was told that plastic lenses were not available under the National Health Service, yet if plastic lenses are of any use I should have thought they could best be used for children, who are particularly liable to break their spectacles.

Another case concerns a 14 year old girl who has worn spectacles since the age of five and has had a new pair every nine months. Under the National Health Service she had to wait for six months, and when I raised it with the Ministry of Health I was told that the kind of lenses required were of a special kind. That, of course, is the whole tragedy of these cases, that the delay almost invariably occurs in the cases of children who need particular kinds of lenses, yet theirs are the cases which ought to have special priority. I hope that tonight, after what my hon. Friend the Member for Cardiff, West (Mr. G. Thomas) has said, my hon. Friend the Parliamentary Secretary will do his best to ensure that whatever priority scheme is in existence operates as efficiently as it ought to do.

10.18 p.m.

Colonel Stoddart-Scott (Ripon)

I want to say just two things. First, we are all grateful to the hon. Member for West Cardiff (Mr. G. Thomas) for having raised this question, because before we had the National Health Service these children were able to get their spectacles. They were able to get not only ordinary spectacles, but splinterless spectacles, which the National Health Service has never yet provided. In fact, that is one of the disadvantages of our Health Service, that these children are actually the victims of the Service, and I hope that tonight the Parliamentary Secretary will tell us how he will give them priority. There are already certain types of priority in the provision of spectacles, and I hope that he will extend that priority so that none of these children shall be the victims of this great Health Service. I also hope that he will issue, not only spectacles but splinterless spectacles for our children, which they had before the National Health Service came into operation.

Secondly, I wish to say this about dentists. Before the National Health Service there was one dentist for every 3,000 children in our schools. Today, with this Act on the Statute Book, which instructs the Minister of Health to produce a priority dental service for our schools, there is not one dentist for every 3,000 children but one for every 6,000 children. Once again our children are the victims of the National Health Service when they should be the beneficiaries. While the National Health Service Act does not compel the Minister to provide a dental service for everybody else, it does insist on his providing a dental service for our schoolchildren, but that he does not do. I hope that tonight he will give some assurance as to how the people will be helped and not made victims of our Health Service.

10.20 p.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)

I am grateful to my hon. Friend the Member for Cardiff, West (Mr. G. Thomas) for raising this subject tonight. I can assure him, and my hon. Friend the Member for Rossendale (Mr. Anthony Greenwood), that I shall be very happy to look into the individual cases they have raised, as we have always been willing to do in other cases that have been raised from time to time. I should like to give him some information about the steps we have taken to deal with what we agree to be a serious position, both in regard to glasses and the dental services for school children.

I will deal first with glasses, which is the subject that has been chiefly referred to tonight. As soon as it became clear that manufacturers could not keep up with the heavy demands that fell upon them on the introduction of the Health Service we had discussions with the opticians and the manufacturers to arrange for a priority scheme to meet the emergency. It is quite clear that if we are to have a priority scheme it must be restricted to be really effective. It was agreed between the opticians, the manufacturers and ourselves that a 5 per cent. priority scheme would be reasonable if we were to assure speedy delivery in the field of most urgent cases.

It was also agreed that the only person who could choose priority cases was the optician with the full details of the case before him. We agreed, therefore, to what was originally a 5 per cent. selection of cases, but, later, it was possible to increase the figure to 7½ per cent. because of the increasing production of lenses. We had to give some guidance as to the type of case we felt should come into this 5 per cent. and later the 7½ per cent. category. It was agreed that it should include school children whose eyesight would particularly suffer from delay. We could not include all school children who were thought to be in need of glasses because it would have been quite impossible to have brought in other groups also deserving special priority, particularly those working in industry, who could not have carried on their job without glasses. That was the second category we wished to bring into this 5 per cent. total.

That priority scheme, which was worked with the co-operation of opticians and manufacturers, has been successful on the whole. We are fully aware of the difficulties in cases where orders were placed before the scheme was introduced, where it was extremely difficult for manufacturers to turn back to cases which to some extent had been caught up in the general run of cases, and also of the difficulties where perhaps an optician had judged that a case did not deserve special priority as compared with others.

In addition, we managed to secure importations of large numbers of lenses. The total number of lenses imported from abroad has been something like one million pairs to date. This has been of very great assistance in helping to meet the back-log of orders. The main solution for our difficulties is obviously to improve the production of our own manufacturers, and I am very glad to be able to say that very great steps have been taken in this direction. During the last quarter, which ended on 14th January this year, we have been able to establish a production of lenses in this country some 33 per cent. above demand, which has meant that there has been a steady eating into the back-log of orders and that delays we have been experiencing are steadily being reduced; so much so that I hope it will be possible, before very long, to abolish the priority scheme altogether, because the supply should have met the demand.

That is not to say there will not be individual difficulties, because it is true that with special types of lenses, particularly bifocal lenses, we meet special problems, particularly due to the lack of specially trained labour in the industry. We are getting on with the problem, and I hope we shall be able to overcome it. Although in real difficulties we are willing to investigate individual cases, I can assure my hon. Friends that the position has steadily improved, and it should not be long before we overcome the difficulties existing today. It is possible under the Health Service to provide splinterless glasses where they are medically judged to be necessary. It is not a case, however, that splinterless glasses were provided automatically free under the old service. That is very far from being the case. There is no backward trend there.

So far as the dental services are concerned, we are facing a more serious position because we are up against an over-all shortage of dentists. The fact is that many dentists have unfortunately been attracted into private practice by the higher rate of payment. We are doing all we can to encourage the training of more dentists. That is obviously the long-term solution. In the meantime, some local education authorities—for this is the responsibility of the education authorities, though naturally we are most concerned in it—have been able to make up for the loss of full-time school dental officers by securing the part-time services of practising dentists on a sessional basis. Cardiff is a case in point where they are in a better position in regard to school dentists today than they were some years ago. They have been able—although I am not saying that they have enough—to meet the danger there by the employment of part-time dentists, and we hope these appointments, by which dentists in general practice will be able to offer some sessions in the clinics and for the school dental service, will be extended to other areas where there are difficulties.

The position varies very much from one part of the country to another, but where there are difficulties we hope that the local education authority, together with the local professional committees, will approach practising dentists to secure, if possible, their co-operation in this way. I am sure that this will be approved of heartily by the general public, and it should be possible for dentists generally to co-operate in this way to maintain what we all agree is a most vital part of our Health Service by ensuring the inspection of teeth as well as the treatment for them, which is a vital issue in this regard.

10.29 p.m.

Dr. King (Southampton, Test)

If I may take up the last minute to add a practical suggestion to what has been said by my hon. Friend the Parliamentary Secretary, I should like to ask him if he will consider taking up with my right hon. Friend the Minister of Health the possibility of requiring dentists to undertake one or two sessions of school dental service as part of the condition of their going into the dental service. We are not likely to be able to recruit sufficient school dentists in any reasonable time, and it may be a practical solution of this very difficult question if the Minister would take up the whole question of the terms of dentists being in the National Health Service so as to ensure that they do a session for school children as part of their duties.

The Question having been proposed at Ten o'Clock and the Debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at Half-past Ten o'Clock.