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the same services for one-quarter of the reduced feeshe could so ill afford and one who was encouragedin her national vice of seeking a specialist for everytrivial ailment. After all, she might not have beenso lucky in her choice.

It seems hard to the family doctor that the specialistshould so easily have it both ways-playing the con-sultant when asked, free to practise independentmedicine (faintly tinged with specialism) when occa-sion serves-yet not accepting the full day and

night responsibility for the patient’s welfare whichfalls almost automatically on the family doctor if hedoes anything at all for a patient. If the American

lady had rung up An Aural Surgeon at 10 P.M. twonights later complaining of acute pain in the throator even earache, would he have gone at once to herbedside ? And try as we will to thicken our skinsit does gall us to find that our patients have beenseen behind our backs and we not told. " For a birdof the air shall carry the voice and that which hath

wings shall carry the matter," and we may be surethat the village doctor in Polznooks has already heardthe story of the squire’s ear.

Hospitals, in their out-patient departments, dothe same thing on an enormous scale, quieting theirconsciences with identical arguments, and experienceof these pin-pricks, many times repeated, humiliatesand embitters the family doctor, digs a gulf betweenhim and the specialists who should be his friendsand helpers, and, I suspect, indirectly keeps manygood men out of general practice.

If the whole profession kept its own rules, in spiritalways, in the letter as nearly as is humanly possible,and taught the public to understand that theserules are at least as much in their interest as in ours,how much happier we should all be and how muchmore respected !

I am, Sir, yours faithfully,London, July 2 4th. LINDSEY BATTEN.

PARLIAMENTARY INTELLIGENCE

LORD HORDER ON QUACK MEDICINES

IN the House of Lords on July 26th Lord HORDERcalled attention to the enormous growth of thequack medicine trade, and to the incongruity ofexercising no control over the deleterious effectsof such trade upon health at a time when a seriouseffort was being made ’to improve national fitness.He moved for Papers. He said that the quackmedicine trade was a poisonous growth that had gotentirely out of hand. The head and front of theoffence was the grossly misleading if not fraudulentadvertisement. He had been told that he wouldhave heavily against him the vested interests ofnewspaper proprietors, press agencies, and owners ofhoardings. But he had received help and encourage-ment from the reputable members of those groups whohad themselves taken steps to exercise that controland censorship which in other countries was imposedby responsible authorities. He had also been toldthat if he, a doctor, raised this question he would becharged with trying to create a monopoly for his ownprofession, and with depriving the poorer classesof cheap cures. If there was any monopoly, it lay,in his view, with the trade that bled the public ofjB25,000,000 or 230,000,000 a year-nearly as muchas the total spent on all our hospital services. Hewas seeking to break up a formidable and largelyunscrupulous monopoly which, judging from theexclusion of patent and proprietary medicines andfoods from the Food and Drugs Bill, successive govern-ments seemed almost to go out of their way to guard.If the doctor thought only in terms of hard cash hewould benefit from this unprincipled trade, which even-tually brought him more patients ; ultimately even theundertaker benefited sooner and oftener than he need.

Only now was there something better to put in theplace of these dubious " specifics." We had thefinest health services in the world. The slogan" Use your health services " was one of the mostintelligent he had heard. These were what theGovernment must encourage people to put in theplace of this costly and perilous witch-doctoring.His main reason for pressing the matter at this timewas his concern for the success of the national fitness

movement. For every 2100 the Government spentin making the people health-conscious the quackmedicine mongers paid 21000 in making them disease-conscious. A few patented and proprietary thingswere good, and the claims made for them reasonable ;a great many did little good or harm, and were soldat fantastic prices ; and now and again somethingwas sold that did definite harm. An enormous

number of preparations were fraudulent in varyingdegree. The great increase in advertising media

was capable of appalling results, in its mass suggestion,on the country’s health and morale. The advertise-ments had become a graver danger than the medicinesthey served. Fear was the chief emotion they playedupon, and much of the trade was in effect a hugeform of blackmail. This was a cruel ramp, whichwas forbidden in many countries. Voluntary effortby reputable newspapers had been on trial for over20 years, but things were much worse than they were,and a central or Government control was needed.Lord FARINGDON and Lord ADDISON supported

Lord Horder’s motion in the course of an importantdebate to which we shall return next week.

