§ 6 and 7. Mr. Jegerasked the Minister of Pensions and National Insurance (1) the number, and amount, of National Health Service prescription charges refunded by the National Assistance Board in Goole and Knottingley, respectively, to persons not in receipt of National Assistance supplementation during each of the last two years;
(2) the number, and amount, of National Health Service prescription charges refunded by the National Assistance Board in Thorne to persons not in receipt of National Assistance supplementation during each of the last two years.
§ The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Miss Patricia Hornsby-Smith)Separate figures are not available for the places mentioned as Thorne is only part of an area served by the National Assistance Board's office in Goole and Knottingley a small part of the area served by another office. The figures for the Goole office are £33 in 1959 and £18 in 1960, representing 660 and 360 prescription items, respectively.
§ Mr. JegerIn view of these large figures for such small communities, does not the right hon. Lady appreciate that a large saving in time, trouble and administrative expense would result from the abolition of these restrictive charges?
§ Miss Hornsby-SmithI do not think the hon. Member can really consider that these are large figures over the whole year when there are over 3,000 people on National Assistance in the area.
§ 9. Mr. Houghtonasked the Minister of Pensions and National Insurance whether he will circulate with the OFFICIAL REPORT a draft of the proposed leaflet to be issued informing those not currently on National Assistance how, and in what personal circumstances they can claim a refund of prescription charges.
§ Mr. Boyd-CarpenterI am informed by the National Assistance Board that it is preparing a new leaflet which will include the required information. I will arrange for a copy to be placed in the 1169 Library as soon as it is available and I will, of course, send the hon. Member a copy.
§ 10. Mr. Houghtonasked the Minister of Pensions and National Insurance whether his consultations with the Chairman of the National Assistance Board have been concluded on a simplified procedure for claiming refunds of prescription charges by those not currently on National Assistance but where hardship may exist; and whether he will make a statement.
§ Mr. Boyd-CarpenterThe procedure for claiming refund of prescription charges by those not already receiving National Assistance has been fully explained by my right hon. Friends the Minister of Health and the Secretary of State for Scotland. I do not know what simpler procedure the hon. Member has in mind.
§ Mr. HoughtonIf the right hon. Gentleman looks on the Order Paper, he will see at least one suggestion from some of his hon. Friends. Is not the Minister aware that the procedure which has already been explained to the House will be cumbersome and wasteful of time and of money in administrative cost? Is he not aware that it will involve either a visit to the National Assistance office or a visit from the National Assistance office to the person, or both? Is the Minister not aware that many hon. Members, on both sides, are looking for something simpler and more easily understood and a method that will give the refund without all this complicated paraphernalia to get back the prescription charge?
§ Mr. Boyd-CarpenterNeither the suggestion on the Order Paper nor the suggestion made by the hon. Member has anything to do with the Question on the Order Paper. The Motion on the Order Paper would eliminate both refund and reference to the National Assistance Board, whereas the hon. Member's Question includes both.
[That this House is of the opinion that persons of limited means should not he required to apply to the National Assistance Board for the refund of National Health Service charges, but that instead all persons entitled to treatment under the National Health Service whose total net income is below an agreed income tax 1170 code number or its equivalent shall, on production of evidence of that income rating, be excused payment of all National Health Service charges.]
§ 14. Mr. Liptonasked the Minister of Pensions and National Insurance what was the number and amount of National Health Service prescription charges refunded during 1959 and 1960 to war pensioners.
§ Mr. Boyd-CarpenterThe amount refunded was about £30,000 in each year. Figures are not available as to the number of war pensioners concerned.
§ Mr. LiptonDo not these figures indicate that many war pensioners either do not know or have forgotten that they are entitled to claim refund for their prescriptions pertaining to their war disabilities? Will the right hon. and learned Gentleman, in connection with the circular to which he has just referred, take steps to ensure that war pensioners are reminded, particularly now that the cost of prescriptions is going up, that they are entitled to a refund on prescriptions?
