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Volume 322: debated on Tuesday 13 April 1937

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Civil Estimates And Estimates For Revenue Departments, 1937

Order for Committee read.

Motion made, and Question proposed, That Mr. Speaker do now leave the Chair."—[ Captain Margesson.]

Voluntary Sterilisation

4.13 p.m.

I beg to move, to leave out from the word "That" to the end of the Question, and to add instead thereof:

"in the opinion of this House, the Government should give further consideration to the potentialities of voluntary sterilisation for hereditary defectives in accordance with the unanimous recommendations of the Departmental Committee that reported to the Minister of Health on 8th January, 1934."
I think it will be generally agreed that there is a growing anxiety in this country about the problems connected with the population in general and the health of the individual in particular. We had in this House last week a full day's Debate on physical training. There was also recently a Debate on the general problem of nutrition. I, therefore, make no apology for inviting the House to consider one particular aspect of possible benefit to the health of the nation as a whole. I would like to start by quoting, from the report of the Committee on Scottish Health Services, a paragraph which puts the whole matter in a nutshell. I give the quotation because this was a very strong committee and the most recent Health Committee to report. It says:
"In considering what measures should be taken to improve the health of the people, we have to take into account at the outset the question of heredity. Physical and mental capacity has a basis in inheritance, and some people, therefore, because of their hereditary constitution, will be less fit, physically and mentally, than others, no matter what is done by way of medical care and improvement of environmental and other conditions."
There is a slight disparity between the Amendment in my name which is on the Order Paper and the recommendations contained in the report of the Departmental Committee commonly referred to as the Brock Report. That is due to the fact that it would be out of order for me this afternoon to propose legislation designed to implement the recommendations in the report. Therefore, all that I can, and that I intend to do is to invite the Minister to give his attention to the need for further research into the problem of genetics. The fact that my Amendment is not completely in agreement with the recommendations is not because I disagree with any of them, or would in any respect depart from them but is merely a matter of technical form.

I believe that in this matter in which no party issues are involved, for the problem of sterilisation cuts across all parties. Nor is there any controversy between what I may broadly call nature and nurture.

The first point I will endeavour to make is that mental deficiency, which covers the largest number of people concerned, has generally, in varying degrees, a basis in heredity. There is a great deal of published evidence on this matter, some of it reliable and much of it unreliable, but I will refer to a specific piece of accurate research which is quoted in the report of the Departmental Committee. In the case of the Colchester inquiry it was shown, in a considerable number of cases examined, that heredity played the greater part or the lesser part in the predisposition to mental deficiency in approximately 91 per cent. of the cases. In addition to mental deficiency, there are other forms of hereditary disability, notably some forms of blindness, which are much more directly hereditary even than the average form of mental deficiency.

I do not intend to weary the House by going into great detail, because a very comprehensive survey of this most interesting and important subject was made and published in the report of the Departmental Committee, commonly known as the Brock Committee. That report is perhaps the most interesting Blue Book that has ever been published. It is full of original research and is very readable, and I hope that all hon. Members who are interested in social problems will read it. One finds that most of the opposition to the idea of sterilisation comes from people who have not read that report. There are two points in the report to which I will refer as a basis for my arguments, the first being the extent of the problem. The Brock Committee agreed with the findings of a previous committee—the Wood Committee, which published a report in 1929—that there were in England and Wales about 300,000 defectives, and they gave it as their opinion that of that number approximately 200,000, that is to say, two-thirds, were fit for community life, their degree of deficiency or defect not being high enough to justify their being retained in any form of institution. At the present time, of course, a very much smaller proportion than one-third is in fact in institutions or under care.

I will give one other instance of the extent of the problem of deficiency. On 1st January, 1936, the London County Council published a report containing the statement that the London County Council Hospitals Committee was responsible for the care of 27,730 persons of both sexes. In an earlier report they stated that 30,000 beds were occupied by deficiency cases. They stated further, in the 1936 report, that since 1920 there had been an average annual increase of 603, and that during the next few years they anticipated a net annual average increase of 560 in the number of persons for whom accommodation would have to be provided.

Is the hon. and gallant Member referring to those certified under the Lunacy Act as well as those certified under the Mental Deficiency Act?

I am referring to the report of 1st January, 1936. I do not wish to mislead hon. Members in any way. It should be remembered that the increase recently is partly due to the growth of population of the London County Council area, which should be taken into account in comparing it with less rapid increases previously. I am not arguing as to the increase that is taking place, but am stating the problem that has to be faced. The expenditure on such cases by the London County Council during the last financial year was ¤1,698,633. As to the cost of deficiency, I have frequently tried during the last few years to obtain figures showing what is the burden of mental deficiency and certain forms of physical deficiency, but it is impossible to arrive at even an approximately accurate figure, because the expenditure comes under so many votes and under so many departments. It comes under national expenditure and local expenditure, under the Ministry of Health and the Board of Education, in the expenses of voluntary hospitals, in charities and in relief. All one can say is that there is an enormous total expenditure in connection with this problem.

I do not suggest for one moment that if sterilisation were legalised it would be an economy. In the long run there might be an economy, but it is not from the point of view of economy that the Brock Committee recommended sterilisation, or that anyone else should consider the problem. If sterilisation were legalised, the immediate effect would be small. All I am suggesting is that there is an enormous expenditure which, if any part of it could be diverted to other channels and other social services, would benefit the community as a whole. Any hon. Member who is interested in this subject and who has not been over a mental hospital ought to do so. He would then get an extraordinarily vivid picture of the great misery which afflicts so many people. The hospitals are extraordinarily well and very sympathetically run, and the treatment given to these unfortunate people is splendid; but in going over one of these hospitals one sees the number of unfortunate people who are condemned, largely through hereditary causes, not only to lead miserable lives themselves, but to be a source of great misery to their families.

I would like now to refer briefly to the first three recommendations of the Brock Committee. They recommended that, subject to certain safeguards which they proposed, voluntary sterilisation should be legalised in certain cases. In the body of the report there are most powerful arguments as to why sterilisation must be voluntary. The cases in which it is recommended are as follow:
"Firstly, a person who is mentally defective or who has suffered from mental disorder;
Secondly, a person who suffers from, or is believed to be a carrier of, a grave physical disability which has been shown to be transmissible; and
Thirdly, a person who is believed to he likely to transmit mental disorder or defects."
They recommended that before sterilisation is sanctioned in the case of a mental defective, care should be taken to test his or her fitness for community life, and that such a person should receive adequate supervision. There is a statutory body, supported by a great many devoted and voluntary workers, which does an immense amount of valuable work, and which does not receive half enough credit for what it does. It is the Central Association for Mental Welfare. It is a body, mainly on a voluntary basis, which looks after persons who have been in institutions and have gone back to their homes, or persons who need assistance and help. That body has vast experience and it actively supports the suggestion that sterilisation should be legalised. Its members know more about the condition of defectives, probably, than any other body of persons in this country, and they have pointed out that if the fear of parenthood could be removed, it would greatly ease the mental condition of many defectives. They have pointed out that there are persons in the community who are mentally unstable but in many respects perfectly normal, and who know that their unfortunate condition is due to their unhappy inheritance. Those persons often marry, and are capable of conducting a home, but if and when a child arrives, the extra strain imposed by the burden of parenthood may throw them off their balance again.

Another point in opposition to this proposal which has been raised before, and will I am sure be raised this afternoon by the hon. Gentleman opposite—I think it is one of the arguments which he and his friends always use when there is any attempt to make an advance in these matters—is that the existence in the community of persons who have been sterilised would lead to a lowering of the standard of morality. That point was examined, and answered by the Brock Committee. It has been examined and reported upon elsewhere, and if the hon. Member opposite or any of his hon. Friends raise that point this afternoon, I hope they will produce some evidence in support of it. So far, I have not heard any evidence adduced in support of that general statement.

There are one or two other considerations which I wish to advance. There is still a great deal of misunderstanding about the nature of the sterilising operation. If there are any doctors among hon. Members who are here I think they will confirm the statement that the operation is very simple, and in the case of a male trivial. In the case of a male it is wholly unattended by risk and in the case of a female it is virtually unattended by risk. It has no effect whatever upon the normal ordinary life and health and capacity of the individual. It has nothing in common with any of the operations used for the removal of any gland. It in no way affects sex life or sexual secretions. The only effect is that the sexual act when performed does not result in fertilisation. It has no other effect.

Another argument frequently used against the recommendation of the committee that sterilisation should be legalised is that a mentally defective person cannot have full volition. That argument, again, was dealt with extensively in the report, but as some people have not read the report I may be allowed to refer to it. I have always been reminded in this controversy of the comparison with a Ministry of Defence. Most people who interest themselves in the co-ordination of the Services, at first glance become protagonists of the idea of a Ministry of Defence, but when they go into the matter they become firm opponents of a Ministry of Defence and see that co-ordination can be achieved better in other ways. So sometimes people when they first consider sterilisation get the idea that sterilisation of the unfit should be compulsory, but when they examine the facts and figures and go into the recommendations of the committee, they are left in no doubt about the fact that sterilisation can only be, and must only be, voluntary.

It should be remembered that sexual sterilisation is legal to-day in cases of operations for the health of the individual, that is to say that sterilisation for health reasons as opposed to eugenic sterilisation is perfectly legal. Let it not be forgotten that every year hundreds of people in this country have such operations performed either by private practitioners or in general hospitals for reasons of their own health. Most frequently this occurs with women who are likely to be endangered by child-bearing and are voluntarily sterilised, and that operation is legal. Thus we have the curious anomaly that whereas it is legal for a man or a woman to be sterilised, even in a public general hospital if his or her own life is in danger, it is illegal for such a person to be sterilised in the interests of posterity—or it is probably illegal, because it is not settled as a matter of case law or statute law. That is a curious and accidental anomaly of the law.

As I said earlier, of the 300,000 defectives estimated to be in England and Wales, 200,000 at least conduct their lives in the ordinary way as members of the community and for all other purposes save this are held to have volition. Their volition, however, is sometimes denied in the arguments which are put forward on this particular score. Persons who have suffered from, and recovered from, some mental disorder are held to have complete volition, and I would make just this distinction between mental disorder and mental defect. Mental disorder implies that a person is in possession of full mental capacity, but suffers from a disturbance of the brain, whereas mental deficiency indicates that the person is actually short in some degree of capacity. One class of person can in case of recovery exercise full mental powers, whereas the other can never rise above a certain level. But as I say those who have recovered from mental disorder are held to have complete volition in other respects save this, and research tends to show that theirs is the most hereditary type of mental trouble. Then you have people who have disabilities, such as certain forms of blindness which are hereditary. Is it to be said that they have not complete volition? There are also carriers, persons who being themselves sound, come from stocks so tainted that it can be said with varying degrees of assurance, from moral certainty down to possibility, that their progeny will suffer from some congenital trouble. It is right to remind the House that, in the last few years, since the medical profession and a large section of the public learned how simple, safe and effective the operation was, many people are to-day upon eugenic grounds having themselves sterilised. There are no figures available, but it is well known that many people are having themselves sterilised on eugenic grounds. [An HON. MEMBER: "Where?"] If the hon. Member makes inquiries from his doctor, he will find that it is being done.

There is little doubt that there is a general tendency for mental and physical defects to spread among the population. That is only to be expected when it is remembered that our social services, of which we are rightly so proud, have had the effect among others of preserving the life of a great many of the weaker stocks which in earlier and less happy times would have been killed off by the ruthless pruning of nature. Before 1875 there was a birth-rate of between 31 per cent. and 38 per cent., but this high birth-rate was accompanied by a very high death-rate. Then, came the development of medical science, and improvements in sanitation, housing and nutrition. The social services were expanded. All these alleviating and ameliorating factors operated discrimination, and to-day many children are born and grow up who, in the lifetime of many of us, and certainly in the lifetime of our parents, would have been killed off by nature's hard hand. There is one point by which the Brock Committee was very much impressed, and by which anybody who has encountered it must be impressed, and that is the position of the unfortunate normal child of a defective parent. It is perhaps one of the most telling arguments in favour of sterilisation. Just think of the position of such a child. I think I see a light brightening in the eyes of my hon. Friend opposite, and I hasten to add that there is no inconsistency in my remarks at this stage, for the reason that some proportion of mental deficiency is due to environmental causes usually pre-natal infection. At present such persons, who may be described as borderline cases, may marry and have children. I ask hon. Members to consider the life of a child who is being brought up by a defective parent, though defectives may be and often are extremely good and affectionate parents. This point has been emphasised by the Royal Society for the Prevention of Cruelty to Children.

One of the obstacles to what many of us believe would be a desirable reform arises from the opposition of the Roman Catholic Church, and I wish to say a few words on that head. I yield to nobody in this House in my respect and admiration for the most powerful, and best organised and perhaps greatest of the Christian churches. I would not willingly say anything which would give offence to any Roman Catholic. But their attitude in this matter is one which is not always easy to appreciate. I have studied it for many years. I have tried to inform myself of their position, and to appreciate what it is. I have discussed this matter with many Roman Catholic priests during the last 15 or more years. I have read their literature on the subject very carefully, and tried to see their point of view. In a study of this matter, one thing has impressed itself upon me, and that is the extent to which the attitude of the spokesmen of the Church of Rome has been modified. Fifteen years ago the whole question of sterilisation was brushed aside as so improper, so unthinkable and so impracticable as to be unworthy of argument. Public opinion has moved a long way since then, and with it that great Church, which for generations has moulded and directed so much of human thought but which, I believe, has never in the long run stood across the path of progress, has also modified its position.

Four or five years ago I was very kindly put in touch with the leading Papal authority in this country. I went to see him in the country, where he gave me a most excellent luncheon and put certain points to me. My first and most important impression was that the objection of the Roman Catholic Church to sterilisation is a matter of discipline and not of dogma. There is no reason why, if the Papal authorities decided to do so, they should not with perfect consistency change their attitude on the subject. As I say, it is a matter of discipline only and not of dogma. I think it is really rather a queer turn of the wheel of fortune that the main opposition to the idea of sterilisation should come from that great Church one of whose most distinguished sons, the Abbe Mendel was, jointly with Darwin, the founder of the modern science of genetics, and the main inspiration of modern thought upon heredity. The short answer to that objection—I think I see my hon. Friend opposite taking notes; perhaps he is going to speak and perhaps he will address himself to this particular point—is that since no responsible authority in this country has ever advocated sterilisation being anything but voluntary, and since, therefore, there is no possible suggestion that it could be inflicted on anyone, why should they, so Far as we who are not Roman Catholics are concerned, deny to us a form of relief which we desire?

One other point which I should like to raise is the political aspect of this subject. Members of Parliament are of necessity timid creatures. If they sit for seats with a very small majority, like I do, they tend to become more timid still; but this is a subject on which no hon. Member need be in the least afraid. It so happens that the very last speech I made in my constituency before the last Election—it was most widely reported,. I have never been so widely reported before and never shall again—was a speech advocating voluntary sterilisation. That was on the eve of the General Election. I did not know the Election was coming, but it came. Not one word of complaint of any sort or kind did I have on that score. I have spoken on this subject in a good many parts of this country, in Scotland, and England, and in the East End of London among the very poor and in the West End among the supposedly richer classes. There is not only much less opposition to the idea in the country than is supposed, but particularly among the poorer classes, who are the people who suffer most from the proximity of defectives and comprise the class which cannot afford the use of nursing homes, there is a fervent demand for the legislation of sterilisation.

The present position is class legislation. Those who are well off can get themselves sterilised if they want to, and those who are not well off cannot do so. There comes in again the question of volition. I have had people come to me and ask how they can possibly get themselves sterilised. They have produced a history and a story which, to my mind, abundantly justified their demand. One woman had five children, three were defective and one was too young to yet know. She herself was a high-grade defective and a most worthy person up to a point, but she had a bad family heredity. She was the wife of an agricultural labourer, and I had taken the matter up with the county council. But no, they could do nothing, because it was not possible for the local practitioner to say that the woman's life would be in danger by child labour; so she could not be sterilised. If the local practitioner had been able to say that her life would be endangered, she could have been sterilised, That is the present position of the law. Hon. Members should not be deceived by a certain taboo which still operates in this matter. Ten or 15 years years ago it was impossible to get the Press to refer to sterilisation at all. Now that taboo is dying down, but it still occasionaly persists, I observe, in "The Times." Only yesterday "The Times," referring to the business in the House this week, said that, "Tomorrow (this day) will be devoted to a discussion of matters arising from the Estimates for the Civil and Revenue Departments." That taboo is breaking down, and Members must not be deceived by the fact that for various reasons the demand for sterilisation is relatively unexpressed.

I will inflict on the House a brief note of some of the more important bodies which have recently signified their support of the principle of voluntary sterilisation. They include the Royal College of Physicians, the Royal College of Surgeons, the Society of Medical Officers of Health, whose journal has been very good in this matter, the Mental Hospitals Association, the Women's Public Health Officer's Association, the County Councils Association, the Association of Municipal Corporations, and many others. As I say, there are many more, and especially among societies for the welfare of the blind there has been a large number of resolutions on this subject. Among other outside bodies I would refer to the National Conference of Women at Edinburgh, in October, 1934, which passed a resolution by a very large majority. Last, but by no means least, the National Conference of Labour Women at Swansea, in May, 1936, emphatically passed a resolution in favour of voluntary sterilisation. That I who sit on this side of the House, should find myself cordially agreeing with the resolution of a National Labour Conference is a remarkable thing.