THE GOVERNMENT’S REPLY

Viscount GAGE said investigation had borne outthe fact that improper use of substances in them-selves harmless was a distinct danger to the healthof the country, and handicapped the work of themedical profession, and that we were behind othercountries. He was ready to agree that it mightconstitute an obstacle to national fitness. Theproblem of the dangerous drug had been solved,except possibly for new drugs which were being puton the market. It had been said that the publicwere being used as a guinea-pig by unscrupulousmanufacturers. He was informed that there was nomethod of foretelling the effect of some compounds,and that the effects on the human body could onlybe ascertained by experiment. That constituted apositive danger, but it was difficult to put absoluterestriction on new inventions. The majority of thesubstances were made by firms of the highest repute,who, in their own interests, saw that the pre-cautions taken were very complete.The real difficulty arose from products and sub-

stances which were not in themselves harmful, butthe improper use of which constituted a danger.Aspirin, used properly, provided relief from a numberof minor ailments, but used to excess it was notbeneficial. The inherent difficulty in dealing withcertain substances was that the real fault lay with theindividual who used them. If people did not use theimmense State-assisted medical schemes, and pre-ferred to diagnose and treat their own complaints,it was largely their own responsibility if they sufferedin consequence. They were encouraged to do so

by very carefully worded advertisements. In theory,. there was a case for controlling the advertisements,but it was not easy to design forms of words whichcould not be evaded. He was not attempting toexclude the possibility of some legislation on certainlines, but it was difficult to guarantee that it wouldbe effective. Repression alone was one of the mostdubious of all lines of progress. The Minister of

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Health would examine what Lord Horder had said,and see if anything could be done to incorporateon the educational side of the national fitness move-ment some warning against the abuses of drugsgenerally. Perhaps Lord Horder might still benot convinced by his reply. If so, possibly, he wouldlike to have a try at legislating himself. In regardto legal matters the Government would be pleasedto place all their resources at Lord Horder’s disposal,but on medical matters they had no higher sourcesof information than Lord Horder himself commanded.The Government’s attitude must, to some extentat any rate, be dictated by public opinion, becausein these matters the public must have the last word.The Government were perfectly prepared to lay anypapers for which Lord Horder might wish.Lord Horder asked leave to withdraw his motion

for Papers and this was agreed to.

NOTES ON CURRENT TOPICS

Nursing Homes Registration (Scotland) BillIN the House of Lords on July 19th the Nursing

Homes Registration (Scotland) Bill was consideredin Committee. An amendment by Lord ALNESS,to make it clear that a qualified nurse might actas an officer authorised by a local authority to inspecta nursing-home, was agreed to.Lord ALNESS moved a new clause giving power to

the Department of Health for Scotland to exemptany nursing-home carried on in accordance with thepractice and principles of the Church of ChristScientist from the requirement that the home shouldbe in charge of either a registered medical practitioneror a qualified nurse who was or would be residentin the home.He said that the clause merely echoed the corre-

sponding provision in the English Statute of 1927,which was re-enacted in the Public Health Act, 1933.The clause was drafted by the Department of Healthfor Scotland and was brought before the Housewith their sanction. The clause did not exemptthese nursing-homes from any of the structural orsanitary requirements which the Board of Healthmight impose, and merely related to the requirementsabout doctors and nurses. The English Act hadworked smoothly and well. The new clause wasagreed to, and the Bill passed through Committee.

Milk (Extension and Amendment) BillIn the House of Lords on July 19th the Earl of

FEVERSHAM moved the second reading of the Milk(Extension and Amendment) Bill, which has passedthe Commons. Lord MARKET asked whetherpasteurised milk was provided for children in theschools ; and, if not, what steps were taken to ensurethat the milk provided was clean and not likely tocause any illness to the children ? He said it was atragedy that there should be any delay in the pro-vision of milk for expectant and nursing mothers.The Earl of FEVERSHAM said that according to the

returns made to the Board of Education, at the endof last March 2,672,000 children in elementaryschools in England and Wales were taking milk underthe milk-in-schools scheme. That was 161,000more than on the corresponding date last year.Both the source and quality of the milk suppliedhad to be approved by the medical officer of healthin the area. Where possible, in the larger urbanareas and the great cities, the medical officer of healthinsisted on pasteurised milk where it was available.In those areas served by rural districts pasteurisationwas not always possible, and in those circumstancesthe milk of attested herds was used. Under the Billan increased sum for milk was being devoted toschemes organised by local authorities not only forchildren attending elementary schools but fornursing and expectant mothers. It was a featureof the Bill that, in order to accelerate this service,an extra jS250,000 was being provided until theGovernment’s long-term proposals could be placedbefore Parliament. The Bill was read a second time.

