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this system ?-Mr. VOSPER: The hon. Member said that therelatives do not know, but it may be that they would preferto use the one-certificate procedure. In any case, the medicalsuperintendent also examines the patient. In consideringwhether any action should be taken on the administrative sideof the proposals made by the Royal Commission, I will lookat this point. _

Private Patients

Mr. JOHN HALL asked the Minister if he would now amendthe National Health Service Act, 1946, so. as to allow privatepatients to utilise the other facilities provided by the Act ;and so as to allow the provision to all private patients freeof charge, other than the prescription charge, a selected list ofpreventive and life-saving drugs and drugs designed for thealleviation and treatment of lethal diseases.-Mr. VOSPERreplied : The private patients of general practitioners havefull access to all the facilities of the National Health Service,other than the supply of drugs as part of general medicalservices. The provision of a selected list of drugs for privatepatients would raise many problems of great difficulty. Mypredecessor invited the British Medical Association to discussthis matter with the department, and those discussions areabout to take place.

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Cost of PrescriptionsMr. R. W. SORENSEN asked the Minister if he had now

reviewed the effects of increased prescription charges ; andwhat information he had in respect of the decrease in thenumber of prescriptions and their cost.-Mr. VospER replied :Examination of a sample of prescriptions dispensed inDecember has shown that the increase in average cost of about5d. was probably due almost entirely to doctors prescribinglarger quantities. The trend of costs since December suggeststhat this has continued. The number of prescriptions hasalso been much lower than a year ago, but this must be due

partly to the low incidence of sickness. Mr. SORENSEN :Could the Minister indicate to what extent the anticipationof these increases has been fulfilled financially ?-Mr. VOSPER :So far as I can gather at present, the anticipated saving andthe actual saving will be about the same. Mr. ARTHURBLENKINSOP : Does not the Minister recognise the very realdanger of waste involved in prescribing larger quantities,which he himself is encouraging ?-Mr. VospER : I cannot

accept that, which suggests that the general practitioner isnot competent to exercise discretion. The ordering of largerquantities is not wasteful if there is a continuing need. Itdoes help people with chronic or continuing illness. That, Ibelieve, is what is happening at the moment. Dr. SUMMER-SKILL : Would the Minister say it is an overstatement to saythat most people have in their bathroom cupboards unusedtablets, lotions, and ointments which have cost the country agreat amount of money ?-Mr. VospER: I have seen allega-tions to that effect, but I have no evidence that it is true.

Radiostrontium in Bone

Mr. D. HowELL asked the Prime Minister what advice hehad received from his medical and scientific advisers aboutthe’fact contained in the report of the Atomic Energy ResearchSurvey that the bones of a stillborn child in Carlisle con-tained about seven times as much radiostrontium as that foundin older people examined at about the same time.

Mr. MACMILLAN replied that the heavier concentration ofradiostrontium in the bones of children compared with adults

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was fully considered in the M.R.C. report. It was for this andother cognate reasons that the maximum permissible level ofradiostrontium in the human skeleton accepted by the Inter-national Commission on Radiological Protection was regardedas being too high for the general population. The MedicalResearch Council considered that the maximum concentrationof radiostrontium in the bones of the general population,with its proportion of young children, should not be greaterthan a tenth of the maximum permissible level for adultsin special occupations.

Mr. HOWELL asked whether it was not disturbing to findsuch quantities of strontium in a baby that has neitherbreathed nor fed ? Because the M.R.C. report showed thatbabies up to one year of age already had 1-2 units of strontium,and because of the growing medical and scientific perturbationabout this, would not the Prime Minister refer this matterspecifically to his advisers.

Mr. MACMILLAN pointed out that, in the case mentionedthe figure was 0-45 unit. That was still a hundred times less

than the average allowable level of the amount of radio-strontium in the bones of both children and adults.

Expenditure on Social ServicesMr. G. P. STEVENS asked the Chancellor of the Exchequer

how the increase ill expenditure on the social services by thecentral government, the National Insurance Fund, and thelocal authorities between 1951-52 and 1956-57 compared withthe rise in retail prices during the same period.-Mr. J. ENOCHPowELL, the financial secretary to the Treasury, replied:Between 1951-52 and 1956-57 expenditure on the socialservices increased by 38% and retail prices by about 23%.Mr. STEVENS : I ask my hon. Friend whether he agrees that,despite economic difficulties in the past few years, there hasbeen a very substantial advance in the provision of real socialservices for the people ?-Mr. POWELL : Yes, Sir. Mr. ARTHURBLENKiNSOF : Does not the hon. Gentleman also recognisethat a very large part of any increased expenditure is in factdue to rises in prices, and that the real increases in the valueof the services are extremely limited ?-Mr. POWELL: Thatdoes not detract from the fact that there has been a substantialincrease in real terms over the period-about 12½%.

Mental Illness outside the HospitalIn England and Wales the attendances at psychiatric out-

patient clinics were 523,000 in 1950 and 714,000 in 1955. Thenumber of domiciliary psychiatric visits in 1950 was 5600and in 1955 11,200.

Some Hospital FiguresIn England and Wales, altogether 474,000 patients were on

waiting-lists in 1954, and 455,000 in 1955. The provisionalfigure for 1956 is 430,000. Though there has been an improve-ment in the E.N.T. section, that and general surgery still havethe longest waiting-lists.The annual number of patients per allocated bed in hospitals,

other than mental hospitals, for 1954 was 13-1; for 1955,13-2;for 1956, 13.4.

1. Lancet, June 1, 1957, p. 1139.

Public Health

Influenza in the Far East

IN addition to the countries which we mentioned lastweek, outbreaks of influenza have now been reportedfrom India (Madras and Bombay), Cambodia, Indonesia,Sarawak, and North Borneo. Epidemics continue to bewidespread, but the disease itself has remained mild. Ina ship recently arrived in Rotterdam from the Far East30 % of those aboard had had influenza. By the time theship reached Rotterdam the outbreak appeared to havedied out. So far there is no news of outbreaks in theNorthern hemisphere, where epidemic influenza usuallybreaks out in the winter months.