I very much hope that the Minister of Health will be able to give us some statement as to what is being done about the research that was recommended by the Brock Committee, and incidentally by other bodies, such as by the Departmental Committee on Scottish Health Services of 1936. I should like to remind the right hon. Gentleman that there are now many countries abroad which have on their Statute Books and in practice sterilisation laws. Those countries include not only Germany but the Scandinavian countries and some British Dominions. I hope that the Ministry of Health is keeping itself informed as to the progress of sterilisation in those countries. Those of us who advocate this do not for a moment suggest that it is going to be a universal panacea or a substitute for other efforts. All we say and believe is that voluntary sterilisation for those who want it, administered under adequate safeguards—such safeguards as are recommended by the Brock Committee—would be a more important and very necessary weapon in the armoury of preventive medicine.

4.54 p.m.

I beg to second the Amendment.

The hon. and gallant Member has made so good a case in his extremely interesting speech that I do not want to take away from the impression he has made by labouring the case at any length. All I would say is that though I have come into the field very much later than he has done, the more I have studied the question the more convinced I have become that something ought to be done without too long a delay. As to what, it is not for us this afternoon to suggest. It was quite natural, I think, within the first year or two after the publication of the Brock Report, that anyone approaching the Minister of Health on the matter should be told to go outside to make converts, to provide their appeal, to have it well explained to the working classes who were concerned, and to see what action they might provide. That was done. But when the matter was raised only last year, when almost everything of that kind that could be done had been done, it was just a bit disappointing to be told again that we must still work away at public opinion and get Resolutions passed. Whatever we may hear to-day, and there are things to be said, of course, on both sides of the question, I rather hope that we shall not be told that now, having got every possible organisation and society which we can have and which looks at these matters as matters of public health, in favour of this scheme, we are expected to do further missionary work. That would be only boring to the working classes, who have already considered this matter and made up their minds, and it would be rather vexatious to those who have worked very hard in bringing these questions properly before responsible bodies.

I do not want to read the long list of bodies which I have here, and which I can give to any hon. Member who is interested. I want to draw attention only to this in connection with the bodies in favour of this reform, that they are not only technical bodies connected with health or with mental deficiency, who are really strongly in favour of some action being taken, but ordinary common-sense bodies like the County Councils Association and—taking a very different type—the Women's Co-operative Guild, a body for which I have had a great deal of respect ever since my brother founded it, and the Church of England Temperance Society. Of those bodies the only one with which I am personally connected is the County Councils Association, and I should like to dispel a suspicion which I have heard mentioned by those who argue against the case I am trying to make, namely, that the minds of the representatives of local government bodies are influenced by the belief that if this change were to be brought about they would be saved from doing a considerable part of what is now their duty under the Mental Deficiency Acts, and so the ratepayers' money would be saved. I agree with my hon. and gallant Friend that that is not the attitude from which the matter is being regarded.

As I see it the position is quite different. There are many people falling under the custody of local authorities, suffering from various degrees of mental incapacity, who must always be kept under restraint, and I fear that the way in which some of those persons are treated by some local authorities leaves a good deal to be desired. I saw some terrible quotations from a recent report with regard to the treatment of the insane which were horrible to read. Although that is not the matter which we are discussing to-day, it needs a good deal of attention. But the development in the work of the local authorities which has been most striking in recent years, under the influence largely of the Board of Control, has been on its remedial and education and training side. Of course that training cannot be given to persons who are wholly irresponsible. These institutions very largely specialize on this remedial treatment. Such persons are fitted to take, not a full place but some place in ordinary human society, and they are taught suitable occupations, which give them an interest in life.

There are now many in those institutions who have been benefited in that way, and who might be allowed to go back and take such place as they can in civil society but for the danger that they will become mothers or fathers of defective children. They have been taught all they are capable of learning, and they have parents or other relations who have that splendid thing, keen family affection for them, in spite of their defects, and who want them back at home and could make something of a home for them; and they are in many cases of the class who know thoroughly well, although their minds are to some extent defective, what it would entail if they were to ask for voluntary sterilisation, and are therefore capable of asking for it. If they could go back, as they could, under those conditions, the effect on the local authorities would be this. There would be nothing in the nature of closing down institutions in which they now have to be kept, but the work of those institutions in training those who are trainable could be extended because, so far as my information goes—and I have made a considerable number of inquiries—there are always people on the waiting list who would be willing to go into institutions for training, who now cannot be accommodated, but for whom training and remedial work is really extremely desirable so that the more modern methods of remedial treatment may really be applied to them. The point I make is that the desire of local authorities, as shown by careful consideration and approval of this reform by organisations like the County Councils Association, is not a desire for economy, but a desire for greater efficiency in the work that they do.

Now I intend to confine myself almost entirely to one other subject. I wish to make a point which is implicit in the whole campaign for voluntary sterilisation on the lines of the Brock Report, namely, that this campaign is not only, as it has been represented to be, the thin end of the wedge towards compulsory sterilisation; it is in fact the very reverse and antithesis of the whole idea of anything compulsory. In the first place I have never come across—and I do not suppose my hon. and gallant Friend, with his longer experience has ever come across—anyone who would not agree with us that to introduce compulsory sterilisation would be utterly alien to all our traditions and inclinations, and would lead, in the hands of certain executives and in certain countries, to most pernicious abuse. I feel that it would be a terrible wrong to the conscientious religious convictions of a definite section of the community. But may I at the same time say in rather different words what has already been said by my hon. and gallant Friend, that, while I take that view very strongly, I may be allowed to quote this sentence from the Brock Report:
"The law has long recognised that a man should not be compelled to submit to something which he conscientiously believes to he wrong, but the law has never recognised the right of an individual to impose his scruples on others who do not share his views."
So, while we fully respect and intend to safeguard the views of those to whom I have referred, we ask them to respect ours. That view, I think, is universal among those who advocate this reform. But, besides that, there is this, which in practice is still more important. The proposal is not that anyone can go and get himself or herself sterilised, but there must be very careful inquiry and certification by the two doctors, who are both specially approved for the purpose, with an expert Ministry of Health committee in the background in case the Minister's advisers are not satisfied with the medical reports and certificates. Well, that has this importance, that in three out of four classes who would be entitled to apply for voluntary sterilisation under the Brock Report, the certificates could only be given if the practitioner were satisfied that the person applying was suffering, or had suffered, from disability or disorder deemed to be inheritable, or was a person deemed to be likely to transmit defectiveness or disorder or great disability to a subsequent generation. I am not using the precise words, but I think I give the precise sense.

But the point is that no really honest opinion with regard to that can be formed—and it is intended that these opinions shall be honest and careful opinions—unless the practitioners concerned have had access to the family histories of both, of the past generations and of the collaterals of the persons concerned. Now no one will give information with regard to people of a superior generation, or of his own generation, or of a subsequent generation, if there is any possibility that, as a result of that opinion, that person may be sought out and compulsorily sterilised. Therefore, the whole machinery on which voluntary sterilisation rests, which depends on the care and conscientiousness and thoroughness of these reports, would be brought to naught immediately any system of compulsory sterilisation were to be introduced.

There are two other small points I would like to mention, pointing in the same direction. First of all, people will not enter institutions, which it is very desirable that they should do, if they feel that there is any liability that they will have to be sterilised as a condition of leaving those institutions. That is just what one does not want, because one wants them to go into a remedial institution in many cases. Further, once you allow compulsory sterilisation, a person known to have been sterilised would surely be believed to have been sterilised by some compulsory legal process. He is, therefore, under some stigma, and the chances therefore of voluntary sterilisation being resorted to, for good and sufficient causes, practically disappear, because nobody wants to put himself under what may be regarded as a stigma. I therefore conclude on this matter that if ever there was a case where the thin-end-of-the-wedge argument, which has been used so much, is inapplicable it is this case, when it is suggested that voluntary sterilisation would lead to compulsory sterilisation. The two things are built up on entirely differing conceptions, and one is the direct opposite of the other.

The only further point I desire to make, is to give a slight elaboration of the legal position. As my hon. and gallant Friend said, therapeutic sterilisation, that is, sterilisation for the benefit of the health of the individual sterilised—of those who are at the time insane or mentally defective—is probably illegal. The law as to sterilisation of persons who are in their right mind at the time that they apply for the operation is uncertain, and they would, I believe, be a considerable majority of those who might come under the Bill. It is believed to be legal if there are good eugenic reasons for it, and if the proper consents have been obtained. That means, of course, as my hon. and gallant Friend said, that it is frequently performed now, probably with adequate inquiries and safeguards, but of course without the full safeguards that would have to be applied to similar cases in future if anything were done on the lines of the Brock Report. But the doubt means in practice this, as my hon. and gallant Friend said, that persons who have the means to consult a private physician and to employ a private surgeon can get the operation done, but those whose means are limited, so that they would be compelled to go to a hospital, cannot, and they of course are just the class who, because of the narrow compass of their homes and housing and sleeping accommodation, find lifelong and invariable self-control in the married state particularly difficult and almost impossible.

As the writer of a letter said—the victim of a hereditary, and actually inherited, physical deformity, who had succeeded in getting himself sterilised, though only after a special fund had been raised on his behalf—the promoters of this Bill, in trying to get sterilisation legalised, are only trying to get made available for the poor what is now the privilege of the rich. After the reasons I have ventured to give, in addition to the far fuller and masterly sketch of the matter given by my hon. and gallant Friend opposite, I very much hope that the Government will now be able to give a favourable reply to the Amendment which I have the honour to second.

5.15 p.m.

I wish to thank my hon. and gallant Friend opposite for the manner in which he approached this subject. I may perhaps be isolated in this House in answering one or two of the queries of my hon. and gallant Friend, but in the first place he postulated that the individual has the right to be able to say that he or she shall carry on in a certain fashion. I am one of those who believe that, as far as the law of the land is concerned, that is a falsehood. You are subject to the law and you must obey it. It is one thing to talk of legal ordinances; it is another thing to talk of the law of the Church, which often differs from it because one deals with material and the other with spiritual things. I believe that there is not only a teaching but a moral force in a particular Church, and therefore, in regard to faith and morals, those who belong to that Church and are not slaves to the law, but are within the law, are bound by the law of that Church. I am bound to analyse the reasons that are put forward for this Amendment.

The popular front point of view does not appeal to me because, if we look at the wonderful popular front point of view which we have in this House, we find it is neither in consonance with good management or organisation of government, nor with what is beneficial to the State. It is illogical politically, opportunist in its action, and injudicious in its representatives. Therefore, the criterion that a popular movement or popular opinion may be in favour of some faddist point of view does not appeal to me. One would imagine that every new-fangled notion that comes along must be carefully examined. There are in the country sane men and women, but the majority of mankind, as I know them, appear to be insane. I often see as much insanity on this side of the House as I see exhibited on the other side, and on this particular point I am wondering who will come into this category. Who is to decide about mental defectives? Two men may have a conversation. We are told that if two people in company have a conversation for any length of time there must be equality from the point of view of association. If two people, one sane and one insane, talk together, it is a bad thing for the sane man because of the company he has been keeping. If two insane people get together talking about other people they form an opinion. I am asked to accept the authority of certain individuals who have expressed an opinion.

I am told that there is a popular front, an association in this country, that has met with a view to making everything all right in the world. He have had our fanatics in the House who have wanted to do that. Are they to be classified as insane? Is that to be one of the hereditary defects that ought to be got rid of? Where are we going to stop? This Amendment speaks of voluntary sterilisation for hereditary defectives. That is incorrect. The English has no meaning. It is nonsense. It implies that if you are going to volunteer you have to be compos mentis because my right hon. Friend the Member for North Cornwall (Sir F. Acland) said there is to be no compulsion. A person who is in a state of mind to know exactly what he is doing will be able to consent to voluntary sterilisation. If a person is unfit and he knows he is unfit, it implies a very high state of sanity. People are going about who do not recognise that they are insane, and we are going to impose the choice of sterilisation only on people who are defective. It is an imposition because anything that takes away from the faculties of a man or woman is an imposition. It prevents them from carrying out the functions for which they were made. Many people want to get rid of Christian teaching because it lays down laws and rules that they have to obey, and they want to have an easy state of society which enables them to be rid of the ordinary functions of life without having the terrible indictment which may be raised against them of not doing the right and proper thing.

The hon. Member will be able to say what he wants to say in regard to the Vatican. I know that he is an advocate of the Vatican and that he will bow to anything that comes ex cathedra from it. As I believe that the hon. Member has a right to express his view, I believe that I have a right to express mine on this matter. If I can incite hon. Members who take a rationalistic point of view to some intelligence on the subject, I shall be pleased, for I shall know that they at least do not come within the category of mental defectives. We are told that a person can make a statement to a medical man that he is willing to undergo this operation, but surely it is wrong to say that anybody who has that power of will is defective. I find great difficulty in this House at times to understand many of the speeches that are made. I am at a loss to understand why men should vote without hearing the discussion. They take second-hand information. In regard to something which is important to the individual, however, I take a different view. I maintain that my life and all that I am is mine, and that I have the right to protect that which is mine against all others.

I believe that all men and women are equal, but there are gradations in life, and who is going to set the standard in regard to mentality? Some of the greatest men of England were considered to be defective, and the whole of their lives shows, from the point of view of rationalisation, that they did not lead a rational life. We have the progeny of those people with us to-day, and I should like to know, in regard to extermination by sterilisation from the point of view of the propagation of the species, where we are going to end. I want to know, if people are compos mentis, to what they are going to consent. They can only consent to the prevention of the only thing for which men and women were created, namely, the propagation of the species. It may be a fallacy to pronounce it to-day, and it may he one of those doctrines of the Church which appear to the modern mind to be out of touch, but the teaching of the Church is that man was made to multiply, and there is no getting away from that special ordinance.

It has been stated that people in possession of their faculties would not apply for sterilisation. I maintain, therefore, that this Amendment cannot work, because people in the possession of their faculties, if they would not apply, are the very people who would not be considered mentally defective. If they have not got their senses, it cannot be voluntary, for they would not know what they are applying for. Therefore, this measure cannot be applied until it is made compulsory. We are told that many people in possession of their faculties do apply. That is a very specious argument. The hon. and gallant Member said that many people ask for sterilisation on eugenic grounds, and he went on to amplify that by mentioning people who do not want to have more children. If my hon. Friend is going to qualify that with the word "defective" it will mean that a defective parent is able to consider what is the right and proper thing to do in regard to a family, and we credit him with faculties which he does not possess. It means that the defective parent is regarded as able to take a whole survey of life and, even after three or four children have been born, to decide for voluntary sterilisation.

With the falling birth rate and the demand of the nation for men and for women, there are other points of view to be considered rather than the point of view of the mental defective and his attitude towards sterilisation. I want to see remedial measures taken by this House which will avoid the difficulties with which the right hon. Gentleman has to deal. We are taking up the wrong end of the stick in dealing with the problem under this proposal. If we want to deal with mental deficiency cases, we have a Mental Deficiency Act for that purpose, and remedial measures can be applied in institutions. What right has anyone to come along and suggest to the individual that his standard of life is such that we consider him to be defective, effete and an incubus on society? It is a very bad thing for medical men in Council to advocate sterilisation, in view of the great advances in science, and I suggest to the Minister that we should be doing better to give attention to the question of raising the standard of life for the worker.

There is a particular hereditary disease which has brought terrible trouble into homes and yet no one who brought in a proposal to make that disease notifiable would get a majority in this House, although in walking through our hospitals and asylums we see the effects of the ravages of that disease. Through malnutrition, poverty and a thousand and one other effects of the general depression many of the poor are brought to terrible straits, and we ought to undertake measures which will assist in building up their lives, thus giving men and women the opportunity to live the normal life which is ordained for them. The advocacy of sterilisation is pernicious. It is working in conformity with the easy code of the year 1937, with its week-ends and the promiscuity of male and female—making all that a much easier proposition. When the voluntary system can be brought into operation by those who fear to have children, you make disregard of the conventions of life much easier. From the moral point of view the adoption of sterilisation would bring many difficulties, and I feel that the protection of the morals of our people is absolutely essential. In a world of disorder I find no discipline except through the influence of the Church. I cannot see that the State, with all due respect to its legislators, exercises the moral influence which it ought to exercise among the people of this land, but I do believe that a Church can exercise a moral influence. In view of the abuses that would be likely to arise under this pernicious system, I think the Minister would be well advised not to countenance it.

5.35 p.m.

We all appreciate the sincerity of the hon. Member for the Scotland Division (Mr. Logan) and his references to his Church. I had the honour to serve with an Irish Regiment, and though I am not a member of his religious faith, I very much admire the leaders and the laity in that religion. In listening to him I felt that if we had been talking about the causes of mental deficiency and any remedy had been suggested other than sterilisation, he would have been with us. He suggested that one of the causes was a certain disease, but if he looks at the report of the Brock Committee he will not find that idea borne out. Environment is undoubtedly a contributory cause where there is the hereditary element existing, but the Minister of Health, who has been so energetic in clearing the slums, will tell us that slum clearance and improved housing conditions have not resulted in diminishing the number of cases of mental deficiency. The Brock Committee, while admitting that there were many other contributory causes, came to the conclusion that heredity was one of the chief factors. On page 21 of their report they say:

"The children of parents one or both of whom are mentally defective are, on the average, below the normal, and our inquiry shows that nearly one-third of such children as survived are likely to be defective, and more than two-fifths must be expected to exhibit some degree of abnormality."
In the face of evidence like that can we really say that we ought not to take measures to reduce the number of mental defectives born into the world? We are not proposing to take any function away from any subject in this country, but we do say that where a man or woman suffers from mental deficiency and fear that they may convey it to their children it is a Christian act that they should be allowed voluntarily to undergo sterilisation, so that there shall be no children to suffer as they themselves have suffered.