Scottish Health Services

In the House of Commons on July 20th Mr.COLVILLE, Secretary of State for Scotland, in intro-ducing the Vote for the expenses of the Departmentof Health in Scotland said that in health mattersthey were going forward in Scotland and continuingthe great advance begun early in this century. Theyhad a very severe influenza epidemic in the spring-the worst since 1929-but the general death-rate hadremained practically the same. The infant mortality-rate fell from 82-3 to 80 per 1000 and only in threeyears, 1923, 1934, and 1935 had better figures beenshown. The latest figures, those for the first quarterof 1938, were 20 per 1000 below the average of thefirst quarters in the preceding five years. Perhapsthe most welcome improvement of all was the fall inthe maternal mortality-rate. In 1937 the rate was4-8 per 1000 registered births, which was the lowestrecorded this century. The Maternity Services(Scotland) Act passed last year gave Scotland themachinery for what might be one of the best, if notthe best, maternity services in the world. Whenthese schemes were in operation he hoped that everymother in Scotland would be able to secure theservices in her own home of midwife, doctor, and incase of necessity consultant.As a result of the medical service under the

Insurance Act it had been found that about two-fifths of the total sickness among insured persons wasaccounted for by those who were chronically sick,that was to say, those who were ill for more than ayear. The Department of Health, with the coöpera-tion of insurance doctors and the approved societies,had begun an intensive investigation of this problem.The number of certified tuberculin-tested cows inScotland had increased by 50 per cent. from 20,459to 30,002. Notwithstanding the fact that since thepost-war housing effort began some 290,000 housesof the working-class type had been built in Scotland,they had not yet by any means got rid of slum housesand overcrowding. They still needed some 250,000houses.-Mr. T. JOHNSTON criticised the report ofthe Department of Health for devoting only six linesto atmospheric pollution. Our most fatal diseaseswere not, as many people believed, tuberculosis orcancer, but respiratory diseases. In Glasgow duringa fog- period the death-rate from respiratory diseasesrose six times.-Mr. LEONARD said the importanceof dental treatment warranted a much wider networkof officials attending to this work than existed at thepresent time. He had read in THE LANCET ofMay 28th a report of a statement by Prof. Mottramthat by the time children came under the care ofthe education authority they were already damagedgoods. It was in order to save the sending ofdamaged goods to school that he (Mr. Leonard)wanted the Department of Health to see that greaterattention was paid to pregnant mothers and youngchildren. Real economy could be obtained bygenerous spending in this matter. There was nodoubt that a very large percentage of the diet ofpregnant women was deficient both as regardsquality and quantity in vitamins, mineral standards,and other factors necessary for this period of life.

Mr. WEDDEBBUBN, Under-Secretary of State forScotland, said that in proportion to the populationof Scotland they had in the way of slum clearanceand relief of overcrowding done a great deal morethan England, but they had six times as much to do,because while of all houses in England less than 4 percent. were overcrowded, in Scotland the figure was23 per cent.

School Health Services in Scotland

On July 21st, when the Vote for public educationin Scotland was considered, Mr. WEDDERBURN saidthat last year there had been established altogetherin Scotland 28 nursery-schools with a total attendanceof 1067, as compared with 25 schools and an enrol-ment of 943 in the preceding year. The number hadnow increased to 31 schools, and the Glasgow educa-

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tion authority was proposing to erect 10 nursery-schools, while many of the other authorities also hadschemes in hand. Considerable progress had beenmade in regard to physical education since the issueof the circular on the subject in 1936. School-building proposals between 1936 and June of thisyear had included 205 new halls and gymnasia,7 new swimming-pools, and 54 playing fields, and inmany cases the improvement of existing play-grounds. Continuation classes in various forms ofphysical education were continuing to expand. Oneof the chief reasons for the increase was the successof " Keep Fit " classes, chiefly for women. Duringthe past two years the number of specialist teachersof physical education in Scotland had risen from476 to 547.-Mr. WESTWOOD said that experience hadshown that the main functions of the health servicein the schools had not been to prevent the diseasesof children, but to discover and to remedy developeddefects which might give rise to troubles in later life.Children were medically examined as a routine threetimes during school life-at entry, age 5 or thereby,at age 9, and before leaving school, about age 13.Now that the health and educational authoritieswere usually the same body, age 5 had no particularsignificance and it ought to be possible to use tobetter advantage those who were engaged on schoolhealth services. The three routine examinationscould easily be cut down to two, at 7 and 13. Thiswould release some of the medical staff for pre-schoolmedical examination and would give them a moreeffective service in discovering defects that ought tobe remedied before the children entered school. Thereport of the Departmental Committee on HealthServices in Scotland stated that the school healthservice was seriously hampered by the inadequacy ofmedical supervision at home, and that the law shouldbe amended so as to remove any doubt about thepower of local authorities to provide meals as a

preventive measure. Power was given to providemeals for necessitous school-children under the 1908Act, but unfortunately the authorities provided mealsto cure a disease that already existed, instead ofproviding them to prevent disease. If the countrywas to get full value for the money spent in educa-tion it would be wise to see that the children wereprovided with an adequate mid-day meal.-Mr.MACQUISTEN suggested that residential schools shouldbe started in rural areas where children could learnto grow their own food and attend to themselveswhile they were receiving their education.-Mr.COLVILLE said that in the year 1936-37 35,818 school-children in Scotland were provided with meals free ofcharge, and 39,827 were supplied with meals onpayment ; in 1935-36 the numbers were 33,800 and30,900. In the year 1936-37 66,300 children receivedmilk free of charge and 260,700 children receivedmilk on payment. In Glasgow 27 per cent. of childrenwere receiving milk free on March 31st, 1938. Itwas not necessary that a child should have a medicalcertificate that it was in need of food before foodwas provided. Many of the children were providedwith food on the report of the headmaster or teacher.