§ Mr. Boyd-CarpenterI do not think that one can draw the inference the hon. Member does from the figures, but I will bear the hon. Member's practical suggestion in mind.
§ 15. Mr. Frank Allaunasked the Minister of Pensions and National Insurance if he will make a statement about his discussions with the National Assistance Board regarding prescription charges.
§ Mr. Boyd-CarpenterI do not know what discussions the hon. Member has in mind. The National Assistance Board will continue to discharge their duty to relieve need.
§ Mr. AllaunI was referring to the discussions which I thought were suggested last week, but I want to ask the Minister, if there are to be any prescription charges at all—which we challenge—does he not think that the most unfair, unpopular, unpleasant, impractical and inconvenient way is the present method and that the least so would be the proposal that all those below a certain net income for tax purposes should be exempt? Will he consider that proposal? Was it discussed previously?
§ Mr. Boyd-CarpenterIt was not a proposal, whether it has merit or not, for me to consider. I am answering in this respect on behalf of the National Assistance Board in the discharge of its duty to relieve need. Proposals which would exclude the National Assistance Board would, of course, be entirely beyond my compass or responsibility.
§ 17. Mr. Millanasked the Minister of Pensions and National Insurance if he will give an estimate of the administrative and other costs, per prescription charge refunded, of the National Assistance Board in investigating claims for refund from persons not in receipt of National Assistance.
§ 24. Mr. Manuelasked the Minister of Pensions and National Insurance what is the estimated administrative cost to the National Assistance Board of assessing the income of applicants for refund of National Health Service charges who were not in receipt of National Assistance during each of the past two years.
§ 25. Mr. Smallasked the Minister of Pensions and National Insurance what is the estimated average administrative cost to the National Assistance Board in assessing the income of an applicant for refund of National Health Service prescription charges who is not currently in receipt of National Assistance supplementation.
§ Mr. Boyd-CarpenterIt is not possible to make an accurate apportionment of the estimated total administrative costs as between different classes of recipient and the different processes of dealing with an application.
§ Mr. MillanYes, but is not the cost in this case going to be very high in view of the cumbersome method of administration? Is not the Minister aware that there is a considerable feeling even on his side of the House about this? Is he going to try to make any real effort to get a less cumbersome method of administration?
§ Mr. Boyd-CarpenterI can answer as to the total cost, but I cannot break it down into the various precise components in the three Questions. As I have already indicated, my responsibility in this matter is on behalf of the National Assistance Board, and its 1172 methods of relieving need, in whatever way it arises, have stood the test of experience.
§ Mr. ManuelIs the right hon. and learned Gentleman aware that there is a considerable difference in the three Questions he is answering? The first deals with the administrative cost of prescription charges per single items. Mine deals with the whole of the administrative cost of the refund of National Health Service charges for those not in receipt of National Assistance. The third is about the average. As I estimate the figure as a large one, does the right hon. and learned Gentleman not think that he should consult his right hon. Friend to obtain some better administrative arrangement which would save money and be fair to the applicants?
§ Mr. Boyd-CarpenterThe hon. Gentleman underrates the precision of his Question. It asked me for the cost of assessing the income of applicants. That is, of course, only part of the process. As for the rest of the supplementary question, I have already answered it in replying to his hon. Friend.
§ Mr. ManuelI do not think so.
§ 18. Mr. Doddsasked the Minister of Pensions and National Insurance if he will state the numbers and amounts of National Health Service prescription charges refunded in Kent to persons not in receipt of National Assistance supplement during the past two years; and what increase is anticipated in this respect as a consequence of the proposed increases.
§ Miss Hornsby-SmithThe County of Kent is served by fifteen offices of the National Assistance Board of which two also serve a part of Sussex. In the area served by these fifteen offices, the figures asked for are £1,280 in 1959 and £1,080 in 1960, representing rather more than 25,000 and 21,000 prescription items respectively. Some increase in the number of applications for refund may be expected.