A mental disease is probably the worst illness to which the body can be subject, and surely we ought to do all we can to reduce mental diseases. It is some years since the Brock Committee reported, and I hope that when the Minister of Health replies he will be able to give us some indication that the Ministry of Health have not been inactive in the interval, and that they propose to take more active measures in the future. In the Brock Report we are informed that it is difficult to trace the antecedents of mental deficients. Of course it would be. People are not proud to say that their grandparents were mentally deficient. But a good deal more research on the matter could be undertaken. The Brock Committee came to the conclusion that though it might be difficult to trace antecedents, valuable information might be obtained by finding out the proportion of mental deficients and subnormal children coming from mentally-deficient parents and they wrote to the local authorities to ask if they would help in an investigation. On pages 16 and 17 of the report they print the result of that inquiry, which I regard as really startling.

I do not think that the hon. Member for the Scotland Division can have read that report; I doubt it after hearing his speech. They found, out of 8,800 cases investigated, that 2,000 children died at a very early age, which does indicate some direct connection betweeen infant mortality and mental deficiency on the part of the parents. They divided the remainder into age groups of those between 7 and 13 and those over 13, and found that no less than 40 per cent. of the children still living were subnormal. When it is remembered that 22 per cent. of the children had already died, it will be seen that the proportion of subnormal children was high, so high that this House cannot regard the situation with complacency. When we realise all that normal or abnormal children born of abnormal parents must go through, surely we are not asking very much in advocating that sterilisation should be permissible. A fellow Member said this afternoon that he did not agree with my attitude, that he thought the matter should be left to the individual, but the matter cannot be left to the individual, contrary to the belief of many people. No doubt many families in this country have some hereditary taint, but they do not want to be prevented from marrying. If people are in an institution they do not want to think that they may never return to live with their families.

All that we ask is that, by their own voluntary action, and with the advice and consent of their medical advisers, they may have sterilisation, so that they can lead a normal life without feeling that they run the risk of bringing into the world children who will suffer as defective children do now. I hope that the Minister of Health, who is well aware of the terrible sufferings caused by mental disease, and who has been renowned for his forward action in dealing with health problems, will not be frightened at the opposition which he may get from people with points of view like that of the hon. Member for the Scotland Division of Liverpool. I hope also that he will give us a lead this afternoon and that the coping-stone of his great work at the Ministry of Health may be action which will make it possible for mentally deficient people, and those suffering from mental diseases, to have a small operation done to them voluntarily, with the advice of doctors. It is not very much to ask, and I hope that we shall have a favourable answer from the Minister.

5.47 p.m.

I did not intend to intervene in this Debate, and I propose to speak only for a short time. The speech of my hon. Friend the Member for the Scotland Division of Liverpool (Mr. Logan) made me feel it necessary to say a few words. So excellent a case was made out by the Mover and Seconder of this proposal, and by my hon. Friend who supported it, that very little more needs to be said about its merits, but the speech of the hon. Member for the Scotland Division, coming from the Labour Benches, might give a false impression. It might give the impression tha the Labour movement as a whole supports the obscurantist and reactionary attitude taken up by him, whereas, in point of fact, the Labour movement as a whole is strongly in favour of the proposal. The very representative conference of Labour women which has gone into this matter thoroughly, passed a resolution in favour of this project by an overwhelming majority. That opinion of Labour women accurately reflects, I think, the opinion of Labour men.

Let us be under no misapprehension on that point, but the point that I wish to deal with in particular is the claim of my hon. Friend to impose the authority of the Roman Catholic Church upon the British people. In tearing a passion to tatters in the way that he did, he was taking up an altogether mistaken attitude. We are not asking members of the Roman Catholic Church to obey any other law than that of their church. If they feel that sterilisation, divorce and birth control are contrary to faith and morals, by all means let them leave the accursed things alone, but let them have the decency and the toleration to allow other people who want to make use of those things have the freedom which they claim for themselves. This is an entirely voluntary proposal, and we do not want any one to be subjected to it who is not freely willing to have the operation performed. My hon. Friend made the suggestion that people who did not know what they were undergoing would be subjected to the operation, but I can give him a very long and impressive list of representative associations, technical and other, which support the proposal. That ought to be sufficient safeguard against the suggestion that people will have the operation who ought not to do so.

In the list to which I referred are the Royal College of Surgeons, the Royal College of Physicians, the Association of County Medical Officers of Health, the Society of Medical Officers of Health and the Central Association for Mental Welfare. There is a long list of extremely representative and very well-qualified persons, who are fully in support of the proposal. I back up the appeal made to the Minister by the hon. and gallant Gentlemen opposite not to be timid in approaching the question. I remember the unnecessary timidity exhibited years ago by the Ministry of Health on the question of birth control, when Government action in the matter was proposed. It has been proved by experience that public opinion was behind that movement. To-day, in a modified form, the Ministry of Health supports the policy of giving birth control information to women who want it.

Although I am a Labour Member, I hope there is no misconception or wrong statement. There is no truth, as I understand the position, in the statement just made by my hon. Friend, that there is any countenance from the Ministry of Health. I should like to know whether that is not the case.

All I can say is that all over the country—I do not know the number, but I should think there are hundreds—are clinics which have been established by municipal authorities and which are giving, among other things, information with regard to birth control, and they are doing so with the approval of the Ministry of Health. If that is not a justification for my statement I should like to know what is. The hon. Member who moved the Amendment said that the Roman Catholic Church had never stood in the way of progress. I shall not differentiate between churches, but I join issue with him on that statement. The record of history will show that churches have been standing in the way of progress all along the line. If we consider our laws, what I would call ecclesiastical domination has left an evil mark upon many of them. There are the marriage laws, which are known to be archaic and mediaeval in their conception, but every attempt to change them is opposed steadily and with the utmost bitterness and virulence by the churches to-day. There is the question of birth control; that also has been opposed with the same unscrupulous bitterness by the churches. I might give other instances. About a century ago, thanks to the discoveries of scientific men, it was found that the sufferings and agony of women in childbirth might be mitigated by the use of anaesthetics but we find, even on that proposal, we have the churches in bitter opposition against it. Time went on, and they gave way. They have largely given way on birth control and are giving way, to some extent, on divorce. With a little courage on the part of the Minister of Health they will give way on this matter of sterilisation.

I would emphasise what has been said about the class nature of this issue. If people with money, men or women, feel that they want to be sterilised because they are going to bring unwanted children into the world, they can go to private practitioners and get it done without let or hindrance, but poor people, who may have an overwhelming case for having the thing done, may go to hospital after hospital, and panel doctor after panel doctor, but there is never a chance of their getting the operation performed. That is an entirely unjustifiable class distinction. I hope that the Minister will therefore see the necessity of taking action in this matter.

We are discussing to-day the standard of health and fitness of the nation—very desirable objects. We want to see this nation a body of fit men and women, as far as is humanly possible, and we are talking of measures for bringing that about. Whether they will be adequate I do not propose to say at the moment, but that is our ideal. We want to get a fit nation, and an overwhelming argument can be produced by medical men for dealing with a situation which is lowering the physical and mental health of the nation. It is incumbent upon the Ministry of Health to use the power which it undoubtedly possesses to take action which will enable us to improve the national health and to get rid of this particular evil.

5.53 p.m.

I support the Amendment which has been so admirably moved by my hon. and gallant Friend. The hon. Member for the Scotland Division (Mr. Logan) posed the dilemma that if people were in possession of their faculties they would not be sterilised, and if they were not in possession of their faculties they would not understand the meaning of sterilisation. I would point out to him that that has not been proved to be the case in California, where a great advance has been made in the matter.

May I remind the hon. and gallant Gentleman that the Mover, when he put forward his proposal, itemised those two points about those that would and those that would not apply? In any case it was a question of abuse which was likely to arise.

Perhaps the hon. Gentleman does not appreciate all that my hon. and gallant Friend said. The point is that the dilemma is not a correct one, as we are able to prove from the example of California, where they have gone a long way in this direction. There, where there are defectives in an institution, the doctors in charge of the institution are often asked by the defectives how soon they can have their operation so that they can he sent out. They are not in possession of their faculties, they are apparently non compos mentis, and yet they apply for the operation. Again, even if it is not certain that every child of a mentally defective parent would be defective, yet such a parent is totally unfitted to bring up a child, whether that child be normal or defective. If the child were normal and were brought up by a defective parent, I agree that it is a heartbreaking situation. Such a parent is quite unfit to bring up any child, normal or otherwise, whether from a moral, material or physical point of view, and it is most undesirable that they should have to do so.

Again, where one or both of the parents are mentally defective, if they live in a block of flats or in any small community it is possible for them to become a sort of plague spot. However sorry we may be for the individuals, such a family must have a demoralising effect on the children of other families. In my own county of Hampshire, in 1935, there were just over 2,500 mental defectives under supervision of some sort. Of these, only just over 900 were actually in institutions; the rest were living quite free of all restraint. They included a large number of men and women of an age to have children, even after making allowance for those who were too old or too young, and actually three men and TO women who were known to be mental defectives got married in that year. It is not good for man to dwell alone, and I do not wish to deprive this unfortunate class of any of the happiness that they may be able to get in this way, but I do not wish to see their numbers increased if it can be avoided, and I think the State should do everything it can to help and enable them to think for the good both of themselves and of the State.

With a potentially falling population and a low birth-rate, it is a matter of great importance to the State to keep the proportion of low-grade minds among its citizens as small as possible, but, almost from the very nature of their disease, it follows that these people will not, in matters sexual, exercise any self-restraint any self-denial, any moderation of any sort. Therefore, they are likely to have large families, and these are the only large families which the coming years are likely to see. There is a chance that some at any rate of these unfortunate people might be persuaded of the great wrong they are doing by risking the passing on of their own defects, and might consent to voluntary sterilisation, and, therefore, I support the Amendment with all my heart.

It is sometimes said that legislation on this matter must await the de- velopment of public knowledge and demand, and I think that this Debate will do good in that way, but I venture to suggest that an announcement by the Government that they are giving further consideration to the report of the Committee on Voluntary Sterilisation would arouse interest and stimulate knowledge, and that eventually the legalisation of the operation on a voluntary basis would be the best possible way of bringing the benefits to be obtained by it to the knowledge of the country.

6.5 p.m.

We heard, from the hon. and gallant Member who opened the Debate, with that skill and learning which we recognise whenever he gets up, the observation that there was still need for further research, and, while that was not the general burden of his speech, it is in a sense the burden of the somewhat unworthy speech with which I will not detain the House very long. Attractive, and almost overwhelming in some ways, as the arguments for the Amendment appear, as arguments nearly always do when they are in favour of a proposition for a purely voluntary reform, I and some others feel that this is a very fundamental step to propose, and that further research is really the proper course. We are not, even now, any too sure how far mental defects are hereditary or transmissible. There are informed and scientific observers who say that 50 per cent. of the defects commonly attributed to heredity are not so due, and we do not know how far environment can really either create, on the one hand, or cure, or at any rate alleviate mental defects, on the other. One thing of which we can be quite sure is that it is no use simply getting rid of a certain number of potential mental defectives in the next generation if at the same time we leave virtually untouched all the evils of environment that are bound to create further mental defectives.

The hon. and gallant Member for Thornbury (Captain Gunston) suggested that progress with slum clearance had not diminished the statistics of mental defectives, and that, therefore, one could not look for very much help in that direction; but I think that perhaps he was speaking a little too quickly, because no one would suggest that slum clearance has yet proceeded far enough to produce any substantial effect on people most of whom, at any rate, are still young. And, of course, it is not only slum clearance that we want, but nutrition and many other things as well as better housing. Not very much has been said on either side of the discussion about the experience in the United States. Certainly it provides some argument, but I understand that on the whole the results so far from those of the United States that have seriously applied voluntary sterilisation have been a little disappointing from a statistical point of view. The results in Germany, I hope it is fair to say, really ought to be ruled out entirely, because in the first place they have not been going very long, and, secondly, they are obviously administered with such bad motives and such reckless disregard of decency that it would not be fair even to use them as an illustration of the abuses that might result in a civilised country.

A good deal has been said about the difficulty of talking about voluntary sterilisation when what is the matter with the defectives is that they have not much voluntas, or volition, or whatever one might call it. I respectfully agree with the hon. and gallant Member for the New Forest and Christchurch (Major Mills) that that is nothing like a complete dilemma, but I do think there is something in it. As I understand it there is a large number of people coming within the classes recommended in the Brock Report who have, at any rate frequently, if not always, sufficient mentality to make up their minds with at any rate sufficient intelligence to form a real resolution, and those people, at any rate, can arrive at a true voluntary decision. I remember an interesting case, some 20 or 25 years ago, of a Noble Lord whose mentality on close inquiry was found to be sufficiently good to allow him to go to another place, but not sufficiently good to enable him to look after his property, and he might perhaps have had some difficulty in arriving at a proper consent to his own sterilisation. But, after all, one Noble Lord does not make a summer.

One difficulty which I regard as possible in connection with the proper exercise of a voluntary will in the matter is of a type that is familiar to a number of us in cases where people make voluntary confessions, or do other voluntary things, under strong pressure. There will be hundreds of people in this situation who can really arrive at a decision by the use of their own will, but who will be much more easily brought to a decision by the not wholly unreasonable urgings and persuasions that may be brought to bear upon them. I do not suggest that it covers the whole field, but it is a matter for some little anxiety. Of course, when a man or woman is told that they can be given their discharge from a mental home of one kind or another—which, if it is good, is still a prison, and if it is bad is something too dreadful to think about—if they voluntarily submit to sterilisation, it may sometimes be a good thing to put before them, but it is an abuse of language to say that the decision arrived at in circumstances of that kind is really a voluntary decision in any full sense of the term. In all the circumstances I suggest that, attractive as the arguments are, and cogent as the point is, all that is being asked for is that people shall be at liberty to make a voluntary decision about some part of their own destiny, and that the matter should be very carefully looked into.

6.13 p.m.

In the brief observations that I desire to make, I would first like to congratulate the Mover of this Amendment, my hon. and gallant Friend the Member for Wellingborough (Wing-Commander James) on his statement of his case. I think that anyone who reads it to-morrow will agree with me that it is one of the best presentments of the case that we have heard; and it has been ably seconded by the right hon. Gentleman the Member for North Cornwall (Sir F. Acland). I think that very likely the object of my hon. and gallant Friend in moving the Amendment is to call the attention of the House and the country to this matter, and that all that he is asking—I do not think our procedure permits anything further—is that the Government should give further consideration to this question. It may well be that he and his friends may at some later date do what I do not think has yet been done, and that is to test the opinion of the House on a matter of this kind, which, I may say, raises other questions besides that of health, including, perhaps, matters of conscience and religious conviction.

I would like to make one or two observations on what has been said this afternoon from the point of view of my Department and my own official position. An allegation has been made that there has been an increase in the number of defectives in this country. Of course it should be borne in mind by the House that the number of defectives under care increases as the general population increases, and as the local authorities become more efficient in ascertaining the existence of defectives, but I think it can be said with authority that there is no proof that the incidence of mental deficiency in this country is rising. Reference has also been made to what has been done by other countries with regard to sterilization, and I would like to assure my hon. and gallant Friend and the House that of course my Department and the Board of Control keep themselves, as the House would expect them to do, fully informed of the progress made under foreign statutes; but I would remind the House that this legislation in many other countries is comparatively new, and I think it can be said with accuracy and truth that, at any rate up to the present time, no results of significance can yet be assessed. For instance, a system of voluntary sterilisation was approved in Norway, and also in Sweden, in 1935. Germany brought in a compulsory system of sterilisation in 1933. Although Denmark began a system, as regards a limited class, in 1929, again no useful lessons can in fact be learned from it. The hon. Member will appreciate the importance, apart from the merits of the case of taking public opinion wholly with you. Sterilisation laws are in operation in several of the United States but, in some, little use has been made of them. In certain cases the laws appears to have been enacted without any money being provided to work them, but the real explanation of failure in other cases is probably that the enthusiasm of small groups secured the passage of legislation for which there was no general demand and no sufficient backing of public opinion.

One or two hon. Members, perhaps unconsciously have let fall observations which would lead one to think that perhaps in certain cases the treatment of people who unhappily suffer from this terrible disease is—I think one expression used was "very horrible." I should very much like anyone who comes across a case of that kind to give me information at once. I share the view of a good many people of what a terrible tragedy it is and what it must mean to people who have to be dealt with in this way. But I must testify to the increasing provision, care, forethought and kindness that are displayed in these institutions. I should not like it to go out that there was anything else but the utmost consideration shown and large sums of money spent in order to see that reasonable care and treatment are given. I was asked whether the Government, and my Department, and the Board of Control, were taking further steps, which I still think are necessary in the matter and which may help those who support this campaign, in connection with research. Undoubtedly a great deal has been done, as I think the House would desire. For instance, only in 1934, in consultation with the Board of Control, the Medical Research Council appointed a new committee to advise and assist them in promoting research into mental disorders. Another committee of equal importance has also been appointed by the Medical Research Council, a committee on human genetics, because in spite of the advances made in the biological study of heredity and the application of the results it was felt that the study of human genetics had been relatively neglected. Under the aegis of this latter committee some very interesting researches are now taking place at the Royal Eastern Counties Institution at Colchester by Dr. Penrose and his colleagues, and an important examination of the hereditary characteristics in the blood of mental defectives and their families is now being made by Professor Fisher and Dr. Taylor of the Galion Laboratory, University College, London. This work is being assisted by grants from the Rockefeller Foundation. Dr. Slater at the Maudsley Hospital, London, is also working on a large-scale field of inquiry into certain different types of mental disorder amongst twins. Other work is also being carried on, so that my hon. Friend will see that this aspect of the question is not being neglected by the Government.