Certification of Criminal Lunatics

Mr. CASSELLS contended that a great proportion ofthe expenditure on Borstal treatment, approvedschools, and the probationary system could beavoided if in cases of juvenile delinquency the servicesof a psycho-analyst were enlisted in the first instance.- Mr. WEDDERBURN said that in England psycho-therapeutic treatment of young delinquents, if given,was generally combined with Borstal detention. Thisform of treatment was still in an experimental stage,and if it was found satisfactory it would be extendedto Scotland. In regard to the procedure for thedetention of persons in a criminal lunatic asylum, atBarlinnie and Perth prisons certificates were normallygiven by the two prison doctors, and at Edinburghprison the certificates were normally given by theprison doctor and by the medical adviser tothe Prisons Department. At all other prisons the

certification was normally by the prison doctor anda doctor independent of the prison service. Under theexisting law any or all of the foregoing certificatescould be granted by doctors in the employment ofthe Prisons Department. When the Criminal Lunatics(Scotland) Act, 1935, came into operation the existinglaw would be altered in two important respects.First, while it would remain competent to remove aperson from prison to the new criminal lunaticasylum at Lampits on certificates by two doctors inthe employment of the prison authorities, it would beopen to that person, or to someone on his behalf, todemand that he be examined by an independentdoctor, and the Secretary of State would then beunder an obligation to consider the report of anysuch independent doctor. Secondly, no person wouldbe liable to be detained in the criminal lunatic asylumafter the expiry of his sentence, unless one medicalcertificate was granted by a doctor who was not asalaried officer of the Prisons Department.

In the House of Lords on July 19th the EssentialCommodities Bill was read the third time and passed.The Commons amendments to the Divorce

(Scotland) Bill were agreed to.In the House of Lords on July 20th the Still-Births

(Scotland) Bill was read the third time and passed.On July 22nd the Nursing Homes Registration(Scotland) Bill was agreed to on report.On July 22nd the Holidays with Pay Bill passed

through its remaining stages in the House of Commonsand was read the third time.

In the House of Lords on July 25th the Milk(Extension and Amendment) Bill, the Finance Bill,and the Nursing Homes (Registration) Scotland Billwere read the third time and passed.The Fire Brigades Bill passed through report

and was read the third time and passed.The Holidays with Pay Bill was read the second

time.

_

In the House of Commons on July 27th Mr.MATHBRS presented the Prohibition of Vivisection onDogs (Scotland) Bill.

QUESTION TIME

WEDNESDAY, JULY 13TH

Drug Traffic in ChinaMr. ARTHUR HENDERSON asked the Prime Minister

whether he was aware that opium was being distributedin China by Japanese employers to their Chinese employeesin lieu of regular wages ; and whether, as this constituteda breach of the International Opium Convention, HisMajesty’s Government would cooperate with the UnitedStates Government in making representations to the

Japanese Government on the matter.-Mr. BUTLER

replied : My noble friend has no information to this effect,but if the hon. Member will communicate to me anyreport which has reached him, I will make inquiries.

Mr. HENDERSON : Is it not a fact that this allegationwas made at Geneva at a recent meeting of the Com-mission, and does not the report of that Commissionestablish the fact that the very serious situation whichnow exists in China is the result of this widespread drugtraffic ? Will not the Government do something to dealwith the situation?

Mr. BUTLER: I am aware of the serious position inregard to the drug traffic. In this particular instance wehave no information.

Mr. NoEL-BAEEB : In view of the fact that it is notoriousthat Japan is conducting the campaign by the use ofdrugs, will the hon. Member instruct his Majesty’s agentsin China and Japan to make a full report so that theHouse may have full guidance ?

Mr. BUTLER : His Majesty’s consuls have been asked tomake a report on this matter.

. trHUBSDAY, JULY 14TH

Employment of ChildrenMr. LESLIE asked the Home Secretary whether he could

inform the House on what points the International Labour

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Convention of 1932, which laid down a minimum age fornon-industrial employment, went beyond the Childrenand Young Persons Act, 1933, relating to the employ-ment of school-children in this country.-Sir SAMUELHOABE replied : The main points on which the Conventionof 1932 goes beyond the provisions of the Children andYoung Persons Act, 1933, and the by-laws made there-under regarding the employment of children, are the

prohibition of all employment of school-children exceptlight work for children over twelve, no employment evenin such light work on Sundays or public holidays or before8 A.M. on either school days or holidays, and the limitationof such employment during school holidays to two hours.a day.Mr. LESLIE : Did not the Government in November, .

