On a point of order. I desire to seek your guidance, Sir Charles, on a question of procedure. At the commencement of the Committee stage of the Bill last Thursday, I raised a point of order, and you were good enough to give your Ruling. When you had answered my question, you proceeded to put before us a proposal of your own. As I now understand it, that proposal was that when we reached the second Amendment now on the Order Paper, that is to say, the Amendment in page 1, line 9, at the end, to insert "other than artificial limbs," we could discuss with it the subsequent 13 Amendments, down to, and including the Amendment in page 1, line 9, relating to trusses for hernia.

I think I am right in saying that that was the first occasion of a Chairman of a Committee being willing to allow such a large number of Amendments to be taken together for the purpose of debate. Your proposal therefore came to us as a surprise, and was not readily accepted by the Committee. I have since discussed the matter with some of my hon. Friends. I need hardly tell you that we think that there is a very good case for taking separately each of the Amendments to which I have referred, but I understand that that course would not be acceptable to you because you are compelled by Standing Orders to exercise your right of selection.

That being so, I think that it would be in the best interest of Members on all sides of the Committee if we took those 14 Amendments together for the purpose of debate, and at the conclusion of the debate, if the Government reject any of the Amendments, for you to allow a certain number of Divisions. May I ask whether you would be willing to renew the kind offer which you made to us last Thursday, and whether you would give your Ruling on the matter of Divisions at the end of the debate in question?

I thank the hon. Member for very kindly giving me notice that he was going to raise this matter again. I selected four Amendments at the end of line 9, designed to include various appliances. In view of the fact that many hon. Members on both sides of the House who wanted to speak on the Second Reading were disappointed, it might be for the convenience of the Committee if the debate on the first Amendment were wide enough to range over all these various appliances. At the end of this debate the Committee could divide on four of the Amendments if they wish to do so. I shall call the Amendments in the order that they appear on the Order Paper, and should there be four Divisions I shall then call the Amendment in the name of the hon. Member for Tottenham (Mr. Messer), in page 1, line 9, at the end to insert:

Provided that no such charge for an appliance shall exceed one-quarter of its cost to the Minister or the sum of one pound whichever be the less.

On the Second Reading, the Minister was asked which of the surgical appliances would bear the charge, and he specifically mentioned four of them. Hon. Members on this side of the Committee will feel compelled to divide on those four, but we might be eased out of our problem and difficulty today if the Minister, having told us on Second Reading that he would make charges on only four, would give us some reassurance that between now and the Report stage he would consider bringing forward an Amendment to make it quite clear that he does not intend to charge for the others that we have had to list to protect ourselves. If the Minister will do this—apparently this was his intention—it will ease our problem this afternoon

Might I ask a question, Sir Charles? I take it that the number of Amendments you mentioned does not include the one standing in my name to insert a proviso?

No, the proviso is a different one. After the four Divisions I propose to go straight to the Amendment of the hon. Gentleman. The question of the hon. Member for Stoke-on-Trent, Central (Dr. Stross) is one for the Minister, not for me.

You have suggested, Sir Charles, that the debate can range very wide, so that we shall be able to bring in the various Amendments. Many hon. Members on this side of the Committee would also like to know that there will be adequate time given to this debate, and that the Closure will not be moved as quickly as it was both times last Thursday, when there were still many hon. Members who wished to take part in the debate.

The acceptance of the Closure is entirely in the hands of the Chair, and if the Chair thinks there has been adequate discussion, the Chair is willing to accept it.

You said, Sir Charles, that the matter I raised was essentially one for the Minister. May I suggest to you, with respect, that I am asking for your protection against the Minister, and I do so with some confidence. The position is this. If, having received a verbal promise on the Floor of the Committee on the four kinds of surgical appliances, the Minister is not willing to say that he will include them at the next stage, how are we to trust him, how can we give up our rights, and how are you to assist us in the matter?

I cannot see how I could assist hon. Members in the matter.

On a point of order, Sir Charles. I am particularly interested in one kind of appliance. The Minister was kind enough to say during the Second Reading that he would not include hearing aids among those to be charged for, but unless something is put into the Bill to that effect, how can I know that there may not be a complete change in what he proposes to do?

That question is one which will come up in due course as we proceed with the Committee stage of the Bill. I cannot pretend to answer it, because I do not know the answer.

But how can hon. Members show their disapproval if we cannot divide on these Amendments?

I do not quite understand that question.

If you accept only four Amendments for Division, Sir Charles, how can we show our disapproval of the others?

It appears to be acceptable to the Committee that as soon as we have had four Divisions we shall go on to the Amendment of the hon. Member for Tottenham (Mr. Messer).

That means, then, that hon. Members on this side of the Committee will be limited as to the number of Amendments on which they can disclose their point of view.

No, they will not be limited as to the number of Amendments on which they can express their point of view, but they will be limited as to the number they can divide on.

But they can only disclose their point of view in the Division Lobby.

It would be for the convenience for both sides of the Committee, Sir Charles, if we could have an assurance from the Minister on what he is prepared to accept and what he is prepared to reject. It is no use our wasting time discussing Amendments on the Order Paper if, at the end of the day, the Minister tells us that between now and the Report stage he will consider the proposals we put before him. May I ask the Minister to give us a reply to the question we have put to him?

On a point of order. I am very ready to do so, Sir Charles, but I did not see how I could do it on a point of order. If an Amendment were moved, I could say what was necessary, but it is not a point of order. That was the only reason for my hesitancy.

I beg to move, "That the Chairman do report Progress, and ask leave to sit again."

I do so simply to enable the right hon. Gentleman to make the statement he wants to make.

I think we had better start with the Amendment of the right hon. Member for Middlesbrough, East (Mr. Marquand). If the first Amendment is carried, the other 14 will not arise.

I am rather confused, Sir Charles. My hon. Friend the Member for Wolverhampton, North-East (Mr. Baird) rightly pointed out that, as we have been given no guarantee and there is no terminal point to this Bill, it is important for us to ensure, not merely in regard to the right hon. Gentleman but in regard to any possible successor of his, that certain appliances which, we think, should never in any circumstance be charged for, shall be discussed and shall be included in the Bill in such a way as to prevent any possibility of charges for the future. There is involved here not merely the question of the immediate intentions of the right hon. Gentleman in any regulations which he may bring forward, but also our desire to protect for the future the users of various appliances from any possibility of the imposition of a charge. At the moment we are rather confused as to how we stand on the point of principle.

All I can say is that I have called the right hon. Gentleman to move his Amendment—[An HON. MEMBER: "He has moved a Motion."]—I have not accepted it. If the Amendment is carried, then all the 14 other Amendments fall because all appliances will be left out.

On a point of order. Would the Minister be in order in replying to my question, Sir Charles?

That is not a question for me.

If I move my Amendment, recognising that you have not accepted the Motion I have just moved, Sir Charles, I hope it will be open for me at the conclusion of the debate on that subject, if I still need further clarification, to move to report Progress so that we may know what the position is on the subsequent Amendments, assuming that the Minister might refuse to accept my Motion.

I cannot give any promise that I will or will not accept any Motion.

May I put this point, Sir Charles? I think it is a little discourteous of the Minister of Health. The right hon. Gentleman said he was prepared to make a statement to clarify the position, but was not in a position to do so because there was no Motion before the Committee. My right hon. Friend had no intention of obstructing. To help the Minister, he moved a Motion and you, Sir Charles, have refused to accept it.

I refused to accept the Motion to report Progress, but I have called an Amendment. Once it is moved, perhaps the Minister will reply.

I beg to move, in page 1, line 9, to leave out "or appliances."

You have already said, Sir Charles, that if this Amendment were accepted the 14 other Amendments about appliances would be unnecessary. The right hon. Gentleman himself, earlier this afternoon, in a statement which he made to the House, as distinct from this Committee, said he hoped that hon. Members in all parts would co-operate in speeding up the consideration of the Bill. The right hon. Gentleman has now been given a golden opportunity of setting an example in this respect. If he will accept this Amendment, we shall have made some progress because the 14 other Amendments will not be necessary.

The right hon. Gentleman has also shown that in this field of the Bill, at any rate, he is prepared to listen to representations. When the proposal to make charges of this kind was first announced by the Chancellor of the Exchequer, my hon. Friend the Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) drew his attention and that of the House to the hardship which would be caused to old people in general, and to old age pensioners in particular, by imposing a charge on hearing aids. The Minister has since told the House that when he brings forward his regulations he has decided not to impose such charges. In that respect he has listened to the voice of public opinion.

Since then, looking at the whole thing again, he has gone even further than that and said that when he introduces his regulations he will impose charges on four types of appliances only. Now as a result of imposing charges on four sorts of appliances only we understand that he hopes to get a saving from this part of the Bill of only £250,000. That is not a very large contribution towards closing the inflationary gap. To accept this Amendment would not greatly affect the purpose which he has told us he has chiefly in mind—the reduction of Government expenditure; it would reduce it by only £250,000.

Perhaps this afternoon the Minister will think again. Perhaps he will harken a little to the voice of public opinion which has expressed itself in recent days in the London County Council and other elections. I hope that the hon. Member for Enfield, West (Mr. Iain MacLeod), will add his voice to mine on this occasion. He must have listened rather closely to the voice of Middlesex when it was expressed in recent local elections. Perhaps he will come forward now and make a speech on this Bill.

Hitherto, the speeches with which he has regaled us have been addressed principally to the Bill I introduced last year. We should like to hear from him what he thinks about these charges. Rumour has it that he played a significant part behind the scenes in securing certain Amendments to the Bill which the right hon. Gentleman has put down, and I hope that he will strive to add to his score this afternoon.

The right hon. Gentleman is quite wrong on that point. He really must not judge this party by his own. Our private meetings remain private, and, consequently, the Press have to guess at what takes place. On this, as on many other occasions, they guessed wrongly.

I am sorry to find that the hon. Gentleman has not a kind heart after all. He sits there looking very stern, but I thought that was perhaps a poker face—I am not sure what a bridge face may be—for concealing warm emotions, and that he had been active in this matter.

What I wish to draw attention to particularly is that on this Clause we are dealing only with appliances supplied through the hospital and specialist services, yet we were told by the right hon. Gentleman that there was abuse. I think we are entitled to ask for a further explanation of how there has been abuse in the supply of appliances through consultants at the hospitals. On 27th March the right hon. Gentleman said:

"there have been a good many cases of alleged abuse reported."—[OFFICIAL REPORT, 27th March, 1952; Vol. 498, c. 850.]

That is not a very emphatic statement, and it certainly is not very convincing.