Can my right hon. Friend give an assurance that any funds needed for research would also be forthcoming from the Government?

That would be a very bold undertaking to give without consultation with the Chancellor of the Exchequer, but, if a question of money arose which I thought was important, I should not hesitate to take it to the Chancellor of the Exchequer. I can say from my knowledge of many years now in connection with health work that there is no doubt that opinion is growing in favour of sterilisation. When I came back to the Ministry after an absence of some time I saw the record of a deputation from the County Councils Association and the Association of Municipal Corporations in 1935. They represent a large body of people discharging responsible duties in a wide field of public and social work. It would have astonished a great many people if such a deputation had taken place only two or three years before. But we cannot disguise from ourselves the fact that opposition still remains and there is much conflict of opinion, particularly on religious grounds. The medical profession are by no means unanimous on the matter. If you ask even the medical men that one knows in one's private circle, there is not a great deal of unanimity of opinion. Resolutions of certain learned Colleges have been quoted but I very much question whether you would get anything like unanimity from the British Medical Association.

Is it not a fact that on most matters you cannot get unanimity in the medical profession?

There are always small minorities, and one deals with them as best one can, but there will be found, I think, in the British Medical Association a pretty steady and strong view on most medical matters of the day. I am endeavouring to put fairly the other side of the matter and I doubt very much whether you would get such a strong vote as would justify a Bill being promoted at this moment. I think it is desirable that ample time should be given for consideration and to get public opinion developed as I believe it is developing, so that whatever action may be taken may follow generally the desires of the country and the dictates of the public conscience. We should be wise if we could gain their support. However, these investigations are taking place and, no doubt, as my hon. and gallant Friend pursues his advocacy the time will come when he will be able to test the opinion of the House and see whether the representatives of the constituencies are so strongly in favour of the matter. I hope my observations will be satisfactory to him as far as this afternoon is concerned, and I think a very useful purpose has been served by the Motion, and everyone will desire to congratulate and thank my hon. and gallant Friend for bringing this very important subject forward.

6.29 p.m.

Probably if a suggestion of this character were carried into effect I should be one of those who would be sterilised, because within recent months I have been mentally and physically afflicted. Therefore, on the terms of this proposition I should not be able to propagate my species—not that that would matter much to the general interests of the Empire. But I want to ask who are the people who are to be experimented upon voluntarily? I have been a member of a mental hospital committee for 33 years, and we have had experience of the kind of people who enter into those institutions and are supposed to be mentally unfit and physically incapable in many cases. I could take hon. Members to my institution and show them men of great ability, men who can do all sorts of things of an artistic character, yet they are mentally unfit, according to the doctors.

I do not know much about these psychological problems. You require to be a psychologist to understand them. I have heard our doctors explain how certain people have come into a certain condition. All sorts of troubles come into their lives. A man may have a row with his wife which may drive him off his head, and a woman may have a quarrel with her husband and become mentally defective, and, according to the proposition that has been made, as far as I understand—and I do not understand a very great deal—that man and that woman, in certain circumstances, could be voluntarily sterilised. Are you going to ask that man and that woman voluntarily to agree to become incapable of enjoying the ordinary conditions of life? I do not know what is meant by voluntary sterilisation. I think it means that you begin on a so-called voluntary scale, and you end up with compulsion. That is the way you will end—with compulsory sterilisation. Fancy Members of the Tory party wanting to sterilise us‡ If the Labour party come into power, as at sometime they will, we might want to sterilise them, because they will be mentally deficient.

This proposition may be coming from gentlemen who represent the Services. Do they imagine that the ordinary workers have no rights? How are you to decide who is to volunteer to be sterilised? Who is to settle it? What kind of board is to be established to settle whether a man or woman is to be sterilised and made incapable? Frankly, I would not trust any board to decide that matter. In view of my experience of 33 years as a member of a mental hospitals committee, I would not even trust the doctors, much as I respect them. They make mistakes, and if they did not make mistakes their lives would not be worth living. As to the attitude of the Government towards the Amendment, the Minister of Health is a very kind gentleman. He is like Caesar's wife, "All things to all men." He tries to oblige everybody, and he ends up by obliging nobody, generally speaking. Some of us are opposed to this proposition. We have got on very well without voluntary or other sterilisation. They have tried it in Germany, and what is the result? They have sterilised the whole population. They can say nothing but "Heil Hitler." A hundred Members of this House are to accept an invitation to go to Germany and "Heil Hitler." They are going round Germany. What for? To become part and parcel of the machine. [An HON. MEMBER: "What about the right hon. Member for Bow and Bromley (Mr. Lansbury)?"] I do not care what the right hon. Member might say; it does not interest me. If he can convert Hitler I shall be glad, but I am afraid that it is he who will be converted.

There is no such thing as voluntary sterilisation. If you are to have sterilisation it must be compulsory, because the only people who will suffer as a result of voluntary sterilisation are those who cannot help themselves. They will be put away by other people. I know that voluntary inmates of a mental hospital with which I am connected are not always there by their own volition, but because their relations have put them there. They have not the sense to be able to say whether they should or should not go. What is it proposed to do with voluntary sterilisation? Are persons who are mentally and physically unfit to be asked to go into an institution to be treated or not? If they are, you will not get the answer that you want. It means that compulsion will be enforced upon people who are not capable of resisting, and, speaking for myself, and for other hon. Members, we are opposed to the system of so-called voluntary sterilisation.

Owing to the nature of the reply of the Minister of Health, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Question again proposed, "That Mr. Speaker do now leave the Chair."


6.37 p.m.

I wish to draw the attention of the House once again to the question of malnutrition that is prevalent in this country. I do not think that there is an hon. Member of this House on either side, but would agree that there are many people in this country suffering, from a shortage of essential foodstuffs. The matter has been brought forward by many people outside this House who are representatives of public authorities, medical officers of health, medical men who are not employed in that capacity, and also one of the latest to come forward and talk about the underfeeding or malnutrition of a large section of the population is the right hon. Gentleman the Secretary of State for War, who has spoken in no uncertain terms about the low standard of physical efficiency of many of the young men who apply for Army service. We have to agree that the standard of physical fitness and the physical determination of measurements and so forth, as far as Army service is concerned, are very low in many instances. The chest measurements and the heights required are very low. I have heard it said that during the Reign of Queen Victoria the standard for entrants into the Army was lowered on two occasions. I do not know whether that is true or not, but we have to agree that, if we have a very large proportion of the young men who apply as recruits not up to the physical standard required for the Army, there is something wrong somewhere.

That is not the only evidence of underfeeding and the lack of nourishment among young people. Some people will say that there is not the amount of malnutrition existing that we claim. We might ask the question, Does malnutrition exist, or is there convincing evidence that malnutrition exists? If that question were put to me I should reply with an emphatic, Yes; that malnutrition exists all over the country, in various parts, in a greater or less degree. I would not depend entirely upon medical or expert opinion. In going about the streets of our towns and cities, and even in urban and rural villages, in some instances, we can see with our own eyes that men, women and children are lacking something because they are obviously in a state of nutrition which cannot but be called below the normal. I know of scores of cases that are well below what they ought to be in appearance, in weight and in stature, and particularly does that apply to many of the school children. I know that the Minister of Health has received certain information as to what is prevailing in many of the districts in this country, and also that there are certain public representatives who say that those who are raising the question of malnutrition on the Floor of this House and outside are doing it because it has become a popular fad and that in many cases it is the result of the Press stunts of some months ago. But I would urge on the Minister to have some regard for the expert opinion which is being expressed up and down the country on this particular subject. Quite recently Major-General Sir Robert McCarrison wrote an article on the question, "Is Malnutrition a Real Problem or a Fad?" He concludes the article with these words:
"Malnutrition is no fad, no fussy insistence on a thing of naught; it is one of the most urgent problems of the day; and without the better nutrition of many of our people, other enterprises designed for the building of an A.1 nation must have their foundations on sand."
That is the opinion of an expert. If further opinion is required I have here a pamphlet written by Alderman Barbara Drake who is a member of the London County Council and who gives further evidence of malnutrition among the children. I know the Minister may quote the school medical officer's report and that is mentioned in this pamphlet. I will quote the following paragraph on page 10 of the pamphlet:
"'The reports from school medical officers,' states the Annual Report of the Chief Medical Officer for 1934, 'concerning the nutritional state of school children are generally reassuring, though there are exceptions.' The figure of malnourished children (including those in need of observation only), is given as 2.6 per cent. of all those examined. Intensive investigations in particular areas show results which are less reassuring. In Sheffield, for example, the percentage (including 'bad' as well as 'subnormal' nutrition) is given as 11.04 per cent.; in Newcastle as 13.46 per cent.; in 36 rural schools in Monmouth County, as 14.4 per cent. (none of whom were receiving free meals); in six poor schools in Sunderland, as 20.9 per cent.; in three colliery towns in Sunderland, as 21.9 per cent. Similar percentages to those in Sunderland were found by Dr. Glover in poor schools in Tyneside, County Durham and South Wales. Even in a prosperous seaside town, where it had not been thought necessary to make provision for free meals, Dr. Glover found the figure of 'subnormal' nutrition to be as high as 15 per cent. in a poor area elementary school, though not more than 4.4 per cent. in a 'central' school in a good area."
I could go on quoting figures to show that there is a large amount of malnutrition and subnormal physical conditions among large numbers of school children. I am prepared to concede that as a result of measures taken recently in the free distribution of milk there has been an improvement, and although the Minister, if he compares present conditions with those which obtained before the War and for 20 or 30 years before that, may get a lower standard than we have now, it does not alter the fact that in a land flowing with plenty there is still a condition of affairs which everyone must regret to see. The case is proved and accepted that large numbers of people are suffering from malnutrition.

Can the hon. Member let me have the pamphlet from which he has been quoting?

Yes. Sir John Orr says that there are 13,500,000 people who do not spend more than 6s. per week per head on food—

At any rate, there is a good preface to it written by the hon. Member for the English Universities (Miss Rathbone). There are 4,500,000 people who do not spend more than 4s. per head per week on food. I do not care who is responsible for providing food for children, I am sure, despite anything which may be said by the Minister of Health or by anybody else, that it is utterly impossible to provide a diet which is body-building and strengthening for a child, an adolescent, or an adult on such a figure. Let me tell the House what it costs for food at the Miners Convalescent Home at Blackpool. We give four meals a day, good, wholesome food, with splendid variety, and we are able to buy in bulk at a good deal less than the retail prices. A housewife cannot get food at anything like the price we pay. But before the rise in the cost of living it cost us in Blackpool 1s.3½d. to 1s. 4d. per day per person, that is 9s. 4d. per week for food alone. When you consider that there are great masses of the population who have less than half that amount it shows at once that they are getting a good deal less than they should.

I am prepared to admit that sometimes malnutrition among miners is not altogether due to low wages. Malnutrition and a sub-normal physical condition may be due to the speed at which they have to work and the heat they have to endure. They may get good food, but some of those who work in hot mines look as though they have not a drop of red blood in their veins. It may not be due altogether to low wages. A miner went to the Blackpool Convalescent Home and put on 14 lbs. in weight during the first fortnight, and said that if he were allowed to stay there he would put on another 14 lbs. in the second fortnight. It shows that these men can pick up when they have the chance. In the case of mothers and children, especially pregnant mothers, it will be agreed that in the distressed areas there is a good deal of malnutrition. I was talking last week to a maternity nurse in my constituency on the question of malnutrition, and she told me that she came across many pitiful cases, but that only in three cases during the last 12 months had she what is known as primary uterine inertia and these were the cases of women whose husbands have been unemployed over a long period. The Minister's statement is quoted in the pamphlet, namely, that if we want to look for malnutrition anywhere in this country the first place to look is among the mothers. I hope due notice will be taken of the suffering entailed in so many ways by women.

The Minister of Health might do something to get the people to realise what is necessary in foodstuffs. I do not say that it is all caused by unemployment and low wages, but it will be agreed that 90 per cent. of the cases of malnutrition are due to unemployment and low wages. There are odd cases, where a man or woman is so exceptionally thrifty that for the sake of saving money they will deny their children the proper quantities of food. I will admit that there may be such cases, but they are very few. There may be cases of malnutrition due to ignorance and lack of knowledge on the part of mothers and housewives as to the proper foods to get and the way to cook them. I have some experience of Lancashire cotton workers and miners and their wives, and it is surprising what they can do with a bit of beef, a few bones, and some vegetables. When I hear hon. Members talk about lack of knowledge of how to deal with food I am certain that many of our Lancashire mothers could give lessons to them in how to prepare and cook food, and, whatever may be said for the exceptional cases, generally speaking it is not a lack of knowledge of how to treat food but a lack of money to purchase the right kinds of food that is the main problem. If it were a lack of knowledge then it is a slur upon our education system.

One thing has always occurred to me as being particularly funny. I think the Minister of Health might enter upon a poster campaign. It always amuses me to see that huge poster "Guinness is good for you," and at 7d. per half-pint. That is the poster where you have a working man who, after having drunk half a pint of Guinness, is performing the function of a modern Samson by pulling down the pillars of a temple. It is about the best joke of the century and worthy of the pages of "Punch." We all know that it is silly, childish exaggeration to put such things on the hoardings of the country. I suggest that alongside posters of a quart of Guinness stout, which costs 2s. 4d. the Minister of Health should put another 2s. 4d. worth in ordinary good food—a quart of milk, six eggs, 10 lbs. of potatoes, and one pound of carrots. That would be a good way to advertise the way in which the people might more profitably spend their money. I think the Minister might show another group of commodities and show the calories, the proteins, and the vitamins which are contained in these foods, as against the silly stuff they are asked to buy at 7d. per half pint. Everybody knows that there is more nutritive value in a pint of milk than in two quarts of this so-called glorious stout brewed by Guinness. I am not a narrow-minded fad, and I am not putting this forward because I am a temperance advocate, but I do not think that any man or woman should spend money on drink until their children and they themselves have sufficient food and clothing.

I do not know where we can find a remedy for all these things, but the Ministry of Health is certainly the best Department through which we can act if we desire to improve conditions among the people. I would suggest that we extend as far as possible the drinking of milk and also advice on the right kinds of foodstuffs to be used and consumed. I know we may be told that there are children who are getting a sufficient quantity of food, which satisfies their appetites but which is not as good as it ought to be for building up their physical and mental well-being. We want the right kinds of foods, foods that will act as preventatives of disease, foods that will save the child or the adolescent from the diseases of rickets, anaemia, dental caries and so on. I am sure that the right hon. Gentleman will not disagree with what I have said; the only question is of finding ways and means of getting it done. I would like to see through the health committees of our local authorities a more widespread use of the valuable food that is produced, and, if necessary, free distribution among the child population."

When we come to the boys and girls who go to school I would suggest that we accept the advice of another eminent authority, the Archbishop of York. I cannot say that I am suffering from malnutrition and we who are well fed ought to take an interest in these poor creatures who are underfed. In dealing with this question of malnutrition the Archbishop of York made reference to the new measure which we have just passed for physical exercises, and he mentions the differences in individuals. Where in an elementary school, he says, you have a child who may not be up to the requisite standard for taking certain vigorous exercises, you will not find that difficulty among public schoolboys. But in the elementary school there will have to be a fine discrimination between the types of individuals to whom you will apply your physical exercises. He says:
"No doubt the instructors will do their best, but the task of discrimination will be beyond the capacity of any but the most expert. If what we are concerned about is physical well-being, milk is more indispensable than jerks."
I have no doubt that the Minister has seen that statement; if he has not, it is in the "Highway." The Archbishop mentions the conditions prevailing shortly after the War and says:
"There has been some improvement since the War, but not enough to make irrelevant an experience which was very startling to me at the time. Just after the Armistice I was offered an important administrative post in a University. I consulted a man who had been the Vice-Chancellor of a University. He said that if I took up the work my first task must be to establish a refectory and provide cheap and nourishing meals, because the work of students Ns as greatly damaged by their malnutrition."
If that is the case with those who go to public schools and universities, it is much more the case in elementary schools. I ask that the Minister of Health should do something with a view to organising the better feeding of children in the schools. I am certain that it would be a good thing. We may have certain prejudices to break down. In the higher-grade schools and the grammar schools, the child can get a good midday meal for 0d. and 8d. a day. I am all for the practice of children staying in school for their midday meal if we can provide it, and then we can organise as a community a proper service of food and determine in many ways the physical well-being of the children who are attending school. If we could get that going, I am certain that it would prove to be beneficial. I do hope the Minister and all hon. Members of this House will recognise that this is a problem which must be faced. There is intense suffering all over the country, and we ought to do our best to remedy this terrible evil among our people.

7.6 p.m.