1934, state that they would after a period see how the1933 Act worked and consider the question of notification,and is not the time ripe to consider that now ?-Sir S.HOARE: I understand that at that period inquiries weremade from the local authorities. They then agreed withthe line that was taken by the Government. I am now

making further inquiries of the local authorities to seewhether, and, if so, how far, the position has changedsince that time.

Inquiry into Working-class BudgetsMr. PAEKEB asked the Minister of Labour whether he

could name any date for the publication of the resultsof the inquiry into working-class budgets now beingcompleted.-Mr. ERNEST BROWN replied : The last ofthe four collections of weekly budgets which are beingobtained at quarterly intervals is being taken during thepresent month. In the case of expenditure on clothingit has been necessary to arrange for the collection of

particulars of such expenditure week by week from alarge number of households for a period of twelve months,ending in October next. Statistics summarising theinformation obtained will be published as soon as possibleafter the completion of the inquiry, but I am not atpresent in a position to state by what date publicationmay be expected. The House will realise that the workinvolves the examination and tabulation of some 50,000budgets, and 150,000 weekly returns of expenditure onclothing.

TUESDAY, JULY 19TH

Sickness and Mortality-rates in Glass-bottleIndustry

Mr. RHYS DAVIES asked the Minister of Health whetherhe could give statistics showing the incidence of sickness,disease, and mortality-rates among those employed in theglass-bottle industry ; and how those figures comparedwith the general averages and with any other industries.-Mr. BERNAYS, Parliamentary Secretary to the Ministryof Health, replied : The most recent available figuresare as follows :-

Standardised mortality from all causes of males ages 20-65 forthe years 1930-32 inclusive in England and Wales

Glass-blowers and finishers (not machine hands) .. 160Glass moulders and pressers........ 96All makers of glass and glassware (comprising

employers, foremen, and all skilled workers) .. 114All males ............ 100

The mortality of glass-blowers and finishers was exceededin 5 of the principal occupations-viz., undergroundworkers in tin and copper mines, underground workers inother metalliferous mines, sand-blasters, stevedores, slateminers and quarriers in Caernarvonshire. I regret thatI have no statistical information as to the incidence ofsickness in this occupation.

WEDNESDAY, JULY 20TH

English-speaking Medical Unit in ChinaMr. WATKINS asked the Prime Minister whether he

could state the number of doctors and others comprisedin the English-speaking medical unit in China.-Mr.BUTLER, Under-Secretary for Foreign Affairs, replied :I understand that the English-speaking unit comprisestwo British subjects, Dr. Robertson, the leader of theunit, and Dr. Hawes ; an Austrian, Dr. Pollitzer ; and anumber of Chinese doctors and assistants.

Service Recruits Rejected as UnfitSir WILLIAM JENKINS asked the First Lord of the

Admiralty the percentage of recruits in the Navy for1938 that was rejected through being physically unfit.-Mr. DUFF COOPER replied : The total number of applicantsfor entry into the Royal Navy and Royal Marines forthe year ending March 31st, 1938, was 58,547, and thenumber rejected on medical and dental grounds was22,039-i.e., 37*64 per cent.

Sir WILLIAM JENKINS asked the Secretary of Statefor Air if he would give the number of applications tojoin the Air Force, the number of airmen, boys, pilots,and observers for each month in 1938, and what numberhad been rejected and the grounds upon which they wererejected in each category.-Sir KINGSLEY WOOD replied :The number of applications for entry during the periodJan. 1st to July 16th, 1938, in the various classes was asfollows : Airmen, 21,876; boys, 3092 ; pilots, 2803 ;observers, 188. During the same period the number ofrejections on medical grounds was : Airmen, 4476;boys, 320 ; pilots, 100 ; observers, 4.

Medical Services in the Gold CoastMr. SoRENSEN asked the Secretary of State for the

Colonies whether his attention had been called to the

recently published report of the Gold Coast medicaldepartment for 1936 in which the senior medical officerin the western provinces described the incidence of pul-monary tuberculosis in the mining area as abnormallyhigh and likely to assume the gravest importance in thenear future ; what steps were being taken to deal with thisquestion ; and whether the committee which this officer

suggested had yet been convened to consider the necessityof a complete investigation.-Mr. MALCOLM MACDoNALDreplied : The answer to the first part of the question isin the affirmative. A new hospital equipped with highpower X ray apparatus has been built at Tarkwa and twoofficers of the medical department, who are working inclose collaboration with the mines medical officers, havebeen posted to Tarkwa in order to conduct an investigationinto the incidence of tuberculosis and silicosis.