If the right hon. Gentleman is not prepared to accept this simple Amendment, which would cost him so very little of the money he aims to save, I hope that he will bring forward more evidence than he has done hitherto and explain to us how abuse can arise in a situation like this. Music-hall jokes about wigs are not enough for this purpose. We want to know how orders which must be signed by a consultant who has examined the patient can be an abuse of the service. We believe that every one of the appliances named in the list of Amendments which have been put down, supplied through the hospital and specialist services, is essential to the needs of patients.

Moreover, because I was responsible for it for a considerable time, I happen to know very well that all these appliances are procured by the Minister of Pensions on behalf of the Minister of Health and the Secretary of State for Scotland. They are bought by an organisation within the Ministry of Pensions. Not only are the goods themselves essential and prescribed by a specialist, but the quality and type of manufacture of the goods are controlled by the Minister of Pensions.

I remember very well that when I was Minister of Pensions, and my officials were making an annual review of what they procured for the Minister of Health for this purpose during the previous 12 months, many Questions were provoked. There was a great discussion; the Surgical Instrument Manufacturers' Association made representations, and many hon. Members opposite put down a lot of Questions to me about the price that was being offered for tender for these types of goods.

Fortunately, the attempt of the Surgical Instrument Manufacturers' Association to ensure that no member tendered except after approval by the Association did not come off: that particular piece of restrictive practice did not come off, and certain substantial manufacturers properly and patriotically tendered at prices which my Department had decided were reasonable.

With that type of scrutiny going on, with the experts of the Ministry of Pensions, who for 30 years have been responsible for supplying appliances to war pensioners, in charge of the procurement of appliances for the Health Service, I do not believe that it is possible for any abuse to creep in at that end. Nor do I see how it is possible for abuse to creep in at the point where the specialist himself, examining a patient, prescribes a particular appliance as absolutely necessary for that patient's welfare.

We here face a very grave risk, where patients are obliged to pay half of the cost of their appliance—and some of them are fairly expensive articles—either of patients being afraid to go to the hospital and submit themselves to the examination which results in the prescription of an appliance, or of patients deferring their return to hospital when the appliance becomes worn out.

When I was Minister of Pensions I put on view in my office at Blackpool an exhibition of artificial limbs which had actually been taken from National Health Service patients. I know that artificial limbs are not likely to be charged by the right hon. Gentleman, but I mention this by way of a perfectly fair illustration. The artificial limbs actually taken from the old men and old women when they came in, when the Health Service had given them the opportunity to obtain properly made limbs free of charge, were completely shocking.

I published a photograph of them in the annual report of the Ministry of Pensions, showing completely unsuitable contraptions—there is not other word for them—bolted together with bits of wire and tied up with string; too heavy, too awkward, and in many cases—it is sad to think so, but it is true—in a disgustingly insanitary condition because these poor old people quite unable to pay even part of the cost of such appliances, had gone on wearing them for years.

Some had gone to incompetent manufacturers in the first place; or even when they got a good appliance they had to try to make it last so long, because they could not afford to pay for another, that the thing was positively injurious to their physical condition, and causing them to walk wrongly, and so on. Some of these people were confined to very short journeys indeed because the appliance was such that it could be used for only short periods because of the acute discomfort. That is the sort of danger which arises from a proposal to charge for appliances of the type which we are considering this afternoon There is the danger of failure to get the appliance, or the danger of using an inadequate, monstrous appliance for too long, and we are asked to run a risk of that kind for the sake of saving only £250,000.

I do not want to speak long because I know that many of my hon. Friends wish to submit expert evidence from their own experience on hospital boards and the like. I do hope the right hon. Gentleman will now expedite our proceedings by accepting this fair and reasonable Amendment in the spirit in which I have tried to advance the argument for it and thus shorten our debate.

I am only too ready to assist the Committee. I was in some difficulty earlier on as to whether it was proper to say anything at all. I certainly was not responsible for putting the Committee into any state of confusion, as it was alleged to be 10 minutes ago. I think that if the Committee gets into confusion it will be for somewhat different reasons. It seemed to be really a question of raising different points of order about the Amendments, and I took no part in that at all.

I feel that I was quite clear in my statement on the Second Reading of what was intended. If my statement was not clear, I can only repeat it. I must say, looking again in HANSARD, that it does not seem to me to be anything but perfectly clear. I pointed out that a great many rumours and exaggerations had got about on the subject of the appliances, and I said specifically that we had no intention of dealing with artificial legs or arms. Then I specifically mentioned the four categories which were intended to come within the scope of the Bill.

The first category was surgical boots and their repair. I informed the House that the proposed charge would be £3 a pair and that there would be a charge for repair—in the case of women between 6s. and 13s. 6d. and for men between 8s. and 13s. 6d. The second category was surgical abdominal supports, and there I said that we proposed to charge £1. That was the only case—surgical abdominal supports—in which I made any reference to abuse at all. The right hon. Gentleman objects to that word. It is not a matter on which I have any figures available, I regret to say, but there have been a certain number of borderline cases, shall we say, where we understand that some pressure has from time to time been brought to bear for permitting the use of some supports which were not very far removed from ordinary corsets. I think that must be within the general knowledge of hon. Members.

To whom is the right hon. Gentleman referring when he speaks of abuses?

Those who go to the consultants, I presume. One has heard that. That is all I meant to say.

There is a Central Health Services Council, with advisory duties. Can the right hon. Gentleman say if that body or any other responsible body has submitted any proof at all of any abuses?

No, I do not think they have, but I have been advised that there have been a good many what might be called borderline cases.

The right hon. Gentleman has referred to borderline cases. Is it not for the specialist service to decide whether or not they are borderline cases? Is not the responsibility in this matter wholly with the specialist services that we employ in various hospitals throughout the country? Is the right hon. Gentleman suggesting that the specialist services will allow pressure to be brought to bear on them to supply articles in borderline cases which are unnecessary?

There may be such occasions. This is only a small charge, and this is one of four groups of appliances in which it is proposed to impose a charge.

This is an important point, which obviously interests the Committee. If the right hon. Gentleman has any medical evidence suggesting that there has been improper pressure or abuse of this facility, then I think he has an obligation to submit it to the Committee. If, on the other hand, he has not, I suggest that he should clear the consultant service by saying that he has no evidence of abuse.

I have said that I have no figures or anything of that kind, but that view is still held in many quarters. [HON. MEMBERS: "Which quarters?"] I shall listen to any arguments which are put forward during the course of the debate. That is the only instance in which I used the word, and I thought I might as well explain why I had used those words that were attributed to me—that there had been a certain number of borderline cases or whatever we like to call them.

The third item is elastic hosiery, on which it is proposed to charge 5s. and 10s., and the fourth category is wigs, on which the proposed charge is £2 10s. That is all that I said on the Second Reading, and that is all that is now proposed. I have no intention whatever of asking the Committee to agree to any charges on anything else. I hope that is a clear enough answer to the question which the right hon. Gentleman put to me.

The issue which is raised is whether or not this Amendment should be accepted which takes out the word "appliances" from the Bill altogether. In other words, hon. Members opposite do not wish any charge to be made for any appliance. That is the point at issue between us. We wish to bring the charges for the service within the ceiling which the Government has deemed to be right—and, of course, the use of a ceiling in this field is not novel; it was adopted by our predecessors.

We were seeing how we could keep the general cost below that ceiling with the least possible disadvantage. After all, like everybody else, I agree that if we had no ceilings and could spend all we wanted to spend, no doubt we could do a great many things which we should like to do, but common prudence and the fact that we have to have some regard to the expenditure of public money makes it impossible.

Therefore, we have been looking to see how we can keep below that ceiling and do the least possible damage. This is one of the measures to that end. The right hon. Gentleman said that £250,000 is not very much to save. I agree it is not very much, but it is something. Together with the other items, it enables us to bring the general cost below the ceiling. Therefore, I ask the Committee to keep the word "appliances" in the Bill. That is the issue between us. When I am asked what are the appliances on which there are to be charges, the answer is that they are those four—surgical boots and repairs, abdominal supports, elastic hosiery and wigs.

If I may take the matter a little further, it might be that hon. Members opposite would agree to leave the word "appliances" in the Bill, but according to the Amendments on the Paper they want specifically to exempt a whole series of different things, including, of course, those on which we propose to make a charge. They want each one of them specifically excluded, and a lot of other things as well.

My answer to that general group of Amendments—although they are not actually before the Committee it is part of the argument I am submitting—is that this is just the kind of thing to leave to regulatory powers, so long as there are regulatory powers. There are those powers introduced by the original Act by which, for example, charges on prescriptions given by the general practitioner will come before the House in the form of regulations and the Government came to the conclusion that if we were to make charges for appliances the same practice should be used. Therefore, the regulatory power, rather than the actual enactment in the Bill, was the most convenient form of proceeding.

Instead of putting a series of exemptions in this Clause, I ask that when the time comes that should not be done but that the word "appliances" should stand part—although, by this Amendment hon. Members want to remove it—and that we should keep the power of making charges for appliances by regulation. The regulation which will come forward under this Clause will cover the four, and only the four, things I mentioned in my Second Reading speech, which I repeated today and which, I think, are now clear beyond a peradventure.

The recent demonstration for industrial action in the constituency I represent in the Rhondda Valley is indicative of the mood there towards the charges proposed in this Bill. It may be judged to be an unreasonable mood that has been expressed in the recent boycott of Saturday working, but at least it is a mood and I think that if the measures proposed by the Minister are to be applied they will cause a great deal of irritation among the most important section of the community—the industrial workers.

From what I have seen of it, the proposal to make charges for appliances is bound to cause a great deal of hardship to industrial workers, particularly in the heavy industries. In the industry with which I am connected, and have been connected for more than 30 years—the mining industry—there is a very high accident rate. In fact, 33 per cent. of the injuries and accidents under the National Insurance (Industrial Injuries) Act—a third of the total throughout the country—occur in the mining industry.

From my personal knowledge I know that there are several hundreds of men in the mining industry who have suffered very severely. They have had their bodies severely mangled, deformed, twisted and fractured as a result of following this most arduous occupation. Apart from men totally disabled and remaining out of employment, a very large percentage of men, despite their physical disabilities, are anxious to get back to the point of production. I know of many men who have to wear a type of industrial harness to maintain themselves in employment.

4.45 p.m.

Let it be noted that the Chancellor of the Exchequer, on more than one occasion, has been very flattering and complimentary to the miners. The Committee are fully aware of the extent to which the miners are responding to the appeals made from both sides of the House to assist the Government and the country in emerging from the present crisis. What does the Minister consider would be the reaction of these men, who are not only working five days a week from Monday to Friday but also on Saturday and Sunday, and putting their whole effort into the job, when they meet with an accident and its nature is such that they require some type of industrial appliance to maintain them in work? What is likely to be the reaction of such men in such an important industry?