§ Mr. DoddsWhile thanking the right hon. Lady for that information, may I ask whether it is not inevitable that increased charges will encourage an ever-increasing number of people above the 1173 National Assistance Board's scales to send in their applications for refund by post because of the distaste for going to any of the premises, and since the National Assistance Board cannot give any money without an inquiry, which may entail one or more visits to the home, is it not obvious that the staffs will have to be increased to do the job, if the offices are not over-staffed now? Does not the money entailed make nonsense of the claim that this is to save money? Or does it not expose the plot really to have a smack at the National Health scheme?
§ Miss Hornsby-SmithMost people who will be receiving these refunds are normally on National Assistance and are people who have been served in this way by the National Assistance Board under the present Regulations. There may possibly be a few additional applications but I cannot share the hon. Member's view that there will be a great increase in numbers that will overweigh the staff, or that the Board will not be able to deal with the matter.
§ 20. Mrs. Braddockasked the Minister of Pensions and National Insurance what arrangements are made to pay a prescription charge, before the prescription is obtained, where the patient cannot afford to pay for it in advance.
§ Mr. Boyd-CarpenterIn a case of urgent need, payment may be made at once on application at the Board's area office.
§ Mrs. BraddockYes, but is not the Minister aware that this is a really important matter, that many people, when they get their prescriptions, find they have not the money to pay for them? Is there not a simpler way of dealing with the matter than requiring that the person who has a prescription or a relative should go to the National Assistance Board or wait for an Assistance Board officer to come before he obtains his prescription? Surely the time has arrived when some simpler method ought to be found in cases of this sort?
§ Mr. Boyd-CarpenterThe hon. Lady will be aware that this is the method which has been working for a number of years.
§ Mrs. BraddockVery seldom, indeed.
§ 22. Mr. Prenticeasked the Minister of Pensions and National Insurance what was the number and amount of National Health Service prescription charges paid in advance by the National Assistance Board in each of the past two years on behalf of persons not currently in receipt of National Assistance supplementation.
§ Mr. Boyd-CarpenterI am afraid this information is not available.
§ Mr. PrenticeIs the Minister aware that the Minister of Health placed a lot of importance on this arrangement in recent debates? If the information is not available, how can we judge whether this method really will be capable of relieving hardship? Will not the right hon. and learned Gentleman agree that the figures are very small indeed and will make very little impression on hardship?
§ Mr. Boyd-CarpenterI have given a good many figures on this matter, but in the form the hon. Member has asked for them and for reasons which I think he understands, they are not available.
§ 23. Mr. Lawsonasked the Minister of Pensions and National Insurance whether a separate income assessment is made by officers of the National Assistance Board in respect of each application for refund of National Health Service prescription charges made by persons not currently in receipt of National Assistance supplementation.
§ Mr. Boyd-CarpenterIf refunds are needed at frequent intervals, the Board's officer will not normally require more, on the second and subsequent occasion, than a simple statement that the person's circumstances are unchanged.
§ Mr. LawsonDoes the right hon. Gentleman mean that if these refunds are not made at very frequent intervals a highly paid civil servant will be calling upon the person concerned to make such an assessment and perhaps spend half a morning doing it? Is not this a very Irish way of saving money? Would it not be more sensible to cut out the 2s. charge altogether?
§ Mr. Boyd-CarpenterUnlike the hon. Member, I shall not introduce nationalistic adjectives, but he underrates the speed with which experienced officers of the National Assistance Board deal with their duties.
§ 27. Mr. Rossasked the Minister of Pensions and National Insurance if he will estimate the average and total cost to his Department of investigations of applications for assistance in respect of prescription charges, dental charges and optical charges, respectively.
§ Mr. Boyd-CarpenterAs regards grants in respect of charges for prescriptions, I would refer the hon. Member to my reply on Friday, 24th February, to the hon. Member for Stockton-on-Tees (Mr. Chetwynd). As regards dental and optical charges the estimated total administrative costs are, respectively, about £27,000 and £86,000 a year, which have to be set against grants totalling £387,000 and £651,000, respectively, in 1960 and thus represent a little under 1d. and a little over 1½d. per shilling paid.