I am sure that hon. Members on all sides of the House will desire to congratulate my hon. Friend on the very human appeal which he has made this evening. We have had many discussions in this House on this grave problem. Very largely they have consisted of the quotation of the opinions of experts and doctors, but this evening we have had the essential human appeal and it will be refreshing to the House to have this matter discussed in this way. I myself have formed the conclusion that there is a tendency to raise this matter into some great scientific problem which is very difficult to understand. My view is that this problem is a problem of the purchasing power and the wages of the people. My hon. Friend has quoted slogans and advertisements. If I may suggest a slogan it is, "Give the mother the money; she will provide the vitamins."

It is not a question of knowledge. The old mothers of the last generation may have been lamentably lacking in knowledge. If one had mentioned to my mother and the mothers of that generation anything about vitamins they would not have known what one was talking about, but they did know how to rear families. They knew the kind of food to give children and they could do it to the extent that the husband or the one who earned wages brought them home. I am not going to decry increased knowledge of food values, but to have lectures, reports and talks on the value of vitamins, to have these talks broadcast to people who are compelled to live on miserably low wages and still more miserably low unemployment allowances, is really an insult to the people.

During the last week-end—I believe it has been the common experience of Members—I had no end of letters and I have had them since I came back to the House; a large number of letters, pathetic appeals from unemployed men who are finding that they have got to cut down week after week, that their allowance this week will provide less than it did last week. The Minister of Health should consult with the Unemployment Assistance Board. We protested against these unemployment allowance scales when they were introduced. We said that they were far from being adequate and that they would reduce our people to a starvation level. But these scales are less valuable than they were last year. The price of all foodstuffs is increasing and these poor people are finding that their allowances buy less bread, less meat, less of everything that is required to maintain health.

One of the best services which the Minister of Health could render—he is enthusiastic in his work and keenly desirous of improving the standard of physique and health in this country—would be to make representations to the Unemployment Assistance Board. Why not increase these scales to make perfectly sure that they will in 1937 week by week buy the same amount of food as they bought when they were first fixed? We did not consider them adequate and we protested, but if the cost of living is up 5 per cent. on what it was when they were fixed, ought not 5 per cent. to be added to keep them up to the level of last year?

Generally speaking, we have been regarding malnutrition as a problem of the Special Areas and of industrial areas. During the last few months I have come in contact a great deal with the agricultural section of the county, part of which I have the honour to represent, and I have come to the conclusion that this problem of malnutrition is more widespread and more calamitous in its consequences among our rural population than among the population in the distressed areas. The county of Carnarvon, part of which I have the honour to represent, contributes largely to supplying the Metropolis with milk. One of our critics, who comes from this county, said at one time—and it amuses us very much—"One of the greatest services the Welsh people and particularly the people of Carnarvon taught the English, was how to mix water with their milk." That is a gross exaggeration, for if water is added it is added after the milk arrives at Paddington. But there are a large number of children in Carnarvon who never get milk. They do not get it in school. The schools are too small, the area covered is too wide. It becomes their living and consequently it is the last thing they get. They sell it all.

I would urge on the Minister to make inquiries to find out why this should be in a county like Carnarvon. Even the industrial areas have wide areas and valleys which are very much healthier than the narrow valleys of Glamorgan and Monmouthshire, In Carnarvon and similar counties we have a fertile soil and a beautiful coast and yet we have an appallingly high rate of death from tuberculosis in those counties. Why? All the natural aids to health are there, and I am convinced that it is due to the very low standard of life, to the terrible standard of housing, to the horrible cottages in which they live and to the fact that they have to sell all their best foodstuffs in order to live on what is left. These children go away to industrial areas and in a short tithe come back to die of the terrible white plague.

Last week we opened a Temple of Peace in Wales, in which I believe there are also to be the offices of the Welsh National Memorial, which is doing such good work to combat the ravages of tuberculosis. We all know how difficult it is to cure tuberculosis, but it ought to be possible in these days to prevent its ravages. I suggest that the only way to do it is to raise the standard of life of our people. This is a rich country: at this time it must be richer than it has ever been before. The country is so rich that the Chancellor is able to tell us that we can afford the expenditure of hundreds of millions of pounds on armaments, that our credit, power and wealth are such that we can stand this enormous expenditure without inflicting damage on the credit of the nation. Sometimes I doubt it; but if the country is rich enough to be able to afford to spend these millions on armaments, it is rich enough to raise the standard of life of the people.

Therefore, I urge hon. Members not to be drawn into regarding the question of malnutrition as some learned thing. Sometimes I am afraid that the tendency to consider malnutrition as an abstract thing takes us away from the reality of the problem. The reality is that malnutrition exists because the purchasing power of the people is low. Malnutrition is not due to ignorance, but to poor pay and low unemployment benefits and allowances. When people get a few shillings at the end of the week, they have to buy the cheapest food. Like my hon. Friend the Member for Farnworth (Mr. Rowson) I have had experience in these matters, and could give figures similar to those which he gave. We have in South Wales a convalescent home run by the Miners' Welfare Fund. Men who go to that home put on three or four pounds weight in a fortnight, but then they have to go from that beautiful place, with its good food, to unemployment benefit and allowances, or to hard work in the pits.

The other day, when we were discussing the question of food supplies during war time, I asked the Parliamentary Secretary to the Board of Trade whether, during the next war, having the experience of the last war in mind, he would make sure that there would be such a system of rationing that those workers who expended the most energy would get the best food, and the Parliamentary Secretary said that, of course, the Government would. We know that miners require more food than other people, because their work is more arduous. How can we give the miners, the workers of this country and their wives and children, more food? There is only one way, and that is to raise the level of wages, thereby giving them greater purchasing power. I congratulate my hon. Friend the Member for Farnworth on having brought the discussion of this matter down to earth, and I urge the Government that the way to tackle this problem is to increase the purchasing power of the people.

7.20 p.m.

I understand it would meet the convenience of hon. Members opposite if I made a few observations at this stage. I would like, in the first place, to congratulate the two hon. Members who have spoken on their very interesting contribution to this subject. Recently we have had a good many Debates on nutrition, and I do not complain of that, for I think it is a good thing to bring public attention to this matter. To-night the hon. Member for Farnworth has put the case with vigour and with comparative moderation—as much moderation as one can expect when dealing with the question of malnutrition. I welcome discussion this evening also because it comes at an opportune moment, and I seize this opportunity to call the attention of hon. Members to the publication of the first report of the Advisory Committee on Nutrition of the Ministry of Health.

I consider this is the most valuable document on nutrition that we have had up to the present time, and I do not think there can be any question as to the authority of the committee. There are on the Advisory Committee some very representative people of all types, not only doctors and experts, but other people. The chairman of the committee is Lord Luke, and among its members are Mrs. Barton, Professor Cathcart, Sir Gowland Hopkins, Professor Mellanby and Sir John Orr. It may astonish hon. Members opposite, when they read of the number of doctors and medical men on the committee, to know that the report is unanimous. I think that report serves a very useful purpose at the present time in that—I think hon. Members will agree with me—during the last year or two the question of nutrition has not only been a subject of much discussion, but one on which all sorts of statements have been made as to the condition of the nation. Many people have been bewildered and confused by masses of assertions and advice, informed or otherwise, on the matter.

I think this report may be fairly summarised in the following way. The committee say that, as far as this country is concerned, much has been achieved in this field, and much has still to be done. I agree with them. In the course of the report, they also state that a great deal of further information on the facts must be obtained before we can reach a final national policy on nutrition. I consider the report is particularly valuable in that it points out a number of ways along which we can make many advances. In considering nutrition, we must have a right perspective in the sense that, while this is an important side, it is one side only of our national health problem. A man does not live by calories alone; the national health does not depend only on vitamins, but I believe on a steady pursuit of many objectives, such as better housing, the clearance of slums, maternity and child welfare, the provision of more open spaces and physical recreation.

The hon. Gentleman who opened the Debate referred to the statements of Sir Robert McCarrison, which are certainly well worth quoting. I would like to add to those quotations a quotation of some remarks which he made:

"The efficient fulfilment of the function of nutrition depends mainly on five things—abundant fresh air, the free consumption of water, the action of sunlight on the skin, properly constituted food and the proper exercise of the body."
All those things go to make up what has properly been described as nutrition. As far as the word "malnutrition" is concerned, I suppose that to-day no word is more often used and more often abused. I would ask hon. Members to read Dr. M'Gonigle's book, in which he gives a very fair description of what malnutrition really means.

Does not Dr. M'Gonigle say that the income of an unemployed family is totally insufficient to buy the necessary amount of food to maintain that family properly?

I would not like to pledge myself to the statements made in a very large book by Dr. M'Gonigle, whose views I appreciate and know, but he says:

"There are those who maintain that the incidence of malnutrition is trifling; others see it everywhere. One result of the apparently contradictory views expressed by men of science and able clinical observers is to be found in the loose and confused manner in which the word 'malnutrition' has been used. This confusion is unfortunate, for it has given rise in the public mind to doubts as to the motives activating the savants. The word 'malnutrition' has by many been used in its narrow sense to indicate a bodily state, resulting from an insufficient supply of food, and characterised by loss of body weight."
He goes on to say:
"The word 'malnutrition' is used by others in a different sense. These people use the word to signify deviations from normal bodily growth or function attributable to incorrect diet. If this latter interpretation of the word is accepted, it follows that a high percentage of the population of this country must be categorised as having been at one time or another victims of malnutrition."
I think that is a fair statement of the position, I would like now to say a word on behalf of my friend Sir John Orr, because I do not think any man has been so misquoted or had such extraordinary conclusions drawn from his observations as those which I am constantly hearing attributed to Sir John Orr. It must always be remembered, in connection with a man who has made a very useful contribution to this subject, that he said in his book:
"There is need for further investigation and further discussion on the whole question in all its complicated relationships in order that the measures taken to deal with the situation may be based upon generally accepted facts and well-informed public opinion."
Sir John On never pretended in his book to give anything more than the results of an investigation.

If the hon. Member win read the book, he will see that Sir John Orr gives some tentative conclusions. I have referred to Sir John Orr because he is an important signatory to this report. That leads me to make some observations on the conclusions of the report which I think should be placed before the House. When I have drawn the attention of the House to one or two important conclusions of the Committee, I will tell hon. Members what I would propose to do as Minister of Health, and then I will make some final observations on the matter. I would like to draw attention to one of the conclusions in the report of the Advisory Committee. The conclusion is a general one, and does not refer to the Special Areas in particular. The committee show how the consumption per head of most foodstuffs has increased since before the War and give the proportionate increases in condensed milk, fruit, butter, vegetables, eggs, tea, margarine and cheese. They say that the consumption of butter and margarine together, is now 50 per cent. higher than it was before the War, but on the other side the consumption of cereals has fallen by nearly 10 per cent. since 1913 and milk and cream by about 6 per cent. They consider that this increased consumption of foodstuffs is evidence of a continued improvement in the national dietary and a rise in the standard of living and I would recommend hon. Members to examine page 16 of the report where they will find the exact figures.

On their broad survey, therefore, this representative committee come to the conclusion that the consumption per head of most foodstuffs has increased since the War and I think the weakest thing to which they can point in connection with the national dietary, is the consumption of milk which is on a very low level in this country. The committee draw some instructive conclusions by comparing the quantities of food available with the nutritional requirements suggested by the technical commission of the League of Nations Health Organisation with which they say they agree, subject to a few minor reservations. They find that, on the average of the years 1934 and 1935, the national food supply contained a fair margin of calories available over calories required and that there is no lack of energy-giving foods in the national food supply. In their opinion all, except a relatively small fraction of the population, are obtaining the full amount of calories which they require. Similarly, comparing protein requirements, based on the League Commission's recommendations, with the total protein supplies of animal and vegetable origin, the committee reach the conclusion that the national diet contains a sufficiency of protein, subject however, to the qualification that the consumption of animal protein increases, while that of vegetable protein remains nearly constant, as the standard of living rises with income. They call particular attention to the low milk consumption and say that the consumption of liquid milk per head has slightly declined since before the War. They record with emphasis the opinion that milk is the most complete food known and that there is no single step which would do more to improve the health and the resistance to disease of the rising generation than a largely increased consumption of safe milk by mothers, children and adolescents. They then turn to other kinds of food which they recommend.

I should also refer briefly to some passages in the report calling attention to two or three inquiries which the committee say ought to be made and pending which I think people ought to suspend judgment. The report is described as a preliminary survey of the whole field and a further investigation into family budgets and matters of that kind is recommended. In the circumstances in which I received the report I thought that a useful step forward could be taken in the direction desired by the committee if I communicated immediately with the local authorities on the matter, Accordingly, some days ago I asked the local authorities to do certain things. Before detailing the things which I asked them to do, I would say, as the committee said in their report, that a large number of local authorities are doing good work and I would not like it to be thought that the request which I am making to them is at all by way of criticism, at any rate, of a large number of the authorities. I have asked each authority to review at an early date its arrangements under the Maternity and Child Welfare Act for the supply of milk and other foods. in view of the importance of securing that the diet of expectant and nursing mothers shall contain the proper constituents and that the consumption of milk, especially by young people, shall be increased. It is true that practically all local authorities have already made some arrangements for the supply of milk, and many have also made arrangements for the supply of other foods, but it is essential that this important matter should be adequately dealt with throughout the country.

I have also drawn their attention to the fact that there is to be no question of the limitations which have hitherto been in operation in some areas. I have said that I do not think it desirable to adopt any such restriction, for instance, as that the supply of milk to expectant mothers should be only during the last two or three months of pregnancy, or that children should be supplied with milk only up to the age of LS months or two years, or that the limit of supply in every case should be one pint per day. I have further asked them to review the scale of income which the authorities at present use in connection with the requirement as to payment for milk and other food supplied. I have not suggested that there should be any departure from the principle that such part of the cost as the recipient can reasonably afford to pay should be recovered, but I have said that it is of great importance that the scales should not be framed so as to render it difficult for any mother to take advantage of the authority's arrangements.

I have added, as regards liquid milk, that wherever possible a supply of efficiently pasteurised milk should be provided and that where this is not practicable, the medical officer of health should approve the source and quality of the milk supplied. Finally, I have asked them to consider afresh the question of a properly organised system of meals. I concluded my communication to the authorities by saying:
"In some areas local authorities have hesitated on grounds of financial stringency to develop these services as fully as they desire to do In areas of this character the additional financial assistance afforded by the recently passed Local Government (Financial Provisions) Act, 1937, provides a further reason for an early review by the authorities of existing arrangements."
The block grants to local authorities have just been raised by £5,000,000 to nearly £50,000,000 a year and the re-arranged distribution gives a larger share to the authorities whose need is greatest. Therefore, I consider, and I have reason to know, that many of them will be able to continue and extend the work which they are doing in the direction indicated by the Advisory Committee.

With regard to the increase in the aggregate of block grants, is the right hon. Gentleman not aware that in the case of many of these services, including education services, the increase in prices which has taken place in the last 12 months is so serious that, even with the larger amount of block grants, local authorities have less money to spend?

I do not for a moment think that that suggestion could be made. In fact, I know, and I can on another occasion give instances to show, that the great majority of local authorities in the country will be enabled and have been enabled during the last part of the period to which the right hon. Gentleman referred, out of the additional grants which they are receiving, to make further provision in these respects, and as I propose to show in a few minutes, during the last few years steady progress has been made.

With regard to the phrase "Can reasonably afford to pay," would the Minister expect an unemployed person to be able to afford to pay for the milk?

Naturally this matter is administered by the local authorities, but if there is any case in which the hon. Member thinks that people are not being treated fairly, I shall be glad to do what I can with the local authorities concerned. Obviously, I cannot be the judge in each case, but as the hon. Member knows I am only too anxious to have these matters dealt with as fairly as possible. The Advisory Committee asked that two or three inquiries should be made, and we are putting one of these in hand through my right hon. Friend the Minister of Labour who is shortly to undertake a family budget inquiry to provide the material required for a revision of the basis of the cost of living index.

This is going to be incorporated in the Ministry of Labour cost-of-living inquiry. The committee have asked for certain further information before they issue their next report. I am arranging with my right hon. Friend the Minister of Labour to incorporate in his inquiry the obtaining of the further particulars which are required by the Advisory Committee. The proposals of the Ministry of Labour Advisory Committee will involve the collection of budgets from 10,000 families for one week, and from the large proportion of those families for three other weeks and also supplementary budgets of personal expenditure from wage-earning members of the families. By means of those particulars we hope to be able to obtain the further information asked for by the Advisory Committee.

Are we to understand that a report is going to be made upon a selection of family and supplementary budgets, and if so, what is to be the method of selection?

I cannot give details at the moment, but if the hon. Gentleman would like some more precise information on the subject, I will try to let him have it. I say, broadly, that we hope to be able to obtain the information which the Advisory Committee require through this inquiry of the Ministry of Labour, but as to the precise method I do not know sufficient at the moment to make a detailed statement. We also propose to make certain dietary studies which are recommended by the Advisory Committee.

Some of them will naturally take a considerable time, and I would not like to say when they will be completed, but obviously this information is required, and I hope the hon. Member will not have it in mind that these inquiries will stop other work from proceeding. Obviously, when an advisory committee of this character say they want further information, the Government have to do their best to obtain that information. Finally, I would like to satisfy hon. Members of this. I am conscious that there is much to be done and that in this examination we are only at the beginning of the process of dealing with a nutritional policy for the country. But a great deal has been done in the direction of improving the health of the nation in the matter of nutrition, and in order to impress that fact on the minds of hon. Gentlemen opposite, I will take what has happened since August, 1931. Since August, 1931, the biggest milk-in-schools scheme in the world has been started, and the Milk Marketing Board, in co-operation with local authorities and the Commissioner for the Special Areas, have devised schemes for the provision of milk at a cheap rate for expectant and nursing mothers and for children not of school age. Schemes are in operation in the Rhondda and at Jarrow, and one has been started, I think, within the last week at Walker-on-Tyne, and there will probably be others elsewhere. The main provision is that milk should be supplied at the reduced price of 2d. per pint.