When I speak of the coal industry I am not unmindful of men in the other heavy industries in the country, but my illustrations are drawn from the mining industry because I am so near to it. Provisions made by the National Coal Board for the maintenance and replacement of machinery are well known to all hon. Members. If a jigger, a coal cutter, or a belt is worn out, or fractured, there are facilities and means of replacement out of moneys set aside by the Board, which, after all, is the national wealth, to provide for replacements.

But when we come to the human factor in the industry, the man who, by his efforts and enthusiasm, meets with an accident and has to obtain surgical supports, anyone acquainted with the mining industry in particular and other industries generally knows full well the very high incidence of hernia cases which occur.

The imposition of this charge will not be an incentive but a deterrent, because the greater effort the man who has been disabled as a result of a severe accident makes to fit himself for replacement in the mining industry the more it will cost him. There are many men in the heavy industries—hundreds in the coal mines—who are able to carry on in employment and respond to the appeal of the Chancellor only because they wear a support to enable them to continue their work. That being so, why should the Government at this or any other stage impose this charge upon willing men who want to be maintained in employment not only to preserve their standard of life, but to make their contribution towards national recovery?

At the time the Clause was drafted, I do not know whether the Minister was fully conscious that it would have this far-reaching effect and of the punitive implications of this imposition upon such a body as I refer to, the industrial workers. The charge now to be imposed is, I think, cruelly unjust. I appeal to the right hon. Gentleman, on behalf of the men in heavy industries, to reconsider the matter and accept the arguments which have been, and will be, advanced for this Amendment.

After listening to what the Minister of Health said just now, it is very difficult to escape the impression that the Government are desirous of making charges on the National Health Service for purely doctrinal reasons; that they appear to think that there is something wholly bad about a free Health Service, and that no matter how flimsy the pretext, charges should be made. That is the only conclusion one can reach from what has been said.

No substantial argument has been advanced that this proposal is necessary to obtain finance. The whole of the appliances, as I believe, including appliances made by the Ministry of Pensions amounting to about £4 million a year, the whole of the cost of the charges now proposed to be made, about £250,000, is out of the total hospital expenditure of £230 million. It is very hard to listen to those figures without coming to the conclusion that the members of the Tory Party represented by the Government are concerned primarily about breeching the principle of free service rather than collecting revenue for the State.

With the support of their back benchers.

I am astonished that hon. Members sitting behind the Minister have allowed it to go on. I can understand hon. Members taking the view that certain policies are right and for the welfare of the State and should be proceeded with despite their temporary unpopularity. That is a perfectly proper point of view which any responsible public man must face from time to time. Very often, to use Tennyson's phrase, he has to

"Await the far off interest of tears"

and to apply that principle although, for the moment, it is to his electoral disadvantage. But for the life of me I cannot see any justification for inflicting inconvenience upon large numbers of people without any corresponding financial advantage. It is most astonishing, and I am amazed that right hon. and hon. Gentlemen of such long public experience should expose themselves to such electoral disadvantage for such a ridiculous reason. I should have thought that they would reconsider the whole matter.

When the right hon. Gentleman said that this proposal was necessary to keep within the ceiling—once more we are back to King Charles's head—he did not seem sufficiently to appreciate the fact that the ceiling has already gone. Is he really seriously proposing to assimilate the £10 million a year increase for general practitioners within the ceiling? I should like an answer to that. Is he intending to do it? I should like to know. I am prepared to give way to the right hon. Gentleman—[HON. MEMBERS: "Answer."] I do not want to embarrass him; I merely want to put the Committee in possession of the facts.

I have already put the Committee in possession of the facts. What I was trying to remember was exactly which occasion it was when I pointed out that the adjudication—which has nothing to do with this, Sir Charles, but I hope you will allow me to reply to the right hon. Gentleman—

The right hon. Gentleman said "ceiling."

—the adjudication covered, of course, what would be the charge for the year 1950–51 plus the preceding and subsequent years. The charge for the current year was somewhere in the region of £10 million and there was some little room for manœuvre, if I might use the right hon. Gentleman's own words. That is to say, the ceiling had not been quite reached under the Estimates for this year and it would therefore be very little exceeded, so far as I can see at present, by the addition of this £10 million. It would probably be slightly exceeded—

May I put this to the Minister? His words at the end of his explanation on the matter were:

"That is on the assumption that the £30 million payable next year is taken out of this account altogether. That is the assumption I made; it is not to be counted against the ceiling."—[OFFICIAL REPORT, 27th March, 1952; Vol. 498, c. 859.]

I am not speaking of the £30 million at all. It is perfectly clear from what the right hon. Gentleman said on a previous occasion that he was not expecting to reach £30 million out of his ceiling. I am talking about the £10 million. It would be quite unreasonable for the Chancellor to expect the right hon. Gentleman to find £30 million. That would "bust" the whole hospital service. I am not talking about that. I am speaking about the £10 million. What we would like to know is whether, assuming that the Chancellor finds the £30 million, the right hon. Gentleman intends to find the £10 million within the ceiling.

May I continue with my quotation? I think I put it perfectly clearly. Perhaps the right hon. Gentleman was not present—oh, I see he interrupted in one sentence, so he must have been here:

"The conclusion is that it is not the intention of the Government, as a result of the Danckwerts award, to increase any of the charges I have mentioned in connection with this Bill and that if, as a result of this award and the £10 million or so next year, the figure of £400 million is surpassed in 1952–3 that is a situation which we shall all have to accept."—[OFFICIAL REPORT, 27th March, 1952; Vol. 498, c. 860.]

That really shows the frivolous irrelevancy of the reference by the right hon. Gentleman to the ceiling.

Not at all.

The right hon. Gentleman has just said that the Government do not expect to find the £10 million within the ceiling. So the ceiling has gone—

I cannot let the right hon. Gentleman go on in this way about this. The argument about the ceiling and the introduction of the Bill, and all that, was decided before the Danckwerts award. Therefore, the objective this year was to keep below the £400 million ceiling. Then this award came along, which was on a far larger scale than anyone had anticipated, and the extent to which it will be falsified or it may be falsified we shall not know until after the end of the year. If it is we shall have to accept it. But that is no reason why our previous efforts to keep under the £400 million should be denigrated.

All I said was that on the last occasion—and all the right hon. Gentleman has now said, but I put it quite colloquially—was that the ceiling is "bust." That is all I am saying now. All the right hon. Gentleman has done is to put it in more circumlocutory language. The ceiling is gone. If there was any validity in that ceiling—and there never was—there is no justification for going on with this particular provision of the Bill in an effort to keep within the ceiling, which was the only argument of any relevance used by the right hon. Gentleman. That is gone.

indicated dissent.

The right hon. Gentleman shakes his head, but he will find that in a year's time, if he is still in office—and we hope that he will not be—he will find this coming back and hitting him in the face.

A ceiling cannot do that.

We are now told that the right hon. Gentleman is to try hard to keep within the ceiling, knowing he will exceed it, but that because of the increased payment to general practitioners he is to collect payment for abdominal belts. That is a nice way to produce harmony inside the Health Service. Every time a person comes along for a truss, an abdominal belt or a special surgical boot or shoe, he will be made aware that the money is being collected from him to pay an additional £10 million a year to the general practitioners. That is a curious kind of conflict to create inside the Health Service. I can imagine no consideration likely to do more damage to the general climate inside the Service than a proposal of that sort.

It is all the worse because of the smallness of the sum involved. Hon. Members must keep in mind all the time that they are not really conferring power upon the Minister by this Clause only to impose charges on the four items mentioned, but on the whole range of appliances inside them; and even if the whole range is included, it amounts to only £4 million. It is to that extent that the Committee and the country should estimate the real emnity of the Tory Party to the free Health Service.

There is one consideration which I think the Committee and those hon. Members who support the Government ought to keep in mind. I was always very anxious to provide for appliances for civilians inside the Health Service on the scale required because of the important bearing it had on the creation and maintenance of certain special skills. When there is a great war and we have large numbers of wounded people a great strain is placed upon a small number of specialists and a small range of industries producing these appliances. For some time wounded ex-Service men suffer considerably while they are waiting for these appliances to come along and for them to be improved.

It always seemed to me to be one of the most exciting aspects of the National Health Service that the fact that the injured civilian population would be able to call upon this special range of skills would keep them in existence, not only doing good in the meantime for the civilian population but maintaining this skill and this narrow range of industries so that, in the lamentable event of another war, we should immediately have these skills in existence for injured soldiers, and easily expand them to the scale required. It therefore seemed to me to be a valuable and important part of the national economy that the pool should be maintained. The pool could only be maintained if the civilian population, injured in the same way as people are injured in battle, could have access to these special skills.

I assure hon. and right hon. Gentlemen opposite that that is a very important part, and one of the most civilised parts, of what might be called war preparation. In the past, they were dispersed. Indeed, as those of us who have experience of industrial communities know, some of our people had to put up with the most shocking appliances—the trusses I have seen some of our people wear, the monstrous stuff advertised in magazines and newspapers which they were encouraged to buy. Members in all parts of the Committee ought to regard this as most uncivilised behaviour for a most unworthy motive and for financial considerations which are not really substantial at all.

There is a further point. The right hon. Gentleman really based his case upon gossip. It is fantastic that the House of Commons should be reduced to, the level of a 19th century bakehouse. Because certain people have got a bitter attitude towards the Health Service, the right hon. Gentleman seeks the first available opportunity to harness it against the Service. We have had a lot of talk about wigs. The Tory papers have been making jokes about wigs for a long time. The right hon. Gentleman is the last person who ought to decry the value of wigs. No one can say that I have a vested interest in that matter. The provision of wigs in certain cases is a most important part of mental and physical recuperation.

If people have had serious operations the provision of wigs is a necessary part of the treatment. The same is true of some skin diseases and of some of the industrial diseases which result in the falling out of hair. It really is not good enough that serious Members of Parliament should allow their emotions and their decisions to be influenced by such stupid, silly, frivolous behaviour as that. Therefore, I seriously suggest to hon. Members opposite that they ought to have a look at this matter again.

The argument about borderline cases is silly. I have never heard such a thing. The right hon. Gentleman is losing his grip. What does he mean by a borderline case? It does not matter where one fixes the limit, there always will be a border. The Minister does not seem to think that some people fall one side of the border and other people fall the other side of the border. I have had letters from men and women complaining that they have been refused abdominal belts when they thought that they ought to have them and when the specialist in the hospital has said that, after careful consideration, he did not think that on medical grounds they ought to be provided. That happens normally.