THURSDAY, JULY 21STProbation Officers and Medicompsychological

TrainingMr. SoRENSEN asked the Home Secretary whether

probation officers attached to matrimonial and domesticcourts in the Metropolitan police area were required tohave knowledge and training in the medico-psychologicalaspects of cases with which they might have to deal;and whether, in view of the importance of probationofficers possessing this qualification, he would offer someguidance to the courts respecting the selection and appoint-ment of probation officers.-Sir SAMUEL HOARE replied :The Central Training Board which has been set up on therecommendation of the Departmental Committee on theSocial Services in courts of summary jurisdiction is awareof the need for giving some guidance to probation officerson the matters referred to so as to enable them to decidewhen to seek expert assistance. The candidates trainedunder this scheme are available for appointment in Londonas well as in other probation areas in England and Wales.

Mr. SoRENSEN: May I take it that probation officersin the future will have this requisite knowledge, in viewof the very intimate nature of some of the matrimonialtangles that have to be solved ?

Sir S. HOARE : It is very difficult to say of anyonethat he will have the requisite knowledge for anything.We do try to provide that the candidates for the probationservice shall have enough knowledge to know when treat-ment of this kind is likely to be useful.

Institutional Accommodation for Maternity CasesDr. HADEN GUEST asked the Minister of Health the

number of local authorities which provided accommodationfor maternity cases in special institutions ; and whatwas the number of local authorities which only providedsuch accommodation in wards of institutions used also forother purposes.-Mr. ELLIOT replied : The numbers are139 and 88 respectively.

Dr. HADEN GUEST asked the Minister of Health thenumber of local authorities which provided accommodation

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for maternity cases through or in association with arrange-ments for public assistance ; and what was the number oflocal authorities which provided accommodation for

maternity cases apart from arrangements for publicassistance.-Mr. ELLIOT replied : The numbers are 95 and199 respectively.

Tuberculosis in WalesMr. JAMES GRIFFITHS asked the Minister of Health

when the report into the causes and the methods of

prevention of tuberculosis in Wales would be completed ;and whether it was intended to publish the report.-Mr. ELLIOT replied : I understand that the Committeehope to complete their report within the next few weeks,and I will consider the question of publication as soon asI receive it. ,

MONDAY, JULY 25TH

Disability PensionsMr. EDWARD WILLIAMS asked the Minister of Pensions

the number of persons in receipt of disability pensionsand the number granted each year to date since thetermination of the great war.-Mr. H. RAMSBOTHAMreplied : The number of disability pensioners on March 31st,1938, was approximately 434,700. The number of awardsmade each year was as follows :—

The Law of AbortionSir HENRY MoBRls-JoNBS asked the Minister of Health

whether his attention had been directed to the recentacquittal at the hands of the jury of Mr. Aleck WilliamBourne, who was charged, at the Old Bailey, with unlaw-fully using an instrument with intent to procure the mis-carriage of a girl of 14 years of age ; and whether, as thiswas a test case, he intended introducing legislation toclarify or amend the law dealing with such offences.-Mr. ELLIOT replied : Yes, Sir. My attention has beendrawn to this case. In reply to the second part of thequestion, I am not in a position to make any statementpending the issue of a report by the inter-departmentalcommittee which is investigating this and other mattersconcerning abortion.

Diphtheria Immunisation in ScotlandMr. MCGovERN asked the Secretary of State for Scotland

the number of immunised children who had suffered from

diphtheria since immunisation was started in Edinburghand the number of fatal cases in immunised children;and similar details for Glasgow, Dundee, and Aberdeen.-Mr. WEDDERBURN, Under-Secretary of State for Scotland,replied: In Edinburgh out of approximately 27,000children inoculated against diphtheria since 1924, 140have suffered from diphtheria and 3 have died. InAberdeen, out of approximately 4500 children so inoculatedsince September, 1936, 23 have suffered from diphtheriaand none has died. I regret that information relatingto Dundee and Glasgow is not available.

Mentally Defective Children and CorporalPunishment

Mr. RIDLEY asked the Parliamentary Secretary to theBoard of Education whether his attention had been drawnto a recommendation of the education committee of the

Liverpool City Council to authorise corporal punishmentfor mentally defective children under the control of theeducation committee ; and whether he proposed to takeany action in the matter.-Mr. KENNETH LINDSAY replied :The Board have received no communication from theLiverpool local education authority on this subject, butI have seen press reports of the recommendation inquestion. The Board’s view is that the use of corporalpunishment in a special school for mentally defectivechildren is to be deprecated and should only be resortedto in exceptional circumstances.