The right hon. Gentleman put a question to me—and I am very glad to answer it—to the effect that prices have gone up so much during the last year or two that local authorities would be unable to make provision for these services and that they were generally in a very bad way. That is an extraordinary statement. I have obtained the figures relating to free meals which were provided during the period I mentioned—a period which no doubt the right hon. Gentleman well remembers—August, 1931. In 1931–32, so far as milk is concerned, about 16,472,000 meals were being provided. That figure in 1935–36 had reached 63,710,000. So far as free meals were concerned, in 1931–32 the figure was 93,232, and last year it had risen to 406,341. The same proportion obtains pretty well so far as other meals are concerned. I also got the figures out, because naturally the people who are concerned with the health of the nation will be interested in them—to show what has been done for the infant welfare centres where provision is being made for a large number of meals. The number of infant welfare centres in 1932 was 3,074, and in 1936 3,368. The total number of attendances of children under five in 1932 was 7,676,000, and that had grown by 1936 to 8,889,000.

That does not meet my point. What I said was that the increasing prices in all commodities, including building materials and the like, had been so heavy that local authorities even with the increase in the block grant would find very great difficulty in meeting the cost of these services.

I do not know what the right hon. Gentleman means by "very great difficulty." I should say that that was a wholly exaggerated statement. I think it will be found that he is dealing with conjectures and the future, and I am dealing with facts as they are, and that in the next 12 months, with the additional sums which will be made available in the form of block grants, local authorities will be able, as many of them are beginning to do, to extend their services in this connection.

I agree with what both the hon. Gentlemen said about one of the secrets of better nutrition in this country being more employment and better wages. It is a very important thing. It will be some comfort to hon. Gentlemen opposite, as it is a great contribution to the improvement of nutrition in this country, that since August, 1931, the numbers of those in employment has increased by 1,500,000. That is one of the best contributions you can make to the improvement of the nutrition of those people. So far as wages are concerned the Ministry of Labour Gazette in 1936 published these figures. In 1929–31, a period which the right hon. Gentleman opposite will never forget as long as he lives, 4,000,000 people suffered a net decrease of wages of over £250,000 a week. That, I should say, was a blow to the nutrition of those people. Since 1933, conditions have improved, and in 1935 over 2,350,000 work-people benefited from a net increase in wages of nearly £190,000 a week. So far as the nutrition of those people is concerned we did the best we could by obtaining better conditions.

7.52 p.m.

There is one aspect of the policy of nutrition on which I should like to touch for a very short time. One part of the Technical Commission's Report of the League of Nations has not been dealt with by the advisory committee. If the hon. Members would turn to page 44 of the commission's report they would find that white flour in the process of milling is deprived of important nutritive elements. This country is living on white bread, and all the beneficial properties of bread are being taken out in the process and we are being given something which is very bad for the nutrition of the nation. I am told that there was an experiment, I think at Cambridge, where they fed rats on white bread. After a few days some of the rats were dead, and the rest were at the point of death. They then gave them one little grain of wheat and those rats which were not already dead immediately recovered. That is of great importance to the nation. It is unfortunate that those facts have been put before the country by scientists and that the advisory committee is silent on the subject of the recommendation about bread. Other countries have taken drastic action to deal with this bread problem.

Signor Mussolini in 1932 ordered that 95 per cent. of the wheat grain should be a component part of the bread, and here in this country we are not at the moment taking any action to deal with this question. Gluten is extracted from the bread and is being sold as a separate product. You will find it advertised. Farmers are advised to give gluten extract to their livestock to make them fecund, yet we in this country are eating bread without it. That may raise another problem and I do not want to take up the Committee's time in discussing it at the moment.

There is, however, another factor which we might remember. Every year 36,000 people are dying of tuberculosis, and I would attach considerable importance to the connection between the bread we are consuming and the rate of tuberculosis mortality. I was interested in a speech of the hon. Gentleman the Member for Llanelly (Mr. J. Griffiths) when he talked about malnutrition in rural areas. In the North Riding we have tried to do what we can to improve nutrition and lower the tuberculosis rate, and we have been extremely successful. One of the ways in which the very energetic tuberculosis officers have dealt with the matter in the North Riding has been to give those suffering from tuberculosis a large proportion of bran in their diet. That has meant that when those suffering from tuberculosis have been caught at an early stage, those who are dieted on bran are completely cured. Surely, this advisory committee should go into the question of the bread we consume with great care, and we should, if necessary, follow the example of Italy in this respect and enact, by order or otherwise, that the bread should be composed of whole wheat and that the gluten and other products should not be extracted from bread.

In the rural areas there is a good deal of malnutrition which we ought to avoid at the present time. Cheap milk is possible to those who are employed in agriculture, but those who live in agricultural districts without being directly employed on the farms find it hard to get milk at the present time. The increase of manufactured milk from 250,000,000 to 410,000,000 is unfortunate in that respect, because some of that milk could go into the feed both of the children and of the stock of the country. Also I have noticed in the country districts a gradual increase in the consumption of tinned food. I would like the advisory committee in their next investigation to inquire more fully into the value of tinned foods as opposed to fresh foods. We must not isolate the nutrition problem and confine it to the urban areas. It is very real in the rural areas, and the rural dwellers are most anxious to benefit from the great work the Government is doing towards improving the nutrition of its people.

7.59 p.m.

I do not propose to follow the last speaker in what he said about Italy's example. I should feel very disinclined to follow the example of Mussolini in anything. I am sure I voice the views of all my colleagues on this side of the House when I say that we do not in any sense deprecate the investigations that are being made by scientists and other eminent people in this country into the food supplies of the people, but we are very much concerned about the enormous delay that these investigations seem to cause. Whilst we are theoretically analysing the problems of malnutrition we are permitting hundreds of thousands of people literally to starve, and it is quite impossible to maintain health if the breadwinner in the household, whether he receives wages or unemployment benefit, or comes under the jurisdiction of the Unemployment Assistance Board, cannot obtain food for his family. The figures that have been cited by the Minister, showing the increasing percentage of milk consumed in this country, are perhaps the most concrete piece of evidence we have of the extent of malnutrition, and of the enormous suffering due to the fact that people are poor. This evening we concluded in Standing Committee upstairs the consideration of an agricultural Bill which has for its purpose the granting of £5,000,000 in order to help the producers of prime beef. If people were provided with adequate wages the standard of living would be so raised that they would consume an ever greater quantity of prime beef.

The Minister, when he was talking about the year 1931, conveniently forgot that since 1931 the Government, by its tariffs and quotas and other restrictions, has deliberately prevented the people from obtaining as great a quantity of foodstuffs as they enjoyed prior to that year. In addition to raising the price of food, they have reduced the income of the people and even though, as they assume, prosperity has now returned, they allow a portion of the Economy Act to survive in the Means Test, as if such an economy were as necessary to-day as in the year 1931. The people who suffer most from malnutrition are the people who reside in and about the Special Areas. As the hon. Member has just said, there are a large number of agricultural workers who are suffering from malnutrition. It is only the poor who suffer from malnutrition, or rather, I should say that 95 per cent. of those who suffer from malnutrition are the poor. Hon. Members say quite correctly that as the income increases so does the standard of living; obviously the converse applies too. If you cut benefits by 10 per cent., whether in the form of wages or public assistance allowances, you lower the standard of living, and to that extent cause increased malnutrition. People in very many instances are faced with slow starvation—and I think that is the term that ought to be used. The National Government, with its enormous powers, ought to see that a sliding scale is applied to wages and to public assistance allowances. The cost of living has risen during the last 12 months by 12 per cent. That is half-a-crown in the pound. Nothing is being done by the Government in order to put that right.

Well if it is 12 points I think it is not far from 12 per cent.—but I think you will find that it is quite 12 per cent. Whatever the figure is—and no doubt we shall hear from the Government—to that extent the people are deprived of food and suffer more from malnutrition. I would ask the Government in the first instance to restore to those who are on unemployment assistance allowances at least what was taken from them under the Economy Act, 1931. The breadwinner in the household should receive what he received before 1931, in order to maintain his family. That reduction is one against which Members of the House have protested during the last few years, but it still continues. There can be no doubt that there is a tendency for the cost of living to rise, and I think it would be well if the Minister of Health tackled that matter immediately; it is of far greater importance than any theoretical inquiry as to the cause of malnutrition. There is a case not only for the supply of free milk, but for the supply of free beef if the people are not to suffer from malnutrition. There is a case for the supply of free bread, and of other things that are necessary to health. One wonders sometimes what is the reason why the introduction of free milk has caught on in this country. It might be interesting to analyse the reason for the setting up of the milk marketing schemes, but that perhaps would be wife of our discussion this evening, and I do not wish to enter into the reasons why the Government has provided subsidies and produced marketing schemes in order to dispose of a surplus in such a way as to give advantage to the industry in high prices as well as in subsidies—for that is what has actually been taking place; the producers of milk and many other commodities have not only been raking off substantial profits but have been receiving a subsidy from the taxpayers as well.

I would like to put what may seem perhaps a small point to the Minister, and I hope we shall have a reply to it. I saw in the Press last week-end that a man for whom I have very great regard, and for whom I know all my colleagues have very great regard, and I trust that the Minister has great regard for him too—Dr. Samuel Hastings—was speak- ing at one of the university colleges and mentioned the time that was taken in inspecting school children under the school medical service. He was, I think, dealing with the London County Council schools. He said that six minutes is the time taken to examine a school child, and he complained that it is quite impossible to find out the flaws in a child's health in six minutes. He also indicated that, whilst it is obligatory on education authorities under the school medical service to examine a child three times a year, the London County Council examines school children, I think, four times a year.

I want the Minister to consult the President of the Board of Education to see whether something cannot be done to give far more accurate information as to school children's state of health than we have at the present time. A few days ago we had occasion to discuss this matter, and we not only questioned the figures that the Minister placed before us, but also the method of computation. Dr. Samuel Hastings has to some extent corroborated what we had to say on this side of the House, and I hope that what he has said in this regard will be examined by the Department, to see whether it is possible to find out the actual physical state of a child in six minutes, including the time in which a report has to be written on the child's condition. I am sure most hon. Members will agree with me that six minutes is certainly not sufficient time. And yet the figures that are presented to us in reports on the condition of school children in this country are dependent on such scanty examination as that.

We do not really know the physical state of our school children, and with such inadequate medical examinations we cannot hope to know it. I hope the Minister will insist that the school medical service is treated in a far more scientific way than it is treated to-day. If the National Government want to deal adequately with the question of malnutrition they would at this juncture, particularly with a rising cost of living, support the people who are on strike on the Clyde, who are asking for just a penny per hour increase on their wages; they would support miners and others, who are working for wages that are totally inadequate to maintain them in a proper state of health. They would also increase the measure of allowance that is paid by the Unemployment Assist- ance Board, and certainly recommend that the surpluses which are accruing in the Unemployment Fund ought to be distributed in increased benefits. That is the concrete way of preventing malnutrition in future.

8.15 p.m.

We have been so long in starting to deal with this serious problem that there is a certain amount of leeway to be made up. The nation is much below the standard of an Ai nation. I remember during the War how we were frequently referred to as a C3 nation, and one would have imagined that, as the result of our experiences, we would have put our house in order immediately after the War. Instead of that, we have made no definite attempt except for the recent splendid work of individual doctors and men who have given their time for a scientific examination of this problem. The wage factor is undoubtedly the main obstacle. Another obstacle is caused by the housing position. An increasing burden is being placed upon working-class people on account of the action of the Government. On the day that the National Government withdrew the subsidy from housing, they put another obstacle in the way of the solution of the problem of subnormal children and people and of the people who are suffering from malnutrition.

If the Ministry were to take a return from the various councils asking them to furnish the number of people on their waiting lists for houses, the country would be appalled. I know several councils in my area which are still busy with the 1930 and 1931 applicants for houses. There are anything from 400 to 800 people on these lists waiting for houses and unable to get them. The alternative is that they often have to live in flats, paying up to 14s. or 15s. a week out of the wages of men who are employed regularly—because in Northumberland we have had fairly regular work for some time. As the result of the increase in wages in January last year, the wages of our subsistence men are 6s. 9½d. a day, and when they are in a full week's work they probably have 37s. to take home. Many are paying 13s. to 14s. a week rent, which leaves them with 23s. for food, clothing and all the necessary expenses of living, without any question of amenities. When Sir John Orr published the fact that there are 4,500,000 spending up to 4s. a week per head on food, I can subscribe to it knowing the conditions that our people have been enduring.

Figures have been quoted by the Minister of the rapid increase in milk meals. The Department ought to go into the question of solid meals. I heartily subscribe to milk meals, but I would prefer the milk to go into the homes of the people so that the milk could be taken at the regular meal times. I sometimes wonder—and I am speaking a little from experience—whether, if the milk is not served to the children in school until 11 o'clock, and they go home at 12 o'clock, they are getting the full benefit of the milk. If we could have an extension of the scheme which has been carried out in parts of South Wales and Jarrow, where milk is supplied to necessitous families at prices they can afford to pay, the milk could be prepared in the cooking at home and be used at the proper meal times. I do not decry the milk meals in the schools, but I would like the Minister to make inquiries and to see that where the milk is supplied in the schools it is supplied as early as possible so as not to militate against the child when it goes home for its midday meal.

This debate is a remarkable sequel to the one we had yesterday. Then we were discussing salaries and pensions, so that we could be sure that certain people could live with dignity, free from temptation, and that they would be assured of being comfortable when they had gone out of harness. Now we are at the other end of the scale, where the millions are. I would ask that some of the vast sums of money the existence of which has been revealed by the armament programme should be given to the millions of the poor and to hardworking people who are receiving low wages, because that would be the proper way to secure efficiency and to abolish malnutrition and the subnormal condition of our people.

8.26 p.m.

I wish to direct attention to one aspect of this matter which I regard as of primary importance. I share the view expressed by the hon. Member for Llanelly (Mr. J. Griffiths) that this is a matter of simplicities and not complexities, and that economically nutrition should have as its basis adequate family purchasing power, but it is not less accurate to say that physical nutrition must have as its basis a sound nourishing meal daily in the early years of life and in that sense I share the regret expressed by other Members that we have extended so little the nursery school system. There are permissive arrangements which enable local authorities to repair some of the dire deficiencies which the lower-paid sections of our workers and also unemployed men and women are experiencing. On 22nd March I addressed to the President of the Board of Education an inquiry as to how many free solid meals were supplied in schools in England and Wales in 1936, and I received a very interesting reply that 22,000,000 free solid meals were so supplied. I regard that as "not a bad bit of Socialism," inadequate as it may be—it was so described in the early days of legislation on this question by an hon. Baronet who was a distinguished Member of this House.

The criticism I have to make first of all is that the number of free solid meals provided is inadequate, and, secondly, that they are very unevenly distributed. The President of the Board of Education supplied me further with an analysis of the figures, and I desire to place them on record for some of them are of an extremely disturbing character. Of a total of 434 local authorities equipped with permissive powers to feed school children only 28 per cent. use them to provide free solid meals, that is to say that 72 per cent. of the local authorities do not provide a single free solid meal to one hungry child in their administrative areas. Among these authorities are 62 county authorities, and of those 83 per cent. do not provide one free solid meal to one hungry child. In the county boroughs the figures are exactly the reverse, which is perhaps a reflection of the complexion of the local authorities concerned.

I would direct attention to this unevenness in the distribution of free solid meals for a reason which I feel keenly. My constituency is situated in Derbyshire, and it is not possible for me to believe that in my constituency, or in Derbyshire as a whole, there is not one hungry child who does not need one free solid meal, and yet the Derbyshire County Council does not provide one free solid meal to one hungry child. I know that the Ministry of Health and the Board of Education have done a great deal to encourage local authorities to use their powers, and I would appeal to them to pursue that process, and to do all they can to make it clear that all the hungry and needy children are not to be found in the areas at present providing free solid meals and that it is not the case that in the areas not providing them there are no children who need them. It is an axiom that you cannot adequately educate an inadequately fed child, and therefore the whole purpose of education is being frustrated by niggardliness and meanness on the part of local authorities who will not adequately employ the existing powers. I ask the Parliamentary Secretary and the Board of Education to pursue the policy of persuading reluctant local authorities to use these permissive Powers in order that badly nourished school children shall at least be more sufficiently fed.

8.32 p.m.

I am sure that the Debate of yesterday must be in the mind of every Member, and I feel very much that the House ought not to have agreed to increasing salaries to a very high level until it had succeeded in removing all the malnutrition which arises from poverty. It can be said with truth that a large amount of the malnutrition in the country arises from poverty. Reference was made by the Minister to the block grants and he argued that with the increased money now going to a number of the distressed areas they would be able to provide services which they have not otherwise provided. I have taken out some figures with regard to the additional money which some of the distressed areas will receive under the provision of the block grants, and they show that the claim of the Minister is unfounded in a large number of cases. In Cumberland the county council, as the result of the block grants, got relief to the extent of 23.8d. in the pound, and that is a substantial amount, but the rates this year will not be reduced at all. It is not true to say that Cumberland as a special area will be in a position to increase its services over and above those provided last year. That is characteristic of a number of the distressed areas, because with continuously falling rateable values the existing services need a higher rate to maintain them. Durham, with a rate level of 18s., which is high, have got under the block grant 20.8d. in the pound, but the reduction in the rates in Durham will be only 8d. and not 20.8d. That is another case of a distressed area where the county will not be in a position to provide the added services.