What is this business about the borderline cases? The right hon. Gentleman ought to consider this matter again. I suggest to all hon. Members that to pursue this power much further will be understood by the country merely as an attempt to provide the widest range of excuses not for charges but for the destruction of the free Health Service.

I should like to ask the Minister whether he would postpone further consideration of this Clause until he has had the opportunity of making specific inquiries about the suggested abuses. I want to consider the four items for which he suggests that there should be a charge. I cannot imagine anybody wanting a wig just for the sake of having one. I cannot understand a specialist issuing directions for a wig to be provided to someone who does not need it. I cannot imagine that there can possibly be any abuses in relation to surgical boots and shoes. Nobody who does not really require them would think of asking a specialist to provide them.

Surgical boots and shoes are not very comfortable to wear, and only certain people with physical deformities have to wear them. It has been proved that people who have had to wear such appliances have been unable to have them repaired because of the high cost. They have carried on for long periods wearing surgical boots and shoes which have done more harm than good because they have not been kept in satisfactory repair.

It is very serious to suggest a charge of 10s. for elastic hosiery. It is possible—and I think it will happen—that some firms will take advantage of the situation. They will manufacture and provide at a cheaper rate than 10s. an inferior article of elastic hosiery, and, even if it is only to save 2s. or 3s., people who medically need elastic hosiery will purchase the inferior quality goods, to make that saving. Perhaps the Minister does not understand in how very many cases 2s. or 3s. is of great importance to the people who require these articles.

I cannot understand the Minister making any suggestion at all that there may be abuses by people wearing surgical or abdominal belts. They are not comfortable things to wear, and people do not wear them for fun, but because they are medically necessary. I do not think that the application of charges on the four items will bring into the Health Service anything like the £250,000 that the Minister has suggested, because there will be all sorts of things done, some of which will be referred to when we discuss the question of dental charges.

All sorts of things will happen outside the Service altogether, and it will open up the possibility of inferior goods being offered to people who need these articles for medical reasons so that they might save the amount of money which the Government are proposing to charge for them.

I have had a very long experience of hospital services, both of the old methods and the new methods under the National Health Service, and I am certain that the specialist service will very much resent the allegations of the Minister that there are abuses in the supply of surgical appliances of all sorts through the Health Service. I find from personal contact with one of the hospitals in Liverpool which supplies a very large number of surgical appliances, that the question of issuing surgical appliances is solely in the hands of the specialist service. The general practitioners have nothing to do with it, except that, perhaps, they recommend to the specialist service that these appliances may be necessary.

The specialist service alone is responsible for issuing the instructions about the supply of these appliances, and I know from practical experience that the most careful consideration and examination is given to all patients who go to hospital for the purpose of obtaining these surgical appliances. I can say, first, that there is no abuse at all, and, second, and most important, that the right type of surgical appliance of whatever kind is issued to the person who needs it.

Although the Minister has suggested that it is only in the case of these four items, the fact that a charge of £3 for surgical boots and shoes is to be made will have a very bad effect upon those who are compelled from physical deformity to wear these appliances. It is a very paltry charge, because it concerns wholly the people who are either born with physical disabilities or have a street accident or an accident in industry, and who require to use and wear surgical boots and shoes.

Then there is the question of the cost of repair. Where surgical boots or shoes are worn, it is very often the case that one foot uses the article much heavier than the other, and that, therefore, it constantly needs repair. In this case as well, the wearers cannot take the boot or shoe to an ordinary shoemaker for repair. The person concerned must get a certificate from the hospital or specialist declaring that the appliance requires repair, so that there can be no question of abuse there.

5.15 p.m.

I ask the Minister to say immediately, to save further discussion on the matter, that he will withdraw this Clause, at any rate, temporarily, until either tomorrow or after the Easter Recess, so that he may ask for evidence from the specialist staff of hospitals throughout the country as to the possibility of any abuses taking place in regard to these four items in respect of which he has suggested that a charge should be made.

I suggest that he should make his inquiries through the proper channel, and that he should not take notice of comments made on public platforms by members of his own party or of other parties which are against the Health Service. I ask him not to listen to that sort of allegation, but make inquiries himself. He has his own medical superintendents, medical officers and regional officers, who can give him all details concerning the use of the surgical appliances.

I am prepared to say to him now that, if he makes these inquiries, he will not be able to prove one instance throughout the whole country in which a specialist responsible for the examination of the patient and the issuing of these appliances will have been found to have abused in any way the issue of these articles, which are so desperately needed by people who suffer from these disabilities.

It has been one of the most important features of the Health Service that so many people who did without the things which they urgently needed in the old days, when private enterprise used to take advantage of the disabilities of people and charge them outrageous prices for surgical appliances—people who needed them on medical grounds—have been able to get them, when, formerly, they did without because they had not got the money to pay for them.

I am certain that if the Minister looks at this matter again—and I do hope he will—he will realise that he will not get the amount which he suggests, but that people who need these appliances will go for long periods without re-examination if anything goes wrong with their appliances, in order to obviate the possibility of being charged, either for repairs or renewal.

If the Minister obtains this information and takes time to look at it, I am sure he will find that the statements I am making are correct. I therefore hope that the Government will be prepared to withdraw these four items and allow the Service to return to the useful purpose of supplying these appliances to the people who need them on medical grounds.

We listened to the Minister with a great deal of interest when he categorically set forth those appliances for which he proposes to charge the public. What he said is all very well, as far as it goes, and it may be the Minister's intention to adhere to what he has told us this afternoon.

I would remind the Committee, however, that the Minister still retains within the Bill the power to impose these regulations whenever he thinks fit to come to the House to do so, and that what he has said in no way binds his successor. We, on this side of the Committee, have no idea how long the right hon. Gentleman will retain his present office, and we have only his word for what he has told us. Judging by the reactions of the public to the promises made by the other side of the Committee, I do not think that any of us can put any faith in what the Minister has told us today.

I make no apology for doing a little special pleading on behalf of two categories of people who, on the Minister's statement today, will not be charged for the appliances which they desire. They are the people who suffer from disabilities of sight and hearing.

I remember that when my right hon. Friend was conducting the original National Health Service Act through the Committee stage he told us what he proposed to do for the ophthalmic services. He said that one of the appliances he did not intend to give was an eyeglass. I intervened and asked that if he was not proposing to give an eyeglass, would he give a glass eye. He said that was a very pertinent question and that he would consider the point. It turned out, in the event, that that was one of the services rendered under the Service.

Even if the Minister is not prepared to withdraw the whole of the charges that he proposes, I would ask him to insert my Amendment, in page 1, line 9, at the end, to insert, "other than artificial eyes." No one wears an artificial eye because he wants to. It means that the person is either wholly blind or half blind, that there has been an excision of the eyeball and that the artificial eye is put there to help him in two ways. It has, first of all, a hygienic value which in many cases is supremely important and will, if the other eye is healthy, lead to its preservation. Then, of course, there is the aesthetic or psychological effect, and that no one can over-estimate. It gives a younger person who has lost an eye, particularly if that person is a young woman, a feeling of assurance.

When I was associated with the National Institute for the Blind during the war, we were able to give such people, through the provision of artificial eyes, a tremendous degree of assurance and courage to face the disability of blindness caused by air raids. They felt that, after all, they were not so disfigured as they thought they were. It gives such a person great assurance to know that he does not look so very different from the people around him.

The cost of an artificial eye is almost negligible. As far as I have been able to find out they are generally issued through the Ministry of Pensions. Between 7,000 and 8,000 artificial eyes are issued each year. Most of them today are plastic eyes. In the old days, when I first went in for this work, we used to call them glass eyes, as indeed they were. But the development of the plastic industry has inevitably put the emphasis on plastic eyes, which cost £2 as against £3 for the glass eye.

The total cost of issuing artificial eyes is about £16,000 a year, which is obviously a negligible amount. It is also a service which is tremendously important for children. One has only to go to the partially sighted and blind schools of the country to find out how highly valued these appliances are in connection with young people.

The other category of people about whom I wish to say a few words are the hard of hearing or the partially deaf. When my right hon. Friend was introducing the original Act, those of us who spend a great deal of our time with the deaf were very anxious to know what he was going to do for them. He gave them hearing aids which broke the terrific commercial ramp that had been going on in the manufacture of these appliances. I want to make it quite clear that I yield to no one in my admiration of those firms who in the past did extraordinarily good research work in this direction and maintained a high ethical standard in their salesmanship. But we know that there were many firms which fell far below such standards.

It was a great comfort to the deaf to know that the Minister had decided to give them an aid which would bring untold benefits and from which they would derive a sense of fulfilment such as no other service could render them. I happen to be the Vice-Chairman of the National Institute for the Deaf. For many years we conducted inquiries and found that there was a tremendous demand for aural aids. Despite the help given in the past through the voluntary hospitals to people in need of hearing aids, about 50 per cent. of such persons were unable to avail themselves of these instruments.

Gradually we broke down the resistance to wearing a hearing aid. At one time anyone who wore such an aid was almost a museum piece. I was at a meeting of deaf people last Saturday, sponsored by the British Association for the Hard of Hearing. It was a very representative meeting and I think that by now the Minister will have received a communication from its sponsors.

Before we knew precisely what the Minister's intentions were regarding the charge for appliances, it was rumoured that very considerable charges indeed were to be made for hearing aids. The immediate reaction of that body was most emphatic. It represents very wide ranges in the social structure. Some of the people represented by it have very considerable means, but the great mass of the people represented are ordinary working class men and women. The feeling was that in no circumstances should the advantages of a free issue of the Medresco hearing aid be lightly thrown away.

I want the Minister to safeguard the position. He has given us a verbal assurance that it is not his intention or that of the present Government to impose a charge for these aids. But we want these assurances put into the Bill, and I ask him to agree to the insertion of a specific proviso before we proceed to the next stage that both artificial eyes and hearing aids are to be excluded from the regulations.

The hon. Member for Lowestoft (Mr. Edward Evans) expressed alarm that the scope of the charges under this Clause should have been left to be defined by regulation. Accordingly, he devoted most of his speech to dealing with appliances upon which it is known that the Government do not intend to impose a charge. His argument would have had a great deal more force were it not for the fact that under the Act of 1949, which relates to charges for prescriptions and other articles obtainable through the pharmaceutical services exactly the same form of legislation had been adopted.

Section 16 of that Act says:

"Regulations may provide for the making and recovery, in such manner as may be prescribed, of such charges, in respect of such pharmaceutical services, as may be prescribed. …"

The whole matter was left as a blank cheque for the Minister to fill in by regulation. So, whatever objection may be urged against the procedure, it cannot be urged from that side of the Committee. Why, there was even no suggestion in the terms of that Act that the charge would be 1s. per subscription and not 2s. or 3s. There was no indication whether or not all the appliances available under the pharmaceutical services would be included. The whole matter was left absolutely vague.