The Colonial Medical ServiceSir ERNEST GRAHAM-LITTLE asked the Secretary of

State for the Colonies (1) whether he was aware that,whereas the number of persons per qualified doctor in

Great Britain was approximately 1000, in some parts ofthe British Colonies the proportion was as high as 100,000to 1 ; and whether, in these circumstances, he had underconsideration any plans for increasing the personnel ofthe Colonial Medical Service; (2) what was the presentposition with regard to obtaining recruits for the ColonialMedical Service ; and whether the supply substantiallyexceeded the demand or vice versa ; and (3) if he could statethe present approximate number of persons per qualifieddoctor in each of the principal British Colonies.-Mr. MALCOLM MACDONALD replied : The ultimate objectiveat which the Colonial Office is aiming, in developing themedical services of the colonial dependencies, is to bring thebest modern medical resources within the reach of the. whole of the peoples of the dependencies. It would beimpossible in most cases to give accurate figures regardingthe proportion of qualified medical practitioners to thepopulation in each dependency without reference to theColonial Governments. Nor indeed would such figuresgive a reliable picture of the position, since a singledependency may contain areas at very different stages ofdevelopment. There is no doubt that, in some areas,we are very far from having attained the objective whichI have defined. On the other hand, there are manyplaces where ample medical facilities, both public andprivate, are available.The public health services of the dependencies are

being continually developed, as funds and circumstancespermit, but, having regard to the large areas and popula.tions to be covered, it is clear that the eventual attain-ment of the objective must depend not on an indefiniteincrease in the number of imported medical officers buton the progressive training of medical staffs drawn fromthe local inhabitants. The policy of training such staffsis being actively pursued wherever possible.In the meantime, the responsibility for the education

of the local populations in the many aspects of preventivemedicine, for the organisation of the public health services,and for the treatment of disease, rests principally upon themembers of the Colonial Medical Service, and there canbe no doubt that for many years to come that service willcontinue to call for a steady flow of recruits of the bestpersonal and professional type from this country. The

present state of recruitment for the service is satisfactory,and it cannot be said that the demand substantiallyexceeds the supply of fully suitable candidates. Therehas been some recent difficulty in recruiting for service inthe West African dependencies, but I have no reason tosuppose that this difficulty is other than temporary.

APPOINTMENT OF REFUGEE DOCTORS

Sir ERNEST GRAHAM-LITTLE asked the Secretary ofState for the Colonies whether, in view of the large numberof able and qualified doctors who were at present refugeesfrom Greater Germany, he would consider the possibilityof appointing some of them to subsidiary positions in theColonial Medical Service.-Mr. MALCOLM MACDONALDreplied : It is not quite clear what posts my hon. friendhas in mind. Admission to the Unified Colonial MedicalService is necessarily confined, broadly speaking, to personsof British nationality, though a person who is born oris ordinarily resident in a colony, protectorate, or mandatedterritory is not excluded. If the reference is to minor

posts in the local health services, it has been the settledpolicy for some time to train the inhabitants of the variousdependencies to undertake this type of work, and eventuallyto take over the higher branches of medical and publichealth work, as they become qualified to do so. As at

present advised I do not think it is practicable to envisageany general scheme by which foreign medical practitionerscould be incorporated in the State medical services of thecolonial dependencies.

Ammonia Fumes at Ice-cream FactoryMr. THORNE asked the Home Secretary if he could now

give any information in connexion with the escape ofammonia fumes at the Eldorado ice-cream factory,Stamford-street, S.E., on July 12th, and how many personswere taken to the hospitals with severe burns ; and ifhe could say whether the firm were paying compensationto the injured people.-Sir SAMUEL HOARE replied : The

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coroner’s jury found that the pressure in the machinefrom which the ammonia escaped was excessive due toan error in manipulation ; and I understand the connec-tions on the machine are being altered in the light of whatoccurred. About 60 persons were taken to hospital atthe time, of whom 15 were detained. I have no informa-tion as to the payment of compensation, but I understandthat the firm have paid those employees who were

incapacitated by the accident a full week’s wages for eachof the last two weeks.

TUESDAY, JULY 26TH

New Drugs for Malaria TreatmentMr. DAVID ADAMS asked the Secretary of State for War

what proportion of the new drugs now being employed incombating malaria in the British tropical empire, especiallyatebrin and plasmoquine, came from countries outside theBritish Empire ; and whether stores of these drugs weremaintained with a view to ensuring that, in the event ofwar, tropical territories and the British Army would besafeguarded from disease epidemics.-Mr. HORE-BELISHAreplied : I understand that there is no technical difficultyin making these drugs which do come from outside theBritish Empire. Stocks are held and quantities are

reviewed from time to time. The question whether stocksare maintained for use by the civil populations of tropicalterritories is one for the governments of those territories.