Breconshire is another county where the amount is 20.3d. There, the rate reduction will be nil. Some parts of that county are distressed, such as Bryn Mawr, which town has borne the brunt of the industrial depression since 1921. In Carmarthen, to which reference has already been made, the amount of the block grant was 27.5d., but the rate reduction will be only 2.5d., the rest being absorbed in the normal services. In Glamorganshire the rate is 20s. 11d. in the pound. That is one of the most highly rated counties in the country. The revision of the block grant gave 24.5d. but the council are able to reduce their rates only by 1s. 0¾d. In view of the fact that the rates are so high there, I do not think that the Minister can argue with much force that it will be possible to increase the expenditure in Glamorgan, where the need is particularly strong to provide those additional services. In Pembrokeshire, the amount under the revision of the block grant is 34.7d. and the amount of the rate reduction will be nil.

It is entirely wrong of the Minister to contend that these very necessary services can be extended because of additional money under the revision of the block grant. The Government have put very little new money into the block grant. Under the Act of 1929, the Government undertook to bear a certain percentage of the cost of local government for a period of years, in this case five years. During that five years there was an increase in the expenditure of local government bodies, and the Government paid their 23.2 per cent., which necessitated the £5,000,000 to which the Minister referred. That was part of the arrangement under the 1929 Local Government Act. The only new money which the Government put in was about £220,000 in order to balance up. It is entirely wrong of the Minister to claim that additional money has come to local government bodies as a result of the Government's generosity; indeed, what additional money did come to the Special Areas was as a result of the generosity of other and better off local government bodies in the country. They agreed to the revision of the block grant, and as a result of that agreement some additional money went to the Special Areas. Even with that added money, those areas will not be able to incur very heavy expenditure in increasing the amount spent on these services.

Perhaps what is most fundamental to those areas is the rate of unemployment benefit, and the rates of assistance of the Unemployment Assistance Board. One tires of talking in this House about those rates. Everybody who has had the rather nasty job of working out family budgets knows that a very large percentage of unemployed families are living and providing their meals at an expenditure of about 2d. or 3d. each. It is that position which creates the problem of malnutrition in those homes. All the appeals that we have ever made to the Government have been quite ineffective. Then, in discussions such as this, the Minister of Health contends that the Government are anxious to do what they can to deal with malnutrition. Perhaps the best way to describe that is to say that the Minister is not in earnest when he makes statements of that kind, with the full knowledge that a large number of people have been existing for a long time on those paltry rates of unemployment benefit, and the amounts they receive in unemployment assistance. Nobody has ever contended, not even the Minister of Labour, so far as I know, that the rates of unemployment benefit were intended to be adequate maintenance for anybody. The rates were fixed to tide families over from one period of work to another, but lately they have been regarded as amounts sufficient to maintain families, and they have had to maintain families.

One of the things which the Government could do immediately to deal with the problem of malnutrition, particularly among unemployed people, would be to increase those scales to a point where they would enable people to buy sufficient food. What people need most is an increase in purchasing power. That would enable the mothers to buy food to feed their children. One knows that the mothers of the country, particularly mothers in unemployed homes, are making tremendous sacrifices for their children. We have had experience of that in the county of Monmouth. We say to our schoolmasters, "Will you exercise what care you can to ascertain whether these children have been supplied with breakfasts before they come to school?" The headmasters and school teachers generally co-operate with us in that connection. There are many instances, however, where children have had to be sent to school in the morning without breakfast because there is nothing in the home for them to have. Thursday is the most difficult day imaginable for the woman in the unemployed home. All the purchases of food have gone. It is on Wednesday, Thursday and Friday that malnutrition is set up in the unemployed homes.

The Minister made reference to Sir John Orr and quoted certain parts from that gentleman's book, but surely the fundamental point that Sir John Orr stresses is that the purchasing power of people is insufficient to enable them to buy food. What about his 10s. per person? He deals with 4s. per person, 6s. per person, and so on through the scale till he comes to l0s. per person coming into the home for the purchase of food, and it is there that malnutrition disappears. It is at the bottom of the scale that we meet our difficulty. Some years ago an investigation was made in Cardiff and one result was to show the difference in the consumption of milk according to the income of the family. It was found that in homes where the income was about 30s. or lower no milk was purchased but where the income was about n and upwards the supply of milk was adequate for the requirements of the family. The Milk Marketing Board are devising all kinds of ingenious schemes for increasing the sale of milk. I think it is true to say that the board will have to spend approximately £100,000 this year in advertising, in order to tell the people that milk is a good food, while every member of the board knows that the real potential market for food in this country is the poor home. It is those people who have not sufficient money to enable them to purchase milk.

I think the Ministry of Health should recognise that fact. If they did, it would be of great advantage to the State. It would raise the standard of health, and it would improve the dairy trade of this country very substantially, which ostensibly is what the Milk Marketing Board is attempting to do. The Minister referred to Dr. M'Gonigle's book, but he did not quote Dr. M'Gonigle's experience of the removal of those families from slum houses to houses newly built by the council. The rents of the slum houses were, if I remember rightly, about 2s. or 2s. 6d. a week, but the rents of the council houses were approximately 10s. When the people were removed from the slums into the better houses, they had to pay more rent, and they had less money with which to purchase food. The consequence was that, although they were living in better houses, the standard of health fell.

It is no use the Minister talking about houses apart from the question of food; food is more important than houses. I agree that houses are important, but it is necessary to consider both together. If you remove people from the slums, you reduce their food purchasing power, and the result is likely to be more damaging than helpful to the health of the people concerned. This matter is one of considerable importance, and I am sure that every Member on this side of the House would like to see it faced definitely. The Minister has told us about some more inquiries that we are to have. We have had the inquiry of the British Medical Association, and we have had an inquiry and experiments among school children by the Milk Marketing Board. We have had a number of inquiries, and now we are to have another. It is not inquiries that we need. What we need, and what we shall have to have before this problem of malnutrition is solved, is a greater purchasing power in the hands of these people. I hope that the Minister will face that problem. If he does, the Government will then be able to attack the problem in a practical manner, instead of diverting their efforts into inquiries of this kind and that kind and still getting nothing of real importance done.

8.49 P.m.

I am sure the Parliamentary Secretary will not think that this Debate has been useless. The subject is so important that it is a pity there has not been a larger amount of interest in it in some parts of the House. Members on these benches have, however, made a number of speeches in support of the idea that a great deal more is needed in organisation and administration, and especially in good will, if proper benefit to the health of the nation is to result from the efforts to combat what is now plainly known as malnutrition.

The speech of the Minister of Health, although it opened with congratulations to my hon. Friends who commenced the Debate, was in such a form and spirit that I am sorry the right hon. Gentleman is not present now to hear what I have to say in reply. The more I listened, the more I felt that he was completely self-satisfied about this matter. Even though a phrase might be thrown in here and there to the effect that there is much yet to be done, that the Advisory Committee think that some improvement is still possible, and so on, the general attitude of the Minister was, "See what we are doing; see what committees are appointed; see what inquiries I am going to have. Altogether, everything is going to be best in this best of all worlds within the given circumstances, provided that you only trust the present Government to carry out the policy they have laid down." The more I listened, the more I felt that the policy which is being adopted is not touching the problem. Take the report of the Advisory Committee on Nutrition, which the Minister was quoting. The committee say, in paragraph (iv) of the summary on page 29:
"There is, however, much room for further improvement in the health and the physique of the nation, and the more extensive application of recent discoveries in nutrition should result in new and higher levels of physical well-being."
I should have thought, listening to the Minister to-night, that if only you went on pursuing the kind of inquiries and the circulars to local authorities of which he spoke, everything would be all right; but when one looks at the circular issued in the first week in April, it is merely a pious expression of hope to the local authorities that, as a result of the recommendations in the report of the Advisory Committee, the local authorities will do a little more than they have done already in securing milk for expectant mothers and young children. When one examines a circular like that, one feels that, after all, the Minister has made no contribution to the problem. Indeed, he said just now that of course the local authorities would have to do it anyway, that they were going to get between £4,000,000 and £5,000,000 more under the revised block grant arrangements, and there was nothing more to be said. He completely failed to answer the objection which I raised on that matter.

There is no one who has been connected with local authority work during the last six months who does not know that, as a result of rising prices of commodities and materials in connection with the provision of new schools and new institutions, the volume of expenditure to be incurred within the next 12 months or two years is so large that it will go far to wipe out any improvement in the block grant revision that would accrue to some of the depressed areas. Therefore, to express a pious hope in a circular issued in the first week in April to local authorities that they may be able to do something more in bringing supplies of milk to necessitous mothers and children, seems to me to be wholly inadequate, coming from the lips of one who was in such a self-praising mood as the Minister was to-night.

It seemed to me to be very regrettable that, at the end of his long recital of what they are supposed to be doing, he made a sort of political attack. The trouble is that the right hon. Gentleman, with all his personal popularity in the House, cannot forget that he was the head and forefront of the Tory propaganda headquarters at Palace Chambers, and, therefore, at the end of every Ministerial speech he has to have some jibe at the party who were in office from 1929 to 1931, and to claim that all the improvement that ever happened in the social life of this country is due to some miraculous condition of affairs which has occurred since the National Government came into office. What awful "bunk" that is when you examine it. Take, for example, the references to wages. What was the amount of wage reduction per week in the period 1929–31, and what has been the amount since? The Minister was very careful not to compare like with like. He gave certain figures which, so far as I remember them, related to 1929–31, but he did not tell us anything about the reductions which took place in wages from 1931 to 1933. We do not hear a word about that. Since then he has been giving us special figures of increases in the last year or two. He has told us nothing about the vast reduction in the volume of money going into working class homes by the ruthless adoption of the means test. He did not tell us anything about the vast hordes of people turned on to Poor Law relief from 1931 to 1935, one of the blessings of the National Government, with all the extraordinarily increased charges upon local rates.

He is completely silent about all that and he gives us this sort of Edison-Bell record that he is so accustomed to broadcast as the leader of the publicity and propaganda of the Tory headquarters. That really will not do as an answer to a considered case for more to be done by the reigning Government in regard to this problem of malnutrition. It will not satisfy the people of the country. We expect the Government to grapple more firmly with the problem. The problem exists and it is no use for the Minister, or for an advisory committee, or any other body as far as that goes, to think that this problem can be settled simply by quoting mass figures and averages. The Minister might do well, if he has not already seen it, to have a look at a paragraph in the "Economist" this week which deals with a recent report on the comparison between the distribution of income in the case of America and of this country. I should like to read a short passage from it:
"In Great Britain there is some danger of some congratulation becoming self-satisfaction. It seems likely from the figures that the average per capita real consumption of the Englishman, even in 1932, was less than that of the American, although, for all the reasons given earlier in this article, the comparison cannot be more than a first impression. And, in any case, the figures are averages. They conceal an increase of destitution among a substantial majority, balanced by a slight increase of consumption by the majority. Averages can be deceptive, for it is impossible in any ultimate sense to balance the starvation of a miner's family in the Rhondda against the five extra hats of five housewives in Oxford and declare them equal."
That is the danger that we have to guard against in dealing with mass statistics of the kind that I find in this report of the advisory committee on nutrition when they purport to set up the total supplies available for consumption in the country and what is the assumed consumption per head, in consequence, as between the two parties. It all depends where the change of habit has come, and, where the spending income has been available in the particular areas or families, what value can be attached to these figures, and it is not a bit of use to rely upon averages when you are made aware day by day, in the reports from the depressed areas especially, of the tremendous amount of malnutrition. Let us take the danger cited by my hon. Friend the Member for Pontypool (Mr. Jenkins), who was quoting, I take it, from the "Poverty and Health of the People," by Dr. M'Gonigle. I took one or two extracts from the book in regard to the transfer of the working-class population from slum areas to housing estates. He says:
"The population of the Mount Pleasant estate contained a high proportion of young persons and consequently gave rise to the expectation of a low death rate. Calculations based on the age and sex distribution of this group of people show that the expected mean death rate for the five-year period between 1928 and 1932 would have been 8.12 per thousand. Actually it amounted to 33.55. This constituted approximately a fourfold increase on a normal expected death rate.
In 1928 the mean rent on the Mount Pleasant estate was 9s. per family per week. On their transfer to Mount Pleasant the commitments of the translated families were, by reason of higher rentals, increased by 4s. 4d. per week.
It will be noted that the unemployed families on the Mount Pleasant estate spent on food only 2s. 10½d. per man per week."
It is obvious, therefore, that, if you are thinking about the problem of health, if you are thinking about improving housing and the like, it is utterly impossible to hope for a solution of the problem unless, with improved housing conditions and the rental charges involved, you increase the income of the individual holders, whether employed or not, in order that they may be able to obtain the minimum standard of nutrition. Moreover, while I certainly have no objection, any more than my hon. Friend, to an increasing number of inquiries, the right hon. Gentleman seemed to take pride in the fact that there is to be a further inquiry into family budgets. In the Sheffield inquiry, the Liverpool inquiry, the Manchester inquiry, the Salford inquiry, and the inquiry of the British Medical Association, we have an abundance of material available as to what dietaries cost the household for them to take any necessary action if they like. It is simply a long-drawn-out process of appointing inquiry after inquiry instead of doing what is essential, enabling the people concerned in one form or another, either by improved wages, or by increased assistance or by adequate scales for those who have recourse to public assistance, to be able at least to purchase the minimum standard of food required to set up a proper basis of nutrition. There is also sufficient evidence already to show that the increased cost of basic dietaries to-day is such as to justify the special attention of the Government to the income of the families which have to obtain the food.

I hope the Minister of Health has seen published in the journal of the Royal Statistical Society the recent paper by Mr. R. F. George, speaking to the study group of which he is chairman, in which he has clearly proved the case that in settling the poverty line now it ought not to be done by the figures of the British Medical Association scale of two or three years ago. It must be done by the present cost. Mr. George, in a very careful and unbiased and purely statistical way, has worked out the cost on the basis of the British Medical Association's scale. A lot of my friends never agreed that the basic principle of that scale was a fair one, but let us take it. You will find in the paper of Mr. George that in 1933 the cost for an adult meal, on the minimum of the British Medical Association, was 5s. 11d. per week. Mr. George now points out that on the cost-of-living index figure for July, 1936, that same diet would cost not 5s. 11d. but 6s. 9d., and if we examine the change in costs since July, 1936, then the cost of the British Medical Association scale would not be 5s. 11d. per week or 6s. 9d., but 7s. 3d.

The hon. Member for Belper (Mr. Wragg) cannot have studied even the Board of Trade Journal. I observe in the Board of Trade Journal for last week that the wholesale prices of food alone show an increase over the corresponding week of 1936 not of 12 points but of 15.6 per cent. Although it is true that in the case of meat, and in certain districts in the case of bread, the whole rise in the wholesale price has not been passed on by the retail trade, it is inevitable that it will be passed on, and the poorest of our people with their present small incomes will have to deal with the question of diet and nutrition not on the figures for 12 months ago, but on the actual prices at the present time. That figure in regard to food is borne out by the general figures in relation to all wholesale prices, which show an increase in 1936 from 87.8 to 107.3. Let us look at the retail prices so far as they have been reached. The advisory committee in their recommendations said:
"The present average consumption of potatoes is about 56 ounces per head weekly. We recommend that the consumption should be increased."
How is the consumption to be increased by poor people in their present circumstances? We have been begging the Government to remove the levy on potatoes because of the shortage in the main crop; we have been begging the Government to take note of the report of the Food Council about the iniquitous restrictions on the output of potatoes. The Government have taken no action. Let me ask the Minister of Health what he is going to say to his colleagues in the Cabinet. This is what the Food Council said:
"We regret to note the reduction of acreage under potatoes to 590,000 in 1936 as against 671,000 in 1933. This reduction in acreage suggests the advisability of suspending in present circumstances the levy of £5 per acre on plantings in excess of each producer's basic acreage."
Does the right hon. Gentleman propose to say anything to his colleagues about that? It would be doing something to carry out the recommendations of the advisory committee. Or is he going to say to the Import Duties Advisory Committee that King Edward potatoes are being charged at 2d. per lb. retail while in my youth five pounds could be bought for 2½d.

They were not 2d. per lb. in April, 1930. Perhaps the Parliamentary Secretary will check the figure for himself—and they have been figuring wholesale at £10 10s. to £11 10s. per ton. The Government talk smugly about the problem of malnutrition instead of doing something effective by obtaining low prices for the people. Take bread. The price this week in most areas has gone up to 9½d., and I very much regret to say that in one or two other areas it has gone even above that. The price at the moment is bearing very little of the Government's levy to the British farmer because of the effect of world prices, but all the way through the Government have been charging the consumer a special levy on bread and flour. That does not aid nutrition. There is not only a high price for bread at the moment but every prospect of the present prices of wheat going higher still. Sugar is up and tea has increased in price, as well as margarine. Because of world conditions and also because of the inflationary policy of the Government, there is a general stiffening of prices, which is a very serious factor in dealing with the problem of getting food for the nutrition of the people as a whole.