5.30 p.m.

It so happens that under the terms of that Section as it was drawn, charges could have been imposed upon elastic hosiery—one of the items here concerned—for those are amongst the appliances provided under the pharmaceutical services. Therefore, the Committee in dealing with this Clause is under an obligation not to treat with the whole range of appliances but to apply its mind strictly to the four appliances specified by the Minister—

On a point of order. I remind you, Mr. Colegate, that when your predecessor was in the Chair he intimated to the Committee that although the debate was to be taken on the first Amendment to leave out the words "or appliances," he was proposing to allow those of us who have Amendments on the Order Paper to wander over the general field.

It might be for the convenience of the Committee, since some hon. Members have come in since the Chairman made his announcement, if I said that the Chair decided to take the first Amendment and after that, with the agreement of the Committee, it was decided to allow the next Amendments down to but not including the Amendment in the name of the hon. Member for Tottenham (Mr. Messer) on page 370 to be taken together, and a general debate allowed.

I am obliged to the hon. Member for Wolverhampton, South-West (Mr. Powell) for giving way and, judging from his previous speeches, I do not think he has any desire to mislead the Committee, but I think it will be as well if he said that the regulation from which he has just read refers only to pharmaceutical prescriptions.

It refers to "pharmaceutical services" and that covers not only drugs but also a limited range of appliances. That comes in Section 38 (1) of the 1949 Act, and it happens to include elastic hosiery.

I think the hon. Member will agree that this Clause mentions medicines and appliances, and the point we are trying to make is that we are separating the pharmaceutical prescriptions from the appliances which are so essential.

rose—

I am far from wishing to argue that the terms of the Section of the 1949 Act were the same as the present Clause. I was trying to argue that the House of Commons at that time did not object to the procedure that these charges should be allowed to be defined by regulation; nor was I at all criticising the Chair by suggesting that Amendments which it is perfectly in order to discuss happen to be absurd Amendments which my right hon. Friend should not accept.

The hon. Member has made some point of the question of whether the 1949 Act was drafted with reference to this matter, but has he not looked also at the 1951 Act, where we were dealing specifically with appliances, optical and dental? He will find that there exactly the opposite is the case to the one he has now made out. Does the hon. Member want the Committee to believe there is only one year—1949—in the calendar?

I am obliged, but I suggest to the Committee that there is a much closer analogy with the 1949 Act, which laid open the possibility of charges on a wide range of articles than with the 1951 Act, which imposed charges on two very limited specific types of appliances.

At any rate, I shall confine my observations to the narrow and relevant question of the four appliances upon which my right hon. Friend intends to impose charges—intends at present to impose charges—[HON. MEMBERS: "Oh."]—because regulations can be altered from time to time and there is every reason why it should be possible for the Minister by regulation to reduce or eliminate these charges altogether when that becomes possible. [HON. MEMBERS: "Or increase them."]

We have heard the remarkable argument in the course of the debate that because we are now aware that £10 million more will have to be spent upon the National Health Service in fulfilment of a public debt of honour, therefore there is no need at all for the economies and the charges which this Bill makes. We have been told that because £10 million more have to be found anyhow, there is no longer any need to restrain the tendency of the total cost of the Service to rise. That is an entirely fallacious argument to use.

Nobody said it.

I am within the recollection of the Committee. It has been suggested that because in this financial year more than £400 million have to be spent, it does not very much matter how much more.

The hon. Member is suggesting dishonesty now. I was arguing against the point made by the Minister of Health, that after the rewards to which the hon. Member referred had been made the reason for these charges remained the same reason as was in his mind when the Bill was introduced—that it was to try to keep the expenditure within the ceiling. The ceiling was the argument for the Bill.

The right hon. Gentleman in his speech pointed out quite rightly that the sum of £400 million in itself is a purely arbitrary figure which has no special logical cogency. We know now that the total cost of the Health Service in the coming year will be £400 million plus "X." But that, as I said before, increases the necessity for restraining the rise throughout the Service generally, and ensuring that where a rise does take place as in the hospital service, it is taking place in the parts of the Service which are most essential. Therefore, the need for saving here £250,000 which will be applied elsewhere is not only not less than it was before but is greater.

I will also deal with the fallacy of the right hon. Gentleman the Member for Ebbw Vale (Mr. Bevan) that whenever a person has to pay a charge under this Clause he is paying for the doctors. It might just as well be said he is paying for the nurses or for the beds in hospitals or for any other cost. The whole thing is a monstrous fallacy and paradox. If we have to find £10 million more, it is all the more necessary that we should see that the rises in the cost of the service elsewhere come in the most essential and unavoidable parts of the Service. That is exactly what my right hon. Friend is doing.

Because I think it was a very genuine point, I want to deal with the argument of the hon. Lady the Member for Liverpool, Exchange (Mrs. Braddock). She expressed the fear that the imposition of charges upon appliances would encourage patients to go and obtain quack appliances elsewhere. If that case could be made out it would be a very serious one.

I suggest that as these charges are planned and upon the information given to the House by my right hon. Friend on the Second Reading of the Bill, there is no real danger of that taking place. The charges which are going to be imposed do not exceed half the cost of the appliances alone, without any consideration of the cost of fitting and the other surrounding expenses. It is therefore in the highest degree unlikely that a quack appliance could be produced at less than the patient will have to pay under these regulations. I believe that that is an anxiety which the hon. Lady could leave out of her mind.

On this question of the quack appliances, is not the hon. Member aware of the declarations already made by the Minister of Health and the Parliamentary Secretary about the effects that have occurred in the ophthalmic service arising from the charges in the Bill last year?

Your Bill.

Our Bill. The Parliamentary Secretary has already expressed concern about the enormous growth in sales of spectacles in the chain stores, directly arising from the charge.

I should hope that it would be generally agreed that there was very little prospect of providing appliances which any member of the public would regard as in any way comparable with those obtainable through the National Health Service at sums much less than half the cost to the Minister.

I start from the point on the Amendment which we are now discussing by saying that I am one of those people who believe that so long as there are wars we shall have sick and wounded men and so long as we have industry we shall have broken and bruised men, and it is our job, in this assembly, to pool our ideas to give all the help we can to those who have the misfortune to meet with accidents necessitating the use of appliances.

Last Thursday, during the Committee stage, we had two very important statements from back benchers opposite, to which I attach great importance. One came from the hon. Member for Abingdon (Sir R. Glyn), who appealed to the Committee to approach this question from a humanitarian standpoint and the other came from the hon. Member for Putney (Mr. Linstead), whose work on behalf of the National Health Service has always had my admiration. He has played a very important part in it, and he uttered last week a statement which impressed me, though he hardly went far enough.

He gave expression to these words:

"… we are in danger, in the Health Service in particular of forgetting one very fundamental thing. That is, that no State can take away from an individual the responsibility of his own health."

I agree with that. He went on:

"There is a very grave danger that in our desire to spread our social services in every quarter we will make that fundamental mistake. I think most of us take it for granted that the State is greatly concerned with the health of the individual and must of necessity be so; but the State may make a great mistake if it so emphasises the freedom and extent of its services as to take away from the individual man that sense of responsibility."—[OFFICIAL REPORT, 3rd April, 1952; Vol. 498, c. 1979.]

5.45 p.m.

We all agree that there is an individual responsibility resting upon each citizen to look after his own health; but having admitted that, at the same time a responsibility rests upon the State to care for the citizen who is overtaken by misfortune. Therefore, we are now applying our minds to the problem of securing something for those unfortunate people who have had the misfortune, in their industrial life, to be overtaken by accidents which eventually mean that they have to use appliances of so many kinds.

I am amazed that the right hon. Gentleman, charged with responsibility as he is, should bring this Measure before the House, because I recall that, when I was a miner, working in the pit, he occupied the responsible position of Secretary for Mines and he must know—he cannot put forward any claim that he is unaware of these things—that the incidence of accidents in the mine were such that he himself from time to time had to take the necessary steps to minimise those accidents.

Therefore, he must know that if he does not agree to some of the Amendments now on the Order Paper, he will rouse in the miners' fraternity the anger of a body of men who are playing their part in a way that is second to none. I issue this warning: there are many, many little irritants which are now showing themselves, and we in the mining fraternity are anxious to erase those irritants and to try to maintain the morale and the sense of responsibility of our men.

We want to keep that at the highest possible level in order that the productivity of the mining industry will be good and will improve. I know something of the psychology of the miner. There is nothing which disturbs him more than to think that someone, somewhere, in some way is trying to put a "fast one" across him.

I have every sympathy with those who have, unfortunately, been injured in the pit. I have spent a great deal of my time on the industrial side of the industry, and the argument which the right hon. Gentleman is advancing about abuses does not cut any ice at all. I have never, in my long experience known men to make application for an abdominal belt or a truss, or anything else they required to support them, for the sake of making an application. It was always my greatest difficulty to persuade them to wear them. In some cases they were an encumbrance to men when they were working in the pit.

But the right hon. Gentleman comes forward with an argument that he is doing this because of certain abuses that have been discovered. Discovered from whom? Who is giving him the information? From what source does it come? I venture to suggest that if he had a close investigation he would find that those people who are giving him that information do not know the full facts in the minefields. The argument that he is putting forward to support these charges does not hold water.

Another point which he put forward was that such a small amount was involved. If the amount that he is going to recover from the policy which he is now advocating is so small, why pursue it at all? I suggest that he will be well advised if he takes this Clause back and between now and the Report stage cuts out the word "appliances." That is a great irritant and, if I may say so—and I weigh very carefully the words I am using—if he does not it will have a great deterrent effect upon those men working in the mining industry.

We have already conclusive evidence that they are very much opposed to the cuts that have been applied by the Government, and they are very much opposed to the inroads made on the National Health Service. Therefore, I beg the right hon. Gentleman to listen to the appeals of hon. Members on this side of the Committee; men who have had experience and know something of what it means to the men in the pit who are unfortunately overtaken by an accident.

I wonder whether the right hon. Gentleman has ever visualised, when he is talking about making a charge for appliances, what it means to these men who have to buy not only one appliance or even two appliances, but three. Many of the men working in the industry, who have had the misfortune to suffer hernia, have to wear three trusses—not three at once but, because they cannot get admission to hospital to undergo the necessary operation, they have to wear a truss at the pit and another when they get home and they have one being repaired.