Mr. DAVID ADAMS asked the President of the Board ofTrade whether, as the high price of the new drugs usedagainst malaria in the British tropical empire was animportant factor in denying their benefits to native

populations, arrangements would be made for their

manufacture, under licence, in this country, with a viewto increasing supply and materially reducing their price.—Mr. OLIVER STANLEY replied : Section 38A of thePatents and Designs Acts, 1907 to 1932, already providesthat the Comptroller-General of Patents, unless he seesgood reason to the contrary, shall grant to any personapplying for it a licence to use in the United Kingdomany process employed in the production of a medicinewhich is the subject of a patent. The section furtherprovides that in settling the terms of the licence the

Comptroller shall have regard to the desirability of makingthe medicine available to the public at the lowest possibleprice consistent with a due reward to the inventor.

Medical and Health Services in Trinidad

Mr. CREECH JONES asked the Secretary of State forthe Colonies whether, since the report of the Commissionto Trinidad, steps had been taken to implement therecommendations ; and what progress had been made.-Mr. MALCOLM MACDONALD replied : Considerable progresshas been made towards implementing the recommenda-tions of the Trinidad Commission. Under the heading"Medical and Health Services," a draft ordnance hasbeen prepared to transfer the executive functions of theCentral Board of Health to the Director of MedicalServices. As regards housing, I understand that theGovernor contemplates the establishment of a town-

planning and housing authority, which would carry out afar-reaching plan of slum clearance. Legislation is beingdrafted for this purpose.

Nurses’ Hours

Mr. BULL asked the Minister of Health whether his

department had considered the working of the 98-hourfortnight for nursing staffs in general, with specialreference to the London County Council scheme ; if hewas aware that aspects of this scheme, so far as nightduty was concerned, were resented by the staff ; andwhether he would consider the possibility of evolving someagreed system of hours affecting all nurses which localauthorities could introduce without essential modification.—Mr. ELLIOT replied : My attention has been drawn tothe decision of the London County Council to introduce a96-hour working fortnight for nurses in their employment,but I am unable to make any general statement on thissubject pending the issue of a report by the Inter-

Departmental Committee which is considering the con-ditions of service of nurses under the chairmanship ofLord Athlone.

PUBLIC HEALTH

New L.C.C. Hospital at TootingTHE increasing demand for treatment in L.C.C.

hospitals, and especially the pressure upon the acutegeneral hospitals south of the Thames, has led thehospitals and medical services committee of theCouncil to recommend the erection of a new hospitalon a site of 14 acres within the curtilage of thepresent St. Benedict’s Hospital at Tooting. Thescheme provides for four ward blocks with operatingtheatres, radiological, massage, and out-patients’departments, together with a maternity hospital andantenatal clinic, and a nurses’ home and trainingschool. Plastic, thoracic, and neuro-surgical unitswill be provided and another unit which will at firstbe allocated to rheumatic cases. The ward accom-modation will be so designed as to be suitable forany type of patient. Five operating theatres will becompleted and a sixth built in skeleton form. A grouplaboratory, to serve the needs of the locality as wellas of the hospital itself, is to be part of the scheme.The additional new accommodation will be 600 beds.The wards in the present hospital, containing 318beds, will be used for patients suffering from chronicailments. The cost is estimated at nearly 825,000.

Nurses’ Hostels

The same committee expressed the view that theadministration of nurses’ homes should, as far as

possible, be placed on a basis comparable with thatof hostels for students and post-graduate studentsand they accordingly propose, as an experiment, toappoint a warden and an assistant warden to takecharge of the new nurses’ home which is being erectedat Hammersmith Hospital. A nurses’ committeewill be established, with the warden as president, todiscuss and arrange social activities and matters ofstaff welfare. The committee recommend expendi-ture of 10,000 for modernising the equipment atfourteen nurses’ homes.

MEDICAL RESEARCH COUNCIL.-The Council inviteapplications for a third series of studentships and fellowshipsin clinical science and experimental pathology intended toencourage young British medical graduates of special abilityand original mind to become investigators in branches ofmedical science which are concerned directly with diseaseas it occurs in human beings. Post-graduate studentshipsare offered for medical graduates who have already heldhouse appointments and are strongly inclined to a careerin clinical science or experimental pathology. Eachselected student will receive a grant at the rate of E200per annum, during a period not exceeding twelve months,for personal maintenance while undertaking approvedcourses of study in this country to advance his trainingin methods of research. This study may include modernlanguages and advanced physiological, pathological, andspecial clinical work under recognised teachers ; but thecourse may not include studies of which the purpose is toenable the student to pass further examinations. TheCouncil also offer research fellowships for candidates ofsimilar qualifications who have already had some experiencein the use of research methods. Each fellowship will betenable for one year at the ordinary value of 250 perannum, and will be renewable in approved instances at therate of z300 per annum for a second year. These fellow-ships are intended as probationary appointments forresearch in clinical science or experimental pathologyunder suitable direction in this country. Research

expenses may be provided in addition to stipend. Applica-tions should be lodged with the secretary of the Council,38, Old Queen-street, London, S.W.I, before Oct. 1st.