The Government have made no real attempt to-night to deal with the problem of nutrition. I agree that the whole of the factors in regard to nutrition are not to be found in prices. There is something to be said for training in the proper use of food, but it is not very much use to tell a working-class housewife exactly what food is best for her family if you do not give her the minimum sum required to buy what is necessary. That is the real point of our criticism against the Government. I do not mind talking about 1930 and 1931. It is a period that I shall never forget as long as I live. It illustrated the truth of the old saw that figures might not lie, but liars can figure. I shall never forget the lying use that was made of figures in 1931. Ever since 1931 until within the last few months the policy of the National Government has not been to assist the working classes to get a better access to the foods required for nutrition. On the contrary, it has been to say that the country could not afford it and to throw the burden of the general Exchequer more and more on the working classes. It has been a policy to increase the taxation of the poor in their commodities by £90,000,000 a year more than in 1931.

The Chancellor of the Exchequer or the right hon. Member for Hillhead (Sir R. Home) may say that we can afford £1,500,000,000 for armaments, that we can take it in our stride. The argument now is that the Government are doing all they can to give the people access to all the things which are required for nutrition. I beg the Government to get a real change of heart. They need it very badly in this matter. They have a great deal of leeway to make up for all that they have done to the working classes and not for the working classes during the last few years. If at this time the Government will set about a reorganisation of administration in such a way that our people will be properly fed and their health improved, we will not criticise them but will support them.

9.16 p.m.

The right hon. Gentleman the Member for Hillsborough (Mr. Alexander) said that one of the things he learned in 1931 was that although figures could not lie, liars could figure. When I have sat down, perhaps the House will be able to judge which of those two ought to be applied to his speech. I would like to deal with one or two of the points made by various hon. Members opposite. The hon. Member for Ogmore (Mr. E. J. Williams) said that it had been stated recently that the figures regarding the results of an examination of school children could not be of very great value because the time taken for the examination was only six minutes, and obviously it was impossible to have a proper examination in that time. I am told that in fact the time taken for the examination was not six minutes, and that the examination of some of the children took a longer time and that of others less time, the average being six minutes, which was adequate for the purpose.

The hon. Member for Clay Cross (Mr. Ridley) called attention to the fact that no solid meals were granted by the Derbyshire County Council. I understand that the answer to the hon. Member is that in scattered rural areas it is extremely difficult to make the necessary physical arrangements for providing a solid meal, but that the majority of rural counties, where the necessity for school feeding exists, do in fact make adequate provision for the supply of extra quantities of milk instead of solid meals. Another hon. Member referred to the reports of Dr. M'Gonigle. The right hon. Gentleman the Member for Hillsborough also said that in a well-known book Dr. M'Gonigle had reported the results, as he saw them, of the transfer of some people from slums to new housing estates and that Dr. M'Gonigle had drawn the conclusion, from the fact that the death rate went up, that, on the whole, the families were not as well off in the new houses as they had been in the slums. He attributed that deterioration to the fact that they had to pay high rents, and had not enough for food.

I did not know that that point would be raised, or I would have brought with me some extremely interesting results which have been obtained from investigations made by various local authorities into similar circumstances in their own areas. I cannot give the exact figures, but I can assure the House that the general effect was that inquiries were made, on a much bigger scale than those of Dr. M'Gonigle, in Leeds, Manchester and another large town, and it was found that precisely the opposite results had accrued from shifting the population—the mortality rate had gone down and the general health had enormously improved. It is clear that much bigger experiments in large towns such as Manchester and Leeds give infinitely more valuable results than the very small experiment made by Dr. M'Gonigle. I think the House may take it that the figures given by Dr. M'Gonigle are not followed in the rest of the country, but that, on the contrary, the universal experience has been that the people have materially benefited as the result of being shifted from the slums.

The right hon. Gentleman the Member for Hillsborough, in his anxiety to make a case against the Government as regards the provision of houses, forgot to mention that one of the most valuable aids given to the local authorities is the 1935 Act, which enables an authority, for the first time, to lump all its housing subsidies together into one fund and to apply the resulting total subsidy money in the way best calculated to be to the advantage of the people to be moved; in other words, to give the maximum subsidy to the particular house where a person is living with a large family on low wages and cannot afford to pay the big rent he would otherwise have to pay. Consequently, it can be said that this Government, for the first time, has endeavoured to tackle the question of high rents. We have provided local authorities with a weapon which will enable them to give assistance to those families in which it is most needed, and to abolish the danger, to which hon. Members have referred, of people not being able to get enough food because they have to pay too high rents.

Will the hon. Gentleman carry his argument a little further? If you have other families above the poverty line, and they have to pay a higher rent than those below, you will bring them down as well.

It is no argument to say that if one cannot do good to everybody, one should not do it to anybody. The right hon. Gentleman the Member for Hillsborough then spoke about the circular which my right hon. Friend sent to local authorities on 1st April, concerning additional provision for maternity, child welfare and school feeding, and the right hon. Gentleman professed to see in it merely an admonition which would have very little result. If he had read the circular carefully, he would have seen that in one of the later paragraphs my right hon. Friend specifically demanded that the local authorities should inform him at an early date of what action they proposed to take or were taking under the circular. It remains to be seen whether or not that circular has been effective in the objects we have in view. The right hon. Gentleman then went on to refer to rising prices and to wages, but if he will look at a chart which he will find in the current number of the Ministry of Labour Gazette he will see that during the whole time he and his friends were in office, money wages and real wages fell.

That does not affect the question as to whether people in this country have enough money for nutrition or not. The fact that the wages of people in other parts of the world fell is no answer to the suggestion I am putting forward. If the right hon. Gentleman will look at the chart, he will find that under this Government, since 1933, not only have money wages, but, what is more important, real wages, continuously risen, and they are above the level at which they were when he and his friends were in office. With regard to the cost of living in recent months, the hon. Member for Ogmore said that it had risen by 12 per cent. during the last 12 months, and the hon. Member for Belper (Mr. Wragg) said that it had risen not by 12 per cent., but by 12 points. I have the figures here, and the answer is that it has risen neither by 12 per cent. nor by 12 points, but by 4 per cent. and 5 points, which is a very different matter. The figure was 146 at this time last year, and it is now 151.

I might say that I gave an indication that it was quite impossible for the housewife to-day to purchase with £1 what she could purchase for 17s. 6d. a short time ago.

I have here the Ministry of Labour figures which show that the rise in the cost of living is up by five points or 4 per cent.

Food is not the only thing which enters into the cost of living. Even on that point I still have the Ministry of Labour figures, which show that on food alone the cost to-day is not as high as it was when the right hon. Gentleman was in office.

The right hon. Member mentioned three specific items—tea, sugar and margarine. If he will look again at that table in the current issue of the Ministry of Labour Gazette he will see that except for tea the other two items are to-day still below what they were when he was in office. It is, therefore, absurd for the right hon. Gentleman to say that as a result of something we have done the people in this country are seriously prejudiced in obtaining adequate food. He argued also that one ought not to use averages. I happen to sit for a Lancashire division. The hon. Member for Farnworth (Mr. Rowson) started this discussion. He also sits for a Lancashire division. I looked up this morning some of the reports of Lancashire medical officers of health dealing with the health of school children in Lancashire. One of the most reassuring things which emerges from reading these reports is that even in the boroughs in Lancashire, where, in view of the long-continued distress which many of these boroughs have suffered, one would have expected to find high rates of malnutrition and sub-nutrition among school children, actually one does not find that. Take St. Helens. Anyone who knows Lancashire will know of the great amount of unemployment and suffering which St. Helens has gone through in recent years. The medical officer of health of St. Helens reported last year—and there is no question here of averages—that out of a total school population of

Division No. 134.]AYES.[9.30 p.m.
Acland-Troyte, Lt.-Col. G. J.Gluckstein, L. H.Peaks, O.
Agnew, Lieut.-Comdr. P. G.Goodman, Col. A. W.Penny, Sir G.
Albery, Sir IrvingGrant-Ferris, R.Perkins, W. R. D.
Allen, Lt.-Col. J. Sandeman (B'kn'hd)Greene, W. P. C. (Worcester)Petherick, M.
Allen, Lt.-Col. Sir W. J. (Armagh)Grimston, R. V.Pickthorn, K. W. M.
Anstruther-Gray, W. J.Guinness, T. L. E. B.Porritt, R. W.
Apsley, LordGuy, J. C. M.Radford, E. A.
Aske, Sir R. W.Hannah, I. C.Rathbone, J. R. (Bodmin)
Balfour, Capt. H. H. (Isle of Thanet)Harbord, A.Rayner, Major R. H.
Beamish, Rear-Admiral T. P. H.Heilgers, Captain F. F. A.Reid, W. Allan (Derby)
Beaumont, Hon. R. E. B. (Portsm'h)Hepburn, P. G. T. Buchan-Remer, J. R.
Beit, Sir A. L.Hepworth, J.Rickards, G. W. (Skipton)
Birchall, Sir J. D.Herbert, Capt. Sir S. (Abbey)Robinson, J. R. (Blackpool)
Boulton, W. W.Holdsworth, H.Ropner, Colonel L.
Bower, Comdr. R. T.Hope, Captain Hon, A. O. J.Rowlands, G.
Bowyer, Capt. Sir G. E. W.Horsbrugh, FlorenceSalt, E. W.
Boyce, H. LeslieHudson, Capt. A. U. M. (Hack., N.)Samuel, M. R. A.
Bracken, B.Hudson, R. S. (Southport)Sassoon, Rt. Hon. Sir P.
Brown, Rt. Hon. E. (Leith)Hume, Sir G. H.Shepperson, Sir E. W.
Brown, Brig.-Gen. H. C. (Newbury)Hunter, T.Sinclair, Col. T. (Queen's U. B'lf'st)
Bull, B. B.James, Wing-commander A. W. H.Smith, Sir R. W. (Aberdeen)
Carver, Major W. H.Jones, H. Haydn (Merioneth)Somervell. Sir D. B. (Crewe)
Cary, R. A.Jones, L. (Swansea W.)Spens, W. P.
Castlereagh, ViscountKeeling, E. H.Stanley, Rt. Hon. Oliver (W'm'l'd)
Channon, H.Kerr, H. W. (Oldham)Stewart, J. Henderson (Fife, E.)
Christle, J. A.Kerr, J. Graham (Scottish Univs.)Stourton, Major Hon. J. J.
Clarke, Lt.-Col. R. S. (E. Grinstead)Lamb, Sir J. Q.Strauss, E. A. (Southwark, N.)
Clarry, Sir ReginaldLatham, Sir P.Strickland, Captain W. F.
Colville, Lt.-Col. Rt. Hon. D. J.Leighton, Major B. E. P.Stuart, Hon. J. (Moray and Nairn)
Cook, Sir T. R. A. M. (Norfolk, N.)Liddall, W. S.Sueter, Rear-Admiral Sir M. F.
Cooke, J. D. (Hammersmith, S.)Llewellin, Lieut.-Col. J. J.Tasker, Sir R. I.
Cooper, Rt. Hn. A. Duff (W'st'r S.G'gs)Loftus, P. C.Taylor, C. S. (Eastbourne)
Cooper, Rt. Hn. T. M. (E'nburgh, W.)Lyons, A. M.Taylor, Vice-Adm. E. A. (Padd., S.)
Croft, Brig.-Gen. Sir H. PageMacAndrew, Colonel Sir C. G.Thomson, Sir J. D. W.
Crooks, J. S.MacDonald, Rt. Hon. J. R. (Scot. U.)Titchfield, Marquess of
Crookshank, Capt. H. F. C.Macdonald, Capt. P. (Isle of Wight)Tree, A. R. L. F.
Crossley, A. C.McEwen, Capt. J. H. F.Turton, R. H.
Crowder, J. F. E.Magnay, T.Walker-Smith, Sir J.
Culverwell, C. T.Maitland, A.Ward, Lieut.-Col. Sir A. L. (Hull)
Davies, Major Sir G. F. (Yeovil)Margesson, Capt. Rt. Hon. H. D. R.Ward, Irene M. B. (Wallsend)
Denman, Hon. R. D.Markham, S. F.Warrender, Sir V.
Denville, AlfredMayhew, Lt.-Col. J.Waterhouse, Captain C.
Donner, P. W.Mellor, Sir J. S. P. (Tamworth)Watt, G. S. H.
Drewe, C.Mills, Major J. D. (New Forest)Wedderburn, H. J. S.
Duckworth, W. R. (Moss Side)Moore, Lieut.-Col. T. C. R.Wickham, Lt.-Col. E. T. R.
Duggan, H. J.Morris, J. P. (Salford, N.)Winterton, Rt. Hon. Earl
Duncan, J. A. L.Morris, O. T. (Cardiff, E.)Wise, A. R.
Dunglass, LordMorris-Jones, Sir HenryWood, Rt. Hon. Sir Kingsley
Ellis, Sir G.Morrison, G. A. (Scottish Univ's.)Wragg, H.
Emery, J. F.Morrison, Rt. Hon. W. S. (Cirencester)Wright, Squadron-Leader J. A. C.
Erskine-Hill, A. G.Nail, Sir J.Young, A. S. L. (Partick)
Evans, Capt. A. (Cardiff, S.)Nicholson, G. (Farnham)
Fleming, E. L.O'Neill, Major Rt. Hon. Sir HughTELLERS FOR THE AYES.—
Fyfe, D. P. M.Ormsby-Gore, Rt. Hon. W. G. A.Sir James Blindell and Commander
Ganzoni, Sir J.Palmer, G. E. H.Southby.

5,797 who were examined he only found eight individual school children suffering from malnutrition.

You are aware that Lancashire parents see that their children do not go short?

Yes, but it is also a proof that these stories of widespread malnutrition are untrue. I hope that I have said enough to show that the statements made by my right hon. Friend this afternoon were thoroughly just.

Question put, "That Mr. Speaker do now leave the Chair."

The House divided: Ayes, 161; Noes, 120.


Acland, Rt. Hon. Sir F. DykeGriffiths, J. (Llanelly)Owen, Major G.
Adams, D. (Consett)Groves, T. E.Paling, W.
Adams, D. M. (Poplar, S.)Hall, G. H. (Aberdare)Parker, J.
Adamson, W. M.Hall, J. H. (Whitechapel)Parkinson, J. A.
Alexander, Rt. Hon. A. V. (H'lsbr.)Hardie, G. D.Potts, J.
Banfield, J. W.Harris, Sir P. A.Price, M. P.
Barnes, A. J.Hayday, A.Richards, R. (Wrexham)
Barr, J.Henderson, A. (Kingswinford)Ridley, G.
Batey, J.Henderson, J. (Ardwick)Ritson, J.
Bellenger, F. J.Henderson, T. (Tradeston)Roberts, W. (Cumberland, N.)
Benn, Rt. Hon. W. W.Hopkin, D.Robinson, W. A. (St. Helens)
Bevan, A.Jagger, J.Rowson, G.
Broad, F. A.Jenkins, A. (Pontypool)Seely, Sir H. M.
Bromfield, W.Jenkins, Sir W. (Neath)Sexton. T. M.
Brown, C. (Mansfield)John, W.Shinwell, E.
Brown, Rt. Hon. J. (S. Ayrshire)Johnston, Rt. Hon. T.Silkin, L.
Buchanan, G.Jones, A. C. (Shipley)Silverman, S. S.
Burke, W. A.Jones, Morgan (Caerphilly)Simpson, F. B.
Chater, D.Kelly, W. T.Smith, Ben (Rotherhithe)
Cluse, W. S.Kennedy, Rt. Hon. T.Smith, E. (Stoke)
Cove, W. G.Kirby, B. V.Smith, Rt. Hon. H. B. Lees- (K'ly)
Cripps, Hon. Sir StaffordLathan, G.Smith, T. (Normanton)
Daggar, G.Lawson, J. J.Stephen, C.
Dalton, H.Lee, F.Stewart, W. J. (H'ght'n-le-Sp'ng)
Davies, S. O. (Merthyr)Leonard, W.Taylor, R. J. (Morpeth)
Dobbie, W.Leslie, J. R.Thurtle, E.
Dunn, E. (Rother Valley)Logan, D. G.Tinker, J. J.
Ede, J. C.Lunn, W.Viant, S. P.
Edwards, Sir C. (Bedwellty)Macdonald, G. (Ince)Watkins, F. C.
Evans, D. O. (Cardigan)McGhee, H. G.Watson, W. McL.
Evans, E. (Univ. of Wales)MacLaren, A.Welsh, J. C.
Fletcher, Lt.-Comdr. R. T. H.Maclean, N.Westwood, J.
Foot, D. M.MacNeill, Weir, L.White, H. Graham
Gardner, B. W.Mainwaring, W. H.Williams, D. (Swansea, E.)
Garro Jones, G. M.Mander, G. le M.Williams, E. J. (Ogmore)
George, Major G. Lloyd (Pembroke)Marshall, F.Williams, T. (Don Valley)
Gibson, R. (Greenock)Mathers, G.Wilson, C. H. (Attercliffe)
Green, W. H. (Deptford)Maxton, J.Windsor, W. (Hull, C.)
Greenwood, Rt. Hon. A.Morrison, R. C. (Tottenham, N.)
Grenfell, D. R.Noel-Baker, P. J.TELLERS FOR THE NOES.—
Griffiths, G. A. (Hemsworth)Oliver, G. H.Mr. Whiteley and Mr. Charleton.

Supply accordingly considered in Committee.

[Captain BOURNE in the Chair.]