Is the right hon. Gentleman, and are the party opposite, really suggesting that there should be a charge for that type of appliance? They never made a greater mistake in their lives if they think the men in the mining industry will sit down under that imposition. I am very anxious to avoid any upheaval in the industry—and I am not using this as a threat: but they will not keep our men down if the men see that some of their injured comrades are being unfairly treated by the Government.

I can speak from personal experience here. It may be that I am the only hon. Member—I hope I am—who has to wear an abdominal belt as the result of an accident in the pit. When that abdominal belt has to be renewed, I am in the position of being able to pay for it, and therefore I do not trouble anybody; but that is no reason on earth why I should sit idly by and not defend those men who cannot afford to buy their abdominal belts.

After all, we must remember that when they want these belts or trusses, their income is at the lowest possible level because they are in receipt of compensation. The belt which I wear at present cost £4 18s. 6d. How far do hon. Members think that men will be satisfied with the attitude of the right hon. Gentleman and the party opposite when he finds that, out of his 45s. a week compensation, he has to pay £4 18s. 6d. for a belt which he requires—and he requires it not because he neglected his body but because he had the misfortune to sustain an accident in the pit when producing the coal which is so necessary for the nation's prosperity.

I put that aspect to the right hon. Gentleman, and I hope he will respond to the appeals which have been made from these benches. We do not want to make party capital out of this. Please do not misunderstand us. The matter is of such serious dimensions that a man would be wrong if he tried to make party capital out of an injured workman. I hope the right hon. Gentleman will face these facts.

There is another aspect I want to put before the Minister. Since the passing of the Act which gave so many of these benefits to our people, it has been my lot to come into contact with many men who have had the misfortune to suffer from accidents, and they have paid a great tribute to the Act of Parliament, to the great assistance they have received and to the great benefits which were introduced. It will be a sorry day if the right hon. Gentleman pursues the pathway upon which he has entered and, by so doing, upsets these men.

A few years ago, there was a time in the mining industry when we had to take collections in order to buy appliances for our injured comrades. When we discovered that, we advocated the setting up of benevolent societies. Those did not exist for many years. We set up the permanent relief society, from which society we used to derive the benefits which came to us in the 1948 Act. Surely we are not going back to those bad days.

Here the State has an opportunity of recognising the work of those men who are engaged in industry. The State has an opportunity of saying to the nation at large and to the men in industry, "You are playing your part, you have done your whack; and because you are playing your part and because you have done your whack, we are prepared to come to your assistance if you sustain an accident." Will the right hon. Gentleman take this Clause back and consider it between now and Report stage, and bring forward something more reasonable, something which contains a little more justice and a little more honesty and a desire to help the unfortunate men who have been injured in industry?

I think the Minister must be well aware by now that there is not one hon. Member on this side of the House who was pleased with his intervention, or who agrees with what he said. The hon. Member for Wolverhampton, South-West (Mr. Powell), made a simple plea that we should be discussing today only those four types of appliance upon which the Minister says he will impose a charge. We are not at all sure of that.

We find that these charges are expected to bring in £250,000. I think that hon. Members on this side of the House have already shown the drastic effects which these charges will have and the very little saving there will be to the Treasury, and we are afraid that if the word "appliances" is left in the Bill, then at some time, and probably sooner rather than later, there will be an extension from the four appliances which the Minister mentioned to others. That is why I am glad that my hon. Friends have dealt, in particular, with their own Amendments.

I want to discuss one of the appliances upon which a charge is to be made—abdominal supports. Quite a number of hon. Members have already shown to the Minister the effect which this charge will have on industrial workers. I represent a big mining area, and I agree with my hon. Friend the Member for Ince (Mr. T. Brown) about how grateful these men were for the benefits which they receive under the National Health Service Act. These benefits made it possible for many miners, for the first time in many years, to get out amongst their friends in the streets and even to go occasionally to a football match.

When these charges were proposed, and the announcement about them appeared in the Press, I received a letter from a miner informing me that he needed not just one surgical appliance in order to get outside the door, but five surgical appliances of different kinds—and he had to wear them all at the same time. That man broke his back in the pit, and until 1948 he was unable to leave his home. But because of the help of these surgical appliances and because of the motor-propelled chair which he received under our Act, life became a much brighter and happier thing for him, in spite of his broken back.

It seems to me one of the meanest things which the present Government have done to tell these men that we intend to charge them £1. Remember, most of the men who need these abdominal supports are men who are not in work. Some of them are men who hope, when they get them, that they will be able to go to work. Many of them are men who will never be able to work again.

6.0 p.m.

If we consider the women who require abdominal supports, we find that many of them are mothers. Many of them are mothers who, before 1948, were not able to get surgical belts—or abdominal supports, as the Minister calls them. Many of them today are suffering because for years before 1948 they just could not afford these abdominal supports. These mothers now are not only going to pay charges for abdominal supports but they are also going to have to pay the 1s. subscription for medicines.

I myself worked in one of the poorest districts of Glasgow. There I found that, though their husbands were covered as panel patients, the mothers and their children were not. The mother, time and time again, put off going to the doctor, or calling in the doctor, first, because she could not pay his charge, and second, because she could not afford to pay for the medicine he would prescribe. Here, in this miserable Bill, the mother is going to have to pay both for medicines and for abdominal belts.

The truth of the matter is that many of the women will be back in the position they were in before 1948: they just will not go to the doctor in the first instance; or, if a doctor is called in, and suggests that a woman should go for specialist attention, she will just say, "No. Possibly it would mean an abdominal belt, and, in my present circumstances, I just cannot afford £1."

That is a shocking thing to happen in this country in 1952, and it is a shocking thing to think that it will happen because the present Government wish to save this miserable £250,000 out of this Service. I would make a particular plea to the hon. Lady that at least these appliances, these abdominal belts, as they affect the industrial workers and as they affect the mothers, shall be taken out of the range of charges.

The Minister gave us no satisfaction at all. Indeed, I felt he was most uncomfortable at the repeated interventions from this side. What were his words? He said he had been "informed" and that he had been "advised" that there had been abuses in this particular matter of abdominal belts. He would not tell us, however, who had informed or who had advised him.

He went on to say that pressure had been brought to bear on the specialists to give abdominal belts to women. What an indictment that is of our specialists in our hospital services. I feel that it is such an indictment and such an insult that the hon. Lady or her right hon. Friend should forthwith withdraw that indictment and insult against our specialists.

I come next to this charge for surgical boots. We are told that the patient, man or woman, will be able to get surgical boots for a payment of £3. Some people say that that is not much more than a man or woman pays for his or her ordinary boots or shoes. However, there are many men and women today who are buying the cheapest boots or the cheapest shoes, and they are something under £3. Another point that the Minister ought to keep in mind is that the man or woman who needs surgical boots wears them out much more quickly than a man or woman wears out ordinary boots, and for that reason again the Minister ought to have second thoughts on this matter.

On the question of charges for elastic hosiery, I am glad that my hon. Friend the Member for Liverpool, Exchange (Mrs. Braddock) made the point that she did make. There are many women who need these surgical stockings or elastic stockings. They need them for different reasons. It would be a great tragedy indeed if pregnant mothers in this country—and many women need these stockings at that time if not at another time—found it impossible to get them. A charge of 5s. or 10s. is a very heavy one for the mothers, but it is a miserably small amount of money to the Minister.

However we look at these charges, whether at their effect on our people—the tragic effect in some circumstances—or from the point of view of the amount of money that the Treasury is going to get—that miserably small amount of money—it makes one wonder why the Minister ever thought of these charges. I would say that these charges are hitting below the belt. I would say to hon. Members who are, perhaps, not so interested in boxing but who have attended public schools—I would say to them in their own language—that they must really, in their hearts, believe that these charges are just not cricket.

After the eloquent speech of my hon. Friend the Member for Ince (Mr. T. Brown), who has wide experience of the mining industry, and his comprehension of the human tragedy involved, the Minister should forthwith withdraw this Bill. At the very least he should take the path of moral rectitude by making it clear in the Bill that most of the appliances that injured miners need are totally excluded from the proposed payments. We are told that only four items are to be the subject of charges, and that the charges for those four will yield a sum of some £250,000. I should be interested if the Parliamentary Secretary would tell us, when she replies to the debate, what amount will be yielded by each of the four categories, surgical boots, abdominal belts, elastic hosiery, and wigs. I am sure that other hon. Members will also be interested to know how the total amount is divided.

We have had from the other side of the Committee a good deal of abstract argument. I was pleased that a recent speaker on this side of the Committee sought to clothe the abstract argument with the flesh and blood of reality and human tragedy which lie behind these charges for appliances. I shall not deal with the problem of the injured miners, because my hon. Friends the Members for Rhondda, West (Mr. Iorwerth Thomas) and for Ince have already dealt with that point, but in my constituency I have a man who needs surgical boots. I had to intervene with the Minister to get a satisfactory surgical boot made for him, so the Minister will be aware of the case.

This man also suffers from recurrent diseases, asthma and eczema. This Bill imposes charges for the prescription of drugs and medicines to relieve his eczema and asthma. From the age of five, this constituent of mine has had infantile paralysis in his right leg up to the hip. He needs surgical boots. He is a man of courage, character and some intellectual stature. He works at the Remploy Factory for seriously disabled men in my constituency. His total earnings in a full week are about £5 1s., out of which he has to meet some part of the 7s. 8d. for fares from Maesteg to Bridgend. This man, suffering, as I say, from asthma and eczema, being subject to charges for prescriptions, is now to be called upon to pay £3 for his surgical boots.

Incidentally, I should like to know from the Parliamentary Secretary what will happen in cases similar to the one I have in mind where surgical boots are made and fitted, but prove to be unsuitable so that further examinations and fittings are necessary and new surgical boots are required. Will the patient be required to pay £3 on each occasion, or will one payment suffice?

In addition, the man to whom I refer will be required to pay between 8s. and 13s. 6d. every time the boots need repair, and since, as a rule, surgical boots wear out more quickly than those which most of us use, a very real hardship will be imposed upon this man. We are entitled to know why this man and others like him are being singled out for this attack.

We have heard from hon. Members opposite that, in general, these charges are necessitated because there is abuse, but so far no hon. or right hon. Gentleman opposite has had the brass-faced impudence to claim that men and women who wear surgical boots are abusing the Health Service. What, then, is the reason for the imposition of these grave hardships on my constituent and other unfortunate men and women like him? The only case that has been put from the other side was contained in the speech of the Joint Under-Secretary of State for Scotland when he wound up the Second Reading debate, and I propose briefly to refer to the point he made on that occasion. He said:

"The first of these is the argument that these charges have no relation whatsoever to our general economic difficulty, and, in particular, to our balance of payments. Every hon. Member must know that our basic problem today is to stimulate our export trade, and that they must appreciate that any reduction of home demand is bound to be a factor operating in the right direction. That is no less true if the resources set free by any particular reduction in demand do not themselves contribute directly to our exports. We have to look at the economy of the nation as a whole."—[OFFICIAL REPORT, 27th March, 1952; Vol. 498, c. 1022.]

That was the defence put up for these charges, so to solve the economic crisis my constituent, with eczema and asthma, pays the "bob" prescription when he goes to the doctor for drugs and medicines, he than pays £3 for his surgical boots necessitated by infantile paralysis, and finally, he pays his 8s. to 13s. 6d. every time the surgical boots need repair.

I know something about cases of this kind. If this man is also getting the treatment which up-to-date specialists recommend, he should also be having short-wave therapy. In that case, will he have to pay for that?

I will not follow my hon. Friend on that line of argument.

What I say is that, if Britain has a serious overseas trade crisis, and if the best argument that can be advanced for these charges is the one advanced by the Under-Secretary of State for Scotland, then we are placing the burden of Britain's economic difficulties on the least fortunate—the crippled as well as the sick and the infirm. I appeal to the Minister and to his Parliamentary Secretary: Is there no sense of human decency, no sense of moral values left, so that at a time when those fortunate enough to have incomes of £2,000 a year and above are being made a present of £50 a year or more by the Budget in tax remissions, the crippled must be called upon to bear the burden of our overseas trade crisis? I am confident that if there are consciences to be stirred on the other side of the Committee, then not only will this Amendment be accepted but the Bill will be withdrawn.

We on this side of the Committee would want to argue the points put by the hon. Member for Wolverhampton, South-West (Mr. Powell), when he argued that there was no danger of there being any cheap quack substitutes used for appliances that in the past have been obtained free under the Service.

I and others on these benches have had some experience in the Ministry of Pensions of the type of quack appliances, of one sort and another, that were being used until patients were able to get the use of the National Health Service and obtain free appliances of all kinds of real value and real quality. I know the shock of horror that it was to many of us, and to many of the officials concerned with this matter, when we had coming in to the centres of the Ministry of Pensions the National Health Service cases with their wretched bits of wood and peg legs, and all their other bits of appliances of shockingly bad character, for which no doubt comparatively small payments had been made, but which were utterly useless to meet their needs. Yet that was all either they could afford or that their societies were able to provide for them in the past.

I am sorry that the hon. Member is not here at the moment, because I must say it is utterly untrue to suggest that it is impossible for quack substitutes to be provided at half or less the cost. They no doubt will be. They will be of little value, but they will be all these people will be able to get.

This is a shockingly retrograde step to take, and I hope that the Parliamentary Secretary will at any rate say that she will think about this matter again. After all, what is involved in financial terms? We are told that all the Ministry want to save is this sum of £250,000. If we are to believe what we are told and this is the total sum they have in mind, is it really necessary to impose all the difficulties and restraints on both the individuals concerned and the staffs who will be concerned with the collection of these wretched sums of money, in the hospitals and elsewhere? I have a cutting from the "Municipal Journal" which discusses these charges for appliances, and one thing it says is this:

"The costs of collection are likely to be fairly high unless the Ministry forces almoners to relinquish some of their socio-medical work. If each of the 377 management committees appoints one clerk, the collection costs could easily be about £100,000 per annum."

Are not we reaching the height of absurdity if there is any danger of any sum remotely comparable to that figure of £100,000 being expended to save the Government some £250,000? Is not that a ridiculous position for the Committee to be put into?

We have all been very glad that the almoners in the hospitals during the last few years have been taken away from some of the wretched financial collection work which they had to do in the past and have been able to undertake the very valuable social work they are doing today. I ask the Parliamentary Secretary to say whether the almoners are now to be forced back into their monetary collections, or are they going to appoint new staff to do this work. This is an important point to which we are entitled to some reply from the hon. Lady.

Assuming, as was said earlier, that it has been left to the hospital management committees to decide in what way they are going to carry out this work, surely it is not satisfactory for the Committee to be told that no decision has yet been made as to how the work is to be done. How are we to decide whether this is a reasonable proposal, unless we know something about the way in which the collection work is to be carried out, and what waste is to be imposed on the service to enable these comparatively trifling sums to be collected?

I suggest that is a matter which the hon. Lady and her right hon. Friend ought to consider again. They are imposing upon themselves wholly unnecessary trouble. If they want to ensure that these matters are considered more speedily by this Committee, then here is their opportunity to give some indication to the Committee that they are prepared at least to reconsider some of the matters we have been putting before them this afternoon and during previous consideration of the Bill.

I believe it to be true that so far we have not had one single concession or suggestion of any concession. Here is an opportunity, when the hon. Lady comes to reply, to say that she is prepared to take this back and give it further consideration before the Report stage. That, I am sure, would be welcomed by both sides of the Committee.

Do not let us be taken in by the suggestion made by the Minister that the Government are going to impose charges on only some four items. If they believe that, why do not they make that provision in the Bill? At least, we were careful in the Bill we introduced last year to see that the charges were made to alight on specific points. Now, all that we are asking is that they should do the same; they should at least ensure that these vital appliances for which they say they have no intention of charging at the present time are specifically excluded from the Bill. Surely, we are not asking for anything unreasonable to be conceded. If they do not concede this, it makes it perfectly clear that they have every intention of imposing charges in the rest of the field in a matter of a few months, if not almost immediately.

indicated dissent.

The right hon. Gentleman shakes his head. That apparently means that he has no intention of imposing further charges. All we say is: put that in the Bill. If the right hon. Gentleman would agree to intervene to say he will do that now, it might speed up the proceedings. I am very willing to give way to him if he is prepared to say so now. Apparently he is not willing.

We can take it on this side of the Committee therefore that although the Government are trying to get an easier passage of the Bill by saying they are imposing charges on only four items, they have every intention of imposing charges on the whole field before very long. [HON. MEMBERS: "No."] Then, let the Minister make provision in the Bill. There is nothing to prevent him from doing so and following our good example last year by making specific provisions for just those items he intends to charge for. Otherwise, it is perfectly clear that concern on this side of the Committee will be greatly increased and also concern in the country.

When I spoke on a previous Amendment, I said that the Government were faced with a real and serious problem—the rising cost of the drugs and medicine being poured down British throats—and that the Government had selected the wrong and a very cruel remedy of stemming that rising cost. Now, when we come to consider these charges for appliances, we find the Government ruthlessly inflicting hurt to solve a problem which exists only in the fantasy of their own minds.

The Minister stated during the debate on the Second Reading of this Bill that

"when the Government were seeing whether any savings could be made in the Health Service the considerations they had constantly in mind were:"—

and I would like the Committee to note that this is the first one—

"are there any obvious abuses to be rectified?"—[OFFICIAL REPORT, 27th March, 1952; Vol. 498, c. 845.]

Every hon. Member wants to stop abuses in the Health Service. Every hon. and right hon. Member knows that it is his duty to prevent the misuse of public money. But there has been no abuse in the issue of surgical appliances.

Does the Minister of Health claim that surgical boots have been given to people other than cripples? Does he claim that artificial limbs have been provided for people who are fully four-limbed? It was possible from the very start of the Health Service for the Government to make provisions to prevent the abuse of appliances by insisting that no patient should be issued with an appliance until that patient had received a recommendation from his or her own doctor and had been seen and undergone a second and more thorough examination by a specialist; and only after that second examination by a specialist and on the orders of a specialist should a surgical appliance be obtained.

I know that the Minister thinks that there has been abuse in the issue of abdominal supports because he stated on the Second Reading of the Bill, when speaking of these charges:

"The second group is surgical abdominal supports, and we propose a charge of £1 each on them. The right hon. Member for Ebbw Vale (Mr. Bevan) probably knows that there have been a good many cases of alleged abuse reported, of prescribing what was not much more than a reinforced corset."—[OFFICIAL REPORT, 27th March, 1952; Vol. 498, c. 850.]

I think that the Minister of Health must have realised that the allegation was groundless, otherwise he would not have held out the hand of appeal to my right hon. Friend the Member for Ebbw Vale (Mr. Bevan).

I should like to tell the Committee of a case which came my way recently and which concerned a constituent of mine. This was a woman who, I admit at the outset, would have had her figure improved if she had been provided with surgical corsets. She was of the opinion that she should wear surgical corsets and she persuaded her doctor to give her a note of recommendation to take to a hospital where she could be examined by a specialist. The specialist examined her and, finding no surgical abnormality, refused to provide her with the abdominal support.

6.30 p.m.

The woman went back to her own doctor, complained of the treatment that she had received at the hospital, and prevailed upon him to give her a letter to allow her to go to another hospital and be seen by a different specialist. The second specialist examined her and again found no surgical abnormality and refused to order the abdominal support for her. It was after that that she came to see me. She told me what she thought about specialists at hospitals. I had, of course, to tell her that I could not help her.

I have told the Committee of that case to give an illustration of the conscientious manner in which specialists are carrying out their work. The statement which the Minister of Health made during the Second Reading debate casts a very serious reflection upon the integrity of our specialists.

The Minister has given us the list of the appliances upon which these charges will fall. He mentioned surgical boots. This is an attack on cripples. He also mentioned the charges which will have to be paid for the repair of surgical boots, and he specifically mentioned the charges that will have to be paid by crippled women. When we look at the next charge, which is on surgical abdominal supports, and the following one, elastic hosiery, we find that they will fall mostly upon women who have borne children, who, of all people, ought to be honoured, respected and protected. The fourth item was wigs. This is a blow delivered at people who suffer the embarrassment of having a completely hairless head.

So we find that these iniquitous charges are being levied largely on women and cripples. I appeal to the Minister of Health, in the name of chivalry, to withdraw these charges and accept our Amendment. We have been told that the estimated saving on the four selected items will be £250,000. That is, the Government are hoping that £250,000 will be saved within the annual expenditure of £400 million on the National Health Service. To save 1/1,600th part of the National Health Service expenditure, mothers and cripples have been selected to take the kicks when a Tory Government ruthlessly imposes its wrecking measures upon the Service.

That is not all. I have briefly mentioned only the specific items which are already on the lists for a charge. What of the other possibilities? The Minister has said that he does not propose to touch artificial legs or arms and that hearing aids are to be exempted. I trust the right hon. Gentleman to keep his word, but we know perfectly well that he is not going to be the Minister of Health very much longer, and, as the Bill now stands, any successor of his could merely by means of regulations, impose a charge on any appliance at any time.

The Government are seeking powers which the Opposition can only regard as extremely dangerous. Only five months ago the Chairman of the Conservative Party promised that food subsidies would not be cut and yet, in the Tory Budget, subsidies are slashed by £160 million. So voluminous is the catalogue of shattered Tory promises that the Opposition cannot accept their word. The Bill must be altered and it will be altered. It will be altered either now or in the very near future, when we have the next Labour Government.

Perhaps it would be for the convenience of the Committee if I answered one or two of the points that have been raised and tried to clear up some misapprehensions. I must remind the Committee that what we are discussing—however far we may wander from it—is whether or not appliances should come within the scope of the Bill and whether the word "appliance" should or should not remain in the Clause. That is the important point.

I repeat what I have already said, that all that will be concerned in the regulations which the Government envisage are charges on the four items, surgical boots and repairs, abdominal supports, elastic hosiery and wigs. Those are the only four which we have in mind.

At present?

At present, of course, because there are regulatory powers and we are not putting the specific charges in the Bill. We are following the precedent of the previous Act.

Surely not the Act of 1951?

No, it is the Act of 1949. [Interruption.] If hon. Gentlemen do not want to hear what I have to say and keep on interrupting me, I shall not say it, but I was only trying to help and clear up some of the difficulties which have arisen during the debate.

The hon. Member for Ince (Mr. I. Brown), who made such an eloquent speech, as he always does on behalf of the mining industry, of which he has been an adornment so long, was rather under a misapprehension. He and others have not appreciated what I said when I pointed out that the charge which we had in mind for abdominal supports was £1. That is a charge and not a percentage. Therefore, in the case of the belt such as the one costing over £4 to which he referred there is no question of anything more than £1 being charged.

In the same way, it is not suggested in anything that I have said or that the Government have in mind that a charge should be made for lumbar belts, trusses or spinal supports, though I understand that if a truss was ordered as a result of a medical prescription the ordinary 1s. precription charge would apply. That does not come under these provisions, and I merely mention it so that hon. Gentlemen will not some day say I did not say anything about it. If a truss were on a general practitioner's prescription it would be a prescription within the meaning of the regulations under the previous Act, but that has nothing to do with the provisions here. Therefore, none of those come within the regulations which I have in mind.

The hon. Member for Ogmore (Mr. Padley) made a very impassioned speech in which he described a sad case where a pair of boots had been made for a patient and did not fit. May I say to him that there is no intention, in the regulations for which I shall be responsible of making any charge if it is necessary to replace an appliance because of a defect in the appliance or solely because of a change in the patient's condition. If the boots were wrong he would have to pay for the first pair, but would not pay for the new pair or even the pair after that, if a third pair had to be made to remedy the defect. I hope that that clears up that particular misapprehension.

The hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop), spoke of the dangers that might arise from quack remedies as a result of this and the resulting ill-health which would follow. I find it very hard to believe that within the sphere about which I am talking, namely, surgical boots, abdominal supports, elastic hosiery and wigs, any serious quackery can come about.

The right hon. Gentleman must accept the point that, in spite of what he says, he can bring in an Order at any time he likes as soon as this Bill passes making other charges and the House will have no opportunity of stopping it. On any appliance he likes he can put a charge.

The power remains vested in the House under Clause 6 (7), because the power to make regulations conferred by this Bill will be exercisable by Statutory Instrument, and the last word, of course, remains with this House and not with me or with the Government at all.

After they are imposed.

The other point made by the hon. Member was that the administrative costs might be as much as £100,000 a year. That is too exaggerated for words, because we are only dealing with the part of the Clause which is concerned with appliances and we are only proposing to put a charge on four classes of appliance. It is hard to imagine—I am sure that the hon. Member does not, in fact, imagine it—how the administrative costs are to come to anything like that for these appliances. The administrative costs of collecting the charge would be absolutely minute.

The hospitals do not say so.

The hospitals do say so. We should stick to the appliances which this Amendment talks about.

The right hon. Gentleman very kindly gave us a fair warning when speaking about trusses and their prescription. He said that if they were on a prescription form and were taken to a chemist or the orthopaedic branch of a chemist, they would be subject to a 1s. charge if the certificate were that of a general practitioner. Will he clear that point up a little further? Does that mean that if they are prescribed in a hospital there is no charge? If it is a prescription on E.C.10 and is taken to a chemist to fix the truss there would be a 1s. charge, and if that is so it raises my last point. There is a printed form which the doctor must sign and which says, "In my view this patient is suffering from so and so and needs a truss." That is not an E.C.10 but will there be a 1s. charge on that or not?

All that shows how foolish it is to stray out of the rules of order, because that has nothing to do with this particular point. I have merely safeguarded myself for the future, and I really cannot follow the hon. Gentleman into all these intricacies of different forms. I am sure he will absolve me from wanting to do so. The issue is only 1s. either way.

The point I want to raise has something to do with that with which he is dealing. The Minister has said that the hospitals have stated quite definitely that this will not entail great expenditure. Since he has that assurance from the hospital, will he also tell us who in the hospitals is to do the work? Is it the almoner or who is it?

That is still being discussed.

We are dealing with appliances and I will not go back over the very large field of prescriptions, particularly as there are only four types of appliance in question. The number of these which would be disposed of in any given hospital is such a small figure that—[HON. MEMBERS: "No."] Despite what hon. Members say, the number of surgical boots, abdominal supports, elastic hosiery and wigs which are given in the hospitals is so small that it would not entail a great amount of administrative expenditure. I know that one chairman of a regional hospital board agrees with me. That is the information I have; that is what the hospitals tell me. I think that covers all the points which have been raised in the debate since I first spoke.

Could the right hon. Gentleman give us the number of these appliances which have been supplied in these hospitals in any one 12 months since the Health Service came into operation? The right hon. Gentleman keeps referring to the fact that the number is very small, and I think we are entitled to be told the actual number.

I dare say if the hon. Lady puts a Question down in the ordinary way—

No.

But that is the way to get the figures circulated. If I merely give the information to the hon. Lady it will not be circulated to such an extent. Anyway, this is not the kind of information which can be available in five minutes.

How, then, does the right hon. Gentleman know that it is so small?

I have some common sense, I hope.

I would again remind the Committee of what the Amendment does. It decides once and for all whether appliances should or should not remain within the ambit of this Clause. I would remind hon. and right hon. Gentlemen who may not have been here during the whole of the debate on this Amendment that this Bill is not in itself imposing any charges. What it is doing is giving power for charges to be imposed in the hospital field in exactly the same way as the first Act carried by the Labour Government gave power to impose prescription charges.

I have, mysteriously, got some information which, I hope, will help the hon. Lady the Member for Liverpool, Exchange (Mrs. Braddock). I am told that there are about 800 appliances a day over the whole of the country.

Every day?

That is all. It is not much in relation to every hospital in the country. If it was 800 in the Liverpool hospital, in which the hon. Lady is so interested and where she does such good work, that would be one thing, but it is 800 for all the hospitals in the country. Obviously, the administrative work involved in this matter cannot be very great. We have spent a good deal of time on this problem, and I hope the Committee will find it reasonable now to come to a decision on this matter and pass to the next Amendment, because we have still quite a long way to go.

On a point of order. I suppose that the Patronage Secretary is about to move the Closure, but before he does so may I, with great and genuine respect for the right hon. and gallant Gentleman the Member for Kelvingrove (Lieut.-Colonel Elliot) ask whether we are allowed to bring an attache case into the Chamber as the right hon. and gallant Gentleman has done. I have no doubt that it was done to accommodate him, but I should like to ask whether it would not be better to conform to the customs of the House in this matter.

The recent speech of the right hon. Gentleman the Minister of Health has added nothing to what he said in reply to myself when I moved this Amendment some time ago He has listened to eloquent pleas from my hon. Friends, particularly from—

On a point of order. I was once prevented from bringing into the House an attaché case. The offence is more serious in that the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) has been out of the Committee for some time and has left his case lying on the bench. We do not know what it contains. The rule against attaché cases was brought in during the Irish days, because of the likelihood of dangerous weapons being brought into the Chamber.

Mr. Marquand.

Further to the point of order. Do you realise, Mr. Hopkin Morris, that my hon. Friends are calling attention to the fact that the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) has a case in the Chamber?

That is not a matter for me. It is not within the jurisdiction of the Chair.

May I remind you, Mr. Hopkin Morris, that during the last Parliament there was an occasion when, by the direction of Mr. Speaker, a Member was compelled to take a case out of the House? We are asking you to make the same rule applicable to the right hon. and gallant Member that applied in the last Parliament under the direction of Mr. Speaker.

The matter is under the jurisdiction of the Serjeant at Arms.

Surely it will be within your recollection, Mr. Hopkin Morris, as it is within mine, that on many occasions Members have been forbidden to have newspapers to read in the House of Commons. Surely if a newspaper is out of order an attaché case is also out of order.

I have here the Parliamentary debates for 1948–49. [HON. MEMBERS: "Oh."] I am giving a catalogue of the contents of the case. I have HANSARD for 21st March and 27th March; the Report of the Department of Health for Scotland, which will be very useful; the Minutes of the proceedings on the Committee stage of the National Service Amendment Bill, which were ordered by the House of Commons to be printed on 6th July, 1949. I have yet to learn that any of these documents is in any way dangerous.

On a point of order.

I can only take one point of order at a time.

I am in possession of the Committee. [HON. MEMBERS: "And of the case."] If the sensitive natures of hon. Members are in any way disturbed by any of these things I am prepared to leave the documents in the Committee here, and to remove the offending case.

Hear, hear.

We look forward to the participation of the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot), in the debate when the next Amendment is moved, fortified by the ammunition which he has thought fit to bring into the Chamber.

I wanted to put on record the fact that the Minister of Health, having listened to such eloquent speeches as those of my hon. Friend the Member for Ince (Mr. T. Brown), and to well-informed and cogently argued speeches, with great professional expertise, such as my hon. Friend the Member for Batley and Morley (Dr. Broughton) has made, has come no way whatsoever to meet us. He has not offered a single concession of any kind in his speech and he has entirely failed, though he has had hours in the meantime to gather it, to present any evidence whatsoever in support of his allegation that there has been an abuse of the consultant and hospital services in the supply of these appliances.

I assure him, as I know from personal knowledge when Minister of Pensions, that a close review was made of the types of appliance which were being prescribed. It was done particularly for the purpose of ensuring that no appliances which might be embellishments rather than surgical aids were going through the Ministry of Pensions' supply department to the hospitals. The right hon. Gentleman seems to have made no attempt to support that allegation by proof, though he has had time to do so.

He has repeated the threat that lies behind this legislation, because he said that it is his intention to make these charges only, at present. It is because we find that reply completely unsatisfactory and because we are determined to

rose in his place, and claimed to move, "That the Question be now put."